Academic Team 09 FINAL NBSS 2nd Year - 2009

1 | P a g e

#Part 1
1. A 30 years old woman came to clinic with right aural
fullness since 3 days. From HT, she has had cough and
rhinorrhea since 1 week. PE revealed no cerumen from
both ear.
2. Which one of the following is the most possibility of
hearing loss?
a. Right cochlear Hearing Loss
b. Right mixed type Hearing Loss
c. Right conductive Hearing Loss
d. Right retrocochlear Hearing Loss
e. Right sensorineural Hearing Loss
3. -
4. Where is the location of abnormalities?
a. Inner ear
b. Outer ear
c. Middle ear
d. Outer and inner
e. Middle and inner
5. Which one is the most likely right pure tone audiogram
in this case :
a. AC and AB >20, a-b gap < 10 dB
b. AC and AB > 20, a-b gap > 10 dB
c. AC > 25 dB, BC 0-20 dB, a-b < 10dB
d. AC > 25 dB, BC 0-20, a-b >10 dB
e. AC 0-20, BC>25, a-b < 10 dB
6. A 8 month baby girl ada speech delay, ENT exam
normal. Risk factor :
a. History of alergy
b. Obatnyalupa (inisial CT)
c. Gentamycin
d. Birth weight <2500 gr
e. Cry loud ketikalahir
7. A toddler, 18 months old was brought by his mother to
the clinic with speech delay. On ENT exam, the results
were within normal limit. Which one of the following is
the most appropriate hearing test?
a. Moro reflex
b. Reaction test
c. Play audiometric
d. Speech audiometric
e. Pure tone audiometric
8. A 55 years old hypertensive male was admitted with
history of acute onset of right hemiplegia and aphasia of
one day duration. No history of headache, vomiting, or
convulsion. In the past, he used to get occasional
episode of transient inability to speak. On examination,
he had right upper motor neuron facial weakness, right
hemiplegia, and aphasia. There were no other positive
sign. Diagnosis?
a. Hypertensive encelopathy
b. Subarachnoid hemorrhage
c. Intracerebral hemorrhage
d. Ischemic stroke
e. Subdural hematoma
9. -
10. most appropriate diagnosis
A. Usher
B. Alport
C. Penred
D. Scheibe
E. Waardenburg
11. Seorangpriadatangkedokterdengan chief complaint
hearing loss sejak 6 bulanlalu. Priainitidakmempunyai
risk factor terhadap hearing loss.
Which type of examination should be done in this
patient?
a. Visual Reflex
b. Tracheoscopy
c. Sound audiometry
d. Pure audiometry
e. A....apaagitu
12. Which one is the most occur?
a. bilateral,simetis,conductive,itstrats from high
frequency
b. bilateral,asimetris,conductive,itstrats from high
frequency
c. bilateral,simetris,conductive,itstrats from high
frequency
d. bilateral,simetris,sensori neural, it strats from low
frequency
e. bilateral,asimetris,sensorineural,itstrats from low
frequency
13. akuradalupa. Klogasalah audiogram gtu. Tapilupaa :(
Maaf.
14. Which one must appropriate prevention method by
manufactured management?
a. Room analysis
b. Noise analysis for 6 month
c. Hearing measurement for 1 year
d. Provide ear plug for 24 hour
Academic Team 09 FINAL NBSS 2nd Year - 2009

2 | P a g e

e. Provide ear plug at least 24 hour
15.
16. Right Pix Hallpike (+)
a. right cerebellum
b. Left lateral semicircular canal
c. right lateral semicircular canal
d. left posterior semicircular canal
e. right posterior semicircular canal
17. Ancillery test tuhapaajakomponennya??
(maafsayalupanyatetsoal.. Cariajaancillery test..)
1 opsinyaada 3..(ada leukocyte, VLDL, cholesterol, blood
glucose etc..)
18. On history taking, she had tinnitus and fluctuate
hearing. What is the appropriate treatment for her?
a. Low-fat diet
b. Low-calories diet
c. Give her diuretic
d. Give her antibiotic
e. Give her oral steroid
19. The symptom occurs when he get up with roll to left.
Which oneis the first treatment?
a. Surgery
b. epley maneuver
c. rolling maneuver
d. semant maneuver
e. liberatory maneuver
20. Tinnitus and hearing loss
a. Bppv
b. Vestibular
c. Labyrintitis
d. Meniere
e. perilymph fistula
21.
22.
23. The most common adverse effect of limiting this drug is
dyskinesia
24. Sudden rotation while cooking. Jawabannyabetahistine
25. -
26. -
27. Antipsychotic agent



