MCQ RESPIRATORY SYSTEM 10. Male, 30 years old, come with SOB.

On
Physical Examination, you found that the
FK UPH 2014 movement of his right chest is slower than
the left one, Hipersonor and Decrease
Vesicular of the right chest. What would the
1.
doctor do?
A. Nasal Cannulaà O2 60-79, saturation
A. Increase intrapleural pressure
90-94
B. Decrease intrapleural pressure
B. Venturi Mask
C. Increase Intraalveoral pressure
C. Non Rebreathing Mask
D. Decrease Intraalveoral pressure
D. Rebreathing Mask
E. Increase Intrathoracal
11.
2. A Traffic Police. Datang ke temannya dan
12. Female, 67 years old with Chronic Cough,
mengeluh bahwa Ia takut terkena penyakit
productive sputum particularly in the
paru karena terlalu sering hirup DUST,
morning after wake up and while change
ENGINE SMOKERS, etc. Temannya bilang
position, she has recurrent respiratory
material-material itu Fail to reach Lungs.
infection since young and inadequate
What is the protective mechanism to that
treatment. What do you found on chest X-
phenomenon?
ray ?
A. Action of epiglottis
A. Ring nodule à ring shadow
B. Ciliated Mucous lining the nose
B. Increased Vesicular marking
C. Abundant blood supply to nasal mucosa
C. Gohn
D. Porous Structure of turbinated bones.
D. Honeycombà ini CT scan
13.
3. Seorang lecturer, menjelaskan kalau ada
14.
abdominal muscle, khususnya traversus
15.
sama oblique, sama latisimus dorsi untuk
bernapas. Penjelasan yang tepat untuk
[KELLY 16-30]
menjelaskan kegunaan dari otot tersebut
16. Total Lung Capacity = E. 6650 ml?
adalah:
TLC= maximum volume of air that the lung can
A. Normal inspiration
hold= VC+RV= VC+ (IRV+TV+ERV)
B. Normal inspiration and expiration
C. Forced Expiration
17. You were attending a music concert which
D. Normal Expiration
was crowded with fans. This concert held
E. Shallow inspiration
was in a close auditorioum with poor
ventilation. What the process which
4.
happening in this condition ?
5. Gejala malam 2 kali per minggu. Ada asma
A. Decrease O2 and H+ cerebro spinal
setiap hari. FEV 60% (?). Variabilty 30%.
fluid/CSF
Termasuk golongan asma? afalin tabel
B. Increase O2 and H+ cerebro spinal
A. Mild Intermittent
fluid/CSF
B. Moderate Intermittent
C. Decrease CO2 and H+ cerebro spinal
C. Mild Persistent
fluid/CSF
D. Moderate Persistent
D. Increase CO2 and H+ cerebro spinal
E. Severe Persistent
fluid/CSF
E. Decrease O2 or CO2 Cerebro spinal
6. 23 years old man punched in the chest. He
fluid/CSF
felt suddenly breathless and extremely
difficult to breath. Neck vein severely
18. 65 years old come ED with Severe
congested, peripheral pulse could not be
Breathlessness. Dulunya adalah heavy
felt. What is the diagnosis?
smoker dengan 2-4 packs per day. Sudah 3
A. Rupture Lung
minggu berhenti. Obat apa yang cocok?
B. Paradoxical respiration
A. Oral aminophylline
C. Hemo-Pneumothorax
B. Oral albuterol
D. Cardiac Tamponade
C. Inhaler budesonide
E. Tension Pneumothorax
D. Inhaler Salmeterol
E. Inhaler Ipratropium
7. Acute Bronchiolitis
8.
9.
1
19. 16 years old boy presented with sudden
onset of left localized pleuritic chest pain
while having lesson at school. There was no
history of trauma and recent infection.
Nonsmoker and nondrinker and has
enjoyed well past health. On physical
examination patient was alert and in
respiratory distress, vital sign stable,
reduced air entry in the left chest with
resonant percussion. Breath sound was
vesicular and no trachea deviated. Heart
sound was normal and no murmurs. What is
the most likely diagnosis?
A. Atelectasis
B. Asthma attack
C. Pulmonary edema
D. Pulmonary embolism
E. Spontaneous Pneumothorax
20. 25 y.o. men/women went to emergency unit
because of shortness of breath. Radiology
shows pleural effusion. The doctor
undergoes thoracentesis to determine
pleural fluid and it shows exudative. Which
of these criteria to determine this fluid?
