1-10 Christine

11-20 Nana

21-30 Hiensen

31-40 Maggie

41-50 Sylvia

51-60 ChinNur

61-70 Emod

71-75

1. A 10 year-old boy was brought to a clinic because of back pain for around one month
especially while bending. His mother also noted that her son’s left shoulder is slightly higher
than the right. On physical exam the doctor found that Adam’s test was positive but no
length discrepancy.
What is the most appropriate examination to diagnose this patient?
a. Standing PA & lateral X-ray
b. Spine MRI
c. Spine CT-scan
d. Left lateral decubitus X-ray
e. Supine lateral X-ray
2. 65 years old lady presented with left knee pain. Physical examination showed mild
tenderness. X-ray showed reduced joint space and formation of osteophytes. Small
amount of joint effusion was noted. What is the most likely clinical diagnosis?
A. Rheumatoid Arthritis
B. Pseudogout
C. Traumatic Arthritis
D. Reactive arthritis
E. Osteoarthritis
3. Which stastements is true about joints? The knee joint is a synovial hinge joint
4. 20 years old woman with pain in left knee, swelling and tenderness. Kemudian 2 minggu
selanjutnya datang lagi dengan keluhan her left knee unstable when walking. Dokter suspect
ada problem di ligament. What is the most appropriate test for her?
A. Normal X-ray
B. Tomograph
C. USG
D. Isotope radiograph
E. MRI
5. Ada seorang kira-kira umur 47 tahun trus kalau ga salah dia complain di knee, ada
ligament di knee yang tear
6. A 58 years old found muscle easy to fatigue and weak. His physician found there was a
problem with the neurotransmitter such as mye..gravis
A. Epinephrine
B. Norepinephrine
C. Acetylcholine
D. Dopamine
E. -
7. Soalnya itu test apa yang harus dilakukan terus kalo ga salah sakitnya itu RA
8. A 35 years old woman came to out-patient department with pain on her both
metacarpophalenges joints. According to the anamnesis result she suffers stiffness,
pain, warmth, swelling, redness. Which movements will be affected?
A. Flexi, Extensi
B. Abduction, adduction
C. Flexi, Extensi, abduction
D. Flexi, Extensi, Adduction
E. Flexi, Extensi, Adduction, Abduction
9. NA
10. Before taking further history, doctor gave her non narcotic analgetic to reduce
inflammation and pain. It was also known she is 6 months pregnant. Which of the
following drugs is the most appropriate NSAID for this patient?
A. Acetaminophen
B. Aspirin
C. Ibuprofen
D. Methanpyrone
E. Mefenamic acid
11. NA
12. A 58 years old man came to the clinic, his muscles become easily fatigue and weak. The
physical examination shows decrease muscle strength. The physician diagnoses him
with possible myasthenia gravis. What is the neurotransmitter involve in neuromuscular
junction?
A. Epinephrine
B. Norepinephrine
C. Acetylcholine
D. Dopamine
E. Serotonin
 13. During the dissection of the spine, the tutor wants to dissect the spinal cord, the tutor
wants to show and reveal intenmuscents, which part of the spinal is to be dissected?
A. Vertebral body
B. Vertebral arc
C. Lamina
D. Padilux

(UNKNOWN NUMBER) A 35 years old woman came to out-patient department with pain on her
both metacarpophalenges joints. According to the anamnesis result she suffers stiffness, pain,
warmth, swelling, redness. Which movements will be affected?

A. Flexi, Extensi

B. Abduction, adduction

C. Flexi, Extensi, abduction

D. Flexi, Extensi, Adduction
E. Flexi, Extensi, Adduction, Abduction

(Unknown number) 20 years old man came to the hospital with almost constant pain related to
swelling. The pain has last long for 2 months. X-ray findings: bulky sclerotic lesion in lower end
of tibia extended to extra osseous lesion with transverse sunray appearance. What is the
possible diagnosis?

