Endocrine

1. Wanita 45 tahun selalu merasa tired. Selama 4 bulan menjadi sleep more dan tired, mengalami
konstipasi, intolerance to cold, dry skin. Dilakukan lab test. Dan hasil yang mungkin terjadi?
a. Increase TSH
b. Increase T3
c. Increase T4
d. Increase calcitonin
e. Increase glucocorticoid
2. Mobilized second portion of duodenum and head of pancreas. Note : artery and vein anteriorly
uncinated of pancreas, 3rd portion of duodenum. Blood supplynya?
a. Superior mesenteric artery and vein
b. Inferior mesenteric artery and vein
c. Gastroduodenal artery and vein
d. Superior pancreaticduodenal artery and vein
e. Middle colic artery and vein
3. Right adrenal blood supply
a. Arterial blood supply from aorta only
b. Central vein drains inferior vena cava
c. It central veins drains into left renal vein
d. It contact to head of pancreas
e. It is external to renal fascia
4. Kelenjar yang tidak punya saluran kelenjar
a. Exocrine gland
b. Endocrine gland
5. Zona yang banyak spongiosa
a. Zona glomerulosa
b. Zona fasciculata
c. Zona reticularis
6. Terdapat pulau langerhans pada pancreas. Terdapat sel alpha, beta, delta, sel f.
7. Dilakukan pemotongan pada organ pancreas dan dilakukan pewarnaan. Tipe sel yang terlihat atau
terwarnai… hmm.. agak lupa.. bener pewarnaan atau apa.. pokoknya tipe sel yang terlihat
a. Sel b, insulin
b. Sel alpha glucagon
c. Sel d, somastostatin
d. Sel f
8. --
9. Wanita dengan tremor, tangan berkeringat, palpitasi, exopthalmus. Ciri hipertiroid maka
a. Increase iodine uptake
b. Increase iodine intake
c. Decrease iodine uptake
d. Decrease iodine intake
e. Normal iodine uptake
10. Wanita dengan exopthalmus. Hipertiroid. Pengobatannya? Radioiodine Uptake
11. Paresthesia hand extremities, 1 month after thyroidectomy. Pemeriksaan fisik yang dilakukan
a. Murphy sign
b. Trousseou sign
c. Cullen sign
d. Muller sign
12. Increase low back pain, tenderness over lumbar spine. Ct : multiple area of lytic, there is sclerotic.
Diagnosis
a. Osteomalacia
b. Osteoporosis
c. Osteodystrophy
d. Paget’s disease
 e. Rickets disease
13. 24 years old woman. Thyrotoxicosis. Antitiroid terapi, lost follow up. 3 months pregnant,
thyrotoxicosis worst, gland larger and most vascular, surgical. Prophylaxis sebelum dilakukan
surgery
a. Iodide
b. Propanolol
c. PTU
d. Radioactive iodine
14. A boy type 1 DM, severe hyperglycemia, ketoacidosis. Severe ketoacidosis Rapid control of high
blood sugar
a. Crystalline zinc insulin
b. Gliburit
c. Tolbutamid
d. Regular insulin
e. Ultralente insulin
15. Bapak, alcoholic, kasi metformin tidak boleh karena?
a. Hypoglycemia
b. Decrease weight gain
c. Hepatotoxic
d. Dilsufiran like effect
16. Untuk penyakit cushing. Test yang dilakukan?
a. Dexamethasone
17. 50 tahun alcoholic man, Complains cold intolerance, decrease appetite, decrease body weight. For 1
year he was treated with carbamasepine for epilactic seizure. Administered paracetamol occasionally
for his headache, ibuprofen for his rheumatism and multivitamin preparation, compose of 500 mg vit
c, 100 mg vit b, 200 mg vit B12. Lab decrease thyronine 3 ug/dl. Normal serum liver transaminase.
