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SOAL-SOAL UJIAN USU 2009

I.

1. Which of the following about posterior scleritis ( unilateral proptosis,


restriksi gerakan bola mata, retrobulbar pain, kehilangan lapangan
pandang ) is true?
Anterior skleritis: nyeri dan fotofobia
1. Most of the vessels persist
2. Cause exophthalmus
3. Be painless
4. Be associated with pain on eye movement

2. Neurofibromatosis 2 is associated with all of the following, except :


seharusnya tdk pakai except.
Tipe 1: optic nerve glioma, kromosom 17, cafe-au-lait spot, axillary
freckling, fibroma moluscum, plexiform neurofibroma,displasia orbital
walls, congenital glaucoma
1. Optic nerve glioma
2. Localized to chromosom 22
3. Plexiform neurofibroma in the eyelids
4. Bilateral acoustics neuromas

3. About Peters anomaly : adesi antara lensa dan kornea, katarak kortikal
anterior dan polar, lensa displace ke anterior ke ruang pupilari dan
anterior chamber, microspherophakia, the lens may or may not be
cataractous, bilateral or unilateral, glaucoma, 60% kasus bilateral,
sporadik, PAX 6 gene
1. It is bilateral 80% of the time
2. Sporadic
3. 50% associated with glaucoma
4. The lens always cataractous

4. The implantation of an IOL can lead to a variety of secondary


glaucomas :
1. UGH syndrome  pd rigid anterior chamber
2. Secondary pigmentary glaucoma
3. Pseudophakic pupillary block
4. Decreased central corneal thickness

5. The visual field defect in normal tension glaucoma :


1. More focal
2. Deeper
3. Closer to fixation
4. Central scotoma
6. The most common cause neovaskular glaucoma : kelainan retina,
iskemik okular dan inflamasi okular
1. Systemic hypertension
2. Diabetes mellitus  diabetic retinopathy
3. Renal failure
4. CRVO
7.Two form of epithelial proliferation often cause secondary glaucoma is :
a. Epithelial cysts
b. Epithelial ingrowth
c. ‘pearl’ tumor of the iris  epithelial proliferation tp tdk
menyebabkan glaukoma
d. a + b is correct
e. b + c is correct

8. the most common symptom of retinochoroidopathies include :


a. blurred vision
b. scotomata
c. anterior segment inflammation is present  usually absent
d. a + b is correct
e. c + d is correct

9. patient with birdshort retinochoroidopathy: perempuan >, dekade 4-6,


gejala floaters, kabur, fotopsia perifer. Kemudian dpt tjd nictalopia dan
buta warna. 100% vitritis, disc edema, vascular sheating, dan yellow
ovoid birdshot, 90% HLA A-29 (+)
a. retinal autoantigen reactivity and a strong HLA association
b. retinal degeneration consisting of mild RPE pigmentary changes
c. the pthognomonic finding is fundus examination shows multiple
small outer retinal white dots in posterior pole
d. the edges of these lesion may be active, with a yellow-gray and
oedematous appearance

10. About OHS is true:


a. Sign symptom : thrombositopenia, anemia, pneumonitis, abnd
hepatosplenomegaly
b. Primary infection occurs after inhalation of the fungal
spores in to the lung
c. Subretinal neovascularization with significant visual loss may
complicate the usually benign course
d. Macular edema, neuroretinitis, attenuated retinal vessels, and
macular star formation occur
II. Tipe katarak kongenital yang mungkin sedikit pengaruhnya pada visus :

a. Polar anterior  sutural, coronary, cerulean(blue dot/small bluish), capsular


juga
b. Polar posterior
c. Lamellar  tipe yg paling sering, autosomal dominan
d. Membranous
e. Nuclear

1. A 35 year old woman complain of decrease vision in her right eye. The intra ocular
pressure is 38 mmHg. The clinical findings in the right eye : correctopia, ectropion, uveal
peripheral anterior synechia, protrusions of iris stroma created by proliferation of the
endothelial like membrane on the iris surface. What is the diagnose of the patient?
a. Pseudoexfoliation
b. Acute Angle Closeur Glaucoma
c. ICE syndrome
d. Posner Schlossmann syndrome
e. Fuchs Heterochromic

2. A healthy 26 year old man came to ophthalmology clinic with sudden blurred vision,
micropsia, and decrease color vision. He already had the same condition before. The
patient was fired from his job one month ago. Which is the treatment for the patient?
a. Observation and bed rest
b. Oral & systemic corticosteroid
c. Topical midriatic
d. Carbonic anhidrase inhibitor
e. Neurotropic vitamins

3. AV LRE is 6/6. On slitlamp examination he has wedge shape opacities and A 55 year
old man came to policlinic with main complain of monocular diplopia and glare. His
histopathologically characterized by hidrophic swelling of the lens fibers. What type of
cataract is this patient?
a. Nuclear cataract
b. Cortical cataract
c. PSC
d. Anterior subcapsular cataract
e. Lamellar cataract

4. A 56 year old woman came to policlinic with the main complain sudden onset of
decrease visual acuity , metamorphopsia and paracenteral scotoma, clinically there may
be elevation of the RPE, subretinal or intraretinal lipid, fluid or blood, pigmen epithelial
detachment, retinal epithelial tears and occasionally the gray green CNV lesion itself is
seen, Retinal Angiomatous Proliferation lesion (+). After FFA, we diagnose the patient as
Classic CNV and then we do the PDT. What is it recently has been approved for the
treatment with PDT besides AMD?
1. Subfoveal CNV secondary to ocular hystoplasmosis syndrome
2. CSCR
3. Subfoveal CNV secondary to pathologic myopia
4. Ocular tumor

