Multiple Choice Questions

NEUROSCIENCE
FK UPH 2014
Friday, 07 Oct. 16
08.10 – selesai
[Missed questions : 1-3 numbers]

1. 1 year old boy dibawa ibunya karena delayed mental development dan kepala
membesar. Di diagnosis kena hydrocephalus. CSF mengalur dri ventricle tiga ke
ventricle empat melalui?
A. Foramen luschka
B. Foramen magendi
C. Foramen monro
D. Cisterna magna
E. Aquaductus cerebri sylvi

2. 1. Neural crest
2. Notochord
3. Neural plate
4. Neural tube
5. Neural groove
Urutan yg bener gimana?
E. 2-3-5-1-4

3. Male new infant , normal vital sign, have a bulging cyst like diameter 4cm in his back.
Limited low extremities ability to move. Closure bagian mana yg bermasalah?
A. Neural tube
B. Anterior neuropore
C. Posterior neuropore
D. Neural plate
E. Mesenchyme

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4. 3 main function of csf :
A. Homeostasis, immunologis, blood brain barrier
B. Homeostasis, immunologis, mechanical function
C. Homeostasis, immunologis, circulation of nutrient
D. Homeostasis, circulation of nutrient, mechanical function
E. Homeostasis, circulation of nutrient, blood brain barrier

5. Which of the items listed below best characterizes the following statement: A graded,
fast potential, lasting from several milliseconds to seconds, resulting from a chemical
transmitter binding to a receptor to produce either an excitatory postsynaptic potential
(EPSP) that depends upon a single class of channels for sodium and potassium or an
inhibitory postsynaptic potential (IPSP) that is dependent upon chloride or potassium
conductance.
A. Receptor potentials c
B. Electrical postsynaptic potentials
C. Increased-conductance postsynaptic potentials (USMLE)
D. Decreased-conductance postsynaptic potentials
E. Decreased-conductance postsynaptic potentials

6. Which of the following characterizes a principal feature of axosomatic synapses?

A. It is referred to as a type I synapse
B. They have an electrical continuity linking the pre- and postsynaptic cells
C. They are typically inhibitory (USMLE)
D. Synaptic transmission is mediated by glutamate
E. They form the predominant synapse of cortical projections to the neostriatum

7. A 65-year-old man is diagnosed with a form of a peripheral neuropathy. This individual

will likely display which of the following:
A. A loss in motor function, but sensory functions will remain largely intact
B. A reduction in conduction velocity of the affected nerve (USMLE)
C. An increase in the number of Ranvier's nodes
D. Degeneration of myelin but the axon will typically remain intact
E. Signs of an upper motor neuron (UMN) paralysis

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8. 25 years old female comes with paralysis and sensory loss. Oligoclonal igG band was
found in the laboratorium examination. Multiple sclerosis was diagnosed by the doctor,
based on MS McDonald’s criteria. What is the cause of paralysis and sensory loss?
A. Activate Voltage-dependent Na
B. Increase Ca efflux
C. Increase Na efflux
D. Increase Velocity conduction
E. Increase K efflux

9. Neurodegenerative dx dapat menganggu astrosit. Pertubration astrocyte can disrupt

triptate something. Karakteristik yang berhubungan dengan LTP?
A. Habituasi
B.
C. Astrosit Ca2+
D.
E. Pembentukan receptor AMPA yg baru

10. What is the most conspicuous stimulate area that responsible for almost natural sleep?
A. Hypothalamus
B. Locus cerelous NE -> wakefulness
C. Raphe nucleus serotonin
D. RAS
E. Pontomesencephalon

11. 4 years old dibawa ortunya ke RS. Woke up in the middle of the night. Kadang ada di
suatu tempat di rumahnya, crying, screaming. Pas paginya dia bangun seperti biasa
dengan happy mood dan ga inget kejadian malamnya. Dokternya bilang kalau dia
experience nightmare or night terror. Kejadian ini ada di fase mana?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4 parasomnia: night terrors, enuresis, somnabulism, nightmare GA BISA
INGET
E. REM dream DIINGET, atonia

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12. A 2 y.o baby girl is brought to hospital by her mother because an ulcerative mass in her
spine around T12-L1. An examination by CT- scan across abdomen showed an abcess.
A curretage biopsy is performed and its hystopathologic showed necrous caseous, giant
cell of langhan, (satu laginya lupa )
What is your diagnosis that most likely you may describe for this condition?
A. Spina Bifida
B. TB spondylitis
C. Synovitis non specific
D. HNP
E. Poliomyelitis

13. A 32-years old women come to clinic with bilateral weakness of lower limb. The
neurological examination: no neck stiffness; increased tone, hyperactive tendon
reflexes, extensor plantar response on right foot. What type of cells that provide this
mechanism?
A. Astrocyte
B. Oligodendroglia
C. Schwann Cell