The drug that most likely cause the symptoms
a. Ibuprofen
b. Vit B1
c. Carbamozepine
d. Paracetamol
e. Alcoholic drink
18. 45 tahun laki-laki suffer from muscle spasm after thyroidectomy. Pe chovtek sign positif. Defisiensi
PTH was made. Physician tidak get hormone preparation. Alternatif management for hypecalcemia
a. High dose vit D
b. Oral Ca salt
c. Calcitonin
d. High dose Vit A
e. Fluoride salt
19. 27 tahun wanita mengalami amenorrhea, infertility, galactorrhea, was treated successfully with drug
that restored ovulation and menstruation. Before given the drug, the wanita questioned about prenog
mental health problem, which she didn’t have. She was advise to take drug orally. The drug is
a. Bromocriptine
b. Desmopressin
c. Human gonadotropin hormone
d. Leupnolide
e. Octreotide
20. 19 tahun wanita. Mengalami increase urination, dimalam hari. Udah 1 bulan urine pucat. Na
increase, plasma osmolality increase, urine osmolality decrease, glucosa negative. Dilakukan water
depletion, osmolality plasma turun, urine osmolality juga turun. Apa ini?
a. Water intoxication
b. Central diabetes insipidus
c. Polydipsia
d. Diabetes insipidus like syndrome
e. Nefrogenic diabetes insipidus
21. 18 tahun laki-laki. Terkena dm tipe 1. Inject insulin kebenyakan  coma. Glucosa drop. Sel yang
paling banyak uptake glucose?
a. Otak
b. Liver
c. RBC
d. Brain and liver
e. Muscle and adipose tissue
22. Man. Insulin inject. Weakness di kaki. Lack of energy karena?
a. Decrease glucogenesis
b. Decrease glycolysis
c. Decrease ketogenesis
d. Increase pyruvate acid
e. Increase glucogenolisis
23. Pada tubuh dengan keadaan kurang karbohidrat, tubuh akan mnecari alternative energy, yaitu
a. Increase lipolysis
b. Increase ketogenesis
c. Increase ca
24. Wanita sedang puasa, yang mengatur glycogenesis dan glycogenolysis adalah
a. Glucagon
b. Epinephrine
c. Cyclic cAMP
d. Ca
25. Pasien uncontrolled DM, dengan metabolic acidosis, kejadian ini mungkin terjadi karena
a. Hypoglycemia
b. Low blood fatty acid
c. Negative nitrogen balance
d. Low lipolysis
26. HBa1c adalah
a. Nonenzymatic glycosylated product
27. Seorang wanita, mau menurunkan berat badan dengan exersice. Untuk menurunkan berat badan
dengan cara?
a. Glycolysis
b. Glycogenolysis
c. Citric acid cycle
d. Beta oxidation
28. Pria dengan acromegaly, dengan large pituitary tumor. Treatment untuk preopretion?
a. Cosyntropin
b. Desmopresan
c. Leuprolide
d. Octreotide
e. Somatotrop
29. Laki-laki headache, dengan hipertensi, BP 190/110. After 30 min after initial, seated : BP 178/110
HR 90. After 3 menit standing : 152/90 HR 112. Tidak ada exopthalmus. Yang terjadi adalah
a. Catecholamine excess
b. Thyroid excess
c. Mineralcorticoid excess
d. Glucocorticoid excess
30. Moon face, menstruation irregular. Diberi dexamethasone overnight, tp tidak terdapat suppression.
Pemeriksaan plasma ACTH dilakukan the next morning. What mostly the diagnosis is?
a. Cushing disease
b. Cushing syndrome
c. Ectopic ACTH
31. Terjadi constipasi, BP 120/90. Dry skin, pale, thyroid … palpable
a. Myxedem
b. Cretinism
 c. Grave’s disease
d. Morbus basedow
e.
