ARVAGATA RESPI

Untuk no 1 & 2

A 30-year-old man was found trapped in window sill. His chest was trapped between window sill dan
his head was inferior of his body

1. What happened to this person?

a. Hanging
b. Strangulation
c. Postural asphyxia
d. Traumatic asphyxia
e. Suffocation

Suffocation and smothering are two ways of preventing the intake of air into the lungs via the
mouth.

Hanging : "specifically to put to death by suspension by the neck"

postural asphyxia, is a form of asphyxia which occurs when someone's position prevents the
person from breathing adequately.

2. What condition is he?

a. Stupor
b. Drunk
c. Fainting ec. Low oxygen to the brain
d. Immovable
e. Sleeping

3.
 What is the interpretation of this spirometry results?

a. Obstructive disease
b. Mox disease
c. Restrictive disease
d. All of the answer above
e. None of the answer above

4.

What is the interpretation of this spirometry results?

a. Obstructive disease
b. Mix disease
c. Restrictive disease
d. All of the answer above
e. None of the answer above
5. A 40-year-old man was taken to the mortuary. In the examination, there was ligature mark around
his neck. What is the cause of death?

a. Hanging
b. Manual Strangulation
c. Strangulation
d. Choking
e. Suffocation

f.

Untuk no 6-8

Nani, A 56 year old Indonesian female has recently been diagnosed as lung cancer patient, the
location of the cancer is at the periphery of her nght upper lung lobe.

6. Which of the following test is best performed to confirm the presence of gene mutation in above
condition?

a. FlourescenceinSitu Hybridisation
b. Histopathology
c. Immunohistochemistry
d. Polymerase Chain Reaction
e. Physical examination
7. What is the most common type of carcinoma occur in that location?

a. Adenocarcinoma
b. Squamous cell carcinoma
c. Small cell carcinoma
d. Malignant lymphoma
e. Germ cell tumour

About 80% to 85% of lung cancers are NSCLC. The main subtypes of NSCLC are
adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. These subtypes, which
start from different types of lung cells are grouped together as NSCLC because their
treatment and prognoses (outlook) are often similar.

https://www.google.com/amp/s/amp.cancer.org/cancer/lung-cancer/about/what-is.html

8. What is the most common oncogenic driver mutation in above carcinoma?

a. ALK
b. BRAFV600E
c. EGFR
d. KRAS
e. ROS1

Untuk no 9-11

A 5-year-old child was brought by his mother to the primary health care with chief complaint of a
quite hard snoring since 6 months ago. Snoring is sometimes accompanied by brief pauses in
breathing while sleeping and looks suffocated for a few seconds.

Examination in the oropharynx area shown tonsils enlargement of T3-T4, while examination of the
nose shown decreased air passage in both nostrils

9. What are the main indications for tonsilloadenoidectomy in this patient?

a. Recurrent tonsilloadenoiditis more than 3-4 times per year,

b. Recurrent tonsilloadenoiditis more than 2-3 times for 2 consecutive years
c. Upper and lower airway obstruction
d. It was feared that a chronic hypoxia would occur
e. There has been a complication in the form of cor pulmonale
10. What are physical examinations that needs to be done to find the causes of the above conditions?
a. Lung examination, especially auscultation, to see if there is additional lung sound
b. Pemeriksaan hidung, untuk melihat adakah benda asing di hidung dan sinus paranasal
c. Nose examination, to see if there is a foreign body in the nose and the paranasal sinuses
d. Examination of the oropharynx to see the possibility of tonsillar enlargement
e. Otoscopy to see edema in the area of the external acoustic canal.

11. What further examination that is most appropriate to show adenoid enlargement in this child?

a. CT scan as high as oropharynx to laryngopharynx

b. CT scan with contrast around the neck
c. Neck soft tissue X-ray, especially lateral position
d. Panendoscopy with rigid endoscope
e. Indirect laryngoscopy examination with large laryngeal glass

Salman, A 50 years old male came to the outpatient clinic because of tinnitus, physical examination
showed an ulcerative muss at the Rossenmuller fossa The biopsy was performed and the
histopathological examination consistent with non keratinizing squamous cell carcinoma.

