Multiple Choice Questions
Decreased serum renin
RENAL AND GENITOURINARY SYSTEM
FK UPH 2014
Wednesday, 23 Mar. 16 08.30 – 11.00
1. Man, 27 years old, datang dgn keluhan severe sepsis
krn community acquired pneumonia di ICU. Urine
output turun 50 cc per day. Causes of decrease
urine is ...
A. Hypoxia
B. Renal vasoconstriction
C. Systemic vasodilate
D. Immune complex
E. Ga tau hehehe
2. 34 years old man came with laboratory result. The
result was unremarkable only high blood
pressure. Proteinuria +2, hematuria with cast. 24
h urine / 2g. USG abdomen was normal. What is
the diagnosis?
A. Nephrotic syndrome
B. Isolated proteinuria
C. Nephritic syndrome
D. Hematuria unclassified
E. Proteinuria
3. 56 y.o. woman, serum creatinine 1,8 mg/dL. 3 year
controlled DM type 2. Last month she underwent
an annual check up, at the time there is no sign of
proteinuria and her creatinine 0,8. for 2 weeks
she takes cox2-inhibitor to release her knee pain.
What is the pathophysiology for her condition?
A. Glomerulosclerosis
B. Acute Tubular Necrosis
C. interstitial nephritis
D. Glomerulonephritis
E. thickening GBM
4. Pasien dengan edema, hematuria, proteinuria.
Penyebabnya?
A. IgA Nephropathy
B. Complex immune deposition
C. Nephrosclerosis
D. Podocyte detachment
5. Screening dari renal osteodystrophy pakai pemeriksaan
serum apa?
A. Hormon PTH
B. (lainnya lupa)
6. 60 years old man with long history of smoking,
myocardial infarction, ischemic stroke. Recently
had worsen hypertension, with blood pressure
200/110. Diagnosed with renal artery stenosis.
What is more likely to be present?
A. Increased serum potassium
B. Decreased serum bicarbonate
C. Increased serum aldosterone
D.
E. Increased ADH level
7. 42 years old male, came with history of gout-arthritis.
He complains colicky right back pain. Lab result
show high ureum and creatinine. Plain abdominal
X-ray were normal. What is your diagnosis?
A. Prerenal azotemia
B. Renal azotemia
C. Postrenal azotemia
D. Acute on Chronic Kidney Disease Prerenal
E. Acute on Chronic Kidney Disease Postrenal
8. A 57 years old female came to the clinic. She had an
uncontrolled diabetes since 5 years ago, she took
glimepiride 2 mg. She had a history of myocardial
infarction. Blood test result showed ureum 85.
Creatinine 2,1, contrast protein +3. What is the
causal of her diagnosis?
A. Hyperglycemia
B. Contrast agent
C. Hypertension
D. Cardiorenal syndrome
E. Antidiabetic drug
9. Ibu 45 th, diabetus melitus selama 17 th and passing
kidney stones. Sejak itu dia minum obat anti
diabetic rutin. Lalu dia ada diare 10x/day and
profuse vomitting. Creatinine 2.5, ureum 156. Usg
results, early ckd. Apa yang nyebabin ureum dia
naik?
A. Hypertension
B. Urolithiasis
C. Long standing diabetes
D. (lupa)
10. Women 34 y.o. came with dysuria, pain on
suprapubic region, nitrite + on urinalysis. What
further tests to confirm diagnosis?
A. nidus formation
B. bacteria + on urinalysis
C. erythrocyte >20
D. leucocyte >10
5
E. urine culture bacteria >10
11. A 32 year old man come w/ severe uncontrolled
hypertension. The doctor said he might be got
stenosis in the kidney vessel. What is that?
A. A. Renal Arteriole Afferent
B. A. Peritubular
C. A. Renal arteriole efferent
D. V. Renalis
E. V. Peritubular
12. Man comes to hospital with left colicky pain di
flank. Usg : left kidney membesar, no acoustic
shadow di renal or ureter, right kidney normal.