32. Seorang wanita dengan SLE, takut gendut jadi diet restriction, takut kena cancer kulit jadi tidak
berjemur. Pemeriksaan normal, takut osteoporosis. Untuk menghindari terjadinya bone loss gmn?
a. Calcitonin
b. Vitamin D dan ca supplement
c. Alendronat
d. Risendronat
e. Octreotide
33. Seorang istri mengeluh. Suaminya selalu mengantuk, sepanjang hari sudah tidur tp tidak cukup. Juga
snoring setiap malam. Sleep apneu index 25, terjadi ST depression on V5 dan V6. penyebab
terjadinya ?
a. Continous hypoxia
b. Intermittent hypoxia
c. Continous hypercapnia
d. Intermittent hypercapnia
34. Pengobatan untuk pasien tersebut?
a. Surgery
b. Non invasive (CPAP)
c. Drugs
d. …
35.
36.
37.
38. Lab ca naik, phosphate turun, AP naik, lainnya normal. Kemngkinan yang terjadi
a. Hyperparathyroid
b. Hyperthyroid
c. Hypoparathyroid
d. Hypothyroid
e. Hypercortisol
39. Ren mengecil karena komplikasi DM. Penyakit acute pyelonefritis. Yang terjadi pada ren?
a. Amyloid deposition
b. Diffuse glomerulosclerotic
c. Necrosis
d. ...
40. Laki-laki mengeluh terganggu kadang suka susah kencing. Tidak dapat ereksi (sexual erection
defect), pasien mengalami DM. Terjadi karena?
a. Atherosclerosis
b. Arteriosclerosis
c. Hyaline deposistion
41. Waist circumference naik, TG naik, hipertensi  metabolic syndrome
42. 5 tahun kemudian MCI, knp?  dyslipidemia
43. Yang mempengaruhi prognosis? Lifestyle
44. 3100 gr baby girl, 39 weeks gestation, born to 28 years old woman dengan G2P1, spontaneous,
vaginal, good condition, mousy smell. Diagnosis?  PKU
45. Cause : amino acid metabolism
46. Organ affected : brain
47. Treatment yang akan diberikan?
a. Formula low in phenylalanine
b. Lactose free
c. Preotein restriction for life
48. 8 tahun, breasts enlargement, bone accelerated. Pada pemeriksaan hormon LH inggi. What is the
most likely the diagnosis is
a. Gonadotrophyn dependent precock puberty
 b. Gonadotrophyn independent precock puberty
49. Obat yang diperlukan?
a. GnRH antagonist
b. GnRH agonist
50. If the patient doesnt receive any treatment, what happen to her growth velocity?
a. Her height is between 5th – 95th percentile
b. Her weight is less than 5th percentile as adult
c. Her weight is more than 95th percentile as adult
d. Her height is less than 5th percentile as adult
e. Her height is more than 95th percentile as adult
51. A 9 years old boy was brought to hospital with short stature, gonadal dysgenesis, skeletal
abnormalities, cardiac and kidney malformation, dyrmofic face and no mental defect from
chromosomal analysis revealed karyotype 45, x with structural abnormal of x chromosome. What is
your diagnosis?
a. Reifenstein syndrome
b. Klinefelter syndrome
c. Turner syndrome
d. Fragile x syndrome
e. Marfan syndrome
52. Management?
a. Observation
b. Growth and sex hormone
c. Surgical removal
d. GnRH agonist
e. Glucocorticoid abnd mineralcorticoid
53. Baby born with mousy odor?  Phenylketonuria
54. What happened?  amino acid metabolism
55. Yang terganggu? Liver
56. 35 tahun wanita, difficulty swalloewing, feeking fullness of anterior neck, T4 serum normal.
Enlargement of thyroid gland. Di biopsy banyak infiltrate limfosit tissue pada sel-sel tiroid.