A. Hyperparathyroidism
B. Metastatic cancer
C. Osteomyelitis
D. Osteosarcoma
14. A 55 years old woman come to emergency room of Siloam with chief complaint sharp
back pain after lifting her grandson. Radiographic shows compression fracture on
vertebral thoracal 8&9 and thinning of the bone trabeculae. The blood lab examination
result was: serum calcium and Phosphate level within normal limit. What is the most
probable diagnose?
A. Osteoporosis
B. Osteopetrosis
C. Osteogenesis imperfecta
D. Osteomalacia
E. Hyperparathyroid
15. A 60 years old man complains about stiffness and pain in the back after excessive
activity. Radiographic examination reveals narrowing of L4-L5; L5-S1 disc space. What is
the most possible cause of the complaint?
 A. Loss of nucleus pulposus chondroitin sulfate
B. Increase disc water content
C. Annulus fibrosus tear
D. Facet joint degeneration
E. Osteoporosis
16. NA
17. 58 years old man came to the clinic, his muscles become easily fatigue and weak. The
physical examination shows decrease muscle strength. The physician diagnoses him
with possible myasthenia gravis. What is the neurotransmitter involve in neuromuscular
junction?
A. Epinephrine
B. Norepinephrine
C. Acetylcholine
D. Dopamine
E. Serotonin
18. Nenek umur 60 tahun, mengeluh sakit pada bagian T8-T9 setelah mengangkat cucunya.
Hasil pemeriksaan serum Ca dan P normal.
A. Osteoporosis
B. Osteopetrosis
C. RA
D. Lupa
E. Hyperparathyroid
19. A 55 years old woman come to emergency room of Siloam with chief complaint sharp
back pain after lifting her grandson. Radiographic shows compression fracture on
vertebral thoracal 8&9 and thinning of the bone trabeculae. The blood lab examination
result was: serum calcium and Phosphate level within normal limit. What is the most
probable diagnose?
F. Osteoporosis
G. Osteopetrosis
H. Osteogenesis imperfecta
I. Osteomalacia
J. Hyperparathyroid
20. NA
21. A 5 year old girl is on skin traction after fractures her left femur three weeks ago. Now
the physician removed the traction and found that the fracture fragment is not
displaceable anymore but there is still some movement on fracture site with mild
tenderness. What is the most likely phase of healing?
A. Initial bleeding phase
 B. Proliferation phase
C. Soft callus phase
D. Hard callus phase
E. Clinical union phase
22. A 25 years old. Follow up for tibial fracture. Physical exam and radiology shows normal
phase of remodeling. Which cell is most involved in this process?
A. Osteoclast
B. Osteon
C. Osteocyte
D. Osteoblast
E. Osteoid
23. NA
24. Checked (?)
25. Checked (?)
26. Wanita terpotong pisau dapur pada jari tengahnya, lalu tidak bisa ekstensi distal
interphallangeal joint. What structure that might be broken on that finger?
a. Second lubricals
b. Extensor digitorum
c. Extsensor digiti minimu
d. Third distal phallangeal
e. lupa
27. A 5 year old girl is on skin traction after fractures her left femur three weeks ago. Now
the physician removed the traction and found that the fracture fragment is not
displaceable anymore but there is still some movement on fracture site with mild
tenderness. What is the most likely phase of healing?
F. Initial bleeding phase
G. Proliferation phase
H. Soft callus phase
I. Hard callus phase
J. Clinical union phase
28. 25 years old. Follow up for tibial fracture. Physical exam and radiology shows normal
phase of remodeling. Which cell is most involved in this process?
F. Osteoclast
G. Osteon
H. Osteocyte
I. Osteoblast
J. Osteoid
29. Wanita terpotong pisau dapur pada jari tengahnya, lalu tidak bisa ekstensi distal
interphallangeal joint. What structure that might be broken on that finger?
a. Second lubricals
b. Extensor digitorum
c. Extsensor digiti minimu
d. Third distal phallangeal
e. Lupa
30. A 56 years old male consulted the painless subcutaneous nodule at his right elbow. He
has a history of active arthritis episodes affecting ankle and heels. The biopsy was
performed and microscopic shows large collections of monosodium urate crystals fills in
the nodule. What is the probable nodule?
A. Pannus
B. Granuloma
C. Tophus
D. Ganglion
E. Osteophyte
31. Orang RA, udah diobatin pake prednisone and methotrexate tapi gak membaik dan
makin parah. Pengobatan yang dianjurkan?
A. Cyclosporin
B. Etanecerp
C. Phenicillamine
D. Phenylbutazone
E. Sulfalazine
32. 75 year old menopausal women went to evaluate bone mass density. She has low bone
mass density in the lumbar spine, femoral neck and …hip. She has no problem with
absorption in gastrointestinal tract. Which drug is most appropriate?
A. Alendromate
B. Calcium
C. Glucosamine
D. Raloxifene
E. Vitamin D
33. NA
34. Tukang kebun datang dengan gejala sakit pada left ankle. Tidak ada trauma. Merasa
tidak enak dan menggangu pekerjaannya. Dan tidak ada sakit pada sendi2 lain.
A. Reiter Syndrome
B. Septic Arthritis
C. RA
D. Hemaarthrosis