14. 65 yo man brought to emergency room with gradually unconsciousness since 3 days
ago after his head against the floor when he fell down from stairs. The neurosurgeon
did an urgent craniotomy and evacuate blood from space between dura-mater and
arachnoid-mater. What is the diagnosis?
A. Pontine hemorrhage
B. Subarachnoid hemorrhage
C. Epidural hematoma
D. Subdural hematoma
E. Basal ganglia hemorrhage

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15. 45 y.o man previously healthy develop headaches over past month. No remarkable
finding d PE, Cerebral angiogram shows 7 mm saccular aneurysm di trifurcatio right
MCA. Komplikasi:
A.subdural hematom brigding vein
B. Subarachnoid hemorrhage aneurysm, AVM
C.epidural hematom middle meningeal artery
D.cerebellar parotid herniation (kalo ga salah )
E.hydrocephalus

16. 80 years old was admitted to hospital because of recent onset fluctuating level of
consciousness. Ct scan of head show collecting blood between dura mater and skull of
right. What most like produce symptoms findings?
A. Tear of bridging veins
B. Ruptured saccular aneurysm
C. Blood from AVM
D. Ruptured of middle meningeal artery
E. Thrombosis of middle cerebral artery

17. What is the origin of the anterior communicating artery?

A. Internal carotid artery
B. Anterior Cerebral artery
C. Medial Cerebral artery
D. Posterior Cerebral artery
E. Basillar artery

18. An 18 year old college student presented with the following signs after having a
midthoracic spinal injury. With eyes closed he could not tell whether his toe was
dorsiflexed or plantarflexed. In addition, there is loss of tactile discrimination and
vibration sense. The lesion is involved in which of the following tracts?
A. Corticobulbar
B. Spinocerebellar
C. Spinothalamic
D. Cortiocspinal
E. Dorsal column

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19. A 40 year old woman felt uncomfortable going with the car especially during
acceleration and deceleration. What kind of vestibular receptor will be stimulated
during acceleration and deceleration (horizontal)?
A. Utricle
B. Saccule
C. Canal semilunaris horizontal
D. Canal semilunaris anterior
E. Canal semilunaris posterior

20. In testing for motor neuron, a neurologist nemuin An upwards movement of the patient
toe when the plantar surface of his foot was stretch. This respon is indicative of a
lession of a part of the nervous system. Which is the following that cause that response
A. Dorsal collom
B. Sensor neurons
C. Lupa
D. UMN corticospinal
E. LMN

21. Left weakness of limb, left vibration, loss sensation of pain temp which injury?
A. Anteriot cord syndrome
B. Central canal syndrome
C. Left hemisection syndrome
D. Right hemisection syndrome
/
22. Kakek2 dateng hemiparesis, buat exclude hemorrhage pake apa?
A. Angiogram
B. CT Scan with no contrast
(pilihan lain lupa)

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23. 24 years old female complex partial seizure. Automaticism di complex partial seizure?
A. Lip smacking, chewing, gesturing
B. Singing and coughing
C. Choreiform dance like movement
D. Rigid arm motion directed laterally
E. Jerking in extremity

24. 9 years old boy has absance seizure. Which is the best describe absance?
A. Right arm tremulous
B. Stop kegiatan , pandangan kosong, daydreaming
C. Flexion extension of arm leg
D. Loss of tonus and fall to ground

25. The drugs donepezil, rivastigmine, and galanthamine are used in AD to try to raise the
availability of what transmitter in the brain?
A. Dopamine C. Glutamate
B. Norepinephrine D. Acetylcholine

26. Abnormal processing of which of these proteins is felt to be particularly important in

the pathophysiology of Alzheimer’s disease?
A. Acetylcholinesterase
B. Alpha-synuclein
C. Huntingtin
D. Amyloid precursor protein
E. A right spinal cord hemisection syndrome

27. A 61-year-old man is brought into the doctor’s office for memory loss and confusion.
Which of the following symptoms are most suggestive of Alzheimer disease as opposed
to dementia with Lewy bodies?
A. Visual hallucinations
B. Dramatic fluctuations in clinical condition
C. Early anterograde memory loss dementia with lewy bodies : cognitive decline
without prominent early memory impairment -> fluctuating cognitive ability,
visual hallucinations and sign of parkinson

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 D. Early shuffling gait
Lewy body disease kebagi 2 : Parkinson dz with dementia (develop dementia at least 1
year after onset of motor sx) and dementia with lewy bodies (dementia has its onset
prior to or within 1 year of first motor sx).