28. 1 month baby is brought by her mother to the
ophthalmologist with chief complain of his eyeball.
Other complains are tearing and photophobia.
Ophthalmology exam revealed buphthalmia and cloudy
cornea. Diagnosis:
a. Congenital cataract
b. Congenital glaucoma
c. Retinoblastoma
d. Rhabdomyosarcoma
e. Opthalmianeonatarum

29. Seorangwanitaseringmelihatibunyaduduk di sudut,
menonton TV, danmerajutkaos kaki. Diarinduibunya
yang telahmeninggalsebulan yang
lalu.Termasukpenyakit?

30. Where is the position of the focal point before
correction ( S + 1.00)
a. in front of retina
b. behind retina
c. on the retina
d. 2 point behind retina
e. 2 point in front of retina

31. Where is the position of the focal point after correction
a. in front of retina
b. behind the retina
c. on the retina
d. 2 pts behind retina
e. 2 pts in front of retina

32.



Academic Team 09 FINAL NBSS 2nd Year - 2009

3 | P a g e

33. Blurred vision, Visual acuity 6/18 both eyes, koreksi
dengan cyl. -150 x 90
o
, visual acuity kembali normal.
Jenis kerusakan?
a. Pseudomiopia
b. Simple astigmatism myopia
c. complex astigmatism myopia
d. presbyopia
e. lupa

34. bayanganjatuh di manasebelummatadikoreksi :
a. di depandanbelakang retina
b. di depan retina
c. di belakang retina
d. di retina
e. (satulagilupa)

35. 30 y.o, Blurred vision, visual acuity 6/36 both eyes, next
appropriate exam for visual acuity?
a. hirschberg test
b. pinhole
c. version&duction
d. trial&error
e. lupa

36. A 35 y.o woman present with blurred vision. Ophthalmic
exam reveals visual acuity 6/60 on both eyes. With
pinhole examination, visual acuity becomes 6/9. What
does this result means?
a. Ambiyopia
b. Malingering
c. refractive error
d. media refractive opacity
e. organic abnormality

37. Gradually blurred vision, shadow test +.
answer : lens opacity

38. One of neurological factor in psychosis is increased
dopaminergic activity which cause increased dopamine
transmission specifically to mesocorticolimbic system.
Which of the following statement concerning is true
a. synthesized in cathecolaminergic vesicle
b. metabolized by monoamine oxidase B
c. end product of dopamine metabolism is
homovanilic acid
d. dopamine receptor are ligand gated ion channel
e. D2 receptor has high affinity for antypsychotic
drugs

39. What is the most likely diagnosis?
a. senile immature cataract
b. cataract traumatica
c. cataract complicate
d. cataract secondary
e. steroid induced cataract
40.

41. A 25 year-old man chief complaint: red eye since
yesterday. Also watery discharge and foreign body
sensation. His roommate also has similar complaint.
Normal Visual Acuity, conjunctiva injection, other exam
normal. What causative agent?
a. Virus
b. Bacteria
c. Parasite
d. Fungi
e. Allergy

42. Sakitmata yang ada stone2nya, itu
jawabannya ventral apavenkrelgt.ahaha
UNTUK 43-44
Seorangibu, mengalamipenurunanpenglihatan, riwayat DM
selama 10 tahun.Visual acuity 6/18di keduamatanya.
43. Pemeriksaanapalagiselanjutnya? Jb : Funduscopy

Academic Team 09 FINAL NBSS 2nd Year - 2009

4 | P a g e

44. Funduscopy show exudate and intraretinal hemorrhage.
What patophysiology of this case?
a. Retinal detachment
b. Occlusion of central retinal artery
c. Occlusion of central retinal vein
d. Ischemic of optic nerve
e. Microangiopathy of retinal capillary

45. 60 th, CC : painful eyes, blurred left eyes, 1
minggulaluoperasikatarak, VA : 1/300, injeksi,
hypopyon. Kenapa?
a. Cellulitis
b. Keratitis
c. Uveitis
d. Endothalmitis
e. Lupa-