A. Protein content > 2.0 g/dL
B. Serum protein > 0.5, LDH>707, LDH
serum ratio>0.6
C. Serum LDH < 0.6
D. Lupa
E. Lupa
21. 15 years old with asthmatic attack came to
Puskesmas. Dia ga bisa ikutin intruksi dari
dokternya. Mendingan dikasi yang pake
cara apa?
A. Dry Powder di nasal cavity
B. Hold and use Metered Dose Inhaler
when take a deep breath
C. handheld nebulizer with mask
D. administer asthmatic attack
E. insert directly into trachea
Pembahasan
• Metered dose inhaler. Small hand-held
devices, metered dose inhalers are a
common delivery method for asthma
medication. Along with his or her inhaler,
your child will probably also need a
hollow tube (spacer) with a mouthpiece.
If your child is younger than 4
years old, he or she may need a face
mask. This device attaches to the spacer
and delivers medication while your son
or daughter breathes normally.
• Dry powder inhaler. For certain asthma
medications, your child may have a dry
powder inhaler. This device is not
generally used in children younger than 4
years old, as it requires a deep, rapid
inhalation to get the full dose of
medication.
• Nebulizer. A nebulizer turns medications
into a fine mist your child breathes in
through a face mask. A nebulizer can
deliver larger doses of medications into
the lungs than an inhaler can. Young
children often need to use a nebulizer
because it's difficult or impossible for
them to use other inhaler devices.
22. Media untuk grow mycobacterium
tuberculosis? Jensen Lowenstein agar
23. Normal person dtng ke emergency
department cause accidentally a piece of
steak stuck on trakea. Likely to occur:
A. Po2 alveolar = po2 mixed venous
B. High v/q
C. Po2 areterial will rise
D. Po2 alveolar = po2 atmosfer
24. 23-year-old man datang keluhan SOB, feels
weakness. Mukanya edem, lengan edem,
ada jvp. obstruksi dimana? Superior Vena
Cava
25. 55 years old man, smoker, 2 packs a day,
come with progressive 6 months SOB,
cough, and hemoptysis. Doctor said lung
tumor. What is the gold Standard for
diagnosis Lung Tumor?
A. Lateral Chest X-rat
B. Contrast CT-scan
C. Sputum examination
D. USG
E. Bronchoscopy
26. A normal healthy person is come to
emergency department after having a steak
stuck in the trachea that causing a complete
airway block. What is likely to happen?
A. Alveolar PO2 is equal to mixed
venous PO2
B. arterial PO2 will rise
C. High V/Q
D. Alveolar PO2 is equal with atmospheric
PO2
27. 36 years old woman come with Semi-
Comatose state. ABG: pH 6,96 (7,35-7,45) ;
PCO2 25 (35-45) ; PO2 85 (75-100) ; HCO3-
5 (22-26). What type of this Acid-Base
Imbalance?
A. Metabolic acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
2
 E. Mixed Acid Base Imbalance
28. (Intinya) pada penderita emfisema
mekanisme apa yg terganggu?
Macem macem volume yg terganggu
29. Cowo 25 tahun datang dgn keluhan
worsening cough and pleuritic chest pain,
hasil lab menunjukkan gambar:
Anggap aja gambarnya ini
[kalo di soal tahun lalu sih harusnya criptokokus
lol, pokoknya bulet bulet kaya tt]
Diagnosisnya apa?
A. Pneumocystis jiroveci pneumonia
B. Aspergilosis
C. Paracoccidioidomikosis
D. Cryptococcus
E. Histoplasmosis
30. Patient experience weakness, dyspnea,
nausea, diarrhea, bowel movements 5-10
times a day, and is watery. GCS 10. BP
85/50 ; pulse 125 ; RR 32 ; Temperature
37.8oC ; SO2 98% ; pH 7,29 ; paCO2 25,6 ;
PaO2 98 ; HCO3- 14. What is his condition?
A. Metabolic acidosis with compensated
Respiratory alkalosis
B. Metabolic acidosis with uncompensated
Respiratory alkalosis
C. Respiratory acidosis with compensated
metabolic alkalosis
D. Respiratory acidosis with
uncompensated metabolic alkalosis
E. Mixed
[ZEVAR 31-45]
31. A man 20 years old, alergi, tambah parah
saat hujan. Obat apa yang dikasih?
