MDE DMS
1. During insertion of an IV in the median cubital vein, a patient suddenly lost his feeling on the radial
side of the forearm. Which of the following nerve is the most likely appropriate for that injury?
A. Musculocutaneous
B. Superficial radial nerve
C. Lateral antebrachial cutaneous
D. Medial antebrachial cutaneous
E. Posterior antebrachial cutaneous
3. An elderly woman presented with severe pain beneath her left eye, radiating into lower eyelid,
lateral side of the nose and upper lip. Which of the following nerve is most likely appropriate?
A. Supratrochlear
B. Infraorbital
C. Zygomatic
D. Buccal
E. Mental
6. Triangle in which superior branch of ansa carnicals separated from CN12?
A. Carotid
B. Occipital
C. Submandibular
D. Submental
8. In dislocation of jaw, displacement of the articular disk beyond the articular tuber of the
temporomandibular joint results from spasm or excessive contraction. Which of the following
muscles could be injured in that dislocation?
A. Medial Pteryoid
B. Lateral Pteryoid
C. Buccinator
D. Temporalis
E. Masseter
9. In a fall from a horse, rider sustains severe neck spinal cord. The left transverse process of C6
vertebrae is fractured. Which artery could be injured in that fracture?
A. Common Carotid
B. Inferior Carotid
C. Internal Carotid
D. Costocervical
E. Vertebral
13. Fracture of humerus at different region can damage different nerve and rupture blood vessels. One
of it is posterior surgical neck, fracture of this site injure axilla nerve. What is the muscle that may
be affected?
A. Pectoralis major muscle
B. Supraspinatus muscle
C. Infraspinatus muscle
D. Teres major muscle
E. Deltoid muscle
16. The action of group constrictor pharyngeal muscle is to constrict the pharyngeal cavity. Which of
the following nerve that innervate the muscle?
A. Glossopharyngeal nerve
B. Spinal accessory nerve
C. Sympathetic trunk.
D. Hypoglossal nerve
E. Vagus nerve
18. 6 year old child has history of difficult birth, has permanently tilted head posture, right ear near to
right shoulder, face turn upward and left. Which muscle damage during birth?
A. SCM
B. Anterior scalene
C. Omohyoid
D. Trapezius
E. Platysma
25. Pattern of muscle controlled by connective tissue into which myoblasts migrate. Which of the
following patterns of muscle formation are directed by connective tissue elements derived from
neural crest cells?
A. In the head
B. Limbs
C. Body wall
D. Cervical region
E. Occipital region
28. The molecule produces high tensile strength without stretch?
A. α keratin
B. Collagen
C. Hyaluronic acid
D. Elastin
E. Actin
F. Myosin
33. Molecule serves as lubricant in synovial fluid of joint.
A. α keratin
B. Collagen
C. Elastin
D. Hyaluronic acid
E. Myosin
34. Tetracycline – cap for 5 days 3 times after eating
65 years old women with insidious low back pain, no history of trauma, pain at spine, process of
C4. X-ray shows compression ??? of C4.…. cell activity imbalance?
A. Osteoblast-osteocyte
B. Osteoblast-osteoclast
C. Osteoblast-osteogenic
D. Osteoclast-osteogenic
E. Osteoclast-osteocyte
36. A 60 years old has moderate hypertension controlled with HCT 12.5 mg once daily and Losartan
50 mg once daily. Is prescribed Rofecoxib 50 mg once daily to control Osteoarthritis pain. After 3
month, his BP begins to rise. This increase in BP most likely to
A. Arteriolar contraction in the peripheral circulation caused by inhibition of COX-1 by Rofecoxib
B. Weigth gain caused by Rofecoxib’s ability to decrease BMR
C. Increase excretion of HCT due to increase renal blood flow by Rofecoxib
D. Inhibition of COX-2 by Rofecoxib which lead to decrease renal blood flow
E. Increase metabolism of Losartan due to induction of CYP2Cg by Rofecoxib
38. A patient with coronary artery disease is particularly challenging for anesthesia, since alteration in
vascular responsiveness & myocardial function may put them at risk. In respect which statement
correctly describes the cardiovascular action of agents that should be taken into account when
planning anesthesia for such patients?
A. All halogenated hydrocarbon inhalation anesthetics sensitize myocardium to catheloamine
induced cardiac arrythemias
B. Halogenated hydrocarbon inhalation agents reduce cardiac output equally well.
C. Seroflurane directly stimulates sympathetic function
D. Reflex sympathetic stimulation is major component of halothene’s cardiovascular profile.
E. Several halogenated hydrocarbons produce vascular relaxation to renal blood pressure
44. K-opiod receptor activation is required to observe:
A. Respiratory depression
B. Bradychardia
C.
D. Mydriasis
E. Hypercapnia
For question 45 and 46, refer to scenario below:
A 35 year old man complained of thick scaling at his elbow and knee area accompanied by mild itching and reddish.
45. Which of the following is the most likely diagnosis for this particular condition?
A. Psoriasis
B. Erythroderma
C. Sunburn
D. Lichen Planus
46. Which of the following test is appropriate to diagnose this disease?
A. Auspitz test
B. Prick test
C. Skin test
D. KOH test
E. Woods Lamp test
49. Which of the following statement directly trigger the detachment of cross bridge from action?
A. Depolarization of T-tubule
B. Hydrolysis of ATP to myosin head
C. Calcium ion
D. Attachment ATP to myosin head
E. Depolarization of plasma membrane
50. Prolongation of contraction with high frequency is called?
A. Trappe
B. Twitch
C. Summation
D. Complete titanic contraction
E. Incomplete titanic contraction
53. When movement causes someone to get fatigue rapidly, it is resulting from?
A. Red muscle type of skeleton muscle
B. Dystrophy muscular progressive
C. Anterior motor neuron disorder
D. Peripheral neuropathy
E. Myasthenia gravis
A. Troponin
B. Myosin
C. Actin
D. ATP
E. Tropomyosin
54. Has binding site for ATP
55. Responsible for disconnecting to cross bridge
56. Has binding sites for calcium
For question 61 and 62, refer to scenario below:
25 year old, BP: 70/40 mmHg, pulse: 120 bpm, RR: 26-28 bpm and still conscious. History taking: ride a motorcycle with helmet in high velocity, collided with a car from opposite direction. There is deformity of his right thigh and leg, wound on anterior side of middle 1/3 of thigh with bone exposed. Pelvic is not stable in the exam.
61. What should do first in ER?
A. Reduction of bone and immobilized splintage
B. Do 1° and 2° survey simultaneously
C. Close wound with moist gauze.
D. Binding the pelvic with the sheet
E. Resuscitate the circulation
62. Which radiographs are required in the initial assessment of this patient?
A. AP and lateral view of thigh and leg
B. Lateral view of neck, AP view of chest, AP view of pelvis
C. AP and lateral view of pelvis, AP and lateral view of thigh and leg
D. AP view of chest, AP view of pelvis, AP and lateral view of thigh and leg
E. Lateral view of neck, AP view of chest, AP view of pelvis, AP and lateral view of thigh and leg
66) Man come to your clinic-keluar panas di bahagian right thight, history – fracture at right thigh,
have been corrected w extraction internal fixation, but the gudget is still in there after 10 yr ago,
lab exam- increase ESR, N leukocytes, no fever, radiology exam- sclerotic, lesion, new bone
formation
A. Cellulitis
B. Osteosacroma
C. Osteomyelitis
D. Septic arthritis
73. 5 years old boy comes to ENT with running nose as chief complaint. He also suffer nasal block,
itch, sneezing especially when inhale dust. Physical exam shows allergic shines, Dennis Morgan
fold, pale, bluish nasal mucosa. Lab shows IgG 600 Iµ/ml. Which one of the following most
frequent comorbidity on pharynx in PE?
A. Pale mucosa
B. Post nasal drip
C. Cobblestone appearance
D. Pseudomucosa
E. Hyperemic mucosa
76. What is the most frequent lymph node location in nasopharnynx tumor?
A. I
B. II
C. III
D. IV
E. V
77. Angiofibroma. What’s correct?
A. Only in female
B. Bleeding usually only slight exact extract
C. Only in older male
D. In young male
E. Metastasize oftenly
82. A 2-year-old baby girl with cleft palate has hypernasal and articulating disturbance. What
disability at this age?
A. Cleft palate
B. Doesn’t look pretty
C. Cannot talk properly
D. Speech disturbance
E. Ashamed
83. Area for neck metastasis?
A. Jugular superior
B. Submental
C. Middle jugular
D. Lower jugular
E. Post triangle of neck
86. 60 year old woman had bed rest for a prolonged time. This condition can cause mass complication
of the musculoskeletal system. Which of the following is appropriate in this sys?
A. Water control loss
B. Incoordination
C. Loss of energy
D. Osteoporosis
E. Pressure core
89. Case about osteoarthritis. What is her primary problem?
B. Mobilization
90. What of the following a fundamental basis for above condition?
A. Calcium
B. Sodium
C. Potassium
D. Hydrogen
E. Oxygen
92. What is the best approach for second bed rest?
A. Use painkiller
B. Range of motion (ROM)
C. Exercise for muscle endurance for lower extremities
D. High impact exercise
E. Join community program
96. What is the basic tissue type of the damaged organ above?
A. Cartilage
B. Epithelium
C. Connective tissue
D. Nervous
E. Muscle
97. 25 years old man come to ER. He got involved in traffic accident. He got involved in traffic
accident. Based on primary survey there was no abnormality found but radiologic x-ray from
secondary survey showed linear fracture in 1/3 proximal left tibia.