28. College student, injured karna kena tackle pas football game, dibawa ke rmh sakit
ditemukan bahwa:
- unable to abduct and rotate left arm at shoulder
- ga bisa flex elbow kiri
- ga bisa angkat wrist kiri
Pas PF: decreased biceps reflex di limb itu, di limb lainnya normal
Kemungkinan lesinya dmn:
A. Pre central gyrus
B. Basilar pons
C. Ventral horn at C1
D. Nerve root c5-6
E. Triceps muscle

29. What is the most common cause of Bell’s Palsy in an adult?

A. Lyme disease
B. Varicella zoster reactivation
C. Acoustic neuroma
D. Herpes simplex virus reactivation
E. Noncaseating granulomas

30. A 45-year-old woman complains of recurring episodes of vertigo that began after she
bumped her head rather forcefully 2 weeks ago. Her spells last 10 to 15 seconds and
occur whenever she goes to bed or wakes up. She denies any hearing loss or tinnitus.
Her physical examination is normal except for a latent, rotatory nystagmus when she is
lying with the right ear down. What is the most likely diagnosis?
A. Acute serous labyrinthitis
B. Benign paroxysmal positional vertigo
C. Vestibular migraine
D. Ménière disease

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 E. Viral vestibular neuronitis

31. 10 year old girl come with his father to your clinic becausr of weakness on both lower
extremities when she woke up in the morning and it was so hard for her to get off from
her bed. In the afternoon, she had difficulty to rise up her both arm when she try to
comb her hair. She also had a shortness of breath and sore throat for 3 weeks ago. She
underwent lumbar puncture, and analysis of csf showed following result:
 None (-) pandy (++)
 Cell count 4/ul
 PMN -
 Protein 300 mg/dl
 Glucose 98 mg/dl
Diagnosis nya apa?
A. GBS cell normal, protein naik : cytoalbuminologic dissociation
B. Acute stroke
C. Myasthenia gravis
D. Inflammatory myopathy
E. Tick paralysis

32. A 62-year-old man with hypertension and diabetes presents with acute right face, arm,
leg weakness, slurred speech, and right-sided hyperreflexia.
A. GBS
B. Acute stroke
C. Myasthenia gravis
D. Inflammatory myopathy
E. Tick paralysis

33. A 34-year-old woman presents with fatigable muscle weakness with climbing stairs or
blow drying her hair. This is associated with some shortness of breath, which improves
with rest. What neurotransmitter plays a role?
a. NE
b. Dopamine
c. GABA

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 d. Serotonin
e. Acethylcholine myastenia gravis

Soal 34-36
A 35 years old male got a motor vehicle accident, he was unconscious for 15 minutes, forgot
all memory around the accident time frame. He was conscious when he admitted the
emergency unit. BP 130/80 mmHg, HR 88 x/minute. During clinical investigation in
emergency unit, he became unconscious. He also developed right pupil dilatation, and left
side weakness.

34. Why does he develops right pupil dilatation?

A. Direct uncal compression at the pons level
B. Direct uncal compression at the medulla oblongata
C. The uncus cause stretching of the third nerve
D. The uncus cause stretching of the sixth nerve
E. The uncus cause stretching of the forth nerve

35. The physician did a CT Scan, according to the clinical findings, what would you
expected to find?
a. Intraventricular hemorrhage
b. Epidural hemorrhage at posterior fossa
c. Subdural hemorrhage at interhemispheric
d. Epidural hemorrhage at occipital region
e. Epidural hemorrhage at temporal region

36. He got a lucid interval, means conscious interval between two episodes of
unconsciousness. What is the most probable cause of second episode of unconscious?
A. Direct uncal compression at the pons level
B. Direct uncal compression at the medulla oblongata
C. Direct uncal compression at midbrain
D. Direct uncal compression at cingulate gyrus
E. Direct uncal compression at corpus callosum

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37. 25 years old man feel weakness 9n both lower limb after fall from 4th floor building.
Physical examination reveals Babinski reflex positive. What structure involve?:
A. lateral spinothalamic
B. Gracilis and cunateus fasciculus
C. Lateral corticospinal
D. Dorsal column
E. Spinal nerve

38. Cowo umurnya lupa, udah 1 minggu pusing kepala dan demam. Pada pemeriksaan fisik
ditemukan plantar reflex positive, ada nuchal rigidity. Tidak ada papilledema. Sebelum
pemeriksaan lbh lanjut, diagnosis yg paling mungkin..
A. Meningitis
B. Cerebral hemorrhage
C. Subdural hemorrhage
D. Lupa
E. Obstructive hydrocephalus

39. A 56 years old man came to ER with sudden weakness of his left extremities.
He had history of hypertension and diabetes. On examination his strength on left
extremities was grade 2. His rest examination was normal. Brain MRI showed
infarct on right internal capsule. The fiber tract affected by this syndrome
decussates at what level?
A. At the anterior thalamus
B. At the junction of the medulla ob. and the spinal cord
C. At the junction of the midbrain and the medulla ob.
D. At the junction of the pons and the medulla ob.
E. Within one to two levels after entering the spinal cord

