Traumatology 11

1. man 30y/o. naik sepeda motor tanpa helm dan bertabrakan dengan pohon. Saat kejadian, penderita pingsan. Pada saat dibawa, bisa bicara tapi nda ingat kejadiannya. Pada saat diRS kesadaran menurun.Neurologic examination : he could not open his eyes spontan, tapi dengan rangsang nyeri. Moaning with irregular words, his leg was flexed with pain stimuli.

Left pupil bigger than right. Seen hematoma at his face and bleeding from his nose.Symptoms decrease consciousness occurred after patient awake was .

a) cushing syndrome

b) monro kellys syndrome

c) lucid interval

d) cushing syndrome

e) severe head injury.

2. the symptom above was caused by .a) spinal cord injury

b) blood accumulation

c) secondary brain injury

d) concussion was occurred at the beginning and then hematoma accumulate occurred slowly

e) normal response was occur

3. the symptoms above was commonly found ina) intracerebral hematoma

b) epidural hematoma

c) subdural hematoma

d) intraventicular hematoma

e) central contussion

4. BP 160/100 mmHg, HR 50 x/minute was sign of a) body response to the stress trauma

b) sign of neurogenic shock

c) sign of hemorrhagic shock

d) decreased intracranial pressure

e) increased of intracranial pressure

5. the sign was called a) cushings response

b) monro kellys doctrine

c) cushings syndrome

d) lucid interval

e) severe head injury

6. the sign above was body reaction for a) decreased ICP

b) increased ICP

c) maintain pressure of brain perfusion

d) increased CSF stream to the spinal chamber

e) decreased CSF stream to the spinal chamber

7. there was periorbital ecchymosis at the patient which sign of .a) Fracture of anterior cranial base

b) Fracture of basis cranii media

c) Fracture of basis cranii posterior

d) Facial trauma

e) Fracture of bilateral zygoma

8. the sign above was contraindication for a) Examination of plan skull radiology

b) Examination of CT scan

c) Apply nasogastric tube

d) Apply nasogastric through the mouth

e) Apply orotracheal intubation

9. GCS in patient was .a) E3V3M4

b) E2V3M4

c) E3V4M2

d) E2V3M2

e) E2V2M4

10. there was possibility to the patient that the hematoma was occur at .a) Left hemisphere

b) Right hemisphere

c) Cerebellum

d) Intraventricular

e) bifrontal

11. laki-laki, 24 tahun, masuk UGD karena kecelakaan lalu lintas. Tidak dapat menggerakkan kedua tungkai pasca kecelakaan. Ditemukan jejas pada kedua paha tanpa deformitas dan jejas pada epichondrium kiri, penderita juga merasakan nyeri pada bahu kiri tapi tanpa jejas.

Important examination

a) reflex physiologis

b) reflex pathologis

c) rectal touch

d) lab

e) light touch and pin prick test.

12. in this patient, the bulbocavernosus reflex is (+), which is mean .a) Complete spinal cord injury

b) LMN injury

c) UMN injury

d) Severe destruction of bone components

e) Mild destruction of bone components

13. spinal cord injury at level of .a) upper cervical

b) lower cervical

c) thoracal

d) lumbal

e) conus medularis

14. first day reflex bulbocavernosus (-) and in the third day. Sacral Spare sign (+).What is the diagnosis

a) upper motor neuron complete spinal cord injury

b) lower motor neuron incomplete spinal cord injury

c)

d)

e) .

15. in the second day, the patient has hypovolemic shock. BP 80/40. Hb 6 gr/dl.Your suspicion is .

a) Aorta trauma

b) Kidney trauma

c) Duodenum trauma

d) Pelvis trauma

e) Spleen trauma

16. principal management of spinal trauma .a) life saving

b) prevent secondary injury

c) stabilization

d) alignment

e) transportation

17. vacuum mattress is contraindicated in .

a) Pelvic fractureb) Multiple fracture in lower extremity

c) Severe thoracic trauma

d) Head trauma

e) Spinal trauma

18. conditions below include UMN trauma, except .a) Brown sequared syndrome

b) Anterior cord

c) Posterior cord

d) Conus medularis

e) Cauda equine syndrome

19. condition below can lead to hypovolemic shock, except .a) Head

b) thorax

c) pelvic

d) abdominal

e) femur

20. conditions below related to brown-squared syndrome, except .a) MOI : stab wound

b) Lateral mass fracture

c) Total transaction of spinal cord

d) Decrease or loss motor power while normal pain and temperature sensation on the affected side.

e) Normal motor power while decreases pain and temperature sensation on normal side.