Second Gen Anti Histamine
32. Ada anak asma diberikan Salmeterol dan
Formoterol. Ibunya menolak, maunya obat
oral aja. Mending kasih apa?
A. Cell Mast stabilizer
B. Montelukast
C.
D. Phosphodiesterase Inhibitor
33. A 66 years old Female with SOB, left sided
chest pain aggravated on deep breathing. 2
tahun yang lalu melalui Colectomy colon
cancer. Increase D-dimer
A. Acute myocardial infarction
B. Dissecting aortic aneurysm
C. Pneumonia
D. Pneumothorax
E. Pulmonary Embolià D dimet untuk
DVT
34. A man with overdosed nacrotic drug
brought to you by his family. RR 7x / menit.
Penyebab?
A. Paralysis of Intercostal muscle
B. Damaged Respiratory Center
C. Parasympathetic Hypertonic
D. Sympathetic Hypotonic
E. Suppress Respiratory Center
35. A man 22 years old with cough, SOB, fever
since 5 days ago. The doctor diagnosed
him with Empyema. X-ray Finding; Blunting
of Costophrenic Angle
36. Pasien HIV (+). GIEMSA staining shows
budding yeast within macrophages. Culture
Yeast at Temp 37 degree, Hyphae at temp
25 degree. What is the most likely
pathogenesis?
A. Cryptococcus
B. Aspergillus
C. Cocci diodes
D. Blastomyces
E. Histoplasma capsulatum
37. Seseorang pernah kena TB. Sudah
dinyatakan sembuh. 3 Tahun kemudian TB
lagi. Tergolong kasus apa orang ini?
A. Kasus Baru
B. Kasus Relaps
C. Kasus Gagal
D. Kasus Drop Out
38.
39. Male, 48 years old, complain fever and
chills 24 hours with episode rigor. He is
COPD and Smoker 75 packs/year. He also
complains increase dyspnea. Pulse 120 ;
RR 40 ; pH 7,64 ; PHCO3 14 ; PaCO2 30 ;
PaO2 58.
3
 A. Metabolic alkalosis with compensated HR 120 ; BP 100/80. BGA: pH 7.2 ; pO2
Respiratory acidosis 50 ; pCO2 82.5 ; HCO3 28. Blood routine
B. Metabolic alkalosis with uncompensated exam : WBC : 11.000, Hb : 17.8, Ht : 51,
Respiratory acidosis platelets : 420.000, natrium : 135, kalium :
C. Respiratory alkalosis with 5. He is unconscious. Why?
compensated metabolic acidosis A. Severe hypoxemia
D. Respiratory alkalosis with B. CO2 narcosis
uncompensated metabolic acidosis C. Sepsis
E. Mixed D. Hyperkalemia
E. Hyponatremia
40. A 67 years old man, heavy smoker, was
diagnosed with Bronchogenic Carcinoma 44. V/Q mismatch patient hypoxemia. Treated
arrived at the ED. Doctor found facial with supplemental O2. Will supplemental
edema, Upper extremities swelling. O2 be more helpful if the the type of V/Q
Abdominal Vein distention was also noted. mismatch is
What is the possible affected vein? A. Dead space
A. Inferior Vena Cava B. Shunting
B. Jugular Vein C. Low V/Q
C. Superior Vena Cava D. V/Q = ∞
D. Pulmonary Vein E. V/Q = 0
E. Bronchial Vein
45. 40 years old female came to ED with
41. 32-year-old come to pulmonology shortness of breath. On physical
department with complains of progressively examination the doctor found dullness and
shorted of breath and productive sputum. decrease vesicular on both side of the
Actually she often got this kind of condition lungs. Pleural fluid analysis shows Glucose
but not severe and relieves after inhaled 110, LDH 160 blood analysis hb 12, WBC
albuterol which it given by her doctor. She 7000, Erythrocyte 5,06, albumin 1,8. What
always used medication as needed. She is the pathophysiology of this case?
said in this last several days, she used that A. Increase hydrostatic pressure
albuterol inhaler nearly every day and B. Iincrease oncotic pressure
several times a day. She used that inhaler C. Hydrostatic pressure is equal to oncotic
but it seems not working anymore. Which of pressure
the following is the most likely cause of her D. Decrease hydrostatic pressure
problem? E. decrease oncotic pressure
A. Down regulation of receptor
B. Buying an inequality drug [LITA 46-60]
C. Decrease of patient compliance 46. A 60 years old male with batuk produktif,
D. Development of antibody SOB udah lama. 3 hari yang lalu makin
E. Hypersensitivity to the lung parah. Dia heavy smoker. PF nya ada
clubbing finger, widening intercostal space.