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 Possible obstruction? osmo receptor
A. Pelvic renalis D. Increase serum sodium decreases
B. Ureter extracellular volume and intracellular
C. Vesicoureteric junction volume in hypothalamic osmo receptor
D. Vesica urinaria E. Increase serum sodium increases
E. Urethra extracellular volume and decreases
intracellular volume in hypothalamic
13. A 30 y.o sexually active man came to doctor with osmo receptor
complain no sperm come out when he was 17. 54 year old woman with diabetic nephropathy
ejaculating. The doctor said that there might be comes to office because she has vomitting,
obstruction in his genitalia but he said no problen fatigue and metalic taste in the mouth for the past
when he got urination. Where is the possible two weeks. Respi 32x/min. PF shows urine like
place of the obstruction? odor of the breath and 2+ pitting edema. MDRD is
A. Right ureter 14 ml/min/1.73 m2. Additional studies are most
B. Left ureter likely to show ?
C. Vas deferens A. Hypokalemia
D. Urethra pars prostatica B. Hypocalcemia
E. Urethra pars membranosa C. Metabolic alkalosis
D. Metabolic acidosis
14. Young woman, suffer head injury but recovered, E. Respiratory acidosis
get thristy all the time and increase urine output,
total urine examination 5L. No diabetes, gula 18. Female 24 years old came with fatigue since 2
darah normal. What malfunction? months. Diagnosed with CKD. Lipid profile
A. Insertion of Aquaporin 1 in distal convoluted normal. Elevated creatinine and ureum. No sign
tubule of UTI. What is the most common cast to be
B. Secondary active transport of kalium in found during urinalysis?
collecting tubule A. Hyaline cast
C. Insertion of Aquaporin 2 in collecting tubule B. Waxy cast
D. V1 receptor in collecting tubule C. RBC cast
E. Primary active secretion of kalium in collecting D. leukocyte cast
tubule E. Oval fat bodies

15. Man 60 y.o. edema di kedua kaki. Kemudian 19. 34 year old male victim of earthquake came to ER
dikasih diuretic. Sehari setelah dikasih diuretic, suffering from compartment syndrome. Lab
edema nya membaik. Dimana tempat terjadinya results: Ureum 120, creatinine 6.7, sodium 132,
mekanisme obat tsb? potassium 7.2, chlorine, 112. Was given insulin +
dextrose bolus 40% and potassium decreased to
A. PCT
7.0. Management plan?
B. Thick descending loop of henle
A. Give extra insulin
C. Collecting tubule
B. extra fluid
D. Thick ascending loop of henle
C. hemodialysis
E. DCT
D. furosemide
16. A man 24 year old man swam at the seashore.
21.A 65 years old male came with gross hematuria. From
He drank a little sea water. After sometime, he felt
physical examination revealed mass in
thirsty and decreasing his urine volume. What is
left abdomen with + ballotement. The urinalysis showed
the pathophysiology of the thirst?
full hematuria & several RBC cast. What do you advice to
A. Increase serum sodium increases
extracellular volume and intracellular perform?
volume in hypothalamic osmo receptor A. Repeated urinalysis
B. Renal Ultrasoud
C. Abdomen CT scan
B. Increase serum sodium in extracellular
volume and intracellular volume D. Ct Urography
E. Uroflowmetry
decreases extracellular volume and
intracellular volume in hypothalamic
22. 25 y.o woman penderita SLE dateng ke UGD
osmo receptor karena short of breath sejak 4 hari yg lalu. Di
C. Increase serum sodium decreases physical examination dia BP 160/100, ada rales di
extracellular volume and increases basal lung dan leg edem. Waktu di cek di lab Ht
intracellular volume in hypothalamic
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 turun, Hb turun, bicarbonate turun, urea naik, 29. 33 tahun cowo datang dengan purulent urethral
creatinine naik. Management buat anemia? discharge dan dysuria sejak 3 hari lalu, punya
A. Watchful waitinh history unprotected sexual intercourse with
B. Iron supplement different partners, hasil dri gram stain of urethral
C. Erythropoietin supplement swab: gram negative diplococci, what is the most
D. Folate supplement appropriate management: (Maaf gue ga mampu
E. PRC menghafalkan dosis)
A. Cipro IV + ofloxacin PO
23. Female 22 tahun, mengalamai frequency and B. Penicillin + doksosiklin
urgency selama 2 hari. Pada urinalisis di temukan C. Ampicilin + doksosiklin
leukosit 12-20 dan eritrosit 0-2. Nitrit + leukosit D. Ceftriaxone + azithromycin
esterase +. Apa yg mau di lakukan : E. Cotrimoxazole BID 10 hari (500 mg)
A. Biopsy
B. CT scan 30. 8 years old girl with generalized edema since 1
C. USG week ago. Physical Examination shows palpebral
D. Give (obat lupa) edema, shifting dullness +, pretibial edema in
E. Mid stream urinalysis lagi both legs. Lab shows Albumin decrease.
Urinalysis : Protein +4, with oval fat body cast.
