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1. A 36 y/o man has been hospitalized for Nasopharyngeal Carcinoma.

The tumor is
quiet large as he had swallowing difficulty for solid food. Anthropometric exam
revealed his height 168cm, weight 47kg. MUAC 21.4 cm. blood assay showed Hb
10.8 g/dl, serum Albumin 2.8g/dl, total lymphocyte count 1157mol/mm3
Which of the following statements is correct?
A. NGT is needed for enteral feeding
B. Total paraenteral nutrition is required to increase weight
C. His BMI is 18.9
D. Low TLC is due to decrease serum Albumin
E. Iron Supplementation would normalize Hb
2. A women aged 66 is admitted to hospital for late stage colon cancer. Dietary exam
reveals she is severely undernourished BMI 13.5 with intake less that %)% of calorie
requirement. She gives history of inadequate veges and fruit intake
Which of the following statements regarding her dietary management is correct?
A. The patient needs peripheral Parenteral nutrition
B, Total calorie requirement can be achieved through nutrition per oral
C. Total calorie requirement can be achieved through enteral nutrition
D. Parenteral nutrition is to give as the main source calorie
E. Dietary treatments goal is to attain maximum intake of 50% calorie requirement
3. A 65 year old woman is seen in hospital ward for late stage of ovary carcinoma
with ascites. Anthropo exam shows height 156cm, weight after correction ascites is 36
KG and MUAC is 18cm. Dietary exam reveals her intake is only 435Kcal (about 23%
of calorie need). She complains feels fullness after a lil food and epigastric pain. She
refuses tube feeding
Which of the following dietary management for this patient can be applied?
A. Nutrition per oral should be terminated
B. Nutrition per oral should maximal given
C. Enteral nutrition should be given in small amount but frequent
D. Total parenteral nutrition via central vein should be given exclusively
E. Nutririon per oral should be combined with peripheral or central parenteral
4. A man aged 64 years old has been hospitalized for hepatoma. Physical exam reveals
enlarged liver with a stormy-hard consistency, nodular surface and ascites. He also
reports having alcoholic faeces. Anthropo exam shows height 167 cm, weight 47 kg.
Oedema for dorsum pedis is revealed on physical exam. Clinical investigation reveals
increased SGOT<, SGPT, albumin: 2.7 g/dl. and Hb 10.5 g/dl
Which of the following dietary management for this patient are correct?
A. increase fat intake
B. Supplemented woth MCT (medium chain triglyceride)
C. Bmi is 14.7
D. Acolis fieces is associated with elevated bile acid secretion
E. Carcumin could be the agent cause of the hepatoma

5. Food Plays role in prevention of carcinogenesis in which of the following stage?

A. Initiation
B. Promotion
C. Progression
D. Initiation and progression
E. Initiations, promotion and progression
6. Mineral as a strong antioxidant and involves in a cancer prevention and probably
also in particularly in early stage of cancer is?
A. Magnesium
B. Natrium
C. Selenium
D. Kalium
E. Phosphor
7. Hypernephroma arises from
A. Reneal tubular epithelium
B. Renal capsule
C. Inta-renal adrenal rests
D. Renal medula
E. Renal pelvis
8. Which of the following is NOT a advisable in patients suspected of having upper
tract transitional cell carcinoma?
C. Retrograde pyelography
D. Antegrade pyelography
E. CT scan
9. Which is the most common cancer of the urinary ladder?.
A. Sarcoma.
C. Adenocarcinoma
E. Clear cell carcinoma
10. The following are not high risk factors for development of carcinoma urinary
A. Chemical Carcinogens
B. Cigarette smoking
C. Artificial Sweeteners
D. Coffee drinking
E. Tea drinking
A. 21 years old man presented with the history of chronic retention of urine with
overflow incontinence. He had dysuria and frequency of urinated since last many
years. His blood urea was 100mgr% and serum creatineine was 4,5 mgr%. There is no
history of any systemic disease