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40. Cewe 56 yo tiba2 menjatuhkan cangkirnya ketika sedang minum kopi. Dia gak bisa
bangun, gak bisa jalan. Physical examination ada weakness di sebelah kiri. BP: 150/110
RR dan pulse rate normal. Pas di neurologic exam, kekuatan face dan motoric upper
extremities 4, sedangkan lower extremities 0. Kenanya dmn?
A. Arterior cerebral artey jwbn dr vivien.
B. middle cerebral artery
C. Posterior cerebral artery
D. Basilar artery
E. Lenticulostriate artery pure motor

41. A 21 year old man got his left elbow injured after motorcycle accident. The Xray showed
fracture at epycondyle of left humerus. After the surgeon doing fixation and reposition
procedure, he can't move his left thumb. Which of the following nerve is impaired?
A. n. Musculocutaneous
B. N. axillaris
C. N. medianus
D. N. radialis
E. N. ulnaris

42. A man went to the doctor given the injection in right buttock. After the injection he
experienced weakness in the right leg, he cant stand up or squat. Which of the
following nerve is affected ?
A. Inferior gluteal nerve
B. Superior gluteal nerve
C. Pudendus nerve
D. Schiatic nerve
E. Inferior cluneal nerve

43. When somebody exposed to a sharp objects then initially the body will perform reflex.
Which of the following is the sequence of reflex?
A. Impuls > Sensory neuron > Receptor > Spinal cord > Motor neuron > Effector
B. Impuls > Motor neuron > Receptor > Spinal cord > Sensory neuron > Effector
C. Impuls > Receptor > Sensory neuron > Spinal cord > Motor neuron > Effector

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44. laki" 54 tahun terdapat tremor ditangan kanan yg semakin parah sejak 6 bulan. serta
sulit untuk menggerakkan tubuh terutama untuk jalan. PF : tremor tangan kanan pada
saat istirahat, mask face, slow and deliberate gait, tonus tangan dan kaki kanan naik.
treatmentnya apa?
A. amantadine
B. anticholinergik
C. dopamine
D. levodopa
E. SSRI

45. A 62 year old man complain double vission when he looks to his left. On examination,
he experience double vission when pursuing object and being worst when he looking to
his left. When he covers his left eye, the outermost image dissapears. Which of the
following cranial nerves is most likely to be affected?
A. Left oculomotor D. Left trochlear
B. Right oculomotor E. Left abducens
C. Left optic

46. Cewe 70an tahun came to emergency because of paralysis in hand and feet, CT found
out there is infraction in left middle cerebral artery.
What is the best drug to prevent the 2nd time relapse?
A. Streptokinase
B. rTPA
C. Acetylcholie esterade
D. Clopidogrel

47. 35 y.o brought to ER after traffic accident. Neurologic examination: corneal reflex
absent on both eyes. Which is the abnormal Cranial nerves?
A. Optic nerve
B. Oculomotor nerve
C. Trigeminal nerve
D. Vagus nerve
E. Accesorius nerve

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48. 25 years old male with tingling and numbness over the little finger and ring finger,
wasting of the dorsal interssei and abductor digiti minimis, and sensory disturbance
over the little finger and ring finger. Where is the location of the peripheral nerve
lesion?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Peroneus communis nerve
E. Brachial Plexus

49. 45 year old woman presented with blurred vision gradually since 3 months ago. The
neurological examination revealed visual deficit with pattern below:

Which of the following site lesion for her symptom?

A. Temporal lobe
B. Occipital lobe
C. Parietal lobe
D. Optic chiasm
E. Retina

50. 40 yo woman complains headache that is getting worse, she also complains of difficulty
in smelling perfume, Ct shows brain tumor, which lobe is the probable location of the
tumor?
A. Occipital
B. Temporal
C. Frontal dr vivien
D. Optic chiasm
E. Brainstem

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51. A 37 years old man fell down when fix the roof of his house. His back hit big stone on
the ground then suddenly he feel sensory deficit for temperature and pain. Which tract
of the spinal cord is the mostly affected?
A. Fascicullus gracilis
B. Fascicullus cuneatus
C. Spinothalamic anterior
D. Spinothalamic lateral
E. spinocerebellar

52. A 30-year-old man was crashed by motorcycle and felt down at his sacrum. The
imaging showed fracture of his sacrum. Afterwards he has problem of micturia and
dysfunction of erection. What nervous system is the most likely injured:
A. parasymphatetic nervous system
B. symphatetic nervous system
C. sensoric nervous system
D. motoric nervous system
E. central motor neuron