12. Which of the agent is highly related to the pathogenesis of this tumour?

a. Epstein Barr Virus

b. Helicobacter pylori
c. Herpes Simplex Virus
d. Herpes Zoster Virus
e. Rotavirus

xactly what causes the gene mutations that lead to nasopharyngeal carcinoma isn't known,
though factors, such as the Epstein-Barr virus, that increase the risk of this cancer have been
identified. - mayoclinic

Untuk no 13-15

Teen years old boy with severe wheezing had laboratory result of IgE Level 597 IU/ml, the reference
value of IgE Level as shown below

REFERENCE VALUE of IgE level in children and adult:

1) Neonates <1.5 IU/ml
 2) 1 yr < 15 IU/mi
3) 2-5 yr < 60 IU/ml
4) 6-9 yr < 90 IU/ml
5) 10-15 yr <200 IU/ml
6) Adults < 100 IU/mi

13. Please mention several etiology of Hyper-IgE ?

a. The condition of pulmonary disease cause by thoracic trauma always with increasing the IgE
level.
b. The condition of respiratory alkalosis always combined with increasing the IgE Level
c. The condition of allergy, hay fever, asthma, anaphylaxis always increasing the IgE Level
d. Respiratory disturbance cause of pneumonia always increasing the IgE Level
e. Respiratory disturbance cause primary by pulmonary embolism always increasing the IgE
Level

14. What is the method to measure the level of IgE?

a. Immunochemistry test by RIA

b. Immunodiagnostic tests by ELISA method
c. Immunoelectroassay method
d. Immunoelectroassay by ELISA method
e. Immunodiagnostic test by RIA

15. Scientists are studying human lung development by trying to identify which proteins and signaling
factors trigger lung bud division and bronchiole branching, Their main focus is particularly around
the 20th week of gestation, during which terminal bronchioles branch into respiratory branchioles
and further into alveolar ducts.

Which of the following phases of embryonic lung development is the stage in which the scientists
are interested in studying?

a. Embryonic
b. Pseudoglandular
c. Canalicular
d. Saccular
e. Alveolar

Untuk no 16-18

A 13-year-old girl was referred to department of orthodontics of dental faculty of Tehran University
of Medical Sciences, Iran with the chief complaint of lip and palate cleft

16. What is the region in which the lung buds grow into coelomnic cavity?

a. Pericardial cavity
b. Pericardio-peritoneal canals
c. Peritoneal cavity
d. Amniotic cavity
e. Septum transversum
 Week 5 - left and right lung buds push into the pericardioperitoneal canals (primordia of
pleural cavity)

17. Which of the following that the lung bud mesenchyme gives rise?

a. Pseudostratified columnar epithelium

b. Epithelial lining of the alveolar sac
c. Smooth muscle
d. Type Il cells
e. Septum transversum

18. What is the embryological basis for the palatal process?

a. Frontonasal process
b. Medial nasal process
c. Lateral nasal process
d. Maxillary process
e. Mandibular process

The primary palate is formed by two parts:

maxillary components of the first pharyngeal arch (lateral)

frontonasal prominence (midline)

Untuk no 19-22

A 6 years old boy presented to the hospital with shortness of breath since 3 hours ago. He was
cleaning his room for an hour before the symptom developed. He could speak in words, prefer sitting,
not agitated On physical examination he showed tachypnea, use of accessory respiratory muscles,
prolong expiration, and expiratory wheezing, with SpO2 90% room a. He was then given oxygen
supplementation. He has been diagnosed as having asthma since 1 year ago. The exacerbation occur
more than twice a month and nocturnal. Symptoms occur more than once a week.

19. What is the seventy of exacerbation asthma in this patient?

a. Mild
b. Moderate
c. Mild to moderate
d. Severe
e. Life-threatening
20. What controller treatment should be given to the patient?

a. Inhaled low dose corticosteroid

b. Inhaled low dose corticosteroid + long acting B2 agonist
c. Inhaled moderate dose corticosteroid + long acting B2 agonist
d. Inhaled high dose corticosteroid + long acting B2 agonist
e. Inhaled moderate dose corticosteroid + leukotriene receptor antagonist

21. What is the classification asthma severity of this patient?

a. Intermittent
b. Mild persistent
c. Moderate persistent
d. Severe persistent
e. Controlled asthma

22. What is the most appropriate management of this case?

a. Nebulized B2-agonist
b. Nebulized racemic epinephrine
c. Nebulized NaCl 0.9%
d. Nebulized corticosteroid
 e. Nebulized NaCl 3%

23. A 4-year-old woman came with shortness of breath and wheezing, that occurred every day. She
felt the nocturnal dyspnea 1-2 times/week, and from the examination she had APE 70% Doctor
diagnosed her as moderate persistant asthma bronchiale

Which is the most appropriate drug regimen for her?

a. Salbutamol and budesonide

b. Formoterol and budesonide
c. Fluticasone and budesonide
d. Formoterol and salmeterol
e. Salbutamol and fluticasone

24. Y a patient had a progressive lung disease, that required an ever increasing pressure to fill the same
volume of the lung What is happened to the lung compliance?

a. Increase it
b. Stay the same
c. Decrease it
d. Not affected the lung compliance
e. None of the answer above

25. Asthma patients has to breath faster than normal rate. How does it effect her dynamic compliance?
26.

a. Increase it
b. Decrease
c. Stay the same
d. Not affected the lung compliance
e. None of the answer above