11. Which of the following is the most probable diagnosis?

A. Stricture urethra
B. Benign prostatic hyperplasia
C. Carcinoma bladder
D. Vesical calculus
E. Vesical diverticulum
12. Which of the following us the investigation of choice?
C. Renal Scan
D. Uroflowmetry
13. Which of the following is the biomarker investigation of choice?
13 years old girl come to hospital because there is lump at right shoulder which notice
since kindergarten. Physical exam the consistency of the lump is firm and well
defined border. The finger can put in between the lump and the humerus and from xray lump growth from metaphysic to diaphysis.
14. The following signs are benign tumor except:
A. The size tumor a marble size
B. The size tumor a tennis ball size
C. Slow growth
D. Ill define
E. No pain
15. From the history above, other information should get from x-ray to support
A. Cauliflower appearances
B. Sunburst appearances
C. Onion skin appearances
D. Codman triangle
E. Nidus
16.The diagnosis is
A. Osteogenic Sarcoma
B. Ewings sarcoma
C. Osteoid osteoma
D. Osteochindroma
E. Condroma
17 All the following are indication of operation except:
A. Compression to neurovascular bundle

B. Cosmetic
C. Malignant danger
D. The doctor want operate
E. The patient need
12 year old boy came to hospital because of right tibia fracture as a result of slip and
fell. The boy already felt some pain since a week ago and especially at night. The
result of biopsy is Round cell tumor. From physical examination there is swellingat
tibia with ill define border and increase of temperature compare to the noral site.
From X-ray shown there is fracture at the middle of tibia and onion skin appearances
18. Pathologic fracture because of
A. It happen at 12 years old
B. Because of chronic osteomyelitis
C. Because trivial trauma
D. Possibility of bone TBC
E. It happens at a boy
19. The following signs are Malignant tumor except:
A. The size tumor a marble size
B. The size tumor a tennis ball size
C. Slow growth
D. Ill define
E. No pain
20. The diagnosis is
A. Osteogenic sarcoma
B. Ewings sarcoma
C. Osteod oesteoma
D. Osteochondroma
E. Chondroma
15 years old came to the hospital because of swelling at her right knee which she
suffers for 3 months. At the beginning the size like a marble ball and increasing until
the size like a takraw ball. From physical exam there are venectasis at the mass, the
colour darker and temperature warmer than adjacent side. Consistency is bony hard,
ill define and pain on palpation. X-ray shown the tumour at the metaphysic of the
fermur with osteolytic and osteoblastic area.
21. Information that we should be found to confirm the diagnosis is
A. Cauliflower appearaces
B. Sunburst appearance
C. Onion skin appearance
D. Codman triangle
E. Nidus
22. The lab findings which can support the diagnosis
A. Alkali phosphate increase
B. Alkali phosphate decrease
C. Acid phosphate increase

D. Acid phosphate decrease

E. Erythrocyte sediment rate increase
23 The diagnosis is
A. Osteogenic sarcoma
B. Ewings sarcoma
C. Ostiod oestoma
D. Osteochondroma
E. Chondroma
A. Paracetamol, codeine and bisacodyl
B, Paracetamol and tramadol
C. Ketorolac, tramadol and bisacodyl
D. Paracetamol, morphine and bisacodyl
E. Ketorolac and morphine
36. Male, 75yo has been diagnosed Prostatic Carcinoma by Surgeon came to public
health centre with lower abdomen pain. There is problem with communication as
cognitive disorder with the old patient.
Which pain assessment tool can be used for measurement pain intensity of this
A. Numerical Rating Scale
B. Visual analogue scale
C. Verbal Rating scale
D. Face pain rating scale
E. Mc Grill pain questionnaire
37. Morphine as analgesic drug:
A. Is the weak opiod of choice in cancer pain
B. Poorly absorbed after oral admin
C. Amount required is determined by pain relief
D. Has inactive metabolites that can be accumulated
E. Modified release preparation for breakthrough pain
38. Clinical characteristic of neuropathic pain in cancer patients
A. Aching, Throbbing
B. Gnawing, cramping
C. burning, electric like
D. well localized
E. hyperalgesia
39. Disadvantages of tramadol as cancer in equitable dosage
A. more respiratory depression
B. associated with seizure
C. a controlled drug
D. more constipation
E. more sedation

40. Progress in the field of radiotherapy triggered by:

A. Radioactive invention
B. Technological progress
C. Growth of elementary medical science
D. Growth of computer technology
E. All above correct
41. Cancer therapy recognized in this time is:
A. Surgical
B. Chemotherapy
C. Radiotherapy
E. All above correct
42. Non inclusive of a 4R in radiotherapy
A. Repopulation
B. Radiosensitive
C. Redistribution
D. Repair
E. Reoxygenation
43. Combination between chemo and radio can be in form of
A. Neo adjuvant chemo
B. Adjuvant chemo
C. Concomitant chemo
D. Concurrent chemo
E. All above correct
44. Cell Damage which is the most happened because of ionizing radiation
A. Directly damage at DNA
B. damage in nucleus
C. damage in vacuela
D. indirectly damage in the form of free radical
E. damage in cell membrane
45. Acute complication of radiation
A. teloangiectasis
B. Fibrosis
C. mucositis
D. a and b correct
E. a, b, c correct
46. The case which cannot be given radiation
A. mamma carcinoma
B. nasopharynx carcinoma
C. malignant carcinoma
E. Malignum lymphoma
47. Cervical cancer stage IIIa can be therapy by