46. Seorangwanitaumur 35 tahun, matamerahsemenjak 2
minggu yang lalu,matanyafotophobia, blurred vision, di
test visual aquitynya 20/60, adanya injection cornea
danfiltrasi di cornea.most cause disease ????
ans: viral konjunctivitis

47. Bayi 1 minggu, CC : yellowish discharge both eyes,
edema palpebra, conjunctiva injection, mucopurulent
discharge, diplococcus gram (-) intracellular
a. S. Aureus
b. Pseudomonas aeruginosa
c. N. Gonorrhoea
d. Acanthamoeba Sp.
e. Chlamydia trachomatis

48. 25 th, awalnyasehat, jatuhdarikuda,
langsungnggasadardandibawakerumahsakit,
tandaawalpeningkatan ICP adalah?
a. Diminished pupillary size
b. Menurunnya GCS
c. Menurunnya HR
d. Menurunnya RR
e. Meningkatnya blood pressure

49. You are performing cardiopulmonary resuscitation on a
patient who has just suffered a cardiac arrest. Which of
the following provides the best indicate that
resuscitation is effective?
a. Electrocardiograph
b. Palpitation of the femoral pulse
c. Color of the skin and mucous membrane
d. Site and reaction of the pupil
e. Response to stimuli
50. Akulupaceritalengkapnya, maaf.
Tapikalugasalahsihanakmudakecelakaan, fracture fibula.
Lupalagilanjutannya, pertanyaannyaapa yang
harusdilakukanpertama kali :
a. Cek airway, breath, circulation
b. Cek femoral artery
c. Cek breathing and pulse
d. Lupa
e. Lupa, maafyaa
51. A 25 years old came to an otolaryngology with
symptoms of otoicap. The physician diagnosed
witmastoiditis. Then he asked X-ray photo to confirm
the diagnosis. What kind of a ray photo should the
physician order?
a. Schuller& Steven
b. Waters & Caldwell
c. Towne &Submentovertex
d. Ester &Rhese
e. Anterioposterior& lateral skull
52. 55 year old female, left sided hemiparesis,
consciousness menurun, chronic fibrillasi atrial.
Pemeriksaan yang pertama kali dilakukan?
a. CT Scan carotid artery dan intracranial artery
b. MRI dengan MRA
c. X-rays
d. USG neck
53. Gambar yang disuruhcarigambar neural tube di soal
remedial NBSS
54. (maafagaklupa) Anesthesia padawajahdimulaidari
midline, kira-kiradari nasal kananataske eye.,
merupakanterjadikerusakan?
a. lachrymal nerve of ophthalmic division of
trigeminal nerve
b. Frontal nerve of ophthalmic ..
c. ophthalmic division of trigeminal of cranial cavity
55. A patient suffers a fracture of the base of the skull
involving petrous temporal and occipital bones. On
Academic Team 09 FINAL NBSS 2nd Year - 2009

5 | P a g e

examination, it is found that he has nerve deafness and
cannot close his eye on the affected side and has lost
the sense of taste on the anterior 2/3 of the tongue on
the left side.Assuming the symptoms is due to the
injury, which of the following explanations is most
plausible?
a. pressure on nerve 7 and 8 in the internal auditory
meatus
b. pressure involving nerve 8 and 3
c. pressure on nerve 8 in the internal auditory
meatus and on nerve 7 at the stylomastoid
foramen
d. pressure on nerve 8 and nerve 5 (mandibular
division) because of a fracture running from
internal auditory meatus to foramen ovale
e. pressure because of a hemorrhage deep to the pia
on the superior portions of the pons
56. Buatngecekkerusakan hypoglossal nerve, yang
dokterlakukan?
a. Menelan
b. bukamulutdanbilang ah
c. julurinlidah
d. Whistle
e. Puff his / her face
57. Cranial Nerves berapa yang mengaturocculomotor?
58. A 35 year old man presented with lesions in the left
frontal cortex adjacent to the face region of the motor
cortex. What is the most likely the result?
a. an inability to make facial movements
b. loss of sensation from the right side of the face
c. impairment in the ability to recognize faces
d. impairment of spatial abilities
e. impairment of language
59. A 65 years old presents with a 4 hour of diplopia,
vertigo and ataxia. CT brain is normal. If it is assumes his
symptoms are due to cerebrovascular disease, which of
the following vessels is the most likely to contain the
culprit lesion?
a. anterior cerebral artery
b. anterior choroidal artery
c. basilar artery
d. middle cerebral artery
e. posterior cerebral artery
60.