5. A 55 year old woman had benign tumor operation of inferior palpebral margin, mass
dimension was 50%. In the palpebral reconstruction, anterior lamellar can be taken
through preauricular or retroauricular skin. This methode is known as :
a. Modified Hughes procedure
b. Mustard procedure
c. Tenzel flap procedure
d. Semicircular pedicle flap
e. Cutler Bread procedure

6. Wanita 50 thn dating dengan keluhan benjolan di kelopak mata kanan atas warna putih
dan permukaan tidak rata, kemungkinan pasien ini menderita :
a. Kalazion
b. Bowmen disease
c. Adenocarcinoma kel. Sebasea  > kelopak atas, > kel. meibom
d. Limfoma maligna
e. Adenocystic Carcinoma

7. Jenis tumor diatas mempunyai sifat :


a. Klinis serupa kronik unilateral blefarokonjungtivitis atau chalazion
b. Memberi gejala seperti hordeolum
c. Tidak bersifat lethal
d. Merupakan kelanjutan dari Adenoma
e. Perlu tindakan radiasi post operasi

8. Pasien post trabekulektomy dan dengan Mitomycin C didapatkan severe bleb related
endophthalmitis. AV awal 20/20 dan saat ini menjadi 1/300. Manakah diantara
pernyataan ini yang tidak benar?
a. Prognosis AV buruk
b. Organisme yang berhubungan dengan bleb related endophthalmitis adalah H.
Influenza atau Streptococcus
c. Oleh karena AV lebih baik dari 1/s diperlukan kultur vitreus & inj antibiotic
d. ….
e. ….

9. Phacoemulsificataion for cataract case with limited zonular support the following factor
that must be remembered :
1. Reducing flow rate
2. Insertion capsular tension ring
3. Lowering the bottle height
4. ….

III.
1. Neurofibromatosis tipe 1, kecuali :

a. Disebut juga Von Recklinghausen Syndrome

b. Diturunkan sebagai autosomal dominant pada kromosom 22

c.Kelainan dimata antara lain, : lisch nodules, optic nerve gliomas, eyelid neurofibromas dan
glaucoma
d.Diturunkan sebagai autosomal dominant pada kromosom 17q11
e.Kelainan sistemik : cutaneous café au-lait spots, cutaneous neurofibromas dan axillary or inguinal
freckling

2. Seorang pria umur 50 thn datang ke RSUP. HAM dengan keluhan utama penglihatan mata kiri tiba-
tiba kabur, tidak nyeri dan tidak ada riwayat DM. Pada pemeriksaan funduskopi dijumpai oedem dan
milky white retina, juga cherry red spot pada macula. Pasien ini kita diagnosa dengan :

a. Tay- Sachs disease


b. Gangliosidosis type 1
c. Myoclonus syndrome
d. Central retinal artery occlusion  aterosklerosis dgn trombosis, amaurosis fugax
e. Sandhoff disease

3. Terapi pada pasien ini adalah, kecuali: corticosteroid

a. Paracentesis anterior chamber


b. ↓IOP dgn ocular massage
c. Acetazolamide dan Aspirin
d. Inhalasi 85% O2 + 15% CO2  95% O2 + 5% CO2
e. Retrobulbar anaesthesia.
4.Pemeriksaan yang juga diperlukan pasien ini adalah :

1. Perimetri
2. FFA
3. ERG
4. ESR
5. Seorang wanita umur 23 tahun dikonsulkan oleh bagian obstetrik dan ginekologi dengan keluhan
mata kabur. Pada Pemeriksaan funduskopi dijumpai hyperpigmented patches (elschnig spots), juga
tampak siegrist streaks. Pada fase FFA ditemukan :

a. Leakage
b. Focal RPE detachment
c. Focal hypoperfusion
d. Extensive exudative retinal detachment
e. Hypopigmented choroidal arteries

6. Seorang bayi berusia 1,5 bulan dibawa oleh ibunya ke rumah sakit karena mata kiri sering berair, ada
secret agak kental dan lengket di pinggir kelopak mata. Terapi yang dilakukan pada bayi ini adalah,
kecuali:

a. Digital massage
b. Broad spectrum topical antibiotics
c. Probing sesudah usia 12 bln
d. Ballon catheter dilation
e. DCR

7.Seorang wanita umur 20 tahun datang ke RSU. Dr. Pirngadi dengan keluhan ada benjolan kuning
kemerahan di dalam mata kanan dan kiri yang telah diderita os sejak kecil, nyeri tekan (-), esotropia,
kelainan pada telinga dan tulang belakang yang melengkung. Pasien ini didiagnosa dengan :

a. Crouzon syndrome
b. Waardenburg syndrome
c. Treacher Collins-Franceschetti syndrome
d. Goldenhar syndrome
e. Hallermann-Streiff syndrome

8. Seorang wanita umur 40 tahun datang dengan keluhan mata merah, terasa panas, mengganjal,
berkabut, disertai dengan bintilan yang berulang. Pada pemeriksaan terlihat secret di kelopak mata,
cairan berbuih di kelopak mata bawah, dan infiltrat cornea. Diagnosa pasien ini adalah :

a. Rosacea
b. Seborrheic blepharitis
c. Meibomian gland dysfunction
d. Chalazion
e. Sarcoidosis

9. Manifestasi dari penyakit diatas adalah, kecuali:

a. Scleritis

b. Bulbar & tarsal conjunctival injection

c. Corneal thinning

d. Corneal scar & neovascularization


e. Punctate epithelial erosions

10. Management penyakit diatas adalah, kecuali :

a. Massage

b. Systemic Tetracycline 250-500 mg/hari

c. Systemic Doxycycline 100-200 mg/hari

d. Systemic Erythromycin

e. Topical corticosteroids