A. external beam radiation

B. surgical
C. brachyteraphy
D. all above correct
E. a and c correct
48. Cancer that has radio responsive character
A. Malignum Lymphoma
B. Ewings sarcoma
D. Soft tissue carcinoma
E. none correct
49. Perioperative radiation mean:
A. Radiation given 5-6 after surgically
B. Generally in brachytheraphy form
C. Applicator is installation done in operating room
D. All above correct
E. A and C correct
50. A 14 year old boy came to the eye clinic with the complain of proptosis of the
right eye that had been undergone for 6 months, slowly, accompanied by ptosis
symptoms. Eye movement was blocked for all direction. From the slit lamp exam
clear white hyperaemic conjunctiva, pupil and dilation, clear lens, VOD 20/40 VOS
20/20 no history of trauma and infection
What is the best diagnose for the case above?
A. Retinoblastoma
B. Adenocystic carcinoma
C. Basal cell carcinoma

D. Rhamdomyosarcoma
E. Melagnoma Maligna

51. A60 yo women is complaining the lump at the superior palpebra with the size
xxxx cm, lumpy surface, easily bleed, attach with the surrounding tissue. The result
of biopsy is SCC
What is the best management for the case above?
A. Wide excision with Frozen Section
B. Tumor extirpation
C. Eye ball surgery

D. Chemo
E. Radiotherapy

52. A 2 yo child with white spot on the left pupil that has been appeared since 1 year.
The result of exam of eye ball anterior segment oblique illumination is normal.
Following target (-) right eye normal. family history with the disease (-) the ct scan
revealed tumor that filled with all the eye ball
What is the most probable diagnosis of this patient above?
A. Retinoblastoma I
D. Retinoblastoma IV
B. Retinoblastoma II
E. Retinoblastoma V
C. Retinoblastoma III

53. In the case above, the result of enucleation invaded the optic nerve.
What is the appropriate advance management for this patient?
A. Radiotheraphy
D. Cryoteraphy
B. Chemotherapy
E. Avastion
C. Brachiotheraphy
54. A 65 yo man, farmer came to the dermatology clinic with the complain of pimple
around right chick that wet bigger everyday. This had been experienced for 3 year.
Bleed if scratches and there was ulcer un the mid of the lesion. Dermatology appeared
erythematic papule with ulcer at the central lesion, black crest, lesion on the right
What is the diagnosis?
A. Basal Cell carcinoma nodular type
C. Melanoma maligna

D. BCC Morpheus type

E. Dermal nevus

55. Roden ulcer is included in basal cell carcinoma type?

A. Superficial
D. ulcer
B. Morpheus
E. Nodular
C. Pigmented
56. A boy hospitalized with the diagnosis of wilms tumor. The complaint while
entering the hospital was enlarge abdomens since 8 months ago accompanied by
hematuria and reducement of body weight.
What data that finds to be completed to help confirming the dianogsis?
A. Hunger
D. Feeling full of abdomen
B. Feeling hot at the abdomen
E. Abdominal pain
C. Feeling thick at the abdomen
57. Exam that can be perform confirming the diagnosis of the cancer above is
C. Joint fluid
58. Management that can be performed to the diagnosis of the case above
A. Chemo + Surgery + antimicrobial + blood transfusion
B. Chemo + Radiotherapy + Surgery
C. Radiotherapy + Chemo + Immunotherapy
D. Surgery + Radiotherapy + Blood transfusions
E. Surgery + Renal Transplantation + Radiotherapy
59. A 40yo man came to the hospital with the complaint of seizure. The patient was a
heavy smoker. The result of MRI exam is there is a multinodal mass at the lobes
temporalis sometimes that absorbed the contrast and creat a severe oedema to the
brain. This tumor is suspected not a primer tumor so we performs complete blood
exam and thorax and abdominal CT scan that revised normal result.
What diagnostic exam that is advised for this case?
A. Lumbar punction