53. An 18 year old college student presented with the following signs after having a
midthoracic spinal injury. With eyes closed he could not tell whether his toe was
dorsiflexed or plantarflexed. In addition, there is loss of tactile discrimination and
vibration sense. The lesion is involved in which of the following tracts?
A. Corticobulbar
B. Spinocerebellar
C. Spinothalamic
D. Cortiocspinal
E. Dorsal column

54. When hiring a new employee, the doctor examines several reflexes including the
patellar reflex. What is the receptor most related to the reflex above?
A. Corpus Paccini receptor in the joint
B. Touch receptor in the patella
C. Receptors in Muscle spindle
D. Golgi tendon apparatus

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55.
56. Eosinophilic cystoplasmic inclusions in the brain cells of patients with parkinson's
disease is :
A. Tau protein
B. Amyloid plaques
C. Golgi bodies
D. Pachusen bodies
E. Lewy bodies

57. 40 year old male construction worker dtg dengan keluah stiffness pada leher, jaw,&
back. Previously he had nail wound. What is the bacteria responsible for it?
A. Clostridium perfringens
B. Clostridium botulism
C. Clostridium ...
D. Clostridium tetani
E. Clostridium s...

58. A young woman present with sudden onset of double vision, dry mouth, and weakness.
No previous history of episodic weakness or dog/tick bite. Last night she ate som
canned-food. Physical examination show she alert and no fever. Doctor notice
ptosis:bilateral third and tenth cranial nerve, symmetric flaccid of all four extremities,
decrease deep tendon reflex, decrease bowel sound, no sensory loss. Mechanism?
A. Close contact with infected animal
B. Stop___ (?) Elongation factor 2(EF-2)
C. Inhibiton release of acethylcholine botulinum
D. Contagious of ___ infectiouse
E. Lupa maaf

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59. A 18 years old girl was brought to emergency department with 12 hour histroy of high
fever, chills, and severe headache. Soon after arriving at ED, she vomitted twice. She
looked confused and was highly agitated. The patient was unable to answer question of
follow command. Nect stiffness was present, a purpuric rash, mainly on her extremities
was noted. Which of the following transmission is more likely to cause her illness?
A. Fecal oral
B. Droplet neisseria meningitidis
C. Close contact
D. Mosquito bite
E. Intravenous

60. A 62 years old male came to neurology clinic with a history of seizure 5 times in the
last week. Previously he had seizure 3 times in a month. His seizure starts with face and
eyes turning to left, tonic-clonic of the left extremities, and then spreads to the right
extremities with loss of consciousness. His seizure last for 2 minutes and then stopped
and he regained consciousness. What is the diagnosis:
A. Acute symptomatic seizure
B. Chronic symptomatic seizure
C. Epilepsy
D. Status epilepticus
E. Non psychogenic epileptic seizure

61. What is the basic mechanism of the seizure above?

A. Increase Glutamate
B. Increase GABA
C. Increase dopamine
D. Increase acethylcholine
E. Increase cholinergic

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62. Ibu 35 th kejang sekali 3 menit. Normal blood glucose ada dm 2. Penyakitmya apa:
A. Acute symptomatic seizure
B. Chronic symptomatic seizure
C. Epilepsy
D. Status epilepticus
E. Non psychogenic epileptic seizure

63. A 29 years old woman presented with right facial pain a while ago. The pain was hot
and electric pain lasting for 1-2 seconds and the dissapear itself. Pain occured while she
is chewing or brushing teeth. What is the most probable cause of this symptoms?
A. Cluster headache
B. Tension type headache
C. Migraine
D. Trigeminal neuralgia
E. Temporal arteritis

64. A 45-year-old woman complains of recurring episodes of vertigo that began after she
bumped her head rather forcefully 2 weeks ago. Her spells last 10 to 15 seconds and
occur whenever she goes to bed or wakes up. She denies any hearing loss or tinnitus.
Her physical examination is normal except for a latent, rotatory nystagmus when she is
lying with the right ear down. What is the most likely diagnosis?
A. Acute serous labyrinthitis
B. Benign paroxysmal positional vertigo
C. Vestibular migraine
D. Ménière disease
E. Viral vestibular neuronitis

65. Ada orang berdiri ga bisa seimbang. Di PF, dia gabisa bedain jari-jari kakinya sedang
ke arah atas atau bawah oleh dokter. Lesi di?
A. Lateral Spinothalamic
B. Lateral Corticospinal
C. Spinocerebellar
D. Corticobulbar