61. A 45 years old female presented to the emergency
complained of losing the visual field involving both
temporal visual fields (bitemporal field defect). What is
the most likely level of disturbance?
a. Left and right optic nerves prior to entering the
chiasm
b. Chiasm
c. Left and right parietal lobe
d. Left and right occipital lobe
e. Left and right temporal lobe

62. A patient presented with lost of visual field involving the
upper left visual field in both eyes. Location of the
lesion?
a. Left optic nerve
b. Chiasm
c. Right parietal lobe
d. Right temporal lobe
e. Right occipital lobe

63.
64. The right-handed 65 y.o suddenly feels weakness of her
right arm and hand and subsequently finds that she
cant move them voluntarily. During the examination
she has slow and hesitant speech. She can move her
legs normally, her vision is normal, her finger-to-nose
test is normal and there is no sign of disequilibrium.
Which of the following arteries is most likely to have
been affected?
a. Basilar artery
b. Posterior cerebellar artery
c. Anterior choroidal artery
d. Middle cerebral artery
e. Anterior cerebral artery
65.
66.
67. A 70 y.owoman have mild elevation of systolic blood
pressure come to ER with history progressive right side
weakness and speech disturbance. Her relative said that
she take tablet for blood pressure for 3 month. Her
Academic Team 09 FINAL NBSS 2nd Year - 2009

6 | P a g e

complaint transient episode numbness in her right arm.
What is diagnosis?
a. Subarachnoid hemorrhage
b. Viral enchepaly
c. Left side middle cerebral artery occlusion
d. Right side cerebral embolism
e. Left fronto parietal tumor
68.
69. 66 years old falls and twist his right leg. Complain: pain
di upper lateral aspect of his shin. X-ray: spiral fracture
of fibula. Indikasi peripheral nerve injury?
a. Sensory impairment of dorsum of foot
b. Sensory impairment of great toe
c. Weakness of foot
d. Weakness of dorsiflexion inversion
e. Weakness of plantar flexion
70.
71.
72.
73.
74.

75. As the later stage of dark adaptation take place, what
cause the
major change occurring in visual sensivity?
a. cones becoming less sensitive
b. rods -||-
c. cones becoming more sensitive
d. rods -||-

76. A hypothetical patient underwent removal of the left
precentralgyrus. What will be expected in this patient?
a. Spinal shock
b. Extensor rigidity in the right leg
c. Spasticity in the left leg
d. Flaccidity in both arms
e. Loss of sensation in the right leg
77. Hypothetical patient had accident that caused a
destruction of the
left auditory cortex,what will be expected in this
patient?
a. Deafness in the right ear
b. Loss of abilty to discriminate different frequency
c. loss of the ability to discriminate sound intensities
d. impairment n local using sounds bla.bla.bla
e. nonobvious effect
78. A ct scan of an infant with an enlarged head showed
dilatation of
the lateral & 3rd ventricle. Which of the following is the
most likely diagnosis?
a. Hydranencephaly
b. Macroencephaly
c. Arnold-chiari malformation
d. Obstructive hydrocephalus
e. Communicating hydrocephalus
79.

80. A subject is rotated clockwise in a swivel chair for one
minute then suddenly stopped. What are the directions
of the fast phases of nystagmic eye movement just after
the beginning and end of rotation?
a. Both clockwise
b. Both anticlockwise
c. Clockwise and anticlockwise respectively
d. Anticlockwise and clockwise respectively
e. Cannot be identified

80. A bar of light at a particular orientation is the most
effective stimulus in exciting which of the following?
a. Rods and cones
b. Bipolar cells
c. Retinal ganglion cells
d. Lateral geniculate bodies
e. Visual cortical cells

81. A hypothetical patient had an injury of selectively
severed the dorsal columns at the mid-thoracic level.
What would you expect to be found?
a. Prevent the production of voluntary movements of
the legs
b. Initially abolish all reflexes in legs
c. Give abnormalities of posture but no deficit in the
ability to move the toes
d. Abolish the sensation of pain in both legs
e. Impair the ability to stimuli on the soles of each
foot
Academic Team 09 FINAL NBSS 2nd Year - 2009