35. A 37 years old gardener went to Emergency Department to consult his severe ankle pain. His
pain increasing in 4 days. He feels feverish and unvwell. He recall no history of trauma buat his
work is demanding. No pain in other joint. His skin of ankle joint is red, swollen and slightly
tense but soft. Motion is limited due to pain. What is the most likely diagnosis?
a. Pseudogout
b. Reiter’s syndrome
c. Haemarthritis
d. Spetic Arthritis
e. Rheumatoid Arthritis
36. NA
37. 69 years old. Bone erosion progressive, osteophyte subchondral sclerosis, found di jari
and vertebrae, tender tapi gak swollen.
A. Lyme disease
B. OA
C. RA
D. Osteoporosis
E. Remote Fracture
38. NA
39. 36 years old man. Backache for the past 6 months, which has becoming more severe
during the last few weeks. He had history of pulmonary tuberculosis. On examination,
his lower lumbar spine was tender and the right hip was flexed and externally rotated.
There was a fluctuant painless lump (swelling) in his right groin. There was also fullness
in the right iliac fossa. What is the most probable diagnosis?
A. Femoral hernia
B. Inducted (oblique) inguinal hernia
C. Undescended (ectopic) testis
D. Psoas abscess
E. Appendicular mass
40. NA
41. Checked (?)
42. Checked (?)
43. Anak kecil demam dan lain lain. Dia gak ada trauma kecuali pernah kena infeksi kuping.
Dia salut kaki (OM). Penyebaran lewat? Hematogenous.
44. Checked (?)
45. 40 years old man with tuberculosis came to the clinic. Pathological changes with
caseous necrosis encircled with epitheloid cells on infected site. What is the most
probable inflammation cause?
A. Chronic suppurative
B. Chronic active
 C. Granulomatous
D. Acute suppurative
46. Checked (?)
47. NA
48. 50 years old male presents with right tibial pain since one month. X-ray shows
segmented fracture on tibia diaphysis with minimal callus. One month later, another X-
ray is taken, with atrophic changes of bone on fractured site. What is the diagnosis?
A. Malunion
B. Non union
C. Delayed union
D. Reflex sympathetic dystrophy
E. Avascular necrosis
49. X-ray. Fracture no deficit sensoris. Pulse ada.
A. Carpal bone
B. Radiocarpal joint
C. Radial diaphysis
D. Radius epiphyseal plate
E. Radius metaphysis
50. NA
51. 42 year woman goes to hospital and feel pain at her upper spine 4 months ago. History
of surgery of removal bilateral ovarian cyst two years ago. Physical examination shows
no swelling, no redness, tenderness. What is the most possible cost?
A. Osteoporosis
B. Blank
C. Blank
D. Blank
E. Spondylitis
52. NA
53. 19 years old girl with hormonal imbalance, fractured right upper femur. X-ray shows
fibrous tissue, partially cystic. Curettage biopsy is performed: U shaped trabeculae.
Diagnosis?
A. Fibrous dysplasia
B. Osteomyelitis TB
C. Ganglion cyst
D. Ostemyelitis chronic
E. Ostearthritis
54. A 10 years old…Cause of multi-resistant?
A. Sequestrum
 B. Involcurum
C. Cellulitis
D. Abscess
E. S
55. NA
56. NA
57. Checked (?)
58. Orang usia 47 tahun. Cowo merasakan onset back pain menjalar ke bagian posterior:
lateral plantar. Pada examinasi ankle reflex tidak ada dan kesusahan dorsoflexi.
Diagnosis?
A. Acute disc prolapsed
B. Mechanic back pain
C. ?
D. Vertebral fracture
E. Vertebral OM
59. NA (?)
60. A- 62 years old male came with pain and swelling in left knee that began one week ago.
He had high fever and diarrhea 2 weeks ago. Physical examination shows inflammation,
swelling and pain. What is likely the diagnosis?
A. Osteoarthritis
B. Rheumatoid Arthritis
C. Osteoporosis
D. Hemarthrosis
E. Reitier’s syndrome
61. A 20 years old man came to the hospital with almost constant pain related to swelling.
The pain has last long for 2 months. X-ray findings: bulky sclerotic lesion in lower end of
tibia extended to extra osseous lesion with transverse sunray appearance. What is the
possible diagnosis?
A. Hyperparathyroidism
B. Metastatic cancer
C. Osteomyelitis
D. Osteosarcoma
62. NA
63. 7 years old boy goes to Emergency Room. Pain at left fore arm. Cannot move. Close
reduction, cast immobilization. Action plan:
A. ?
B. Joint dislocation
C. ?
 D. Secondary ossification
E. Frequent joint stiffness
64. NA
65. 89 years old woman, 6 years confine in nursing home. She has adequate calcium diet.
However, there are sign of osteoporosis. What supplement suitable for her diet?
A. Calcitonin
B. Melatonin
C. PTH
D. Vitamin D
E. Vitamin A
66. NA
67. A girl fractured her right femur in a car accident 2 weeks ago. Her bone is not healing
well and there is a purulent infection on the areas of the skin around the fracture. X-ray
shows degradation of distal humerus. Microscopic examination of biopsy shows
sequestrum, granuloma and inflammatory cells invasion. What is your most probable
diagnosis?
A. Osteoarthritis
B. Acute osteomyelitis
C. Chronic specific osteomyelitis
D. Chronic nonspecific osteomyelitis
E. Rheumatoid arthritis
68. NA
69. Checked (?)