Based on maturity for type of bone, which is correct for bone above?
A. Irregular array of collagen fiber
B. Small mineral content
C. High proportion of osteocyte
D. Lamellae exhibit a typical organization
E. No lacunae
99. 24 years old sprinter is 7 time winner of marathon (24km). What is the following type of muscle
fiber probably predominant in his leg.
A. White
B. Intermediate
C. Yellow
D. Red
E. Grey
101. A 17 years old girl comes to dermatologist with chief complaint of red pimples on both cheeks
for the last 2 years. She rarely wears cosmetics. On PE, comedo papules and pustules are found
mostly on forehead, cheeks and jaws area. What type of the glands is causing above symptom on
the face?
A. Apocrine
B. Holocrine
C. Eccrine
D. Sitocrine
E. Paracrine
After a heavy rain and a thunderstorm on a mountain, a flood overflow over a river causing a boat with 3 passengers turned upside down. A week later, 5 decomposed bodies were recovered on the river banks. 2 males , 2 females , a boy and an adult skeleton and a femur were recovered. Only 3 families claimed of losing their family. Mrs. X and her daughter claimed the lost of Mr. X. a female reported her brother, Mr. Y. Mr. Z asked for Mrs. Z, his 3 months pregnant wife. All families brought the photograph of their loved ones.
102. Mr. X is better to be identified with which method?
A. Autopsy
B. Nuclear DNA
C. Chromosome
D. Mitochondrial DNA
E. Photographic imposed
103. Mr. Y is better to be identified with which method?
A. Autopsy
B. Nuclear DNA
C. Chromosome
D. Mitochondrial DNA
E. Photographic imposed
104. Mr X’s best method to identify?
A. Autopsy
B. Nuclear DNA
C.
D. Mitochondrial DNA
E. Superimposed...
109. What characteristic that make …mitochondria DNA in advantages in identification body after
composition
A. Non-mendelian mode of inheritance
B. Mother lineage inherited
C. High copy no
D. No recombination
E. Non-nucleated cell
110. One of the undoubled sign of brainstem death found on mrs
A. No pulse
B. Purple skin
C. No breathing
D. No pupil reflex
E. Body stiffness
113. Based on the doctor’s examination, what is the doctor supposed to do next?
A. To do cardio-pulmonary resuscitation
B. To consult to a forensic doctor
C. To make a report to the police
D. To write a death certificate
E. To embalm Mr X
114. A regular 16 year old high school student went to a gymnasium for the first time in order to build
his body muscles. After forcing himself to do some severe and strenuous exercise, he felt painful
muscle cramp at his upper limbs and back. No abnormalities is found but showed elevated serum
lactate dehydrogenase and creatine kinase. Exercising muscle actually consist of cyclic
attachment and detachment of which of the following structure?
A. Globular head region of myosin to F actin
B. Globular head region of myosin to G actin
C. Helix region of myosin to F actin
D. Helix region of myosin to G actin
E. G actin to F actin
For number 117 until 119, refer to scenario below:
A 60 year old man came to the hospital with breathing difficulty and poor condition. He said his weight lost about 10 kg in the last 3 months. Cough without sputum occurred last month. Physical examination was found normal vital sign, anemic conjunctivae, lung auscultation: ronchi (+) in the left chest. In the left extremity the doctor found 3 nodules, 2x3x1 cm in diameter, painless, well-border, left inguinal lymph node just palpable.
117. Which of the following is the most possible diagnosis of the patient?
A. Keratoacanthoma
B. Melanoma malignant
C. Basal cell carcinoma
D. Epidermoid carcinoma
E. Squamous cell carcinoma
118. In this patient, back nodules occurred due to which of the following?
A. Hemorrhagic crust
B. Increase of melanocyte
C. Inflammation
D. Necrotic tissue
E. Disturbance of lymph system
119. Considered of enlargement of inguinal node, which of the following process is the most likely to
occur in this patient?
A. Metastasis
B. Secondary infection
C. Inflammation of lymph node
D. Lymph system disturbance
E. Defense mechanism of the body
121. A 45 years old man came with chief complain chillness & redness most of his body for more than
6 months. Which of the following is most likely predilection (site) for above disease?
A. Sun exposed area
B. Traumatic area
C. Flexor area
D. Extensor area
E. Neck region
125. A man came into clinic with hoarseness since 6 month ago with slight dyspnea. PE show vocal
cord has a tumor with impair mobility and 4cm neck node at mid jugular. What is the likely “T”?
A. T1
B. T1s
C. T2
D. T3
E. T4
126. 56 year old male, has hoarseness for the last 6 months and slight dyspnea. On PE, his vocal cord
having a tumor with impair mobility and 4 cm neck node in mid jugular. No node in other part of
his body. The most likely “T” is?
A. T1
B. T1s
C. T2
D. T3
E. T4
128. Running for a long time decreases level of oxygen in muscle. Which of the following is used as
immediate substitute?
137. 42 year old male visit ophthalmologist complains: watery discharge from both eyes which
become puffy, red. What is most likely microorganism as cause of his condition
A. Bacteria
B. Virus
C. Arthropod
D. Fungi
E. Protozoa
140. A 19 year old girl come to Health Care Centre with pain, redness and tiredness, eyelid margin,
followed by small round tender area in duration diagnosis as stages. In gram +ve staining
appears?
A. +ve coccus, chain
B. +ve coccus, cluster
C. +ve coccus, pair
D. –ve coccus in tail
E. –ve rod, chain
148. Most effective treatment for malaria
A. Put the patient in a cool environment
B. Put the patient in a non air conditioned room
C. Avoid using a circulating air fan
D. Avoid bathing
E. Put the patient in a hot environment
FOR QUESTION 150-152, refer below :
A 60 years old man came to hospital with reddish skin in whole body and thick scales
150. Patient complained of thirst and weak as well as lack of urination. Which of the following skin
function is disturbed due to his complain?
A. Bacterial protection
B. Ultraviolet Radiation
C. Evaporation Protection
D. Trauma Protection
E. Heat Protection
152. Which of the following is cause above disease?
A. Acne vulgaris
B. Basal cell carcinoma
C. Parasite infection
D. Psoriasis vulgaris
E. Onichodyshoprin
156. 35 years old man had discrete, coin-shaped, erythematus patches 20-40mm wide, in which
papules and papulovesicles & exudation occurred. The patches were itchy and appears on his legs.
Diagnosis ?
A. ….neurodermatitis
B. Nummular dermatitis
C. Seborrheic dermatitis
D. Chronic Lichen Simplex
E. Erythroderma
162. A 25 years old woman, good health, went extraction of impacted 3rd molar teeth. In the evening,
she developed low grade temperature elevation. 2 days later, swelling of the bilateral
submandible. Her tongue was elevated, dyspnea, paroxysmus with evidence of respiratory
paralysis. Which of the following spaces is involved in this case?
A. Sublingual and submandibular
B. Sublingual and submental
C. Sublingual, submandibular and submental
D. Submandibular and submental
E. Sublingual only
165. A 40 years old male comes to PH centre with teeths mobility at anterior jaw. Since 4 months ago,
pain is absent. Gum bleeds easily. Clinical exam à many plaques, calculus, supra gingival and
subgingival, moderate alveolar bone loss. Diagnosis?
A. Chronic gingivitis
B. Chronic periodontitis
C. ANUG
D. Juvenile period
E. Periodontal abscess
174. Which one of the following statement is true about Strongyloid stercoralis life cycle?
A. Skin penetration – lungs – adult in intenstine – egg – filariform in soil – skin penetration
B. Skin penetration – lungs – adult in intenstine – egg – rhabditiform and filariform –
autoinfection, direct and indirect development external element
C. Skin penetration – adult in intenstine – rhabditiform in soil – skin penetration
D. Mouth penetration – lung – adult in intenstine – egg – rhabditiform in soil – skin penetration
E. Mouth penetration – lung – adult in intenstine – egg – filariform in soil – skin penetration
185. Adult male come to emergency room 2 hours after burn due to flume. He gets burn in part of face
and neck, half right arm, chest abdomen and whole left thigh. After PE doctor give oxygen and
infusion. Burn estimation for patient?
A. Burn grade I-II 30%
B. Burn grade II 46%
C. Burn grade II-III 38%
D. Burn grade II-III 45%
E. Burn grade II 45%
186. 10 y old, asymmetric of shoulder, diagnosis- idiopathic scoliosis, thoracolumbar area, 25 degree.
When do u treat scoliosis of spine w braces?
A. Patient is still growing
B. Patient reaches adulthood
C. When spine unbalance…
D. When complication to other organ
E. Patient has many complain
188. Burn on face, neck, right arm, groin. Given oxygen and infusion. Burn on arm takes how long to
heal?
A. 1 week
B. 2-3 weeks
C. 3 weeks
D. 3 months
E. 10 weeks
189. One year girl comes to out patient clinic with the red spot in the left upper eyes. The diameter is 3
cm, soft elevated from the skin, compressible, papuplar lesion w sharp border. It was a pin point
red spot at birth which most likely diagnosis of the patient?
A. Port wine stain
196. Besides the pain, what might be the other aspects of her problem that should be attended to be in
rehab?
A. Osteoporosis
B. Renal calculi
C. Muscle atrophy
D. Muscle weakness
E. Excess body weight
196. Frequently vasoconstrictors are combined with local anesthetics to delay the absorption of the
anesthetic for its injection site. What is the most likely employed agent?