Diagnosis?
a. Hashimoto thyroiditis
57. Seorang pasien mengalami tumor pada kelenjar thyroidnya. Akan dilakukan surgery thyroidectomy.
Akan dilakukan prophylaxis dahulu. Prophylaxis dilakukan untuk mencegah?
a. Thyroid storm
b. Pendarahan thyroid
c. Hypocalcemia
d. Recurrent laryngeal damage
e. Hypothyroid
58. Terdapat lump di tiroid dengan ukuran 28mm x 13 mm. Di perikasa throrax xray dan hasilnya
normal (tidak ada metastasis). Tetapi terdapat pembesaran lymph node (Dhenoig or something?...
Staging pada tumor ini?
a. T1N0M0
b. T1N1M0
c. T2N0M0
d. T2N1Mo
e. T2N1M1
59. Penyanyi soprano. Operasi subtotal thyroidectomy karena hyperthyroidism. Abisoperasi tidak bias
nyanyi nada tinggi. Apa komplikasi dari operasi ini?
a. Neck hematoma
b. Recurrent laryngeal nerve injury
c. Superios laryngeal nerve injury
d. Parathyroid gland removal
e. Post surgery thyroid storm
 60. Wanita, tidak mengalami menstruasi. Dalam 3 bulan terakir terdapat breast milk. Tidak makan obat-
obatan. Dan juga mengalami pusing, visual disorder. Treatmentnya?
a. Desmopressin acetate
b. Cabergoline
c. Octreotide
d. Hydrcortison
e. Levothroxine
61. Klo hal ini terjadi pada laki-laki, apa yang terjadi?
a. Sex dysfunction
b. Obesity
c. Diabetes
d. Pubic hair diminish
e. Spermatogenesis decrease

Endocrine

62. 45 yr old woman always feeling exhausted. Selama 4 bulan menjadi sleep more dan tired, mengalami
konstipasi, intolerance to cold, dry skin.Hypothyroid sign. Dan hasil lab test yang mungkin terjadi?
a. Increase TSH
b. Increase T3
c. Increase T4
d. Increase calcitonin
e. Increase glucocorticoid
63. In surgery the doctor want to mobilized second portion of duodenum and head of pancreas. Note :
artery and vein anteriorly uncinated of pancreas, 3rd portion of duodenum. Blood supplynya?
a. Superior mesenteric artery and vein
b. Inferior mesenteric artery and vein
c. Gastroduodenal artery and vein
d. Superior pancreaticduodenal artery and vein
e. Middle colic artery and vein
64. Right adrenal blood supply :
Answer : from aorta abdominalis :
- Right superior suprarenal artery
- Right middle suprarenal artery
- Right inferor suprarenal artery
a. Arterial blood supply from aorta only
b. Central vein drains inferior vena cava
c. It central veins drains into left renal vein
d. It contact to head of pancreas
e. It is external to renal fascia
65. Clusters of cell, between which are many capillaries. No excretory ducts are seen. Which gland is
that?
a. Merocrine gland
b. Holocrin gland
c. Apocrine gland
d. Serous gland
e. Endocrine gland
66. One of the layers consists of foam-like cells called spongiocytes. Which layer?
a. Capsula layer
b. Zona glomerulosa
c. Zona fasciculata
d. Zona reticularis
e. Medullary layer
67. Terdapat pulau langerhans pada pancreas. Terdapat sel alpha, beta, delta, sel f. Dilakukan
pemotongan pada organ pancreas dan dilakukan pewarnaan. Tipe sel yang terlihat atau terwarnai…
 hmm.. agak lupa.. bener pewarnaan atau apa.. pokoknya tipe sel yang terlihat. Which of the
following cells belong to the islets and its coresponding function?
a. Acidophil, growth hormone
b. Basofil, gonadotropic hormone
c. F cell, somastotatin
d. D cell, glucagon
e. B cell, insulin
68. Ga ada soalnya
69. 30 yr old female, tangan berkeringat, palpitasi, exopthalmus. Hyperthyroid sign. Result of nuclear
scanning?
a. Increase iodine uptake
b. Increase iodine intake
c. Decrease iodine uptake
d. Decrease iodine intake
e. Normal iodine uptake

70. 28 yr old female. 2 months of palpitation and unintentional weight loss. Irregular menstruation.