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66. Café au lait. Jawaban : Neurofibromatosis Von Recklinghausen’s
67. A 40 year old female complained headaches . She fell and hit her head. A CT scan
showed a 3 cm mass beneath dura that compresses the underlying left lateral parietal
lobe. She is taken to surgery and after removal by her neurosurgeon, the mass send to
Pathology laboratorium. Microscopic showed elongated cells, oblong nuclei and pink
cytoplasm with psammoma bodies. Which of the following lesions has probably
occured ?
A. Meningioma
B. Schwannoma
C. Astricytoma
D. Ependymoma
E. Glioma

68. (kalo ga salah) Ada orang ngomongnya fluent, tapi ga bisa ngerti kita ngomong apa,
repetitif nya juga ga bagus. Kelainan = Wernicke

69. Can't move her left side of the face. She can't wrinkle her left forehead, can't show her
teeth nor can't purse her left lips. Diagnosed as Bell's Palsy. Another symptoms?
A.Lidah deviasi ke kanan
B. Lidah deviasi ke kiri
C. Abnormal taste 2/3 left tongue
D. left parotid gland ga fungsi
E. Gak bisa nelen

70. A 50 year old woman had shaking her right arm since last month. The episode last 5-10
minutes (or seconds gue lupa lol), occur several times a day and became more frequent
recently. No other symptoms and there is no changes in level of consciousness. Type of
seizure?
A. Simple partial seizure
B. Complex partial seizure
C. Tonic clonic seizure
D. Myoclonic seizure
E. Absence seizure

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71. You are a doctor called to the emergency unit to interpret a ct scan of a person with a
stroke. The ct scan:

LEFT
What is the clinical manifestation?
A. Sensoric aphasia, right side weakness
B. Motoric aphasia, right side weakness
C. Motoric and sensoric aphasia, right side weakness broca (frontal), wernicke
(temporal)
D. Motoric and sensoric aphasia, coordination imbalance

72. Orang 45 thn, trouble walking, wife gait, susah jalan di malam, bisa balance misalnya
tutup mata. NE : loss of fine touch, vibration, proprioception, both lower limb. Other
sensory and motoric are normal. Which spinal cord is affected?
A. Fasciculus grasilis
B. Fasciculus cuneatus
C. lateral spinothalamic
D. ventral spinothalamic
E. spinocerebellar

73. 19 years old woman is admitted to psychiatric by her parents after a week before stating
that she want to drop off college to find paradise. Her roommate told she insist trash in
dormitory consist dinosaurus bone. On the evaluation, she is very quite, put her hands
together as praying, giggling when she look to the ceiling. Her parents say that the
symptoms already persist for 3 months, what is the diagnosis?
A. Schizophrenia paranoid type
B. Schizotypal personality disorder
C. Schizophreniform disorder sx at least dr sebulan tp kurang dr 6 bulan
D. Avoidant personality disorder

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 E. Brief Psychotic disorder sx at least one day tp ga nyampe sebulan

74. Battey, often remarks that she is extraordinarily wealthy, despite her being in a
psychiatry hospital and have an empty bank account. When asked about this apparent
contradiction, she said that the hospital keeps all her money because the administrators
fear of her power if she's not hospitalized. Her symptoms first began when she
graduated from highschool. This symptoms can be referred as...
A. Grandiose delusion
B. Jealousy delusion
C. Reference idea
D. Thought insertion
E. Thought withdrawal

75. A 19-year old man was brought by his family to Psychiatrist. Patient says: The voices
told me to do “bad things”, there are often two or three voices talking, and they often
comment to each other on his behavior. He believes that someone want to kill him. He
has ideation of killing his father occasionally. Which pathway is predominantly
disturbed in this case?
A. Nigrostriatal motor pathway -> parkinson, tardive dyskinesia
B. Tuberoinfundibular prolactin something gajelas
C. Mesolimbic pleasure and reward -> positive sx
D. Mesocortical motivation and emotional -> negative sx
E. Tuberostriatal

76. X 35 years old woman is suffering from sleep difficulties, easily getting tired, lack of
motivation, lack of desire to cope with daily activities, she lose weight for almost 5 kg
within the last 2 months, with suicidal thought. What is the medicine that will help Mrs.
X? The agent work specifically by:
A. Inhibit the reuptake of serotonine
B. Blockade the monoamine oxidase
C. Enhancing the reuptake of dopamine
D. Blockade the chloride channel
E. Inhibit the reuptake of GABA

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77. A 23 year old man who has been receving treatment for substance addiction presents to
physiscians office with complaints weakness and anorexia. Assessment for vital signs :
pulse rate 107 beats per minute and respiratory rate 24 breaths per minute. Lacrimation,
rhinorrhea, and mydriasis are presents, and the patients yawns repeatedly during
interview. The clinical signs and and symptoms are most consistent with withdrawal
from:
A. Alcohol
B. Coccaine
C. Opiates
D. Benzodiazepines
E. Amphetamines

