SOAL TROPMED 2015/2016 16-25 (20 bolong karena ternyata soalnya 85 terus

yang ngafalin mundur, jadinya dapet 10-11 instead of 20)

10. 19 Yo girl, fever everyday since 10 days ago. She complained difficulty
swallowing and diarrhea. 2 weeks prior she bought snacks at roaside. Pf shows
hr 90bpm, RR 18bpm, Temp 40c, hyperemic throat and coated tongue. Chest
exam normal, there was liver enlargement.No history of animal contact. What
is the etiology of her ilness.
A. salmonella typhi
B. shigella flexineri
C. Escherichia Coli
D. Serratia Marcesens
E. Proteus morbilli

11. Lab exam of what we can do in the above case?

A. A.Blood culture
B. B.sputum culture
C. C.urine culture
D. D.feces culture
E. E.liquor culture

40 thn bussiness man, dari thailand. Fever,Hepatospleenomegaly, upper

abdomen tenderness, blood ada ringform in erithrocyte and parasitemia 3,5%.

16. Which of the following is the most appropriate explanation for the patient
symptoms?
A. Parasitemia comes from tissue injury
B. Parasitemia due to sporozoit initiate in human infection
C. Parasitemia comes from repeated cycles schizoit from liver to
erythrocyte
D. Parasitemia release of merozoit for the first time
E. Parasitemia because immunocompromise

17. From case above, what is the treatment:

A. Antemeter/lamifudine
B. IV metronidazol
C. IM cloromphenicol
D. Oral primaquine
E. Quinine

18. A 21 yo man was seen in dermatology clinic because of sore and redness on
his previous skin lesion. He was on MDT treatment since 1.5 year ago. On
skin examination found some painful erythematous nodule spread over his
body especially on arm and legs also fever. What is the most likely diagnosis?
A. celullitis
B. furuncle
C. erythema nodosum
D. multibacillar leprosy
E. pausibacillar leprosy
19. 19.infant 4mo old datang dengan keluhan batuk disertai respiratory gasping
and vomit after cough. Cara diagnosis apa yb tepat dan cepat untuk pasien ini?
A. A. PCR
B. B. Serum antibody
C. C. Media culture
D. D. Immunofluorescence

20.
21. A 3 y/o boy was brought to the emergency department with weakness of his
left leg. He had fever since 5 days ago. His mother said he never had
immunization before. What is the laboratory examination to support this
diagnosis?
A. CBC
B. Viral isolation from urine
C. Viral isolation from serum
D. Viral isolation from faeces
E. Viral isolation from CSF

22. 38th year Old man coma with myalgia, fever, athralgia. he works in barnyard
in iran and visiting tangerang. he likes to drink goat milk and cheese. the
organism is gram negative cocobacilli. No other findings. what is probable
diagnosis?
A. Acute brucellosis
B. B. Pertussis
C. Cutaneous Antrax
D. Malaria
E. Tularemia

23. A 25-year-old G3 at 39 weeks delivers a small-for-gestational-age infant with

chorioretinitis, intracranial calcifications, microcephaly, jaundice, and
hepatosplenomegaly. The infant displays poor feeding and tone in the nursery.
The patient denies eating any raw or undercooked meat and does not have any
cats living at home with her. She works as a nurse in the pediatric intensive
care unit at the local hospital. What is the most likely causative agent?
A. Cytomegalovirus
B. Epstein-Barr virus
C. Hepatitis B virus
D. Parvovirus
E. Yellow fever virus

24. A 4 year old boy was admitted to emergency unit due to fever with sore throat,
swallowing difficulty, hoarseness, malaise, and headache. PE : tonsil and
uvula found adherent membrane, lymohadenopathy, soft tissue swelling, bull
neck appearance. Imunisasi ga lengkap. Treatment?
A. Azithromycin
B. Erythromycin
C. Clindamycin
D. Diphtheria anti toxin
E. Chlarytomycin
25. 25. A 32 year old male came to the clinic with chief complain fever for 3 days.
His fever was high all day, he had headache and pain behind his eye balls. He
felt weak and was not able to eat or drink anything because he felt naussea and
vomitting everytime he ate. Physical examination reveals BP 110/80 mmHg,
pulse 98 bpm, RR 22, temp 38.9°C, petechiae on both forearms. Lab
examination reveals Hb 18.1 g/dl, Hematocrit 55%, leucocytes 2000/ul,
platelets 77.000/ul. What is the best diagnosis for his condition according to
guidelines of WHO 2009?

A. DF
B. DF with warning sign
C. Severe dengue
D. DHF
E. DF with hemorrhage