7 | P a g e

82. A 45-years-old man is known of having damage to the
spino-thalamic tract on one side of the body. What
would you expect to be found below the level of the
lesion?
a. Loss of pain sensation on the same side of body
b. Loss of pain sensation on the opposite side of the
body
c. Loss of fine cutaneous sensation of the same side
of the body
d. Loss of fine cutaneous sensation on the opposite
side of the body
e. Loss of muscle sensations bilaterally
83. Which of the following will occur in a girl who suddenly
stops spinning after several seconds of spinning to the
left?
a. Her eyes will move slowly to the right
b. The hair cells in the right semicircular canal will
depolarize
c. The cupula in the right semicircular canal will move
away from the utricle
d. The objects in the visual field will appear to be
spinning to the right
e. She cannot control the movement of her feet
84. A farm worker inhales a pesticide which blocks
acetylcholinesterase in the neuromuscular junction. He
presents with breathlessness. Which of the following
mechanisms is the most likely cause of his difficulty in
breathing?
a. Blockade of the acetylcholine receptors by
acetylcholine Initially abolish all reflexes in legs
b. Rapid breakdown of acetylcholine in the synapse
c. Lack of acetylcholine production in the synapse
d. Decreased amount of acetylcholine in the smooth
muscle
e. Reduction in acetylcholine reuptake
85. In a psychology practical class, when a steel rod was
held against an area of skin with a constant force,
students notice that the firing rate in the related
cutaneous sensory nerve decreased. What property of
the sensory system does this observation indicate?
a. Change in receptive fields
b. Recruitment of the receptors of a different
modality
c. Increasing sensitivity to the stimulus
d. Adaptation of receptors
e. Adaptation of the central sensory mechanisms
86. If you were to perform a nerve graft that will allow for
fastest conduction, which one of the following nerves
would you choose?
a. 2-3 micrometer diameter, unmyelinated
b. 15-20 micrometer diameter, myelinated
c. 20-25 micrometer diameter, unmyelinated
d. 2-3 micrometer diameter, myelinated
e. 15-20 micrometer diameter, unmyelinated

87. A patient presented with the following speech: Well
this is mother is away here working her work out
ohere to get her better, but when shes looking in the
other part. One their small tile into her time here. Shes
working another time Which ONE of the following
CORRECT?
a. This speech disorder is called Alexia
b. She could understand everything she was told
c. This speech disorder is called global Aphasia
d. This disorder is called Wernicks Aphasia (or fluent
aphasia)
e. This disorder result from a lesion of motor speech
area (Brocas area)
88. A patient with infarction in the left superior cerebellar
peduncle and the left superior cerebellar hemisphere,
physical examination will show
a. Hyperreflexia on opposite side of body
b. Resting tremor in the right hand
c. Reduced muscle tone on the left side of the body
d. Clonus in the left lower limb
e. Loss of pain and temperature sensation on the left
side of the body
89. Zainab had high frequency sound loss (deafness). Which
ONE of the following is TRUE about Zainab?
a. The superior olivary nucleus is damaged in Zainab
b. She cannot hear sounds of 500-1000 Hz frequency
c. The basilar membrane at the base of the cochlea is
affected
d. There is a lesson in the semicircular canals
e. The tympanic membrane is perforated
90. A patient had embolism of the anterior spinal artery.
Which ONE of the following features will be found on
examination of this patient?
a. Muscle weakness in both left limbs but the right
limbs are normal
Academic Team 09 FINAL NBSS 2nd Year - 2009

8 | P a g e

b. Bilateral loss of pain and temperature sensations
below the site of the lesion
c. Normal reflexes In all four limbs
d. Loss of tactile discrimination bilaterally below the
site of the lesion
e. Muscle wasting in all the four limbs

91. badansel yang menyebabkan pupil reflex adadimana?
ans: ciliary ganglion


92. A 70 y.o. man had an ulcer at his right upper cheek,
measured 2 cm, blablabla. Tumor nest resemble normal
basal layer (small columnar cell, palisading) nodular,
polymorph hyperchromatic nuclei. Jawaban : basal cell
carcinoma
93. Drug to produce mydriasis but not paralysis of
accommodation:
a. cholinergic blocking agent
b. alpha adrenergic blocking agent
c. beta adrenergic blocking agent
d. sympathomimetic agent
e. muscarinic agent