A. Dopamine
B. Phenylepinephrine
C. Levonordephrine
D. Cocaine
E. Epinephrine
# The most possible diagnosis for the lesion at the epiphysis w soap bubble appearance
A. Osteoma
B. Osteosacroma
C. Osteochondroma
MDE HIS
1. The special types of lymphatic capillaries in the small intestine are called:
A. Lacteals
B. Ruggae
C. Pylorus
D. Fundus
E. Corpus
6. Lymph enters a lymph node through ------, filters through the ------, and leaves through ------.
A. Afferent vessels, sinuses, efferent vessels
B. Afferent vessels, efferent vessels, sinuses
C. Efferent vessels, afferent vessels, sinuses
D. Sinuses, afferent vessels, efferent vessels
E. Efferent vessels, sinuses, afferent vessels
10. Cause of SLE
A. Complement factor
B. Anti DNA antibodies
C. Immune complex factor
D. Autoantibody e.coagulation factor
A. Glucose-6-phosphate-dehydrogenase
B. Methemoglobin reductase
C. NADPH-oxidase
D. ALA synthase
E. Biphosphoglycerate mutase
B. Methemoglobin reductase
C. NADPH-oxidase
D. ALA synthase
E. Biphosphoglycerate mutase
14. Deficiency of this enzyme maintain heme Fe in its reducing state (Fe2+)
16. This enzyme is the key regulating enzyme in controlling heme biosynthesis.
16. This enzyme is the key regulating enzyme in controlling heme biosynthesis.
17. This enzyme has key role in producing microbicidal at the active leukocyte
19. A young woman come to Gynecology and Obstetrics Department at RSHS with complaint of
metro-menorrhagia. She also said that she bruise easily since child. Doctor suspect that
something is wrong with the platelet .
What is the initial lab evaluation for the platelet?
A. Platelet aggregation test
B. Platelet adhesion test
C. Platelet count
D. PF 3
E. Thromboxane A2
20. A boy with dengue fever came to the clinic. The doctor performs Torniquette test. What is the function?
A. To evaluate platelet count
B. To evaluate vascular function
C. To evaluate endothelial function
D. To evaluate vascular and platelet finction
22. The doctor suggest substation test to 5 year old boy because of prolonged after tooth extraction. He has bleeder’s history among the male family members. Substitution test result as follow:
APTT: 70 sec (N: 24-45), PT: 12 sec (N: 10-14), TT: 11 sec (N:11-15), NP: 40, AP:…, AS: 63. The most likely diagnosis of this boy is?
A. Factor V deficiency
B. Factor VII deficiency
C. Factor VIII deficiency
D. Factor IX deficiency
E. Factor x deficiency
23. 8 years old boy with prolonged bleeding after circumcision. PT normal, APTT 67 sec. Additional test suggest?
A. BT
B. Clotting time
C. Rumpell Lead Test
D. Substitution test
E. Platelet aggregation test
24. Biochemical changes during storage of blood?
A. Increase plasma K
B. Increase plasma Na
C. Decrease plasma Hb
D. Increase 2,3 DPG
E. Increase PH
25. Karen had a sore throat since 3 days before. Seeing her doctor, doctor suggests have CBC exam and the result; WBC: 15 000/mm3. What is the suitable term?
A. Leukopenia
B. Leukocytosis
C. Leukostasis
D. Leukognosis
E. Leukophrenia
26. How to calculate MCV?
- Hb/RBC X 10
- Ht/RBC X 10
- Ht/Hb x 100
- Hb/RBC X 100
- Hb/RBC X 1000
27. Calculate MCHC? Hb: 10g/dl, Hct: 31%
A. 9.5%
B. 27%
C. 32.2%
D. 33.3%
E. 35%
28. Hb 10g/dl, MCV: 67fl
What is the possible diagnosis?
A. Normochromic, normocytic
B. Hypochromic, macrocytic
C. Normochromic, microcytic
D. Hypochromic, normocytic
29. Platelet count is 50000 mm3. Name of this condition?
- Thrombocytopenia
- Thrombocytosis
- Thromboasthrenia
- Thrombopatnia
- Thrombosis
31. What is the appropriate result?
Ans: ↓iron, ↑TIBC, ↓ferritin
33. 7 years old boy presented with fever PE shows skin pale, lymphadenopathy and hepatosplenomegaly. Hb : 3.9 (N 12-16), RBC : 1.61 (N 3.8-5.2), PCV normal, Platelet 26000 (N 150000- 440000), WBC 41000 (N 4000-11000). Differential count : blast 68%, PMN 8%, lymphocyte 24%, MCV, MCH. MCHC normal. Findings suggestive of:
- Hodgkin Lymphoma
- CML
- Leukemoid reaction
- ALL
- CML
34. 62 years old fatigue, pallor.
Physical examination: Skin pallor, hepatosplenomegaly.CBC :
Hb
RBC
Platelet
WBC
Myeloblast 3%
Promyelocte 7%
Myelocyte 28%
Metamyelocyte 4%
A. Polycythemia vera
B. Leukemia reaction
C. Chronic lymphocytic leukemia
D. Chronic myelocytic leukemia
35. A girl,skin develop itchy erythematous ….. .went to botanical garden. What is the type of
hyperseneitivity?
B. Hypersensitivity Type II
C. Hypersensitivity Type III
D. Hypersensitivity Type IV
E. No type
36. 12 years old brought to pediatrician because of itchy, blistering rash on his calves and
forearm. Rash developed 24 hours after returned from a weekend camping. Suspect lesion is
caused by poison ivy. Most likely prominent component causing skin lesion.
A. T cell
B. B cell
C. Mast cell
D. Eosinophil
E. Basophil
37. An increase in Hb A2 is found in?
- IDA
- Aplastic anemia
- Megaloblastic anemia
- Sideroblastuc anemia
- Thalassemia
39. In hemolytic anemia there will be:
- Monocytosis
- Lymphocytosis
- Reticulocytosis
- Eosinophilia
- Basophilia
40. In anaplastic anemia you will find:
- Pancytopenia
- Polychromasia
- Poikilocytosis
- Anistocytosis
- Normoblastosis
41. 11 years old male presented with chief complaint of epistaxis, His mother stated that he never got sick before this in his entire life. No history of recent viral infection. No family history of bleeding disorder. No organomegaly. Blood Test : Hb, RBC, PCV, WBC, MCV, MCH,MHCH are all normal. Platelet count: 10000/mm3,Differential count : PMN 47%, lymphocytosis 39%, monocyte 14%,Blood smear: RBC morphology (normocytic,normochromic), WBC (within normal limit),Platelet (Increase in size). Coagulation test : APTT and PT normal. What is his diagnosis?
- Secondary thrombocytopenic
- Thrombotic thrombocytopenic purpura
- DHF
- ITP
- Drug induced thrombocytopenia
42. Which physical examination result causing a blood donor rejection?
- Weight of 55kg
- Pulse of 75bpm
- Temperature of 36.5
- Diastolic pressure of 110mgHg
- Hemoglobin of 13.5 g/dl
44. A patient with platelet count 350x10/L, bleeding time 12 min
- Increase platelet production
- Decrease platelet production
- Increase platelet destruction
- Decrease platelet destruction
- Defective platelet function
45. Neutrophilic granule development occurs in bone marrow. Which of the following stages of
development of that cell?
A. Promyelocyte, myeloblast, myelocyte, metamyelocyte, band n segmented neutrophil
B. Myeloblast, promyelocyte, myelocyte, metamyelocyte, band n segmented neutrophil
C. Myelocyte, myeloblast, promyelocyte, metamyelocyte, band n segmented neutrophil
D. Myeloblast, promyelocyte, metamyelocyte, myelocyte, band n segmented neutrophil
E. Segmented neutrophil, band, metamyelocyte, myelocyte, promyelocyte, myeloblast
47. A 20 year old man had been complaining of fatigue. He looks pale n has some large bruises.
Hepatomegaly was present, but lymphadenopathy was absent. A routine CBC reveals Hb:
10g/dl, WBC: 110000 mm3, platelet : 35000, but the differential count was as follows: blast
cells 53%, promyelocyte 12 %, myelocyte 8%, metamyelocyte 6%, band 4%, segmented
neutrophil 10%, lymphocyte 7%, Auer rod was seen in many of the blast.
What is the most possible diagnosis?
A. Acute lymphoblastic leukemia
B. CLL
C. Acute Lymphocytic Leukemia
D. Acute Myeloblastic Leukemia
E. Acute myelocytic Leukemia
48. 35 years old women has wheals on her arm, trunks, neck 2 hours after eating shrimp has stinging and itching sensation. Which immuglobulin is involved?
- IgA
- IgE
- IgM
- IgD
- IgD
49. A 11 year old boy came to Dermatology Department with chief complaint itching skin rashes
on both elbows. He also complained about dry skin on limbs. His mother has history allergy
to seafood n cat danders. The dermatological status reveals erythematous papules, scales n
lichenification on both elbows. Which most common predilection site of this case?
A. Face
B. Scalp
C. Diaper area
D. Extensor area
E. Flexural fold area
50. 40 year old man had recurrent blister on his body since 1 year ago. No itching. Nicolski sign
positive. No history of drug allergy. His lesion was improved with corticosteroid. What is
the histopathology of the case above?
A. Intraepidermal blister
B. Subepidermal blister
C. Infrabasal blister
D. Infradermal blister
E. Intradermal blister
53. Antigen will be presenting to T cell by:
- B cell
- APC
- Keratinocyte
- Neutrophil
- ICAM-1
54.52 years old man with burning & stinging dusky red macule on lip and genital. Occur after
taking ibuprofen.