Tachycardia, exopthalmus, diffuse and tender enlarge neck, hyperreflex and tremor. Diagnosis?
a. Plummer’s disease
b. Grave disease
c. Subacute thyroiditis
d. Subclinical hyperthyroidism
e. Thyroid Ca
71. 40 yr man with Paresthesia (baal) in hand and feet about one month after thyroidectomy. Clinical
exam most suitable for this patient?
a. Pemberton’s sign
b. Murphy’s sign
c. Cullen’s sign
d. Muller’s sign
e. Trousseau’s sign

72. 50 yr old man, six months Increase pain in the lower back. PE : tenderness over lumbar spine. Xray
and CT scan : mixed appearance with multiple areas of lytic appearance with some sclerotic changes
mainly affecting vertebral body. Diagnosis?
a. Osteomalacia
b. Osteoporosis
c. Osteodystrophy
d. Paget’s disease
e. Rickets disease
73. 24 years old woman. Thyrotoxicosis. Antitiroid terapi, lost follow up. 3 months pregnant,
thyrotoxicosis worst, gland larger and most vascular, surgical. Prophylaxis sebelum dilakukan
surgery, before surgery can done, her gland should be reduce in size and vascularity by administering
:
a. Iodine ion  menghambat pelepasan
b. ipodale
c. Propanolol
d. PTU  menghambat sintesis  ga boleh klo hamil
e. Radioactive iodine  menghancurkan thyroid ga blh klo hamil
74. A boy type 1 DM, severe hyperglycemia, severe ketoacidosis, pH : 7.15. buat control DM tapi yang
aman untuk ketoacidosis?
a. Crystalline zinc insulin  nama lain regular insulin
b. Gliburit - sulfonilurea
c. Tolbutamid - sulfoniurea
d. Regular insulin
 e. Ultralente insulin – long acting insulin
75. Bapak 54, obese DM type 2, alcoholic, shouldnt receive metformin because it can increase risk of?
a. A disulfiram-like reaction
b. Excessive gain weight
c. Hypoglycemia
d. Lactate acidosis  alkohhol + metformin
e. Serious Hepatotoxic
76. Woman 45, suspect with Cushing syndrome.Confirm diagnosis with oral medication?
a. Dexamethasone test
77. 50 tahun alcoholic man, Complains cold intolerance, decrease appetite, decrease body weight
(Hypothyroid symptom). For 1 year he was treated with carbamazepine (an anticonvulsant and mood
stabilizing drug) for his epilectic seizure. Administered paracetamol occasionally for his headache,
ibuprofen for his rheumatism and multivitamin preparation, compose of 500 mg vit c, 100 mg vit b,
200 mg vit B12. Lab decrease thyronine 3 ug/dl. Normal serum liver transaminase. The drug that
most likely cause the symptoms
a. Ibuprofen
b. Vit B1
c. Carbamazepine  decr. TGB
d. Paracetamol
e. Alcoholic drink
78. 45 yr old man suffers from muscle spasm after thyroidectomy. PE with Chvostek sign is positive.
PTH deficiency is positive. Couldn’t get hormone preparation. Alternative management for the
patient’s hypocalcemia :
a. High dose of vit D (ergocalciterol)
b. Oral Calcium salt
c. Calcitonin
d. High dose Vit A
e. Fluoride salt
79. 27 yr old woman with amenorrhea, infertility and galactorrhea, was treated successfully with drug
that restored ovulation and menstruation. Before given the drug, the woman questioned about
previous mental health problem, which she didn’t have. She was advise to take drug orally. The drug
is :
a. Bromocriptine
b. Desmopressin
c. Human gonadotropin hormone
d. Leupnolide
e. Octreotide
80. 19 tahun wanita. Mengalami increase urination, dimalam hari. Udah 1 bulan urine pucat. Na
increase, plasma osmolality increase, urine osmolality decrease, glucosa negative. Dilakukan water
depletion, osmolality plasma turun, urine osmolality juga turun. Apa ini?
a. Water intoxication
b. Central diabetes insipidus
c. Polydipsia
d. Diabetes insipidus like syndrome
e. Nephrogenic diabetes insipidus  On investigation, there will be an increased plasma
osmolarity and descreased urine osmolarity. Na increased.