94. Sweating salivation lacrimation diarrhea
bradycardiakonstriksi pupil. Obatygmenyababkannya?
a. Atropine
b. Succinylcholine
c. Nicotine
d. Muscarinic
e. Scopolamine

95. Patients have the following sign and symptom :
Parkinson-like tremor, dermatitis, and slight jaundice,
mild hypotension with tachycardia. What is the most
likely drug produced these syndromes?
a. Guanethidine
b. Chlorpromazine
c. Reserpine
d. a MOA inhibitor
e. Mephenesin

96. After installation of an eye drop a patient experience
mydriasis, loss of light reflex, cyclopegia, increased
intra-ocular pressure. What is the most likely
pharmacological profile of drug?
a. A direct acting cholinergic (eg. Pilocarpine)
b. An indirect acting cholinergic (eg. Physostigmine)
c. A local anaesthetic (eg. Cocaine)
d. An antimuscarinic (eg. Homatropine)
e. A sympathomimetic (eg. Epinephrine)

97. A 28 y.o. man is brought into casualty following an
overdose of cocaine. By what mechanism does the drug
exert its effect?
a. blockade of the noradrenaline reuptake
transporter
b. stimulation of presynaptic serotonin receptors
c. blockade of beta-2-adrenergic receptors
d. reduction in circulating adrenaline
e. stimulation of the dopamine reuptake transporter
98.
99. Agitated 26 y.o. man is brought into casualty by the
police. PE & psychiatric exam show that he has smoked
cracked cocain 9 times in his last week. Which
neurotransmitter is most affected by this drug?
a. Acetylcholine
b. Serotonin
c. GABA
d. Noradrenalin
e. glutamate
101. A 40 years old woman had depression. She was treated
with tricyclic antidepressant, What is the function?
(lupapilihannya maap)
102. Dopamine receptor agonist such as bromocryphine are
used to treat parkinsons disease because they
a. Inhibit metabolism of DOPA by decarboxylase in
peripheral
b. Facilitate transport of L-DOPA across BBB
c. Increase neuronal stores of dopamine in basal
ganglia
d. Mimic the action of dopamine at post synaptic
receptors
Academic Team 09 FINAL NBSS 2nd Year - 2009

9 | P a g e

103. Which of the following drugs has the best evidence
supporting its effectiveness for long term prevention of
recurrences of mania and bipolar depression
a. Carbamazepine
b. Lithium
c. Lorazepam
d. Risperidone
e. Valproate
104. Extra pyramidal side effect of antipsychotic drugs are
most likely due to the blockade of which one of the
following type of receptors
a. Adrenergic
b. Cholinergic
c. Dopaminergic
d. GABA
e. Serotonergic
105. The most appropriate drug for therapy of anxiety,
alcohol withdrawal and status epilepticus is
a. Chlorpromazine
b. Diazepam
c. Paraldehyde
d. Phenobarbital
e. Meprobamate
106. Penyakit Alzheimer mengalamigangguanpada
neurotransmitter apa? Jawab : Acetylcholine
107. A 65 years old male patient with mild to moderate
severe Alzheimer disease living with his sons family has
delusion and hallucinations. An appropriate drug to
control his delusion and hallucination:
a. Haloperidol
b. Pthioridazine
c. Lithium
d. Clozapine
e. Diazepam
108. A 49 years old man with chronic alcoholism is admitted
with acute alcoholic delirium. He is prescribed high dose
chlordiaxepoxide as part of his detoxification treatment.
What neurotransmitter is primarily involved by this
drug?
a. 5-hydroxy-trypthamine
b. Acetylcholine
c. Encephalin
d. GABA
e. Glutamate
109. -
110. 14 y.o girl epileptic (tonic-clonic) and has been treated
with carbamazepine. Has poor compliant with her
medication and has been rushed to A/E with status
epilepticus. Most appropriate immediate control of the
convulsion ?
a. Diazepam i.v. injection
b. Phenytoin i.v. infusion
c. Thiopentone sodium i.v. bolus injection
d. Tubocurarinei.v. injection
111.
112.
113.
114.
115. A young child presented with meningitis. A gram (-)
cocobacili isolated from csf on chocholate agar and
require both x and v growth factor. Which one the
etiology?
a. Haemophilus Influenza
b. H. ducreyi
c. N. meningitis
d. H.parainfluenzae
e. H. parahemolitikus
116.
117. Neonatus 3 thn conjunctiva edema pdmatadari 2 hari
yang lalupadahari 3 edema menjadiparahdan purulent.
Etiologi :
a. gram +
b. abundant intracelldipococci in neutrophil
c. extracell lymphocyte
d. intracellular elementary bodies
e. gram