B. Gastroscopy and colonoscopy

C. Excision biopsy

E. Conservative & observe MRI

60. 33 yo man comes with the complaint of repeated seizure that is usually controlled
by standard seizure therapy. The exam reveal 5cm temporal mass in MRI. MRI T1
hipodens and not accompanied by contrast enhance or mass effect. The
histopathology exam reveal an oliga osteositoma WHO grade II. What is the best
management for this case?
A. Strict Observation
B. Radiotherapy
C. Chemo
D. Radiotherphy + adjuvant chemotherapy (PCV)
61. What is the central nervous system tumor that one of the predipositional factors is
hereditary factor?
A. Meningioma
B. Astrocytoma
C. Neurofiromatosis type I
D. Oligodendriglioma
62. Which of the following statements is true for oligodendriglioma tumor?
A. OGD prognosis is better then astrocytoma
B. Primary therapy should be chemo because it is chemo sensitive
C. For progressive OGD we should consider radiotherapy
D. Neoadjuvant therapy with PCV has been showed improvising OGD patient life
E. A & C correct
A 38 year old man came to the clinic with the complain of lump at the lect armpit with
the size of a table tennis ball since 1 week ago. One month before he was complaining
if lump at the inguinal that was painless. There is fever, productive cough, decrease
body weight and no appetite since 3 weeks ago. Lab : HT 18gr%, WBC 14,000 PLT
356,000.PA displayed lymphocyte
63. The most possible diagnosis for the case above is
A. Lymphoma malignan Hodgkin
B. Lymphaadenitis tuberculosis
D. Limfadenitis bakterima
64. Based on the anamnesis and physical exam the patient above is in the stadium
65. Supportive management for the patient above is
A. Analgesic
B. Anti emetic
C. Anti
66. Substitution therapy that is also needed for the patient above is
A. Concentrative Thrombocyte Transfusion
B. Red cell package transfusion
C. Fresh protein plasma transfusion

D. Antibiotic

D. Cry transfusion
A 56 years old woman with colon cancer is being consulted to the haematology
oncology department for chemo. The patient has undergone chemo and the result is
colon cancer stadium III. The result of physical exam is BP 110/80, pulse 80/mins.
IML 17% Lab HT 30% WBC 12,000 mm3, PLT 150,000/mm3
67. Chemo above is an action of
A. Adjuvant
B. Neo adjuvant

C. Supportive management
D. Palliative management

68. The objective of chemo for the case above is as

A. Supportive therapy
C. Palliative therapy
B. Curative therapy
D. Neo adjuvant therapy
69. Other supportive management that can be performed besides for chemo for this
patient above is
A. Antibiotic
C. High calorie higj protein diet
B, Analgesic
D. High fat diet
70. A 48 year old woman with the diagnosis of breast cancer (D) cT4cN0M0 stadium
III b. After undergoing neoadjuvant chemo for 3 cycles, clinically the tumor is 25%
reduced. What is the chemo response?
A. Complete response = CR
B. Partial response = PR
C. No change = NC
D. Progressive disease = PD
71. If a suspected malignant neoplasm patient come to the oncology clinic then the
patient will get a service is based on the malignant neoplasm patient management
which are determine consequently : Diagnosis, staging, appearance status,
management plan, management execution, and evaluation.
Which of the principle management that has the objective of determining the tumor
extension, management type, and comparison of therapy result and prognosis?
A. Diagnosis
D. Management plan
B. Staging
E. Evaluation
C. Appearance status
72. A 26 years old man comes to the hospital with the complaint of lump at the left
mandible for 8 months, slowly and no other symptom. History of infection. At
palpation, the consistency is solid mass, diameter 2cm. Radiology exam : noticed
radiolucent appearance and radiopaque surrounding the eye edge
What is the diagnosis of the above case?
A. Dentigerous Cyst
D. Odontenigenic cyst
B. Dermoid Cyst
E. Racula cyst
C. Follicular Cyst