Ans: Fixed drug eruption
59. A 24 year old woman comes to hospital with chief complaint of redness itchy patches and
some blisters on her neck. For a week, she has redness itchy patches and some blisters on her
neck, collar area which spread rapidly involving upper chest. Since 2 weeks ago, she has
been using imitation necklaces. 6 months ago, she suffered redness itchy patches around her
wrist using new bracelet. Physical examination and lab findings are within normal limit. The
result of patch test is 3+++ (positive) to nickel. Which of the following is most likely
diagnosis?
A. Contact dermatitis
B. Irritant contact dermatitis
C. Atopic dermatitis
D. Allergic contact dermatitis
E. Seborrheic dermatitis
62. The plasma cell which is secreting immunoglobulin developed from:
A. T lymphocyte
B. Mast cell
C. Colony forming cell
D. Fibroblast
E. B lymphocyte
66. Antigen specific .. that occur in graft-rejected as a result from…
A. T cell
B. Plasma cell
C. Monocyte
69. A 60 years old woman comes to your clinic with chief complain of physical weakness since 2 months ago. She looks pale and PE you find papillae atrophy of hair tongue and spoon nail. What is the most important factor in managing the patient?
A. Eliminate the cause
B. Whole blood transfusion
C. With supplement
D. Hematitric agent theraphy
71. 40 years old man evaluate anemia,undergoes operation for his internal hemorrhage. Lab
exam-Hb 8 g/Dl,conjunctiva pale,tongue papilla atrophy,spoon nail. What is the other
possible PE?
A. Moist hand
B. Brittle hair
C. Clubbing finger
D. Hepatomegaly
E. Splenomegaly
73. 14 years old male complained joint bleeding on left leg. Past history shows he undergoes
circumcision when he was 7 years old. Lab shows Hb 14g/Dl,WBC 8000ml,platelet
225000ml. What is the most likely explanation?
A. Quantitative platelet disorder
B. Qualitative platelet disorder
C. Coagulation disorder
D. Thrombosis disorder
E. Vascular disorder
76. If bone marrow smear show cellular hypoplasia, which is most likely to predict the prognosis?
- Hb
- Ht
- RMC
- WBC
- Platelet
77. A patient with aplastic anemia due to bone marrow hypoplasia. What is the type of
transfusion best given to him?
A. Full whole blood
B. Pack red cell
C. Fresh frozen plasma
D. Wash red cell
E. Cryoprecipitate
83. 50 yr woman, painless neck swelling. Fever,night sweat, for last 6 month. No history of
bleeding. PE- 4cm left anterior cervical lymph node, multiple right anterior, right cervical
lymph node, no palpable axillary lymph node, 2-3 cm & 3 cm right inguinal lymph node, non
tender, mobile, oropharynx clear, has splenomegaly . What appropriate treatment??
A. Antibiotic
B. Cytostatic
C. Tuberculostatics
D. Operation
E. Radiation
85. A 50 years old man has progressive weakness and dyspnea with exertion for 3 months. He
appears malnourished and conjunctivae are pale and there are scatterd petichae. Lab study
shows: Hb 6 g/dl, leucocyte 3500 mm3 with hypersegmented neutrophils, platelet 600000,
MCV 115 fL, and reticulocyte count 0.5%.
Bone marrow smear shows:
A. Erythropoietic hypoplasia
B. Granulopoietic hypoplasia
C. Thrombopoietic hypoplasia
D. Giant stab cells
E. Giant platelet
Bone marrow smear shows:
A. Erythropoietic hypoplasia
B. Granulopoietic hypoplasia
C. Thrombopoietic hypoplasia
D. Giant stab cells
E. Giant platelet
87. 15 years old boy,conjunctivae anemic,lymph nodes palpated on right neck,1-3 cm in
diameter,rubbery,not painful. There are also hepatosplenomegaly and bruising on his leg.
Lab findings are Hb 8g/Dl,WBC 3000/mm3,platelet 6000/mm3. Peripheral smear :
pancytopenia and smudge cell,bone marrow : blasts are 30%,1-2 nucleoli. What is the
prognosis of this case?
A. Curable with radiotherapy
B. Curable with chemotherapy
C. Curable with chemoradiation
D. Curable with immunotherapy
E. Curable with antibiotics
93. If the biopsy of the lymph node reveals no Reed Sternberg cells and the abdominal
examination shows paraaortic lymph node enlargement,what is the most likely diagnosis?
A. Non Hodgkin’s lymphoma stage II
B. Non Hodgkin’s lymphoma stage III
C. Hodgkin’s lymphoma stage III
D. Hodgkin’s lymphoma stage II
E. Non Hodgkin’s lymphoma stage IV
96. A 24 years old man,intravenous drug user,comes to the Internal Medicine Department for
general check up. From the lab examination reveals HIV positive. Which of the following
gene is most likely need for replication in above virus?
A. gp 120
B. tat
C. pol
D. gp 41
E. p11
97. Which of the following class Ig is present in highest in concentration in blood of human
newborn?
A. IgG
B. IgD
C. IgM
D. IgE
E. IgA
98. Component of HIV that enhances penetration into host cells
A.gp120
B.gp41
C.gp24
D.p6
E.p55
99. If an individual was genetically unable to make secretory component, which Ig will be
affected?
A. IgG
B. IgM
C. IgA
D. IgD
E. IgE
100. The rate of class I MHC in immune response is to present antigen from..
A. Infected-cell to Tc cell
B. T-CD4 to APC
C. Tc cell to infected-cell
D. APC to Bcell
E. T cell to B cell
101. A 24 years old male, IV drug user, lab result shows HIV +ve. Which one of the following
cell killed by the virus?
A. B lymphocyte
B. Lymphocyte stem cell
C. CD4 + T lympocyte
D.CD8 + Tlymphocyte
E. Natural killer (NK) cells
102. Antigen that come from human body substance & has ability to induce immune response to
human body self is called?
A. Exogenous antigen
B. Homologous antigen
C. Autologous antigen
D. Forssman antigen
E. Heterologous antigen
103. 24 years old man, IV drug user comes to Internal Medicine Department for general
checkup.Lab exam reveals HIV +ve. Which of the following is the most likely characteristic
of above virus?
A. Oncogenic virus genus
B. Genome is –ve genus
C. Single stranded RNA
D. Genome is double stranded DNA
E. Does not have envelope
104. The highest concentration of Ig in gut secretion is?
A. IgG
B. IgA
C. IgM
D. IgD
E. IgE
105. In Indonesia a women with running nose, sneezing, nasal obstruction might suffer these due to which inhalant?
- House dust mite
- Pollan
- Cat dander
- Dog dander
108. 33 year old man, bilateral nasal obstruction, on and off runny nose felt for 6 month , worst
in morning and cold, no fever and headache or nasal itching, PE- boggy edematosus,
mucosa in lateral wall. Diagnosis?
A. Fungal arthritis
B. Allergic arthritis
113. Leukocytes characterized by hyperpigmentation of the nucleus with majority of neutrophil
being bilobed or monolobed. What is the name of the cells?
A. Chediak Higashi
B. Pelger Huet
C. Aider-Reily
D. May-Hegglin
E. Macropolisit
118. The production of the new T Lymphocytes in the thymus occurs in which of the following
of the region?
A. Deep medulla
B. Thymic nodules
C. Superficial cortex
D. Corticomedullary junction
E. Thymic corpuscles
121. Anaphylaxis reaction. Hypersensitivity type?
A.1
B. 2
C. 3
D. 4
122. Cholinergic -- swimming at the beach
123. Lymphoid organ that developed w/o influence of antigen
A. Bone marrow
B. Spleen
C. Thymus
D. Bursa
E. Yolk sac
126. 12 year old boy underwent Skin Prick Test. This test determines allergic reaction through immediate wheal and flare skin testing response. Which reaction can be diagnosed by this test?
A. Non Ig E type 1 hypersensitivity
B. Ig E type 1 hypersensitivity
C. Ig E and non Ig E type 1 hypersensitivity
D. Hypersensitivity type 2
E. Hypersensitivity type 3
128. Due to hematologically similarity, thalassemia trait often misdiagnosed as
A. IDA
B. Aplastic anemia
C. Megaloblastic
D. Sideroblastic anemia
E. Auto-hemolytic anemia
129. Which of the following is the indication for elective caesarean section operation?
A. Maternal HIV infection
B. HIV standard precaution
C. HIV perinatal death prevention
D. HIV intrauterine death prevention
E. HIV transversal transmission prevention
131. Which of the following ARV regimen should you offer the baby according to Indonesia
Department of Health PMTCT programmed?
A. AZT + 3TC + NVP, for 6 weeks
B. AZT + 3TC + EFV, for 6 weeks
C. AZT + 3TC, for 6 weeks
D. AZT, for 6 weeks + NVP single dose
E. AZT +EFV, single dose
132. Mother with SLE, daughter with NLE. What is the auto antibodies passively transferred from mom to daughter?
A. Ig G
B. Ig D
C. Ig E
D. Ig M
E. Ig A
133. Neonatal Lupus Erythematous. Which of the following is the characteristic of the distribution of cutaneous lesion during recurrence of this disease?
- Face
- Acral
- Diffuse
- Extensor area
- Photo distribution
136. 1st week of life, Lulu born from mom with SLE. Lulu suffered NLE result from maternal auto antibody?