24. 45 years old woman come with LUTS especially What is the most likely pathological diagnosis?
frequency. She has already had this symptom A. Minimal Change Disease
several times in the 3 months. Urinalysis reveals B. Focal Segmental Glomerulosclerosis
leukocytes 8-10, erythrocytes 2-4, positive C. Membranous Glomerulonephritis
leukocyte esterase. What is the underlying D. Membranoproliferative
condition?
A. Stone obstruction 31. Berat badan 50 kg. Proteinuria hilang 10 mg.
B. Abnormal contraction of bladder. Berapa Protein Intake ?
C. Renal infection. A. 30 mg
D. Short Urethra. B. 40 mg
E. Gastrointestinal parasitic infection. C. 50 mg
D. 60 mg
25. 27yo pregnant woman suprapubic pain, dysuria, 32. Pria berusia 47 tahun dengan riwayat hipertensi
nitrite+, leukosit +, leukosit esterase +. What drug datang dngan keluhan ..... ( sorry zev lupa ) Yg
recommended? menyebabkan hipertensinya itu apa ?
A. Azythromycin A. Primary hypertension
B. Ciprofloxaxin B. CKD
C. Cefixime C. Hyperaldosterone
D. Amoxicillin D. DM
E. Clindamycin 33. 57 years old male presents with fatigue, vomitting,
BP 140/70 mmHg, Hb 8.4, Leukocyte 7000,
26. A 32 Years old came to the clinic with pain when Platelet 324000, MCV 84, MHC 28, Urea 3.4,
ejaculating and slight fever. Rectal touche is Ureum 57. The common findings?
performed, bilateral prostate tenderness is found. A. Decrease EPO
Urinalysis show leukocyte 10-12, Erithrocyte 0-2, B. Decrease Folic
positive nitrit. What is the diagnosis? C. Decrease Vitamin B12
A. Urethritis D. Decrease RBC
B. Orchitis 34. Male 57 year old uncontrolled HT dan DM, udh
C. Prostatitis ganti life stlye cuma gagal, obat apa yg disaranin?
D. Epidimitis
E. Vesiculitis A. ARB
B. CCB
27. 28 woman fishy odour flour albus positif
C. Beta Blocker
erythrocyte and leukocyte,symptoms is caused
D. Adrenergic receptor blocker
by?
E. Diuretik
A. n.gonnorhae
35. 57 years old female has history hypertension.
B. chlamydia trachomatis
Keluhan edema, pucat, BP 200/100 mmHg,
C. s.aureus
ureum 178, creatinine 7.8, Kalium 3.7.
D. g.vaginalis Pathophysiology dari hipertensi adalah?
E. p.mirabilis
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 A. Renal artery stenosis
B. VE
C. Hyperaldosterone
D. Hypoxia
E. Hypertiroid
36. 5 years old boy comes to ER because having no
testis at the right scrotum. PE there is hernia
inguinalis. Diagnosis ?
A. epispadia
B. hypospadia
C. phimosis
D. chriptorchidism
E. orchitis
37. A 60 year old male experiences the onzet of
headache, naussea ,vomitting fo 1
month.Physical examination reveals hypertention,
subfebril. Pyelogram showed the affected kidney
assymmetrically contracted with deformity of the
calyceal system. Gross of the affected kidney
showed contracted and has irregular granular
surface.The parenchyma is atrophic and replace
by fibrosis. Microscopic showed glomerular
sclerosis, hyalinization and atrophi in cortical
area. Another areas showed fibrosis, chronic
inflammatory cells with limpocytes agregation.
What is the most likely lesions occur in this
kidney?