81. Man 19. With DM type 1. Too much insulin injected. Too low Blood Glucose can be explained as a
result of too much uptake of glucose by :
a. Brain
b. Liver
c. RBC
d. Brain and liver
e. Muscle and adipose tissue
82. Without his insulin injection, he would feel weakness especially in the legs. Reason for the lack of
energy?
 a. Decrease glucogenesis
b. Decrease glycolysis
c. Decrease ketogenesis
d. Increase pyruvate acid
e. Increase glucogenolisis
83. To compensate for lack energy due to defective carb metabolism, his body has to switch to
alternative mechanism, which is :
a. Increased lipolysis
b. FA esterification
c. Transamination
d. Proteolysis
e. ketogenesis
84. Lani is fasting, no sahur. Both pathway center glycogenesis dan glycogenolysis regulate each other
controlled by
a. Glucagon
b. Epinephrine
c. ATP
d. Cyclic cAMP
e. Ca2+

85. Man with uncontrolled DM, until metabolic acidosis. What characteristic?
a. Hypoglycemia
b. Low blood fatty acid
c. Negative nitrogen balance
d. Low ketogenesis
e. Low lipolysis
86. HBa1c adalah
a. Nonenzymatic glycosylated product
b. Glucose oxidation catalyzed by Heme Fe
87. Woman reduce weight by exersice. To be succesful she must exercise vigorously to extend of
consuming calories from
a. Glycolysis  dr glukosa
b. Glycogenolysis  dr glikogen
c. Citric acid cycle  dr glukosa
d. Beta oxidation of fatty acid
e. Ketone bodies oxidation
88. Man 47 acromegaly (growth hormone), dengan large pituitary tumor. Treatment untuk preopretion?
a. Cosyntropin
b. Desmopresan
c. Leuprolide
d. Octreotide
e. Somatotrop
89. Man 35 with headache, BP 190/110. After 30 min after initial, seated : BP 178/110 HR 90. After 3
menit standing : 152/90 HR 112. No exopthalmus. Optic fundus narrowed arterioles with no
hemorrhage or exudate. Cause of the hypertension?
a. Catecholamine excess
b. Thyroid hormone
c. Mineralcorticoid excess
d. Glucocorticoid excess
e. idiopathic
90. Woman 27 Moon face, menstruation irregular, sign of Cushing Syndrome.
Dexamethasone supression test showed no cortisol suppresion when plasma cortisol level was
obtained. Pemeriksaan plasma ACTH dilakukan the next morning. What is the mostly the diagnosis?
a. Cushing disease
b. Cushing syndrome
 c. Ectopic ACTH
91. Woman 54 with lymphoma, constipation, BP 120/90, dry skin, cold intolerance, slow return of
Achilles tendon reflex, thyroid unpalpable. Diagnoes? (thyoid test pending)  hypothyroid
a. Myxedema
b. Cretinism
c. Grave’s disease
d. Jod Basedow phenomenon
e. Ridel’s thyroiditis
92. Seorang wanita dengan SLE, takut gendut jadi diet restriction, takut kena cancer kulit jadi tidak
berjemur. Pemeriksaan normal, takut osteoporosis. Untuk menghindari terjadinya bone loss gmn?
a. Alendronate
b. Risedronate
c. Fluoride
d. Nasal calcitonin spray
e. Vitamin D dan Calcium  vitamin D gantiin sinar matahari, calcium gantiiin dietnya dia
93. Seorang istri mengeluh. Suaminya selalu mengantuk, sepanjang hari sudah tidur tp tidak cukup. Juga
snoring setiap malam. Sleep apneu index 25, terjadi ST depression on V5 dan V6. penyebab
terjadinya ?