78. What test do you think most appropriate and practical ?

a. Blood test
b. Urine test
c. Saliva test
d. Breath test
e. Stool test

79. 55 yo man has been taking haloperidol for schizo since 20 years ago. On exam, he
displays continual facial movement which look as though he is chewing his own mouth.
Which of the following side effects is he suffering :
A. Acute dystonia torticollis, retrocollis dll
B. Akithisia gabisa diem
C. Parkinsonism
D. Serotonin syndrome
E. Tardive dyskinesia kelinci

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80. Seseorang lelaki drug abuse. Dia minum abuse obat yang diduga dapat merusak
neuron-neuron yang berada di midbrain. Setelah sembuh, dia menjadi depresi.
Neurotransmitters apa yang loss ?
A. Enkhepalin
B. Dopamine
C. Norepinephrine
D. Serotonin
E. GABA

81. S25 th cowo tidur sambil jalan bangun tidur pindah tempat. Sakit apa?
A. Insomnia D. Night teror
B. Hipersomnia E. Night mare
C. Somnabulism

82. A 22 year old woman with episodic, uncontrolled, compulsive, and rapid ingestion of
large amounts of food within a short period of time (binge eating) followed by self-
induced vomiting, use of laxative or diuretics, fasting, or vigorous exercise to prevent
weight gain. Which of the following disorder is the most appropriate with these
symptoms?
A. Anorexia nervosa
B. Bulimia nervosa
C. Obesity
D. Kleine-Levin syndrome
E. Major depressive disorder

83. Org 19 tahun, dia merasa mendengar suara-suara yang menyuruhnya do bad things.
Terus ada suara 3 org, ngomongin behaviour dia, terus dia merasa ada org mau bunuh
dia. Psycopathology?
A. Disorganized speech, halusinasi
B. Halusinasi, delusi
C. Derelasisasi, depersonalisasi
D. Depersonalisasi, ilusi
E. ilusi,delusi

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84. Mr. X 27 years old, found vagabond (gelandangan) by his father after he ran from
house 1 month ago. Previously he always sleeps all day, and remain awake at night. He
have irregular sleeping pattern, decreased apetite, and feels angry when his father
wakes him up from his sleep. He likes being alone as musch as possible, less talk with
other people. What is the probable diagnosis?
A. Schizophrenia katatonik D. Schizophrenia paranoid
B. Schizophrenia simple cipi E. Schizophrenia hebefrenik
C. Schizophrenia residual dr engel

85. Ada orang merasa dirinya dari planet lain. Datang ke dunia untuk menyelamatkan
bumi. Mencurigai tetangganya. Psikopatologi:
A. Halusinasi D. Depersonalisasi
B. Delusi E. Derealisasi
C. Ilusi

86. Org 19 tahun, dia merasa mendengar suara-suara yang menyuruhnya do bad things.
Terus ada suara 3 org, ngomongin behaviour dia, terus dia merasa ada org mau bunuh
dia. Psycopathology?
A. Disorganized speech, halusinasi D. Depersonalisasi, ilusi
B. Halusinasi, delusi E. ilusi,delusi
C. Derelasisasi, depersonalisasi

87. A 24 year old man having a motorcycle accident where he banged his head on the
street floor and passed out for 7 minutes, and came round and complains of forgetting
what was happening to him. He remembered only until about a month before the
accident, but from that moment to the time of the accident he could not remember. Can
you indicate what happened to him from a month before the accident till the time of the
accident.
A. Anterogade amnesia
B. Delirium
C. Narcolepsy
D. Retrograde amnesia
E. Frontal lobe syndrome

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88. A person is suffering from typhoid fever with high temperature of 40⁰ C, and when in
this state he became very agitated, hallucinated shouting that so many people are
jeering at him, and would drive all visitors not to come near him stating that they are
robbers, this person is suffering from:
A. Paranoid reaction
B. Schizophrenic reaction
C. Delirium
D. Dementia
E. Affective manic state

89. A patient, male 18 years of age, is brought by his mother to a psychiatrist with a
complaints of always nagging to his mother stating that he is always having the thought
that his body is not masculine enough, he says that his hip is too big and according to
patient he feels like the hip of a female. His dissatisfaction is mounting until he could
not have good sleep for the last month. What do you think he has as diagnosis for his
illness?
A. disturbed body image
B. his sex hormone might be too much of estrogen
C. he has a dysmorphophobic condition
D. he is mentally retarded
E. he is having a mild depressive disorder

90. A 30 years old woman, married 6 years ago complained of having pain during sexual
intercourse with her husband. She did not enjoy having sex with him. She has got no
infection and abnomality in her vagina. What does she got?
a. Chronic pain disorder
b. Does not like her husband
c. Dyspareunia
d. Vaginismus
e. Lack of estrogen