21. 65 y/o woman, feelsnumbness and tingling on index and thumb finger esp night since 2 years ago. Weakness when holding things, but still can do housework. Wasting thenar muscle (-). No palpable tumor, no scar. No tenderness, same temperature with the other hands. Possible diagnose .

a) Ulnar vessels and nerve problem

b) Carpal tumor syndrome

c) Median nerve problem because cooking

d) Ulnar nerve injury

e) Radial nerve disruption because of trauma

22. what are the risk factor a) Osteoporosis

b) Osteoporotic

c) Synovium atrophy

d) Osteophyte

e) Tendon atrophy

23. treatment for this case a) Antibiotic injection

b) Wrist splint

c) Diverse transversal carpal ligament

d) Open surgery

e) Endoscopic release

24. if patient get thenar muscle atrophy.

Treatment a) Steroid injection

b) NSAID

c) Rest and NSAID

d) Wrist splint

e) Open surgical division 25. 35 y/o man, has traffic accident come to hospital with knee ecchymosis. Hip joint slightly flexion, adduction, internal rotation.a)

b)

c) Anterior hip dislocation

d) Posterior hip dislocation

e)

26. what is the additional sign a) Leg length discipancy

b) Unlimited range movement

c) Galeazzi sign (-)

d) Head of femur protrude inguinal

e) Heal of femur protrude lateral

27. what is the management for this patient

a) Traction countertractionb) Mich maneuver

c) Kotcher maneuver

d) Simpson technique

e) Pravin technique

28. the effect of different treatment of children in neck femoral fracture .a) Vessel in the lig. Teres

b) Vessel in the retinacula

c) Intraosseus vessel

d) ..

e) ..

29. man, working at construction, hit by machine.Whats possible diagnosis

a) Open fracture proximal at phalanx hallux

b) Fracture median phalanx 1st toes

c) Fracture distal phalanx 1st toes.

30. treatment a) Buddy tapping, rest and immobilization

b)

c)

d) Buddy tapping and antibiotic

e)

31. in X ray result, communitive fracture at interphalangeal joint.Appropriate treatment .

a) Kischer wire

b) Buddy tapping

c) Casting

d) Splinting

32. 28 y/o man play badminton and do jumping smash. Cant dorsiflexion.a)

b)

c)

d) Achilles tendon rupture

e)

33. what is the injury mechanism from the patient problem?

a) violent plantarflexion of flexi foot as in the fall from height

b) direct trauma at 1st digit

c) twisting mechanism at the interphalanges of the hallux

d) weightbearing foot because extended knee

e) sudden unexpected plantarflexion on the ankle joint34. what is the treatment for case above?

a) ...

b) kessler technique

c) debridement

d) castinge) splinting

35. a patient shallow laceration (10 x/ day. Irritable, sunken eyes, dry mouth, pulse 152x/min, BR 48x/min, BP 70/40 mmHG, very slowly skin pinch.Score

a) 13

b) 14

c) 15

d) 16

e) 17

61. A 5 days old baby was brought by her mother to the hospital with vomiting of >10x/day & watery stool of >5x/day without mucous nor blood. There is shunken fontanella. The baby's weight is 3000g & her birth weight is 3500g.

What is the diagnosis?

a) Very severe dehydration

b) Severe dehydration

c) Moderate dehydration

d) Mild dehydration

e) No dehydration

62. treatment for case a) RL 24 hours

b) RA 8 hours

c) RL 8 hours

d) RA 24 hours

63. (lupa kes tp cerita dia lebih kurang mcm ni la) ada seorang ibu yg sangat sedih kerana dia mendapati anak dia tak bernafas. Lalu dibawalah ibu itu ke UGD dengan penuh linangan air mata. Doktor mendapati bahawa anak itu telah meninggal. Yang peliknya, tidak ditemukan tanda2 respiratory distress. Dokter tu pon buat la autopsy, lalu tidak jua ditemukan kelainan di situ. pening punya pasal (mybe malas nak pikir dah kot) di pon ckp la baby ni meninggal sebab "Sudden Infant Dead Syndrome"?Cause of SIDS

a) Hypothermia

b) Put back in bed

c) Breast feeding

d) Rebreathing asphyxia

e) Neonatum asphyxia

64. 65. man, unconsciouss, unresponsive.Whats the diagnosis

a) Delirium

b) Vegetative state

c) Lock on syndrome

d) Drowsiness

e) coma

66. whats GCS in this patient a) 3-7

b)

c)

d)

e)

67. follow up for patient's brainstem function?

I. pupil reflex

II. corneal reflex

III. oculocephalic reflex

IV. gag reflex68. the position has chyne stoke respiration type due to a) Brain cortical function

b) High intracranial pressure

c) Brain hematoma

d) Brain stem hematoma

e) Brain stem death

69. 70.I, II, III correct A

I, III correct B

II, IV correct C

All correct D

71. 50 y/o man come with blurred right eye. 3 hours ago he had accident ang got head injury. Whats the correct statement of lens displacement I. Slit exam no lens