a. Continous hypocapnia
b. Intermittent hypoxia
c. Continous hypoxia
d. Intermittent hypocapnia  reduce CO2
e. Continous hypercapnia  increase CO2
94. Pengobatan untuk pasien tersebut?
a. Surgery
b.
c. Non invasive mechanical ventilator (CPAP)
Man 50 lose weight, DM
95. Why he lose weight even he eat much?
a. His meal is poorly absorbed by his intestine
b. His body uses mainly fat as the energy source
c. His body fat is converted into glucose and excreted via urine
d. He suffers dehydration
e. He has problem with his intestine in fat absorption
96. Why is his urine reduction 3+?
a. Its normal value
b. His kidney cant reabsorb glucose
c. Hid BG exceeds maximum transport
d. He also suffers kidney disease
e. His kidney secrete excessive glucose
97. Even he DM, his brain still working perfectly. Why?
a. Brain perform better with high BG
b. Brain neuron doesnt need GLUT
c. GLUT from brain differs from muslce GLUT  GLUT di otak ga butuh insulin buat
masukin glukosa
d. Glucose penetrates BBB freely
e. Glucose enter the brain through circumventricular organs
98. Man 58 medical check up. Normal at PE. Lab blood ca naik, phosphate turun, AP naik, lainnya
normal. Kemngkinan yang terjadi?  Ca naik, AP naik  ada nya resorpsi tulang yg tinggi
a. Hyperthyroidism
b. Hypothyroidism
c. Hyperparathyroid
d. Hypoparathyroid
e. Cholestasis
 99. Man 58 Renal kanan mengecil karena komplikasi DM. Increase urea nitrogen and creatinin with
protein urea. Penyakit acute pyelonefritis. Renal biopsy finding?
a. Membranous glomerulonephritis
b. Amyloid deposition
c. Diffuse glomerulosclerotic
d. Necrolyzing vasculitis
e. Chronic pyelonephritis
100. Man 50DM difficulty in urination, sexual erection attained. Vascular pathologic process?
a. Atherosclerosis
b. Arteriolosclerosis
c. Infarction
d. arteriosclerosis
e. Hyaline deposistion
Man 56 burning chest pain, obese, high BP, high BG, high LDL, high tryglyceride 
101. Diagnosis?
a. Obese
b. Dm 2
c. metabolic syndrome
102. 5 tahun kemudian MCI, knp?
a. Hyperuricemia
b. Uncontrolled hypertension
c. Uncontrolled diabetes
d. Dyslipidemia
e. insulin resistance
103. main factor determine his prognosis?
a. Compliance of taking medication
b. Lifestyle changes
104. 3100 gr baby girl, 39 weeks gestation, born to 28 years old woman dengan G2P1,
spontaneous, vaginal, good condition. After 2months she developed seizure, vomit and mousy odor.
Diagnosis?  PKU. KALO CYSTIUREA = sulfourous smell
105. Most possible causes  amino acid metabolism
106. Main orrgan affected  brain  bs microcephaly
107. Treatment yang akan diberikan?
a. Formula low in phenylalanine
b. Lactose free
c. Preotein restriction for life
Girl 8, breasts enlargement, bone accelerated. Pada pemeriksaan LH tinggi. Kalo LH tinggi berarti dari
central = dependent, klo LH rendah berarti dari peripheral/organ penghasil sex steroid = independent
108. What is the most likely the diagnosis?
a. Gonadotrophyn dependent precock puberty
b. Gonadotrophyn independent precock puberty
109. Obat yang diperlukan?
a. GnRH antagonist b. GnRH agonist  However, when used regularly, GnRH agonists
cause a decreased release of FSH and LH. GnRH produced by the hypothalamus is
pulsatile, allowing for a physiologic release of FSH and LH.