A. Ig A
B. Ig D
C. Ig E
D. Ig G
E. Ig M
137. Which of the following is the usual reserved maternal autoantibody?
A. Anti-DNA
B. Anti-nucleic acid
C. Anti-Ro
D. Anti-RN
E. Anti-SM
138. Clinical manifestation present in Neonatal Lupus Erythematosus?
- Congenital heart block
- Cutaneous lesion
- Pulmonary involvement
- Neurology involvement
- Thrombocytopenia
139. A 2 year old girl: underweight. Hb 7.9g/dl, Hct 22%, eosinophilia, ↓MCV, ↓MCH. What is the diagnosis?
Ans: IDA
140. On a routine well- child examination, a 3 year old child is noted to be quite pale. On physical examination, the patient is underweight n other findings are normal. Laboratory results are as follows: Hb 7.2 g/dl, hematocrit 23%, platelet n leukocyte are normal, eosinophilia in differential leukocyte count, low MCV, MCH n reticulocyte.
Which of the following is the most likely diagnosis?
A. Hypochromic, microcytic, anipoikilocytosis with abundant of pencil cell
B. Hypochromic, microcytic, anipoikilocytosis eith abundant of target cells
C. Normocytic, normochromic, anipoikilocytosis with abundant of pencil cell
D. Normocytic, normochromic, anipoikilocytosis with abundant of target cell
E. Macrocytic, normochromic, anipoikilocytosis with abundant of target cell
141. In IDA, this condition will exhibit:
- ↑ serum iron, ↓ TIBC, ↓ transferrin
- ↓ serum iron,↑ TIBC, ↓ transferrin
- ↓ serum iron,↑ TIBC, ↑ transferrin
- ↑ serum iron,↑ TIBC, ↑ transferrin
- ↑ serum iron,↑ TIBC, ↓ transferring
143. Which situation inhibits the release of mediator from mast cells?
A. Activation of guanocyclate
B. Interaction due to cross linkage of Ig E to antigen on mediator
C. ↑ cAMP
D. ↑ cGMP
E. Breakdown cAMP to 5’AMP
145. Which of the following is the most likely sign and symptom in allergic rhinitis?
- Facial twitching and grimacing
- Allergic salute
- Hyperemic nasal mucous
- Sneezing
- Dennie Morgan Fold
146. Agent dampen immune response in organ transplant and autoimmune response
A. Levamisole
B. Interferons
C. Sinolinus
D. IL2
E. Thalidomide
148. What is antihistamine exactly?
A. An H-1 antagonist
B. An H-2 antagonist
C. An H-3 antagonist
D. An H-1 and H-2 antagonist
E. An H-1, H-2 and H-3 antagonist
149. How is the MOA of antihistamine?
- Competitive inhibition of histamine, by irreversible binding to H1 receptor
- Competitive inhibition of histamine, by reversible binding to H1 receptor
- Competitive inhibition of histamine, by irreversible binding to H2 receptor
- Competitive inhibition of histamine, by reversible binding to H2 receptor
- Competitive inhibition of histamine, by irreversible binding to H1 & H2 receptor
151. How do the antihistamine work best in allergic disease?
- Preventing rather than reversing histamine action on target tissue
- Reversing rather than preventing histamine action on target tissue
- Equally reversing and preventing histamine action on target tissue
- Preventing rather than reversing histamine action on mast cell
- Reversing rather than preventing histamine action on mast cell
152. Which of the following can be given simultaneously with histamine, metabolized through hepatic cytochrome p450 pathway?
- Erythromycin
- Antidepression
- Amoxicillin
- Ketoconazoles
153. What might corticosteroid be not beneficial at all in the management of anaphylaxis?
- Acute early phase reaction
- Acute late phase reaction
- Prevention of protracted anaphylaxis
- Prevention of biphasis anaphylaxis
- Part of frequent idiophatic anaphylactic prevention
154. Where is exactly the site of action of glucocorticoid in allergic infection?
- Inhibiting the APC by macrophage to T cell
- Inhibiting IgE isotype switching in plasma cell
- Inhibiting leukotrines binding to its receptor
- Inhibiting …… to liberate Arachidonic Acid
- Inhibiting allergen cross linking to IgE on mast cell
156. Which of the following drugs need intrinsic factor?
- Folic acid
- Cyanocobalamin
- Pyridoxin
- Riboflavin
- Iron
157- What is the influence of CFU-E n …..
Ans: Erythropoietin
161. Polyclonalantibody differs from monoclonal antibody in several ways. Which following is
the difference?
A. Polyclonal Ab produced by advent hybridoma tech
B. Polyclonal more effective than monoclonal
C. Polyclonal safer than monoclonal
D. Polyclonal is generated by injecting thymocte into animal
E. Polyclonal not usually combined with immunosuppressive agent
162. Which of the following statements concerning adaptive immune is correct?
A. Adaptive immune is primitive
B. Does not require priming
C. Depends upon antigen exposure
D. Adaptive immunity is natural immunity
E. Broadly reactive
165. Which of these following statements regarding the effect of H-I receptor antagonist is true?
- Poorly absorbed after oral administration
- Have limited use in allergic bronchospasm
- All have muscarinic cholinergic activity
- MOA induce microsomal enzyme
- Causes increase in apoptosis
166. Treatment ITP
Ans: Corticosteroid
174. Which of the following is drug of choice for this case?
A. Corticosteroid
B. Plasmapharesis
C. Neuroprotectan
D. Immunoglobulin
E. Neurotropics
184. Which is the most effective Ig that produce to protect body from toxiceous infection such as
diphtheria
A. IgG
B. IgM
C. IgE
D. IgD
E. IgA
185. Cytotoxic T cells recognize infected cell with antigen associated with
A. TCR
B. BCR
C. Antibody
D. Class I MHC
E. Class II MHC
186. 30 year old man, allergic rhinitis and unstable BP, which decongestant should be avoided?
A. Terfanadine
B. Psedoephedrine
C. Phenylpropanolamine
D. Azetamidine
E. Cromycin
186. A 30 years old man is the allergic rhinitis patient. He comes to ent clinic to follow up his condition bcoz his severe nasal obstruction. He has history unstable BP Which of the following decongestant should be avoided
A. Terfanidine
B. Pseudoefedrine
C. Phenylpropanolamine
D. Azetamizole
E. Comolyn
199. Prolonged bleeding time is due to
A. Low FVIII
B. Low liver function
C. Low vitamin K level
D. High aspirin intake
E. Oxalated blood
MDE CVS
1. A patient has sustained lower limb trauma that has damage the posterior tibial artery.Therefore,you have to be concerned about the blood supply to the:
A. Posterior thigh only
B. Sole of the foot only
C. Lateral compartment of the leg only
D. Posterior compartment of the leg only
E. Posterior compartment of the leg and the sole of the foot
2. The chief deep veins responsible for deep vein thrombosis is..
A. obturator vein
B. deep femoral vein
C. small saphenous vein
D. great saphenous vein
E. anterior & posterior tibial vein
3. As a pathologist,you must examine the AV bundle histologically.In which of the following tissue samples will you find the AV bundle?
A. Left atrium
B. Right atrium
C. Interatrial septum
D. Muscular interventricular septum
E. Membranous interventricular septum
A. Posterior thigh only
B. Sole of the foot only
C. Lateral compartment of the leg only
D. Posterior compartment of the leg only
E. Posterior compartment of the leg and the sole of the foot
2. The chief deep veins responsible for deep vein thrombosis is..
A. obturator vein
B. deep femoral vein
C. small saphenous vein
D. great saphenous vein
E. anterior & posterior tibial vein
3. As a pathologist,you must examine the AV bundle histologically.In which of the following tissue samples will you find the AV bundle?