70. 17 tahun medical student, twisted on his left ankle. He noticed that he can’t walk stable on
uneven surface. Notice there is ecchymosis on his left ankle. No malleolus tenderness. Anterior
drawer test shows loosen but no fimed at the left ankle. Most probable injured structure?

A. M.deltoid
B. Anteroir talo join
C. Naviculare
D. Tibialis Posterior tendon
E. Achilles tendon

71. A 5 years old boy come to the hospital with intense pain on upper left leg. He refused to move
because of pain. He denied any injury. He has fever and sore throat since three days ago.
Tenderness on proximal tibia and no abnormality of cruris x-ray.
A. Hospital stay and IV antibacterial (kayaknya ini tapi gatau)
B. Order MRI
C. Cold compress several times
D. Outpatient
 E. Pain management
72. 30 years old man. Ada wound chronic di right ankle 2 tahun lalu karena traffic accident. Ada
keluar bone fragment di lukanya. What structure yg bisa bikin bone fragment keluar?
A. Sequestrum
B. Involocrum
C. Cloaca (pada bilang yg ini tapi gatau)
D. Epiphyseal plate
E. Periosteum
73. Ada gram positive cocci in clusters.
A. Neisseria gonorrhea
B. Staphylococcus aureus
C. Clostridium perfringens
D. Strep
E. Strep pyogenes
74. An obese man 68 years old has BMI 30 kg/m2. He has pain in both knees. Ada swelling in DIP
joints, and crepitus when flexing his knee. Which features to determine the diagnosis?
A. Morning stiffness < 30 min
B. ESR > 50
C. Synovial
D. Hyperuricemia
E. Elevated CRP

(mungkin nomor 53) 60 y.o man. Abis makan keripik melinjo. History arthritis di ankle and heels.
Microscopic crystal found.

A. OA

B. RA

C. Gout

D. Rheumatoid fever

E. Synovitis

(Mungkin nomor 58) 19 y.o boy fell when playing football, his forearm is strangely angulated, no
laceration on the skin and neither parasteshea nor disminished distal pulse present. Which is the most
appropriate FIRST step to help this patient?

A. Try to re-aligned the forearm

B. Immobilize the forearm with a splint
C. Apply icepacks directly on the forearm
D. Apply pressure to the forearm to stop swelling
E. Drive him to nearby hospital by motorcycle