42. You ask a severely smoking patient to do Radiologinya ada hyperlucent dan
forceful exhalation in respiratory checkup, hyperinflation. Inflamatory cells yang
what muscle involved in that process? berperan?
A. External costal muscle, abdominal A. Eosinophil
muscle B. Neutrophil
B. Internal intercostal muscle, abdominal C. Limfosit
muscle D. Monosit
C. External intercostal muscle,
sternocleidomastoideus muscle, sclenic 47. A 36 years old female, height 158 cm,
muscle Weight 35 kg. AFB positive for 3 times test.
D. Internal intercostal muscle, Tuberculin test = 4 mm. WHY?
sternocleidomastoideus muscle, sclenic A. Secondary infection
muscle B. Immunocompromised
E. Internal intercostal muscle and C. Allergic Reaction
diaphragm D. Chronic Disease
E. Hypersensitivity
43. Patient is heavy smoker and shortness of
breath. On Physical Examination, RR 42 ;

4
48. Female, 67 years old with Chronic Cough,
productive sputum particularly in the
morning after wake up and while change
position, she has recurrent respiratory
infection since young and inadequate
treatment. On chest X-ray found
Honeycomb appearance. What do you
expect from Spirometry?
A. FEV1/FVC normal
B. Decreasing FVC
C. Increasing FEV1/FVC
D. Increasing MVV
E. Decreasing FEV1/FVC
49. Female 76 years old, came with high fever,
cough, SOB, since 3 days ago. On Physical
examination : Dull percusion on the right
lung, Vesicular naik, croase crackles di right
lung. Blood test : hb 12 ; WBC 14560 ;
erythrocyte 5600 ; thrombocyte 234000 ; X-
ray ada consolidation. Bakteri apa yang ada
di sputum?
A. Streptococcus pneumoniae
B. Legionella
C. Hemophilus Influenza
D. Klebsiella pneumoniae
E. Pseudomonas aeruginosa
50. A 67 years old male with Index Brinkman
400 came to you with SOB. On Physical
Examination, You can see Intercostal
Widening, liver border on 7th intercostal
space, accessory muscle (+), prolonged
expiration, and pursue-lip breathing. Diffuse
wheezing can be heard. What is the
enzyme that has to be blocked to maintain
airway open regarding to this case?
A. Adenylylcyclase
B. Guanylylcylaseà bromide
C. Fosfodiesterase à theophyline
D. Proteinase
51. 25 years old with Chronic cough, sering
SOB at MIDNIGHT. Father has the same
symptoms. Awalnya FEV1 = 63%, setelah
diberi Bronchodilator FEV1 = 78%.
What is the cell plays a role?
A. Eosinophil
B. Basophil
C. Lymphocyte
D. Monocyte
E. Neutrophil
52.
53. 53 years old female, come to lung clinic with
hemoptysis (one dining spoon every cough)
since 2 weeks ago. She feel weight loss,
SOB, night sweat, sub febrile fever. What is
the first diagnostic procedure for this?
A. Thorax X-ray
B. Thorax CT-scan
C. Acid Fast Bacilli Sputum Examination
D. Gram staining Bronchial Lavage
Examination
E. CBC and ESR
54. A normal person lies down to her left side
and breathes normally. Her left lung, in
comparison to her right lung, will have
expected:
A. Higher PAO2 and lower PACO2
B. Lower Blood flow per unit volume
C. Lower Ventilation per unit volume
D. Larger Alveoli
E. Lower V/Q ratio
55. Pasien TB, ada intermittent Join Pain. Obat
apa yang ga boleh dikasih? Pirazinamide
Efek samping obat = numbness di tangan.
Efek samping dari obat apa?Isoniazid
56. Female, 20 years old, experiences SOB
suddenly after lifting a very heavy box. No
history of lung disease and no propr
symptom of Respiratory disease On
percussion the doctor found hypersonor on
right side of the lung. Chest X-ray showed
avascular area and the pleural line on the
right lung. What is the MOST likely
diagnosis for patient?