A. Left atrium
B. Right atrium
C. Interatrial septum
D. Muscular interventricular septum
E. Membranous interventricular septum
4. Blockage of artery to AV node typically arise from?
- Circumflex artery
- Right coronary artery
- Right marginal artery
- Anterior interventricular artery
- Posterior interventricular artery
Label based on embryonic structure
6) buccopharnygeal membrane
7) cardiogenic area
8) dorsal mesocardium
9) heart tube
10) pericardial cavity
6) buccopharnygeal membrane
7) cardiogenic area
8) dorsal mesocardium
9) heart tube
10) pericardial cavity
Question 11-15
A. TOF
B. Aortic stenosis
C. Transposition of great arteries
D. Patent AV canal
E. Patent truncus arteriosus
11. Superior n inferior endocardial cushion fail to fuse
12. Failure of dvlpment of aorticopulmary...
14. Failure of articopulmonary septum to develop spirally
15. Fusion of semilunar valve cusps in aorta
16. Label histo endocardium
17. Subendocardium (kne match ngn gmbr histo)
A. TOF
B. Aortic stenosis
C. Transposition of great arteries
D. Patent AV canal
E. Patent truncus arteriosus
11. Superior n inferior endocardial cushion fail to fuse
12. Failure of dvlpment of aorticopulmary...
14. Failure of articopulmonary septum to develop spirally
15. Fusion of semilunar valve cusps in aorta
16. Label histo endocardium
17. Subendocardium (kne match ngn gmbr histo)
18. Label kn mane myocardium
19. Label purkinje fibers
20. Label cardiac muscle fibers
19. Label purkinje fibers
20. Label cardiac muscle fibers
Question 21-25
(Histology of blood vessel…pic from lab)
21. Endothelium
22. Internal elastic lamina
23. The intima layer of veins
24. Tunica media of artery
26. Endocardium of mitral wall
27. Endocardium of ventricle
28. Subendocardium ventricle
29. Core dense connective tissue of mitral valve
30. Myocardium
- LDH
- SGOT
- DGBH
- CKMB
- Troponin
31. Assist in diagnosing reinfarction
32. This test is characteristically for qualitative test
33. Remain positive on 12th day post infarction
34. Currently it is not used as cardiac marker, but it is most specific test for detecting liver
abnormalities
35. This test sensitively for acute coronary syndrome but rapidly clear from blood circulation
36. Mass examination is better than activity examination
- AMI
- Pericarditis
- Stable angina
- Unstable angina
- Cardiac tamponade
37. Myocardial damage has occurred, even though in a small degree
38. It may rapidly progress to heart attack
39. Pain quickly goes away by sublingual Isosorbide Dinitrate
40. Upon auscultation the friction rub can be heard
- Sodium
- Calcium
- Chloride
- Potassium
- Magnesium
41. It is a physiologic calcium antagonist
42. Large amount of this mineral can cause muscle contraction
43. Majorly found in the extracellular fluid
44. It is a coenzyme
45. It is an intracellular cation
- Low sensitivity examination
- Low specificity examination
- High sensitivity examination
- High specificity examination
- High sensitivity and specificity examination
46. Act in screening test
47. Act in diagnostic test
48. Shows negative results, strongly indicates patient do not have disease
49. Shows positive results, strongly indicates patient have disease
50. Actually it is only theoretically examination
A. ECG
B. Treadmill
C. Chest X-ray
D. Echo
E. Cardiac perfusion scan
53. Check for the size of myocardial damage
54. If ECG exam is unclear this test has to be performed
A. Nifedipine
B. Dipyridamole
C. Nitroglycerine
D. Acetyl salicylate
E. Isosorbic dinitrate
56. Used for inpatient angina
57. The effect is decreased BP
58. High dose prevent blood coagulation
60. Drug used for out patient angina
61. The PR interval of an ECG indicates:
- The duration of cardiac action potential
- The repolarization of ventricular myocardium
- Conduction of depolarizing impulse of atrium
- The refractory period of atrial myocardial cell
- Atrioventricular conduction delay
62. Conduction of impulses through the AV node:
A. is characterized by a reduce conduction velocity
B. Responsible for the delay between ventricular depolarization
C. Is depressed during sympathetic stimulation
D. Is facilitated by virtue of the increased diameter of the conducting fibers
E. Is reflected by the QT interval of ECG
69. Carotid sinus massage sometimes stops supraventricular tachycardia because:-
- It decreses symphatetic discharge to the SAN
- It increases vagal discharge to the SAN
- It increases vagal discharge to the conducting tissue between the atria and ventricles
- It decreases symphatetic discharge to the conducting tissue between the atria and ventricles
- It increases the Refractory period of the ventircular myocardium
70. The first heart sound is caused by:-
- Ventricular filling
- Closure of the aortic and pulmonary valves
- Vibration in the ventricular wall during systole
- Closure of the mitral and tricuspid valves
- Retrograde flow in the vena cava
72. The work performed by the left ventricle is substantially greater than performed by right ventricle because in the left ventricle
A. The wall is thicker
B. The contraction is slower
C. The stroke volume is greater
D. The preload is greater
E. The afterload is greater
73. Second AV block:
A. Ventricular rate lower than second rate
B. Ventricular ECG complex is distorted.
C. There is increase incidence of ventricular tachycardia
D. Stroke volume decrease
E. Cardiac output increase
74. Normally have prominent prepotentially?
A. SA node
B. Bundle of HIS
C. Ventricular muscle cell
D. Purkinje fibers
E. Atrial muscle cell
Ali | Amir | |||
10 hours | 24 hours | 10 hours | 24 hours | |
CK | 748 | 850 | 735 | 790 |
CK-MB | 82 | 75 | 25 | 23 |
LDH | 129 | 182 | 106 | 167 |
76. Tissue damage cause increase serum of enzyme due to:
A. Decrease ability to degrade serum enzyme
B. Decrease ability to absorb serum enzyme
C. Excreted cystolic enzyme
D. Synthesis more enzyme
E. Leak of cystolic enzyme
77. Who suffers mostly from cardiac problem?
A. Ali because CK-MB/CK decrease after 24 hours
B. Ali because CK-MB/CK ratio increase
C. Amir because total CK is high
D. Amir because CK-MB/CK ratio is high
E. Both because both their cardiac markers level increase
78. Both men chest pain because?
A. ATP deprived
B. Glucose deprived
C. CO2 accumulate
D. Lactate accumulate
E. Myosin degrade
81. Appearance of ECG in cor pulmonale
A. Highly sensitive
B. Widened P wave
C. Show LBBB
D. QR inferior leads
E. Decreased R/S ratio in V6
84. High dose of isoniazide dinitrate can cause tachycardia that result from
A. Its direct effect on heart as inotropic agent
B. Its direct effect on heart as chronotropic agent
C. Its toxic effect on myocardial muscle
D. Its compensatory effect on a decreasing stroke volume
E. Its effect directly on AV node on cardiac muscle
85. Baroreceptor and presseroreceptor are located in
A. Heart
B. Arteries
C. Brain
D. Kidney
E. Veins
86. ‘aschoff bodies’ are present predominantly in which of these pathogen infections?
A. Staphylococcus aureus
B. Coxeilla
C. Streptococcus viridans
D. Staphylococcus epidermidis
E. Streptococci group A
87. A 30 years old man, heavy smoker has a small painful ulcer in his left fifth toe. The painful ulcer has been appearing there since 1 month. Blood examination within normal limit, except WBC a little bit high than normal value. He has a temporary redness and numbness in his leg. Arteriographic findings show and occluded left popliteal artery with very poor collateral vessel.
What is the cause of the symptom in his leg vein of the patient?
A. Drug intoxication
B. Allergic vein disease
C. Phlebodegeneration
D. Vein blood cell aggregation
E. Phlebitis
89. What is the best advice to the patient??
A. Decrease glucose intake
B. Decrease fat intake
C. Stop smoking
D. Take analgesic daily
E. Bed rest
90. What is the cause of painful ulcer in the patient above?
A. High WBC
B. Decrease fat intake
C. Ischemia
D. Not taking analgesic
E. Not enough bed rest
92. When during diastolic, a blowing murmur of relatively high pitch and with a swishing quality is heard maximally over the left sternal border of the 3rd Intercostal space. This is called, the murmur of :
A. Aortic regurgitation
B. Aortic stenosis
C. Mitral regurgitation
D. Mitral stenosis
E. Patent ductus arteriosus
A. Aortic regurgitation
B. Aortic stenosis
C. Mitral regurgitation
D. Mitral stenosis
E. Patent ductus arteriosus
93. What is the main difference between rheumatic heart disease (RHD) & acute rheumatic fever (ARF)?
A. In ARF, there is an elevated ESR
B. In RHD, there is a prolonged P-R interval
C. In ARF, there is a history of athralgias
D. In RHD, there is an evidence of chronic heart disease
E. In ARF, there is an evidence of erythema marginatum
94. Which drug has remodeling effects?
A. Digitalis
B. Angiotensin II
C. Vasodilator
D. Alpha adrenergic
E. Beta adrenergic
95. Abnormal ECG?
A. Atrial flutter with ventral pacing pvc
B. Atrial flutter with ventral consecutive pvc
C. Atrial fibril with ventral pacing pvc
D. Atrial fibril with ventral consecutive pvc
E. Atrial fibril with ventral aberration pvc
96. The most important diagnostic tools in peripheral arterial disease is
A. Magnetic resonance imaging (MRI)
B. Arteriography
C. CT scan
D. Phletysmography
E. Color duplex scan
97. A 40 year old man have painless chronic swelling on the left leg, noted since 8 months ago. Skin of leg shows thickening and non pitting edema. If this is primary lymphedema, what is correct diagnosis?
A. Lymphedema tarda
B. Congenital lymphadema
C. Lymphadema precox
D. Lymphadema due to filariasis
E. Infected lymphadema
98. Major criteria of the Duke Criteria for clinical diagnosis of infective endocarditis
A. Predisposition
B. Fever over 36’
C. Vascular phenomenon
D. Immunologic phenomenon
E. Positive blood culture
99. A 58 years old man was hospitalized with chronic cugh and progressive shortness of breath which have increase markedly since 1 week ago. He had been heavy smoker since youth. On examination, he was dyspneic and slightly cyanotic. His chest is hyperinflated and wheezing as well as scattered moist rales were heard. The 2nd pulmonic component of 2nd heart sound has increased. His liver enlarged and there was bilateral ankle edema. The most likely finding in chest radiography?
A. An enlarged LA and RV
B. A widened main pulmonary artery and emphysema
C. Chronic bronchitis
D. Pulmonary TB and pericarditis
E. Pulmonary edema
101. Bloody pericardial fluid maybe due to neoplasm,pericardial injury,post MI and infections.
The bacteria responsible for bloody pericardial fluid in infective pericarditis is
A. Streptococcus viridians
B. Legionella
C. Mycobacterium tuberculosis
D. Streptococcus pneumonia
E. Pneumococcus
102. Anatomic defect which causes acyanotic congenital heart disease is a
A. TOF
B. VSD
C. Truncus arteriosus
D. Double outlet RV
E. Tricuspid atresia
103. Clinical manifestation that usually found in small VSD is
A. Dyspnea
B. Cyanosis
C. Decrease exercise tolerance
D. Normal growth and development
E. Heart failure
104. Heart auscultation of ASD reveals
A. Widely fixed and split S2
B. A narrowly split S2
C. A single S2
D. A paradoxical split S2
E. Normal splitting S2
105. From ECG below,which one shows rare ECG in unstable angina but with harmful prognosis?
A. ST depression
B. Normal ECG
C. Nondiagnostic ECG
D. ST elevation
E. T inversion
A 60 years old man smoker presents to the emergency department with dyspnea,cough and fever since one week. He has been increasingly dyspneic since 5 years old. He has frequent bouts of cough with sputum production. On examination his RR is 32/min,temp ?. Wheezing and most rales are heard over the lungs. A left precordial heave is found. His liver is 4 cm below the costal arc with a positive hepatojugular reflux.