73. A 40 year old man comes to the hospital with the complaint of lump at the
mandible. History of .. and ., position of teeth on top of the tumor is
irregular, the tumor is felt and no pressure pain.
The possible disorder of the case above?
A. Neoplasma
D. Trauma
B. Neo Neoplasm
E. Salivary gland disorder
C. inflammation
74. 55 years old man comes to the clinic with the complain of ulcer at the right side of
the .. Since 4 months ago. Ever medicated before but never cured. History of
smoking, alcohol, In clinical exam ulcer +, indurations +
What exam that is advises to confirm the above diagnosis?
A. Expoliative cytology
D. Biopsy
B. Pap smear
E. Monoclonal antibody
C. Thlanide blue examination
75. A 40 year old woman comes to the clinic with the complaint of lump at the lect
chick in front of left ear, slowly grow, painless and mobile.
What is the possible diagnosis of the case above?
A. Benign Cyst
D. Wathins tumor
B. Lymphoepithelial
E. Oncocytoma
C. Plemorphic Adenoma
76. A 30 year old woman with the complaint of right breast lump, suspected because
of hormonal imbalance. The dominant morphologic changes are : cyst formation and
fibrotic epithelial hyperplasia sclerosing adenosis.
What is the disorder of the breast above?
A. Fibrocystic disorder
D. Papiloma intraductal
B. Fibroadenoma
E. Adenoma Sclerosis
C. Tumor Phyloideus
77. A 24 year old woman come to the clinic with complain of left breast lump since 2
months ago, round, rubber consistency, mobile, painless, diameter 2 cm. location the
upper lateral quadrant
What is the disorder of the breast above?
A. Fibrocystic disorder
D. Papiloma intraductal
B. Fibroadenoma
E. Adenoma Sclerosis
C. Tumor Phyloideus
78. A 47 years old woman come to the oncology clinic with the complain of breast
lump since 6 months ago. History of left breast surgery 1 year ago with
histopathology Fibroadenoma. Married but no children. In clinical exam there is a
skin color changing of the breast, dimpling with solid breast diameter 3.5cm attached
to the skin. There is a regional gland enlargement.
What is the supportive examination to confirm the diagnosis of this case?
A. Try cut needle aspiration
D. Incision Biopsy
B. Fine needle aspiration
E. Excision biopsy
C. Frozen section

79. A 50 year old woman comes to the hospital with the complaint of lump and ulcer
at the left breast. Ulcer is experienced since 3 months ago, lump history since 1 year
ago. First menstruation at 12 years old, married, one child (12 years old). Family
history of the same disease (-). In clinical exam there is a breast skin color changing,
peau dorange (+), ulcer (+). Palpated a solid hard tumor mass, at tge upper lateral
quadrant, attached to the skin but not the the thorax wall, diameter 5 cm,gland
enlargement (+) with the diameter of 2 cm and mobile. Histopathology exam:
invasive ductal carcinoma. The patient is diagnosed with ulcer carcinoma mamma.
Based on UICC/AJCC, what is the TNM clinical classification of the case above?
A. cT2N1M0
C. cT3N1M0
E. cT4N1Mx
B. cT2N1Mx
D. cT3N1Mx
80. A 56 years old woman, multipara, post menopause, come to the hospital with the
complain of slightly smelly flour albus, sometimes theres a vaginal bleeding
especially after intercourse. This has been experienced since 3 months ago. In
inspeculo examination there is a higher portion with irregular surface, accompanied
with blood. Martial history: Married at 13 years old.
What is the important exam if there is a porsio condition as the case above?
A. Pap smear
D. Biopsy
B. Colposcopy
E. Operation
81. The histopathology result for the case above is carcinoma cervix. In vaginal
touch there is nodular lesion limited in the cervix with the diameter less than 4 cm
What is the stadium of this case?.
A. Stadium 0
D. Stadium III
B. Stadium I
E. Stadium IV
C. Stadium II
82. A 38 year old woman, paritu of 3, comes to the clinic with the complaing of flour
albus, itchy since 9 months ago. Sometimes there is a slight bleeding. The pap smear
result is inconclusive. The result of the next pap smear after 3 months is still
What is the next exam to know the cause of the patient complain?
A. Pap smear
D. Hyesteroscopy
B. Vaginoscopy
E. Biopsy
C. Colposcopy
83. A 38 year old woman, parity of 3, comes to the clinic with the complaint of flour
albus, itchy, since 9 months ago. Sometimes there is a slight bleeding. The Pap smear
result is inconclusive. The result of the next pap smear after 3 months is still
inconclusive. One week later the patient come comes with the result of histopathology
exam: abnormal cells are found in the whole epithelial layer, basal membrane is
What is the diagnosis for the patient above?
D. Microinvasive carcinoma
E. Invasive carcinoma