A. Primary Spontaneous Pneumothorax
B. Secondary Spontaneous Pneumothorax
C. Traumatic Pneumothorax
D. Iatrogenic Pneumothorax
E. Catamenial Pneumothorax
57. Ada anak bekas TB, ada bloody sputum,
dan ada honeycomb. Apa yang rusak?
A.(lupa)
B. Main Bronchus
C. (lupa)
D. Terminalis Bronchioles
E. Respiratory Bronchioles
58. 67 years old. Empyshema. Abnormal
Physiological Testing?
A. Decrease total lung capacity
B. Increase Vital capacity
C. Decrease volume residual
D. Decrease lung diffusion
E. Increase Peak Flow Examination
59. What is the function of External Intercostal
Muscle? ELEVATION OF RIBS FOR
INSPIRATION
60. Seorang anak kecil perempuan menelan
kancing metal dan menjadi shortness of
5
 Breath. Ia dilarikan ke rumah sakit dan pada E. Obstruction of lymphatic drainage
PF ditemukan Stridor paling keras
terdengar pada Right anterior Inferior Lobe. 88. soal nya ttg ph ph gitu
Penjelasan yang memungkinkan?
A. Tracheal deviasi [JASON 91-100]
B. Bronkus kanan lebih vertikal 93. Anak umur 3 tahun ada wheezing. Udah
C. Ia supine saat inhalation diobatin tp gak sembuh2. Kebiasaan: main
di karpet sama kucingnya. Penyebab nya
adalah?
[STACEY 61-75] A. Cryptococcus
63. Pekerja datang ke GP dengan komplain B. Histoplasma
Fatigue, Dizziness. Ia kerja di basement C. Dermatophagoides pterynissinus
parking. Kira-kira Pollutionnya apa? (jawaban!)
A. Nitric Oxide D. Aspergillus
B. Sulfur Dioxide
C. (lupa) 61. A 35 years-old male with inferior left sided
D. Carbon Monoxide pleural effusion is examined in the standing
E. Carbon Tetrachloride position. The pleural fluid is MOST LIKELY to
collect in this patient in the :
[NOVI 76-90] a. Oblique fissure
76. Premature baby was born and suddenly b. Cardiac notch
shortness of breath. What is the cell that c. Costodiaphragma recess
influence? d. Costomediastinal recess
A. makrofag e. Horizontal fissure
B. goblet cell
C. type ii alveolar 66. Male 30 years old : short of breathing.
D. eusinofil Physical examination : vesicular breathing &
E. mast cell coarse crackles di paru kanan. Acid fast bacilli
positif, ada oral rush di mulut. Beberapa tahun
80. Seorang anak umur 15 tahun ada lalu dia drug abuser. Exam berikutnya?
wheezing. Ada runny nose klo g salah. A. Liver function
Orang tuanya punya riwayat rinitis. Apa B. CD4 count
pathogenesisnya ? C. Ureum creatinin
A. Bronchus muscle contraction D. Tuberculin test
B. Degranulasi mast cell E. CT Scan
C. Mucousal swelling
D. Increase production of mucous 70. Left pleuritic chest pain .left hyperlucent.
E. Destruction of alveolar Dyspnea. Thorax deviated to the right.

83. ada orang TB, trs dokternya cek cairan 73. A boy 6 month old with cough wheeze and
pleura nya. apa yg di temukan di sna ? sob. History of dec. Appetite and sneezing.
A. LDH : serum rasio > 0,5 Temperature 38,4 and rr 35/mnt. Have clear
B. glucose > 600 rhino, nasal congestion, and nose flaring. What is
C. LDH < 0.5 the pathogen?
A. Adenovirus
85. orang asma stabil dateng ke kita. nah B. Influenza
gimana ngecek nya? C. Rhinovirus
jawab nya yang metacholine test itu D. Respiratory Synctitial Virus
challange test untuk E. Strep. Pneumococcal
86. Pasien bapak" increasing dyspnea he has a
history of uncontrolled hypertension, bp
150/90 pulse 90 dyspneu worsen when
lying down pf: decreased tactile fremitus,
decreased breath sound, dullness to
percussion
A. Decreased oncotic pressure
B. Increased hydrostatic pressure
C. Increased vascular permeability
D.