A. Renal cell carcinoma
B. Chronic pyelonephritis
C. Acute nephritis
D. Nephrotic syndrome
E. Diabetic nephropathy
38. A 5-year-old boy child who had a palpable
abdominal mass brought to hospital by his mother
. The child later had abdominal distention from
bowel obstruction. An USG reveals a 6 cm left
renal mass with necrosis and hemorrhage.
Microscopic showed embryonal tissue with
abortive of tubular and glomerular structures.
What is the diagnosis ot this patient?
A. Teratoma
B. Retinoblastoma
C. Wilms’tumor
D. Hanarthoma
E. Hemangioma
40. A patient came to OPD. Physical examination
shows swelling on his hands, feet, abdomen and
face. Urinalysis shows foamy and bubbly urine.
Patient is suspected to have glomerular damage.
Glomerular damage can specifically damage
which of the following structure:
A. Renal corpuscle
B. Renal pyramids
C. Loop of Henle
D. Renal tubular system
E. Collecting duct
41. A 35-years-old man complain about left flank pain
repeated since 1 week. Urine cloudy. Blood
normal. erytrocyte 20-24, leucocyte 10-15,
positive nitrit and leukosit esterase. Positif oxalate
crystal. What is the GOLD STANDARD for single
radiograph examination?
A. Ultrasound
B. MRI
C. IVP
D. Abdominal CT Scan
E. Abdominal X-Ray
42. 67 years old man came with difficult to start
urination since 2 weeks ago. Cloudy urine,
erythrocytes 20-22, leukocyte normal, no
proteinuria, RT showed symmetric prostate with
no nodule. What is the pathophysiology of his
problem?
A. Enlargement of prostate tissue
B. Repeated infection
C. Decreased stone formation inhibitor factor
D. DNA mutation
E. Congenital anomaly
43. A 63 years old male came with difficult to urinate
since 2 days ago. He did not feel anything. He
was sudden could not move his feet after fell
down from his house rooftop. He also could not
feel sensation from his abdominal to feet. What is
pathophysiology of his problem ?
A. Enlargement of prostate tissue
B. Obstruction urethra by stone
C. Fibroses of urethra
D. Hyperactivity bladder
E. Neurogenic bladder
44. 67 year old female cannot control her urination.
Since then she wears diapers. She felt urgent
before urination. Pain during urination. No
evidence of cough before. Possible cause:
A. Stress incontinence
B. Obstruction urethra
C. Fibroses of urethra
D. Hyperactive bladder
E. Neurogenic bladder
45. 45 years old male came with chills since 3 days
ago. he has got fever, right flank pain, and cloudy
urine. complete blood count showed leucocytes
25.000 urinalysis showed 20-30 leucocytes, 5-10
erythrocytes and protein +1. what do you
recomend to give for him?
A. oral ciprofloxacin 500mg 2x daily
B. oral cefixime 100mg 2x daily
C. iv ciprofloxacin 400 mg twice daily
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 D. iv ceftazidime 1 mg 3x daily
E. wait for urine culture
46. Pada pemeriksaan urine cytology ditemukan
Transitional Cell Carcinoma. Jaringan apa yang
paling less common utk terkena TCC?
A. Renal pelvis
B. Vesica urinaria
C. Kaliks minor renal pelvis
D. Proximal ureter
E. Osteum uretra external
47. Man came with flank pain, USG finding there is an
acoustic shadow in the left pooled kidney. The
stone is count 2cm what is the next treatment?
A. Lifestyle modification
B. ESWL
C. wait and see
D. PCNL
48. A 68 years old male came with difficulty to start n
stop urination. From rectal toucher was found
enlargement of bilateral prostate with no nodule.
PSA level was 1,2 mg/ml. He has already taken
Tamsulosin 1x0,4 mg for 6 months but there was
no improvement. What you advice to him?
A. Increase dose of drug
B. Prostatectomy
C. Transurethral resection of prostate
D. Chemotherapy
E. Hormon therapy
49. A 50 y.o. woman came to you arthralgia on her
right wrist and index finger. Shown chronic kidney
disease. On X-Ray, there is a calcification of soft
tissue. What is the possible cause?