84. A 26 years old woman, parity of 1, comes to the clinic with the complain of
vaginal bleeding since 1 months ago. The patient has been curettage before because of
mola hidatinosa. What is the exam that is needed for this disease?
A. B-HCG tumor marker exam
B. Thorax x-ray
E. MRI exam
85 A 26 years old woman, parity of 1, comes to the clinic with the complain of
vaginal bleeding since 1 months ago. The patient has been curettage before because of
mola hidatinosa. What is the management for this case if the diagnosis is Malignant
Trophoblast disease
A. Observation
D. Chemo
B. Curretage
E. Radiation
C. Hysterectomy
86. A 25 years old woman, no parity, comes to the clinic with the complaint of lump at
the lower abdomen since 6 months ago. Married 3 years ago. Repeatedly come to the
doctor to have children, Body weight drastically decrease within last 2 months
What is the most possible diagnosis of this case?
A. Cervical Carcinoma
C. Malignant trpophoblast
B. Ovarian Carcinoma
D. Tube carcinoma
E. Endometrium Carcinoma
87. A 58 years old woman comes to the clinic with post menopause bleeding.
Endometrium biopsy shows adenocarcinoma. Total hysterectomy and bilateral pelvic
lymphadenectomy is performed. The pathology exam result after operation reveal
tumor has further to cervix. Lymph shows no malignancy cell/
What is the stadium of endometrial carcinoma of the case?
A. Stadium 0
C. Stadium III
B. Stadium I
D. Stadium IV
C. Stadium II
88. A 65 years old woman comes to the clinic with the complaining of abdominal
distended for 3 month. In abdominal percussion there is of lymph with the
tympani sound. In pelvic exam there is at the .. with diameter of 8 cm nodular
and limited on the pelvic. .. not palpated. Blood chemistry, urinalysis, pap smear,
and chest x-ray is normal/
Which marker than has to be examined to diagnose this case diagnosis?
A. CA125
89. To find out a risk factor for a woman with diagnosis of lung cancer, we have to
point out in anamnesis about
A. How long time suffers
D. Carcinogenic food consump
B. Passive smoker or not (husband smokes)
E. History of gas exposes
C. How much body weight loss
90. A man 55 years old come to clinic with coughing Since 5 days ago, accompanied
with chest pain. Has been have cough about 2 months, body weight loss about 5kg, a

history of smoker and has been long time work in cement factory. Thorax photo
showed a mass in the right lung with diameter about 5 cm. Physical exam are normal
Which of the following statement is the cause of coughing?
A. Smoke
D. Secondary infection
B. Respiratory obstruction
E. Prolong cough
C. Irritation of bronchial vascularisations
91. A man, 63 years old came to surgery policlinic with abdomen pain, history of
frequent obstipation, frequent feeling of fullness and if flatus, he fell getting betting.
Defecation sometimes with fresh bloody pain, and never satisfied
The examination that you should do as the first appropriating diagnosis is?
A. Total Colonoscopy
D. Rectal touch
B. Plain X-ray abdomen
E. Mesentrical angiography
C. Double contrast barium enema
93. The most possible diagnosus of this case above is
A. 1/3 Proximal Rectum Carcinoma
D. Rectal
B. 1/3 Mid Rectum Carcinoma
E. Descendens Colon Carcinoma
C. 1/3 Distal Rectum Carcinoma
12 years old boy came to hospital with chief complain diaphysis right tibia pain since?
Week ago. The result pathology exam is round cell tumor with malignant
94. The possible diagnosis
A. Osteomyelitis
B. Osteosarcoma
C. Chondrosarcoma

D. Ewings sarcoma
E. Osteochondroma

95. X-ray from the diagnosis above:

A. Codman triangle
B. Sun rays appearance
C. Onion Skin appearance
D. Codman triangle and sun rays appearance
E. Cliacha??
A 60 years old woman come to doctor because pain in all the ody and feel fatigue.
Punch out lesion was found from radiologic exam
96. Diagnosis possible:
A. Multiple mioloma
B. Tumor Metastases
C. Osteosarcoma

D. Osteoporosis
E. Osteochondroma

97. The kind of exam that we need to support the diagnosis above is
A. CT scan
D. Bence-Jones protein
E. Alkai Phosphate
98. The type of disease above included in group of

A. Hematogen
B. Osteoporosis
C. Metastases

D. Round cell tumor

E. Nutrition disorder

99. According to Kobler Ross states that 5 step physicologic reaction when patient
getting cancer in stage II
A. Denial
B. Depression
E. Acceptance
C. Angry
100. Cancer Stage IV is
A. Denial
B. Depression
C. Angry

D. Shock
E. Acceptance