118. A 42 year old male, had visited the ophthalmologist
with the chief complaint of watery discharge from both
eyes, which become puffy and red. What is the most
likely microorganism cause of infection in this patient?
a. bacteria
b. virus
c. arthropods
d. fungi
e. protozoa

Academic Team 09 FINAL NBSS 2nd Year - 2009

10 | P a g e

119. A previously healthy 7 years old girl presented with a
two-day history of fever, headache, rash, and
photophobia. Blood cuture as negative and CSF analysis
revealed high lymphocyte number, elevated protein and
normal glucose levels. The most ikely etiological
pathogen is :
a. Cryptococcus neoformans
b. neisseriameningitides
c. streptococcus pneumonia
d. coxsackie virus
e. rotavirus
120.
121.
122. You are assessing a child 2 year age. Behavior:
a. ride tricycle
b. draws a circle
c. walk upstairs, alternating feet
d. uses 3 words sentence
e. know full name
123.
124.
125.
126.
127. 6 months old infant, indirect hyperbilirubinemia, he is
babbling, what the best advise to mother?
a. Perform tymphanogram
b. Perform brainstem
c. Plan for cochlear implant
d. Plan for hearing aid
e. Reassure the mother
128. A 7 year old boy has a seizure. Each attack lasts 10-20
second in duration. EEG shows bursts of 3 cycles per
second spike waves. His attacks can be precipitated by
hyperventilation. Attack of the boy are characteristic of:
a. Myoclonic seizure
b. temporal lobe epilepsy
c. petit mal seizure
d. grand mal seizure
e. infantile spasm
129.
130. Anak 14 bulangangguan language development,
yglainnya normal, dianangisdannunjukbuatdapetin yang
diamau, anaksebayanyaudahbisa 2 kata, pernyataan
yang benar:
a. refer to speech rehab
b. investigasi hearing
c. language dev normal
d. cerebral palsy
e. lupa
131. A 6 y.o is brought to your office with a complaint of
stomachache. He has been out of school for the last 2
weeks. His illness is worst in the morning. Tehe most
likely cause is:
a. Hepatitis
b. peptic ulcer
c. lactose intolerance
d. school phobia
e. subacuteappendicitis
132. A man brings his 49 y.o wife to the emergency
department. She is dazed. Confused, disorientated,
agitated and pacing restlessly. She was well until this
morning when she heard about her only son being
admitted to an intensive care unit in a critical state
following a road traffic accident. What is the most
appropriate treatment to help her cope over the next
48 hours?
a. Amitriptysine
b. Diazepam
c. Fluoxetine
d. Haloperidol
e. Lithium
133. A 53 y.o man consult you complaining anxiety. He is off
sick and fearful of returning to work. He is conflict with
his manager. you wonder if he is suffering from clinical
depression. Which of the following symptom support
this diagnosis?
a. avoiding being seen
b. feeling guilty
c. irritability
d. lost interest
e. lost libido
134. A 24 y.o. man presents to you with longstanding low
mood & problems at work. He tells you that he has
been spending excessive time on the internet at work
and has been disciplined for this. He is frustrated with
himself, also sad and guilty. He is a perfectionist with
work tasks and tends to avoid them by going on the
internet and eating chocolate. What is the most likely
underlying problem to evaluate in further HT?
a. Depression
b. generalized anxiety disorder
c. obsession disorder
Academic Team 09 FINAL NBSS 2nd Year - 2009