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91. A person has such a character that he is very quite, will not and cannot make many
friends what he had is only one friend in this world, he talks very little, tendency to
withdraw from group of people, a bit suspicious and can only work alone and prefer to
handle a non living object rather than human such as work with computer only, he is
having a personality disorder of type.
A. Narcisisitic
B. Paranoid
C. Schizoid ga suka ngomong sama orang, sukanya main laptop sndiri
D. Anancastic
E. Avoidant gamau ketemu orang karna takut dikritik

92. People using drugs for many reasons, including non-medicinal indications. Some drugs
can give peaceful feelings, euphoria, increased self-confidence and stamina; and also
used for body slimming or reduce bodyweight.Which drugs do you think can provide
those effects?
A. Opiate.
B. Cannabis.
C. Cocaine.
D. Amphetamine
E. Benzodiazepine

93. Seorang perempuan, 24 tahun datang ke Emergency Room dengan laserasi di

pergelangan tangannya setelah berargumen dengan co-workernya. Sudah 7 kali dia
melakukan hal tersebut. Selain itu dia juga rapid mood swing, merasa sendiri terus.
Disebut apa?
A. Schizoid
B. Anti social
C. Bipolar Tipe 1
D. Bipolar Tipe 2
E. Borderline bunuh diri

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94. A 25 year old man suspected of abusing drugs. His parents find him comatose in his
room and taken by ambulance to the Siloam ER where he is noted to be in a stupor with
bilateral pinpoint pupils, cold and clammy skin, skeletal muscle flaccidity & respiratory
rate 6-8/min. Which of the following medication should be given for this situation?
A. Amphetamine
B. Caffein
C. Flumazenil
D. Naloxone
E. Neostigmine

95. A 42 year old woman comes to your private practice with chief complaint of insomnia
and difficulty falling asleep. She has no symptoms of anxiety and states that she tried
talking some triazolam from her previous doctor, but it made her drowsy and sluggish
the following workday. Which of the following drug is the preffered one, because of it
have a rapid onset of action and low risk of subsequent day time sedation, and can be
safely administered over days to weeks?
A. Diazepam
B. Luminal
C. Chlorpromazine
D. Haloperidol
E. Zolpidem

96. Mr. A 26-year old, he is schizophrenic man, feels restless / walk round in room and
cannot sit still. The doctor of psychiatry said, that this behavior is caused by
medication. What's the name of this symptom?
A. Catatonic
B. Chorea
C. Akathisia
D. Tardive Dyskinesia
E. Parkinsonism

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97. A 37 year old man comes to the psychiatry clinic complaining of sudden shortness of breath,
palpitation, frequent of urination, numbness over his hands, sweting all over his body, and neck
rigidity. He is very afraid if his heart suddenly stopped. This condition appears since 2 months
ago. What is the most likely diagnosis for this condition?
A. Post Traumatic Stress Disorder D. Obsessive-compulsive disorder
B. Panic disorder E. Social phobia
C. General anxiety disorder

98. Laki laki, 38 thn married, hidupnya dependable, kerja sbg book keeper. Bbrp minggu terakhir
ngerasa sleepness, anxious, sulit konsentrasi. Trus dia merasa spt diracuni tetangganya jd
pandangannya kabur, dia dikasih newspaper sm bosnya trus tulisannya ada yg salah. Dia kira
newspaper yg salah itu bkn dia malu, trus dia dibawa oleh psikiater trus di jalan naik mobil dia
ngerasa di setiap mobil ada org yg lg mata-matain dia. Psycopathology apa yg bermasalah dlm
kasus ini?
A. Neurotic D. (Lupa)
B. Reference delusions E. Erotomania delusions
C. Hallucination

99. 50 year old man has been feeling moody and irritable for the past 5 weeks. He lost desire for
sexual activity, susah tidur, decrease apetite, lost 2 kgs in a month. Diagnosis?
A. Cyclothymic 2thn hypomanic+MDD d. Major depressive disorder
B. Bipolar 1 manic (1 minggu) + MDD E. Dysthymic 2 tahun MDD
C. Bipolar 2 hypomanic (4 hari) + MDD

100. A 78 years woman brought to the clinic by her daughters and reported to have difficulty in
sleeping for the last 3 months; she also started to be agitated when she was unable to sleep
during the night. She is also very emotional, angry at everybody, accusing them robbing her
money. She is very good at remembering her past experience. She is able to account very
clearly about her childhood, even the names of all her childhood friends; but she could not
recognize her grandchildren, her name, and her identity. What is the most appropriate
diagnosis?
A. Mild cognitive impairment
B. Schizophrenia
C. Loss of consciousness
D. Organic delutional state
E. Dementia

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