A. Metabolic bone disease
B. Arthritis Rheumatoid
C. Gout arthritis
D. Pseudo-gout arthritis
E. Atherosclerosis
50. 67 years old female with history of uncontrolled
diabetes come to the clinic for evaluation of
decrease of urinary since 3 days prior. She report
that since 2 weeks ago she regularly take
Ibuprofen and mefenamic acid to relieve her
progressive back pain. Her blood pressure is
150/90 mmHg and there is bilateral pedal edema.
Lab reveals ureum 30, creatinine 1.6. What is the
most likely etiology of patient’s AKI?
A. Dilatation of afferent arteriole thus reducing
filtration fraction.
B. Injure Proximal tubule cell cause necrosis.
C. Constriction of afferent arteriole
D. Increase sodium load thus increase back leak
of glomerulus filtrate.
E. Trigger glomerulus inflammation and fibrosis.
51. 70 y.o man with suprapubic tenderness and
burning during urination, admits that for the past 6
months, urinary flow has progressively
decreased. CVA -, leucocyte esterase and nitrite
+. What is the possible risk factor?
A. Dismobility
B. Pelvic floor weakness
C. Immune deficiency
D. Impacted vesicoureter junction
52. A 59 years old man is evaluated for worsening
kidney function. He was hospital 24 hours ago
with a diabetic foot ulcer and cellulitis of 4 weeks
duration. He has history of chronic diabetic kidney
disease and hypertension. On Physical
examination, BP 160/100 mmHg, other vitalsigns
are normal. An area of erythema extends about 3
cm around ulcer on the right heel which is tender
and warm. There is pedal edema. Lab shows
leukocytes, decrease complement C3 and C4 and
serum Creatinine 4.1 mg/dl. Urinalysis shows 25
erythrocytes/hpf and 3-5 erythrocytes cas/hpf,
and urine albumin creatinine ratio 1500 mg/g.
Which of the following is the most likely cause of
this patient acute kidney injury?
A. Diabetic nephropathy
B. IgA nephropathy
C. Postinfectionus glomerulonephritis
D. Primary membranous glomerulopathy
E. Nephrotic Syndrome
53. A 24 years old man came with repeated colicky
flank pain right abdomen since 1 month ago.
Ureum and creatinine were 24 and 0.6 mg/dl.
Ultrasonography showed hydronephrosis dextra.
What is the next step to manage his problem?
A. IVP
B. Urinalysis
C. Magnetic resonance angiograph
D. Nephrostomy
E. Watch and wait
54. A 21 years old woman came to you brought
several urinalysis. The result were microscopic
hematuria. She alson had done ultrasound
examination and all of the results were normal.
What is the next advice would you give to her?
A. Repeated urinalysis
B. Renal biopsy
C. Magnetic Resonance Angiography
D. Retrograde pyelography
E. Abdominal CT scan
55. 18 years old with history of criphtosporidism had
history of surgery , beberapa tahun kemudian
dateng dengan massa, 4 cm, ternyata seminoma,
What will you do?
A. Chemotheraphy
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 B. Radiotherapy decrease. What is the cause of decrease
urination in this patient?
56. 75 yr old male has difficulty controlling his A. Altered renal hemodynamic
urination. He has been using diapers since then. B. Acute tubular necrosis
He feels it is difficult for him to start urinating in C. Interstitial nephritis
the beginning (of his urination(?)). Rectal touche: D. Glomerulonephritis
prostat membesar. Most likely pathophysiology: E. Intratubular obstruction
A. Stress incontinence
B. Overflow incontinence 62. 58-year-old man with history of CKD. Blood
C. Urethral fibrosis pressure controlled. Hb 8.5, potassium 5, GFR 5.
D. Neurogenic bladder Suggestion:
E. Hyperactive bladder A. Watchful waiting
B. Correct Anemia
57. 47 years old female. Urinalysis shows C. Iron examination
erythrocytes 0-2, leukocytes 1, and there is hifa. D. Hemodialysis
What is your advice? E. Phosphate Binder
A. Repeat urinalysis
B. Midstream Culture 63. A 63 years old male with no medical past history
C. CT scan came with increase PSA from 2.2 to 4.3ng/ml.
D. Biopsy DRE founds 0.5 cm nodules in the left lobes of
E. Fluconazole prostate. What your next step?
A. Watchful watching
58. 25 years old with weakness. Extremities check B. Biopsy
motoric 3333/3333 (upper and lower). BP 150/90 C. Prostatectomy
mmHg. Potassium 2.1. What is the cause of D. Monitor PSA in a few months.