11 | P a g e

d. personality disorder
e. schizophrenia
135. 35 y.o male, drug dependent, unconcious on side walk,
brought by ambulance. Exam: pinpoint pupil&multiple
needle mark on forearm, intervensi?
a. naloxon iv
b. diazepam iv
c. folic acid dan thiamine iv
d. haloperidol im
e. observasidan monitoring
136. A 5 y.o boy becomes terrified whenever his parents
leave the house. He also avoids going to school in order
to remain with his mother. Which one is the following is
the most likely the diagnosis
a. social sensitivity disorder
b. generalized anxiety disorder
c. avoidant disorder
d. somatoform disorder
e. separation anxiety disorder
137. A 40 y.o. lady presents with multiple somatic symptoms
in various parts of her body of 15 years duration.
Repeated medical investigations have not revealed any
organic basis for her symptoms. During the interview,
you notice that she is very critical of doctors and she
accuses them of failing to diagnose her illness. Which
one of the following is the most likely diagnosis?
a. hypochondrial disorder
b. somatization disorder
c. atypical disorder
d. conversion reaction
e. dissociative disorder
138. A 5 y.o boy becomes terrified whenever his parents
leave the house. He also avoids going to school in order
to remain with his mother. Which one is the following is
the most likely the diagnosis
answer : separation phobia
139. Patient with sign-symptom: vomit, headache, right
sided ataxia, nystagmus, decrease reflex of cornea.
What illness shes suffering?
a. cerebral hemisphere infarction
b. sagital sinus thrombus
c. intracerebral hemorrhage
d. rupture of posterior communicating artery
e. thalamus hemmorhage
140. A young man complain unsteadiness of gait with sudden
changes of posture. This is most likely due to
a. difficulty with vision
b. posterior column disease
c. cerebellar ataxia
d. involvement of vestibular connection
e. peripheral neuropathy

141. A 45 years old farmer with corneal ulcer of the right eye
comes to the hospital. To determine the etiology of the
ulcer corneal scraping is performed. Doctor gives the
patient natamycin. Mikroorganisme yangditemukan di
corneal scraping:
a. Gram (+) rod
b. Gram (-) coccus
c. Hyphae
d. Tropoziod
e. Cyst

142. A 75 y.o man comes to you complaining pain in the face
(sharp and very severe). It is triggered ny speaking or
chewing. What is the most likely diagnosis?
a. cluster headache
b. temporal arteritis
c. trigeminal neuralgia
d. brain tumor
143. Weak, 63 y.o,, hemiparesis resolves in 24 hours. Sinus
rhythm, carotid Doppler 80% stenosis. Appropriate
management?
144. A 63 years old man complains of burning numbness on
his feet and weakness of his leg. Examination shows
reduction of tendon reflex and superficial sensation in
the leg. The muscles are weak and tender. Diagnosis:
a. Polymyositis
b. sympathetic reflex dystrophu
c. amyotrophic lateral sclerosis
d. peripheral neuropathy
e. multiple sclerosis
145. A 72 years old man is brought by his family for
evaluation of an episode of acute confusion that
occurred 3 weeks ago. His family notes that the patient
has had increasing problem with his memory for the last
year and that his activities of daily living have declined
to the point that they are considering placement in a
long term care facility. The patien has hypertension that
Academic Team 09 FINAL NBSS 2nd Year - 2009

12 | P a g e

is poorly controlled by propanolol. They finding most
likely to suggest a diagnosis of multiinfarct dementia
rather than dementia of the alzeimer type is
a. no familiyhistyory of dementia
b. score 14 mmse
c. asymmetry of deep tendon reflex
d. cerebral atrophy on ct
e. increased protein in csf
146.
147. Wanita tiba2 pingsan, apa yang
harusditanyakanuntukkepentingan diagnosis?
a. Sudahmakanataubelum
b. Ada gejalaapasebelumpingsan
c. Sedangmensatautidak
d. Konsumsiobatapa
e. Ada family history
148.
149.
150. An otherwise healthy 15 yo boy is brought to the gp by
his mother. The mother says she has noticed over the
past 2 weeks that the boy has had black spells, and that
without provocation he becomes uncommunicative,
does not respond to questions and grimaces with
repetitive movement of his mouth. They report that he
complains of strange smells. He has not collapsed to the
floor or been incontinent. His mother say that he has
had 1 febrile convulsion as a child and that he has been
knocked out less than a minute several times while
playing football. He was not brought to the doctor
because he was unconscious for a very short time and
seemed fine when he regained conscious each time.
The most likely ethiology is...
a. febrile illness of any kind
b. epilepsy of unknown/genetic origin.
c. result of head injury meningitis
d. brain tumor