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A mother brought her child (Sarah) on April 10th 2009 evaluate growth development of her child.

She was born on August 12th 2008 ; Weight 3200 g with head circumference 34 cm. Apgar score 8/1. Immunization history : BCG after birth, Hep.B1 at 2m0 age, second Hep.B1 4 weeks later. Immunize for polo 4times % 2nd DPT 2 weeks ago. BW 1mo ago 6300g. Length 67 cm (p 50 : 70 cm) 1. When the child is taken to the hospital, what kind of immunization should be given ? A. Polio B. DPT C. Hepatitis B D. Measles E. Hep B & DPT 2. The mother was worried because the BCG scar was not occurred. What should you do? A. BCG reimmunization B. No need to re-BCG C. Thorax photo D. Mantoux test E. TB infection suspect 3. In 18 months of age, what kind of life attenuated vaccine should we give? A. CPV B. IPV C. Hep B D. Measles E. DPT 4. Which one is true about active immunization? A. Short memory prolem B. Give in as immunoglobulin C. Immunity gained from mother D. Natural infection occured E. Active reaction of antigen-antibody in host 5. A male baby, born on December 25th 2008 at home. The mother takes the baby to primary health care on 27th December 2008. The main complaint was poor intake. The baby looks lethargic. The baby is the 2nd son and his mother

is 28 y.o and suffers from DM. The last menstrual day. 1st April 2008. During delivery, immediately cry, weight 3800g, body length 49cm. 5. Usually fetus with above hostory has failure in : A. Embryonic period B. Fetal period C. Organogenesis D. Vulnerable period E. A & B 6. What is the risk factor in the baby? A. Personal Factor B. Medical condition C. Baby condition D. A & B E. B & C 7. Based on classification of Lubchenco surve, the baby going to : A. Preterm baby/AGA B. Preterm baby/LGA C. Full term baby/AGA D. Full term baby/LGA E. Post term baby/LGA 8. Statement which is appropriate for essential fatty acid W-3 : A. Main source: deep sea fish liver oil B. Arachdonic acid is its biological active form C. Essential for nervous system and retina development D. Pharmacologic action of lowering cholestrol level E. Essential for somatic growth 12. The most possible primary diagnosis for the scenario above is A. Rheumatoid Arthritis B. Stroke C. Hypertension D. Orthostatic hypotension E. Gastritis A 72 yo male come to hospital with dizziness that he experienced suddenly when waking up. He is currently taking anti hypertension medicine. Lately he

feels that his urination disturbed and both of his legs are swelling. On physical exam, found BP: 165/50 mmHg, HR: 52x/min RR : 30x/ min and signs of inflammation on the 1st right toe joint. 14. The most likely anti hypertension agent the patient was taken that cause his leg often swollen A. ACE inhibitor B. Diuretic C. Calcium Channel Blocker D. Beta Blocker E. Angiotensin Receptor Blocker 15. If there are inflammation on toe joints, anti hypertension agent that we must use cautiously A. ACEI B. Diuretic C. CCB D. Beta Blocker E. ARB 16.the most dominant phatogenesis of hypertensi in elderly is A. Increase in renin B. Increase in lipid C. Resistence of salt D. Vascular disorder E. Simpatetic nerve disorder Male 71 y.o come to outpatient clinic with lab result : fasting plasma glucose 112 mg/dl, total cholesterol 321 mg/dl, LDL cholesterol 201 mg/dl, HDL 36 mg/dl, Triglyceride 216 mg/dl. No chief complaint and he feel healthy. Physical exam : BW : 75 kg, height 167 cm. BP 160/100 mmHg, P : 92 bpm, RR : 20x/min. 18. According to glucose status, diagnosis of the patient? A.Type 1 Diabetes Mellitus B.Type 2 Diabetes Mellitus C.Impaired fasting glucose D.Impaired glucose tolerance E. Normal glucose tolerance 19. In this patient, we should perform laboratory tes A.HbA1c

B.OGTT C.2 hours post prandial glucose test D.Glucose urine E.Fructosamine 20.This patient prone to have type 2 Diabetes Mellitus because : A.Increase physical activity B.Decrease insulin resistance C.Increase insulin secretion D.Increase fat cells mass E.Age related increase insulin sensitivity 21.If this patient diagnose to have type 2 Diabetes Mellitus, which of the following statement is the first line treatment? A.Diet and exercise B.Sulphonylurea C.DPP-IV inhibitor D.Insulin E.Thiazolidinedione 22.Hyperglicemia persist, indication of oral antidiabetic A. Fasting Blood Glucose >300mg/dl B. Fasting Blood Glucose >100mg/dl C. Fasting Blood Glucose <150mg/dl D. Fasting Blood Glucose 150-300mg/dl E. Fasting Blood Glucose >150mg/dl\ 23.A man 69y.o shortness breath,cough,heavy smoke... A.Asma inter.. B.Asma cardiac C.COPD D.Bronchoectasis E.Bronchitis Acute 26. Lab exam to determine diagnosis A.level b12 B. coomb tes C. Hb analysis D. Level fe serum