112. Which of the following is the most important exam to establish diagnosis of this patient?
A. Sputum exam and BGA
B. Chest x-ray and ECG
C. Chest x-ray and liver function test
D. Liver function test and cardiac catheterization
E. Cardiac markers and sputum exam
A 55 year old man died suddenly when he was watching a badminton final match.A few hours before the game was started he complained of a chest pain.
113. Which of the following is the most frequent cause of death in such a case?
A. Atherosclerotic of the coronary main branch
B. Atheroscelrotic of the coronary left branch
C. Atheresclerotic of the coronary right branch
D. Endocarditis
E. Koch pulmonum
115. Which of the following ECG changes are tyipical for acute pericarditis?
A. Inverted T waves while ST segment still elevated
B. Localized convex ST segment elevation
C. Diffuse concave St segment elevation
D. Frequent PVCs
E. First degree AV block
113. Which of the following is the most frequent cause of death in such a case?
A. Atherosclerotic of the coronary main branch
B. Atheroscelrotic of the coronary left branch
C. Atheresclerotic of the coronary right branch
D. Endocarditis
E. Koch pulmonum
115. Which of the following ECG changes are tyipical for acute pericarditis?
A. Inverted T waves while ST segment still elevated
B. Localized convex ST segment elevation
C. Diffuse concave St segment elevation
D. Frequent PVCs
E. First degree AV block
A 22 years old women was suddenly dead after she delivered her first baby. The doctor examined for any bleeding but found nothing significant. During the delivery, her blood pressure was slightly increased up to 150/100 mmHg. Nevertheless, her prenatal care record showed that her blood pressure was normal and no history of hypertension. Her aunt was also dead in similar fashion. The doctor suspected that she had had ruptured aneurysm
116. Which of the following is the most suitable mechanism?
- Deep vein thrombosis
- Cathecolamine release
- Central vasodilation
- Thromboembolism
- Varicose vein
120) Which of the following drug has the mechanism of action as an inhibitor of Na+ K+ ATPase and has a positive inotropic effect?
A. Dipiridamol
B. Heparin
C. Digoxin
D. Propanolol
E. Nifedipine
121. Which of the following substances mediate pulmonary vasodilation?
A. Norepinephrine
B. Acidosis
C. Tromboxane A2
D. Nitric oxide
E. Endothelin
123. Best index for preload
A. Blood volume
B. Pulmonary capillary wedge pressure
C. Central venous pressure
D. Left ventricle end diastolic volume
E. Left ventricle end diastolic pressure
124. a man exercise for 1 hour.what happened? (lbeh kurg la) hehe ad dlm pass year..
A. Blood volume
B. Pulmonary capillary wedge pressure
C. Central venous pressure
D. Left ventricle end diastolic volume
E. Left ventricle end diastolic pressure
124. a man exercise for 1 hour.what happened? (lbeh kurg la) hehe ad dlm pass year..
126. The most common form of congenital heart disese
A. Primum atrial septal defect
B. TOF
C. Aortic stenosis
D. VSD
E. Double outlet of right ventricle
128. Which of the following complex of symptom can cause large enough VSD to produce pulmonary over circulation?
A. Harsh,gurgling heart murmur
B. Generalized bloating n cyanosis
C. Rapid breathing
D. Rapid breathing,poor feeding n poor weight gain
E. Shallow breathing n focal bloating
129. A 45 yr old man admitted to d hospital w low grade fever,nite sweat, fatigability, malaise, weight loss n valvular insufficiency.There r also erythematous subcutaneous nodules about d tips of d digits n hemorrhagic retinal lesion.After examine d patient d doctor in charge thought dat d man suffered from sub-acute bacterial endocarditis.what is d common cause of d disease?
A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Streptococcus viridans
D. Streptococcus non hemolyticus
E. Streptococcus gamma hemolyticus
130. Which factor can cause cyanosis:
A. Shunting systemic venous into arterial circuit
B. Decrease cardiac output
C. Arterial blood oxygen unsaturated
D. Peripheral cutaneous vasoconstriction
E. Ventilation-perfusion inequality
131. 45 year old man with low grade fever, night sweat, fatigability, malaise, weight loss, n valvular insufficiency. Erythematous subcutaneous nodule about tips of digit n hemorrhagic retinal lesion, subacute bacterial endocarditis.
What is most likely diagnosed in this patient?
A. chronic bronchitis n liver cirrhosis
B. CHF
C. Alpha 1- antitrypsin deficiency n malnutrition
D. Cor pulmonale
E. Pericardial effusion
132. What is the most common cause of secondary pulmonary hypertension?
A. Liver cirrhosis
B. Scleroderma
C. COPD
D. Pulmonary tromboembolism
E. Schostiosomiosis
Question 133-134
133. Admitted to ER w progress dyspnea w/out fever over a week. She delivered spontaneously 4th baby 5 wks ago. Has no serious health problem b4 or during pregnant except mild hypertension. What cause dyspnea???
A. Pulmonary infection
B. Dilated cardiomyopathy
C. Hypertrophic CM
D. Pulmonary embolism
E. Restrictive cardiomyopathy
134. WOTF diagnostic tool should be done to confirm the diagnosis?
A. Chest X-ray, ECG, BGA
B. Chest X-ray, echocardiography, ECG
C. Echocardiography, ECG, BGA
D. ECG, BGA, echocardiography
E. Chest X-ray, BGA, echocardiography
135. Which is the true of auscultation of heart?
136. A 28 y.o complaint dyspnea on ordinary activity. Physical exam shows diastolic thrill at apex, accentuated p2 and low pitched diastolic murmur at apex. Diagnosis?
137. Genetic disorder of mucopolysaccharide metabolism that can be detected by lab examination may be predisposing factor of the following :-
A. Congenital heart disease
B. Rheumatic heart disease
C. Coronary heart disease
D. Valvular heart disease
E. Heart failure
139. Unstable angina is characterized by?
A. Angina during exertion
B. Angina pain is relieved with sublingual nitrate
C. Angina of less than 10 min
D. First onset angina
E. Angina relieve after rest
140. Which is correct about risk stratification of patient acute coronary syndrome?
A. It is a survey for risk factor
B. Aimed to choose between implementation of primary and secondary prevention
C. Stratification of survey chest pain
D. It is not to be done in patient cardiogenic shock
E. Decision to choose appropriate treatment
141. Thrombolytic therapy is an appropriate choice of treatment for ACS. Whose ECG shows?
A. New bundle branch block
B. ST depression
C. T inverted
D. Non diagnostic changes
143. A man come to ER with chief complaint of chest pain that last for 10 minutes, 2 hours
ago. ECG exam didn't show any changes that indicating ischemia. What is further
management for this patient?
A. Perform treadmill test
A. Perform treadmill test
B. Treat as Acute Coronary Syndrome patient and send him to in-patient ward
C. Treat as Acute Coronary Syndrome patient and send him to Coronary Care Unit
D. Observed and measure by using cardiac markers
E. Send him home
144. Which of the following influences myocardial oxygen demand?
- Systolic wall tension
- Endothelium derived relaxing factor
- Oxygen carrying capacity of RBC
- Nitrogen oxide
- Prostacyclin
145. Most prominent cardiocirculatory change during pregnancy?
- Increase CO
- Decrease systemic vascular resistance
- Increase in LV EF
- Increase systolic BP
- Increase HR
146. Which of the following statement regarding the mechanism of heart failure is TRUE?
A. Salt and water retention leads to the long term maladaptive response to cell death
B. Hyperplasia and apoptosis play a large role in myocardial remodeling
C. A systemic compensating mechanism for heart failure is decrease oxygen extraction by
A. Salt and water retention leads to the long term maladaptive response to cell death
B. Hyperplasia and apoptosis play a large role in myocardial remodeling
C. A systemic compensating mechanism for heart failure is decrease oxygen extraction by
tissues
D. Maladaptive remodeling of myocytes occur long before clinical heart failure begins
E. The role of neurohormone in heart failure is to protect perfusion pressure
D. Maladaptive remodeling of myocytes occur long before clinical heart failure begins
E. The role of neurohormone in heart failure is to protect perfusion pressure
147. Which of the following patient with heart failure should be treated with beta adrenergic
blocker?