II. Pain on the right eye

III. Distance vision 1/60 cor S+1.00 D= 6/75

IV. Near vision not disturbed

72. found in lens subluxation I. Decrease vision

II. Astigmatism

III. Monocular diplopia

IV. Iridodenesis

73. treatment for this caseI. Extracapsular surgery with

II. Intracapsular surgery with

III. Extracapsular with IOL

IV. Intracapsular with IOL

74. 75. causes of lens dislocation I. Blunt injury

II. Accident

III. Congenital ( marfan syndrome)

IV. Perforans (perforation)

76. the disease of foreign bodies in nasal cavity cause by flies meggots a) Nasal mitosis

b) Nasal meiosis

c) Nasal maggots

d) Nasal myasis

e) Nasal worms

77. Appropriate tracheal stoma position for elective tracheostomy is a) 1-2

b) 2-3

c) 3-4

d) 4-5

e) 5-6

78. rapid killing for foreign body at external auditory canal, except

a) Glyserin oil

b) Coconut oil

c)

d) Kayu putih oil

e) Fried oil

79. Strong indication for elective tracheostomy, according the Jacksons dyspnea grading is a) I

b) II

c) III

d) IV

e) V

80. the complication may occurs from inappropriate treated septal hematoma are I. Septal perforation

II. Septal abscess

III. Saddle nose

IV. Conceal atrophy

81. the cardinal signs of menierre disease .I. Tinnitus

II. Sensory neural hearing

III. Vertigo

IV. Severe pain

82. the statement below are related to the posterior nasal bleed, except a) Woodruffs plexus

b) Bellocs tampon

c) Sphenopalatine artery

d) Superior labial artery

e) Large in diameter vascular involvement83. the statement below are situation which need urgent procedure, except a) Coins of esopharyngeal foreign bodies

b) Caf coronary

c) Uncontrolled nasal bleed

d) Diphterie of the larynx

e) Grade lil Jackson dyspnoe

84. rapid killing for foreign body at external auditory canal, except a) Glyserin oilb) Coconut oilc) d) Kayu putih oile) Fried oil

85. mostly blood supplies in the nasal cavity from external carotid arteryBecause

Only blood ethmoidal arteries are branches from internal carotid artery

86. Kasus Glaukoma

alat untuk mengukur tekanan intraocular a)

b) Tonometer

c) ..

d)

e) ..

87. alat untuk melihat scar pada trabecular meshwork a) Gonoscopy

b)

c) ..

d) Ant OCT

e) Bio..

88. 89. diagnosis a) Glaucoma resses angle

b) Pigmented glaucoma

c) Neovascular glaucoma

d)

e)

90. theres scar In trabecular meshwork more half.Treatment of this case are

a. Trabeculoctomy

b. Baerveld shunt

c. Iridectomy

d. A + B

e. A+B+C

91. perempuan datang ditemani oleh suaminya. Keluhan Sebagai seorang dokter apa yang harus qta lakukan

a) Memberi informed consent pada suaminya bahwa istrinya akan diobservasi

b)

c)

d)

e) ..

92. her mother has bleeding pervaginam (klo gak salah).TD 80/60, pulse 110 x/rate, respiration 20 x/ menit.

The examination we do, except .

a. ., Leopold, fetal heart rate

b. Setting IV line, ukur output dan input

c. Inspeculo examination

d. Vagina examination

e. Ultrasonography

93. perdarahan vagina, no pain, heal 5/5, no contraction.Diagnosis

a. Placenta previa

b. Abruption placenta

c.

d.

e. Vasa previa

94. pada abrutio placenta, etiologic yang paling sering ..a) Infeksi

b) External rotation

c) Trauma abdomen

d) Short placenta

e)

95. patient, datang tiba-tiba mengalami penurunan penglihatan, dan mengeluh floaters, photophobia, .

has history of high myopia

whats the diagnosis .

a) Central vena occlusion

b) Central artery occlusion

c) Branch vena occlusion

d) ..

e) Rhegmatous retina

96. 69 y/o man has sudden visual loss, segment anterior normal. Milky white appearance, red cherry spot.

Diagnosis

a) Central vena occlusion

b) Central artery occlusion

c) Branch vena occlusion

d) ..

e) Rhegmatous retina

97. cotton wool spot, red fovea spot.Diagnosis

a) Central vena occlusion

b) Central artery occlusion

c) Branch vena occlusion

d) Branch artery occlusion

e) Rhegmatous retina

98. 60 y/o woman sudden inferonasal vision loss. Control visual acuity 6/6. If patient diagnose with rheugmatous retina detachment. Possible location of retinal detachment

a) superotemporal retina, involved macula b) superotemporal retina, macula still intact

c) inferonasal retina, involved macula

d) inferonasal retina, macula still intact.

e) superior retina.

99. a man come to ophthalmology outpatient clinic with bloody appearance of his eye, which occur suddenly 2 days before. Ophthalmology showed conjunctival htperemia with clear cornea.This patient is likely to have .

a) Hyperemia

b) Conjunctival chemosis

c) Subconjunctival bleeding

d) Corneal edema

e) Conjunctivitis 100. cause of that case except a) Vascular discharge

b)

c) Unknown

d) Infection

e) Prev. hypertension

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