28.Laki2 78thn dtg keklinik dengan keluhan penurunan visual acuity dikedua mata. Mengeluh susah melihat pada dim light room. Hasil pemeriksaan yg didapatkan macular hemorrhage, white ... Diagnosis yg tepat yaitu? A.macular distrophy B.fundus flafinacula C.wet type AMD D.macular hole E.central ..... 30. From Debver II founf 2 FAIL of P25-P75 (areas papa mama spesific,and stand alone) and PASS of P75-90 (areas transfer toys from hand to another hand,and feed self).Tha developmental areas this child is : A. Speech delay B. Gross motor delay C. Social emotional delay D. Global delay E. Normal developmental 35. mother 22 years old. primipartus, bayi 2400 gr, lahir pada usia gestasi 38 weeks. pb: 47cm, lingkar kepala: 35cm. bagaimana status nutrisi?? a. between 10-90th percentile lubchenco b. below 10-90th percentile c. above 90th percentile d. IUGR e. B&D 41.in humans,,enzime telomerase is active in. Except: a.germ cells b.immortalized cells c.cancer cells d.skin cells e.stem cells 42.one of cause increasing the chronic disease in elderly: a.loss of teeth b.xerostomia c.sarcopenia d.constipation e.dysphagia

43. A newborn baby come with umbilical bleeding,petechie,bloody stained vomiting,melena,but come with good general condition,the most common diagnosis is: A.def.vit a B.def.vit b6 C.def vit d D.def.vit k E.def. Vit c (jawabannya) 44. obesitic idiopathic in child? a. Cushing suyndrome b. Leptin deficiency c. Sindrom Prader willi d, kalori berlebihan e. Growth hormone deficiency 46. jumlah protein untuk laki2, umur 65,berat 60, tinggi 165 adalah? a. 64 b.63 c.62 d.61 e. 60 47. One of the aim of control fat intake in elderly is A. prevent from dry mouth B. Prevent from breast cancer C. Prevent from loss of appetite D. Prevent from malabsorption E. Prevent from cramping 50. male, physical exam normal, lab exam: wbc 7700, HB 12.... a. dislipidemia b. hypertrigliserida c. GOUT d. hyperurisemia asymptom e. hyperurisemia 51. what is the common type of UI in women... a. urge incotinence b. stress incotinence

c. mixed with urge and stress incotinence d. functional incotinence e. paradoxical incotinence 52. risk factor for stress incotinence... a. unmarried b. nulipara c. multipara premenopause d. multipara postmenopause e. none all of above 58. efek samping akut obat antihipertensi ! a. hypotensi b. c. d. e. 59.Risk of malnutrition in elderly..? A. B.malaise C.poly farmasi D.fever E. Gender 62. in falls patient what the doctor should be done to assesment the patien a. physical examination b. ECG c History taking d. A+ C e. all above is correct 63. A man, 65 years old, has itchy on medial side of right leg. The efflorescence shows hyperpigmentation macule, scales, and erosion. What are the differential diagnosis? 1. Numular dermatitis 2. Atopic dermatitis 3. Gravitational dermatitis 4. Tinea korporis

64. The right statement about senile pruritus: 1. Most common in <80 years old 2. Worsen at night 3. Mostly systemic pruritus 4. Dry, rough skin 65. Scabies in elderly: 1. Atypical lesion 2. Less pruritic 3. Less inflammation 4. More inflammation 66. related to herpes zoster 1. impaired woundhealing 2. decrease cell immunity 3. neuralgia post hepatic 4. slower resolution of .... 67. 65 y.o women, itching in the right dorsum pedis, for about 1 year, got treatment but did not cure n recurrent. on physicl examination: plaque, fine border, n lichenification? a. numular dermatitis b. contact dermatitis c. atopic dermatitis d. lichen simplex chronic e. asteatotic eczema 68. 70, man comes to ER with hip pain immobile. Fever and less urination. No enlargement in Hepar and limpa.WBC 10000, Hct 17 %, and platelet 100000. Temperature 39 celcius. There are Pansitopenia and IgA 2000, IgG 1700. What is examination to this patient: a. Abdomen Ultrasonography b. Bone Survey c. Chest Ultrasonography d. MRI 69. Additional lab examination to confirm his diagnosis AGE's is universally symptom of aging.. Affecting to organ, except: A. Skin

B. Lung C. Muscle D. Blood Vessel E. Ovarium 73. ideal therapy for this patien... a. calcitriol b. calcitonin c. biphosponate d. glucocorticoid e. simvastatin 75. Normal physiology changes in elderly, Except? A. Decrease total body water B. Decreade lean body mass C. Decrease body fat D. Decrease serum albumin E. All above uncorrect 76. pre treatment evaluation of urinary incontinence should consist of at least.... A.cystometry and pressure flow study B.video urodynamic C.perineal electromyograpghy D.cyctoscopy E.uretheral profilometry 80.The exogonic condition that affected to behavior in elderly A.celullar B.anatomy C.organ target D.life style E.all true 88.bonus question 99. Woman , fracture in wrist hand, stretch out (dinner fork fracture) , diagnosis :A. Smith fracture B. colles fracture C.Bennett D.galleazi

E. montegia