110. If the patient doesnt receive any treatment, what happen to her growth velocity?
a. Her height is between 5th – 95th percentile
b. Her weight is less than 5th percentile as adult
c. Her weight is more than 95th percentile as adult
d. Her height is less than 5th percentile as adult  induce early bone maturation and reduce
eventual adult height
e. Her height is more than 95th percentile as adult
A 9 years old boy was brought to hospital with short stature, gonadal dysgenesis (ga tumbuh), skeletal
abnormalities, cardiac and kidney malformation, dyrmofic face and no mental defect. For chromosomal
analysis revealed karyotype 45, x with structural abnormal of x chromosome.
111. What is your diagnosis?
a. Reifenstein syndrome
b. Klinefelter syndrome
c. Turner syndrome
d. Fragile x syndrome
e. Marfan syndrome
112. Management?
a. Observation
b. Growth and sex hormone
c. Surgical removal
d. GnRH agonist
e. Glucocorticoid abnd mineralcorticoid
113. Woman 25 has lump at anterior neck. Asymetric, palpable nodule in th left lobe.
Thyroidectomy micro : ground glass of the nucleus
a. Morbus basedow
b. Hashimoto thyroiditis
c. Grave
d. Papillary ca
e. Follicular adenoma
114. 35 tahun wanita, difficulty swallowing, feeking fullness of anterior neck, T4 serum normal.
Enlargement of thyroid gland. Di biopsy banyak infiltrate limfosit tissue pada sel-sel tiroid.
Diagnosis?
a. Hashimoto thyroiditis
115. Seorang pasien mengalami tumor pada kelenjar thyroidnya. Akan dilakukan surgery
thyroidectomy. Akan dilakukan prophylaxis dahulu. Prophylaxis dilakukan untuk mencegah?
a. Thyroid storm
b. Pendarahan thyroid
c. Hypocalcemia
d. Recurrent laryngeal damage
e. Hypothyroid
116. Female 35 difficulty in swallowing more than a year. T4 level normal. PE slight enlargement
of the thyroind gland with separately nodule cicatrix. Microscopic shows folicle lymphoid dominant
in the thyroid follicles.
Diagnosis?
a. Papillary Ca
b. Hashimoto thyroiditis
c. Toxic nodular goiter
d. Simple goiter
e. Morbus basedow
56. Complication from thyroidectomy can be prevent by prophylaxis action, which is?
f. Recurrent laryngeal nerve injury
g. Superior laryngeal nerve injury
h. Hypocalcemia symptoms
i. Thyroid storm symptoms
j. Post surgery-bleeding
57.Lady 56 came to the clinic Terdapat lump di tiroid dengan ukuran 28mm x 13 mm. Di perikasa
throrax xray dan hasilnya normal (tidak ada metastasis). Tetapi terdapat pembesaran lymph node
(Dhelphian lymph node). Thorax photo normal. Papillary carcinoma on thyroid right lobe. Staging
pada Ca ini?
k. T1N0M0
l. T1N1M0
m. T2N0M0
n. T2N1Mo
o. T2N1M1
58.A soprano underwent subtotal thyroidectomy because hyperthyroidism. Abisoperasi tidak bisa nyanyi
nada tinggi. Apa komplikasi dari operasi ini?
a. Neck hematoma
b. Recurrent laryngeal nerve injury
c. Superior laryngeal nerve injury
d. Parathyroid gland removal
e. Post surgery thyroid storm
59.Wanita, tidak mengalami menstruasi. Dalam 3 bulan terakir terdapat breast milk. Tidak makan obat-
obatan. Dan juga mengalami pusing, visual disorder.  ada hyperprolactinemia
Treatmentnya?
a. Desmopressin acetate
b. Cabergoline, bs jg dikasi bromocriptine, pergoline
c. Octreotide
d. Hydrcortison
e. Levothroxine
60. If she was a male, what is the symptom?
a. Sex dysfunction
b. Obesity
c. Diabetes
d. Pubic hair diminish
e. Spermatogenesis decrease