- Patient with reversible airway obstructive disease
- Patient with NHYA class III HF
- Patient with advance heart block
- Patient sinus rhythm and heart rate of 40 bpm
- Patient with depression
148. Which of the following statement regarding adrenergic blockage is true?
- Recent studies have shown Metraprolol doesn’t further decrease mortality in patient treated with ACE Inhibitors
- β-1 receptor are unregulated in failing myocardium
- Trials with Carvedilol demonstrate mortality decreased and a dose dependent improvement in left ventrivular ejection fraction
- β adrenergic blockage causes almost immediate improvement, with positive result seen several days following onset of therapy
- Patients class IV are best candidates
149. Which of the following is a feature of Spironolactone?
A. An IV route of administration is preferred
B. It increases both Na and K reabsorption
C. It is an endogenous hormone
D. It is water soluble K sparing diauretic
E. It has been associated with reduced mortality in congestive heart failure, possibly reducing arrhythmic death
150. Which of the following statement regarding ventricular arrythmiain ecg below is true?
A. PVCs, multifocal with R-on-T phenomenan, atrial fibrillation
B. PVCs, multifocal with R-on-T phenomenan, paired PVC, atrial fibrillation
C. PVCs, multifocal with R-on-T phenomenan, paired PVC
D. PVCs, multifocal with R-on-T phenomenan, nonsustained ventricular tachycardia
E. PVCs, multifocal with R-on-T phenomenan, paired PVC, nonsustained ventricular tachycardia
A. PVCs, multifocal with R-on-T phenomenan, atrial fibrillation
B. PVCs, multifocal with R-on-T phenomenan, paired PVC, atrial fibrillation
C. PVCs, multifocal with R-on-T phenomenan, paired PVC
D. PVCs, multifocal with R-on-T phenomenan, nonsustained ventricular tachycardia
E. PVCs, multifocal with R-on-T phenomenan, paired PVC, nonsustained ventricular tachycardia
151. As anti arrhythmia, the mode of action of Amiodarone is by?
- Block sodium channel
- Block Ca channel
- Block potassium channel
- Symphatolytic action
- Inhibit Na-K ATPase
152. A 30 years old man came to ER with fever and chest pain. On PE, pericardial friction
rub is heard. Lab findings : ↑ WBC, ↑ ESR. Which of the following is the typical
presentation of acute pericarditis?
- Onset of pain crescendo
- More comfortable in recumbency position
- Abnormal S3 and S4
- Pulmonary congestion
- Rub can last hours
153. Based on ECG recordings given in the examination paper
- Premature junctional contraction
- Premature atrial contraction with aberrant conduction
- Premature atrial contraction
- Premature atrial contraction with sinus arrhythmia
- Premature ventricular contraction
(Answer may be B, C or D)
154. Which of the following statement regarding the features in ECG below is true? (refer
Record 152 in Skills Lab ECG handout)
A. Atrial flutter with consecutive PVCs
B. Atrial flutter with ventricular pacing beats
C. Atrial fibrillation with consecutive PVCs
D. Atrial fibrillation with ventricular pacing beats
E. Atrial fibrillation with ventricular escape beats
155. Which of the following ECG changes is typical of acute pericarditis?
- Inverted T wave, ST elevation
- Localized convex ST elevation
- Diffuse concave ST elevation
- Frequent PVC
- Ist degree AV block
156. Which of the following concerning physical finding of acute pericarditis is true?
- Acute pericarditis produce dull retrosternal pain
- Pericardial friction rub is hallmark of acute pericarditis
- Pericardial pain is almost always resolve by lying down
- Acute pericardial friction rubs are louder during expiration
- The friction rub is best heard while patient is lying down
157. Which of the following regarding the PE of cardiac tamponade is true?
- Elevation of pericardial pressure, pulsus paradoxus and arterial hypertension
- Basal rales are typically present
- There is rapid X descent in jugular venous pulse, pulsus paradoxus and arterial hypertension
- There are rapid X and Y descent in the jugular venous pulse
- There are normal jugular venous pressure and pulsus alternans
159. Which statement regarding the pathophysiology of constrictive pericarditis is true?
- Increase cardiac index in consequence of impaired filling
- Normal ejection fraction and myocardial aontractile
- Ventricular filling occurs in very early diastole
- Isovolumic relaxation period is longer than normal
- The greatest acceleration of venous return occur during systole
161. Which of the following is true about pericardium?
A. Pericardial space contains up to 50ml of pericardial fluid
B. Pericardium composed mainly of elastin
C. Phrenic nerve runs along the parietal layer along pericardium space
D. Parietal layer is a serous pericardium that composed of a single mesothelium layer
E. Pericardium can expend more at long axis than short axis
162. A patient presents with a systemic embolic event 1 month after uncomplicated mitral
valve replacement. He has been febrile for the past week. Which of the following
microorganism is most likely to grow from blood culture?
- Streptococcus Viridans
- Staphylococcus Aureus
- Staphylococcus Epidermis
- E. Faecalis
- Candida Albicans
165. Which of the following conditions lastly occurs the latest in ischemic cascade?
A. Wall motion abnormalities
B. Diastolic dysfunction
C. Systolic dysfunction
D. Symptom of angina
E. ECG changes
170. Which of the following evolving ECG may be seen in most patient STEMI?
A. ST depression
B. Normalization ECG pattern
C. Pathologic Q wave
D. T wave inversion
E. Tall and peak Rwave
172. Most important factor causing pulmonary hypertension in COPD?
A. Loss small vessel in most vessel wall
B. Emphysema and lung destruction
C. Pulmonary vasoconstriction due toalveolar hypoxia
D. Increase CO from polycethemia
E. High blood viscosity secondary to hypoxia
173. In a rehabilitation program, an AMI patient can begin a dynamic exercise program:
A. 2 to 4 days after AMI
B. 4 to 6 days after AMI
C. 1 week after AMI
D. 2 to 4 weeks after AMI
E. 4 to 6 weeks after AMI
A. 2 to 4 days after AMI
B. 4 to 6 days after AMI
C. 1 week after AMI
D. 2 to 4 weeks after AMI
E. 4 to 6 weeks after AMI
174. Which of the following statements regarding exercises in the maintenance phase of rehabilitation in patients with CAD is TRUE?
A. The improvement from aerobic exercises of certain muscle groups will meet the needs of vocational and avocational activities
B. Continuous ECG monitoring should always be used as it has shown to provide added safety during supervised exercise
C. During exercises, the patient can monitor his/her heart rate using carotid pulse
D. There are a number of complications with exercise testing in the elderly
E. A treadmill or bicycle exercise programme will meet every patient’s need
181. Which of the following valvular lesion is the most commonly resulting from exterior
anterior blunt chest trauma?
- Tricuspid stenosis
- Tricuspid regurgitation
- Aortic stenosis
- Aortic regurgitation
- Mitral regurgitation
182. A 52 year old man was admitted due to chest pain radiating to the jaw and left arm,with
cold sweat,starting 2 hours before admission.The ECG recording showed ST segment
elevation in Lead V2,V3 and V4 with several PVCs.Just after the ECG recording, he
developed a sudden seizure, the ECG monitor revealed a wide QRS tachycardia
degenerating to chaotic electrical activity.
Which of the following statement is the most likely first treatment of the above case?
- Nitroglycerine Sublingual
- Cardioversion
- Amiodarone IV bolus
- CPR followed by synchronized cardioversion
- CPR followed by defibfrillation
184. A 60 years old man comes to ER with chest pain. The examiner describe as typical angina. Which is the best describe its pain?
A. Sharp pain brought on respiratory movement
B. Constant for many hours
C. Described as heavy chest pressure radiating to neck
D. Reproduced by palpation on chest wall
E. Can be localized at the tip of finger over left ventricular apex
For question 185:
64 years old male admitted to ER due to shortness of breath. For past few weeks, he had been complaining: shortness of breath, cough and slight fever. He also mentioned a sensation of “lack of air” which often woke him out at night and when this happened, he would rush to open window to get air. He denied any chest discomfort but admitted that he had been hospitalized 2 times during the past 3 years for heart attack. He had seen cardiologist routinely but he had stopped since months ago, because he felt well. PE: BP 100/70 mmHg, with irregular HR 118bpm, RR 24x/min, jugular venous pressure was not extended. On auscultation, 1st and 2nd heart sound are irregular and grade 3/6 holosystolic murmur heard at apex. Soft basal rale was heard at both lung fields. ECG shows atrial fibrillation with QRS waves in V1-V6. His chest x-ray shows cardiomegaly with signs of interstitial edema.
185. Which of the following is the precipating cause of his current symptoms?
A. Acute coronary syndrome
B. Old myocardial infarction
C. Upper respiratory tract infection
D. Atrial fibrillation
E. Mitral regurgitation
186. Which of the following lab parameter is commonly associated with congestive heart failure?
A. Hyperkalemia
B. Hypernatremia
C. Hyponatremia
D. Hypercalcemia
E. Hypocalcemia
188. A 30 years old female, chest pain with histopathological intimal layer lesion of plaque with lipid deposition and spindle cell.
A. Arterosclerosis
B. Stable angina pectoris
C. Unstable angina pectoris
D. Pericarditis
E. Coronary Arterosclerosis
189. Precursor lesion for atherosclerosis
A. Calcification in tunica intima
B. Neovascularization around periphery lesion
C. Thickening, lipid accumulation on tunica intima
D. Deposition collagen, elastic fibers in tunica media
E. Minimal ulceration causes thrombus formation
190. Which protein is heart cardiac enzyme?
A.CK-MB
B. Lactate dehydrogenase
C. Glucokinase
D. Phospolipase
E. Acid phosphatase
193. Which of the following statements regarding LDL cholesterol is positive?
A. LDL binds to cell receptor and diffuses across the cell membrane
B. LDL transports cholesterol which is being removed from the peripheral cell
C. Lecithin: Cholesterol acyl transferase (LCAT) esterities LDL cholesterol once it enters cell
D. High LDL uptake suppresses the replenishment of LDL receptor
E. LDL uptake by the cell suppresses fatty acyl CoA: cholesterol acyl transferase (ACAT) activity
195. Which of this is TRUE for Low Density Lipoprotein
A. It’s produced by intestine
B. In the oxidized form, it’s atherogenic
C. It’s less dense than water even without centrifugation
D. It has a high degree homology with plasminogen
E. It consists 50% proteins, 20% cholesterol, and 30% phospholipid
198. The heart is able to cope to acutely alter hemodynamic shock?
A. The alteration of the cardiac gene expression
B. The alteration of the perfusion pressure
C. The change of the cardiac cells
D. Hyperplasia of the cardiac cells
E. Hypertrophy of the cardiac cells
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