hypertension? E. Bone scan
A. Sympathetic Overactive
B. Hypertiroid 64. Patient with hypertension, BP 160/100 mmHg,
C. Chronic Kidney Disease Conjunctive anemia. The rest of physical
D. Renal Artery Stenosis examination was normal. He had azotemia, GFR
15. What is the malfunction?
59. A 25 years old came with painless, gross A. Reactive Oxygen Species
hematuria, slight edema in pretibial and slight B. Destruction of tubule
increase of BP. The ureum and Creatinine were C. Destruction of glomeruli
slightly elevated. The USG showed normal result.
D. Glomerusclerosis
What is the possible found in the urinalysis? E. Renal Parenchyme destruction due to
A. Oval Fat bodies cast inflammation
B. Dysmorphic erythrocyte
C. Uric acid crystal 65. Anak kecil dibawa mama nya ke rumah sakit.
D. Triple phosphate Katanya pas pagi ada edema tp pas dibawa udh
E. Calcium Oxalate gak ada edem trs pas di cek sore jam 5 dia juga
ga ada edema. Dia harus di cek apa? (ini
60. A young man recovered from head injury due to pilihannya lupa, mungkin : )
motorcycle accident. Later on, however, he A. Albumin, Protenuria, CRP
becomes very thirsty and his urine output B. Albumin, urine sediment, C3
increases greatly, more than 4L. Portion of the
C. Albumin, Proteinuria, urinalysis.
renal tubule responsible for this is
D. Albumin, Proteinuria, Urine sediment
A. Proximal convoluted tubule E. Albumin, urine profile, urine sediment.
B. Thin ascending part loop of Henle
C. Descending part loop of Henle 67. A 55 years old male came with sharp pain of his
D. Early distal convoluted tubule left flank because of renal stone. His Blood
E. Cortical collecting duct pressure 130/80 mmHg, pulse rate 88,
respiratory rate 14 tpm, Ureum 55, Cr 1.7.
61. 78 y.o woman is hospitalized because of femur Intravenous Pyelography shows stone study. Re-
fracture. After being operated on, she present examination shows dyspnea, Cr 2.8. What is the
with fever and aminoglycoside antibiotic is cause of kidney failure?
prescribed. After 5 days, the patient's condition A. Stone on his left kidney pass down to ureter
deteriorates and reported her urine output
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 B. Sepsis because stone caused infection
C. The use of contrast in pyelography
D. Nosocomial infection
E. Lab error
68. 45year-old male come to ER with foot ulcer. He
has uncontrolled diabetes for 16 years. He is
nausea so he can't drink and urine output
decreased. Blood pressure 80/60, pulse rate
120bpm, respiratory rate 24, temperature 38.5,
ureum 234, creatinine 2,8. Urinalysis found
proteinuria. What is the next management you
hsould give to the patient?
A. IV fluid and maintain fluid
B. empiric antibiotic
C. ACEI
D. Renal replacement therapy
E. Soon start hemodialysis
2
69. GFR 18 ml/min/1,73m . What is the next
management you should give to the patient
according to his stage?
A. Watchful watching
B. Reduce the risk factor
C. Prepare fo hemodialysis
D. Initiate dialysis
E. Treat for . . .
70. Man come to follow up after an elevated serum
creatinine. He has Pneumonia 2 days ago and
take Floxacib. He has no family history
hypertension. He had BPH treated with dozin. BP
180. Pulse Rate 64. Urinalysis : leukocyte
esterase, erythrocyte 3-5, leukocyte 0-2. Serum :
Kalium 5.7. What’s next?
A. Cystekinin
B. Serum Creatinine Kinase
C. Ultrasound
D. Biopsy
71. 7 years old woman comes into you with
complaints of pinky cloudy urine in the morning.
She also complained of having light headache. All
vitals are normal except BP 130/88 and slightly
edema legs. What is the primary lab test will you
suggest?
A. Urine sedimentation, albumin, ASTO
B. Urine culture, urine profile, albumin
C. Urine culture, urine profile, ASTO
D. Urine sedimentation, renal function, ASTO
E. Urine profile, renal function, albumin
72. Iwan, 16 years old, is going to represent his
school in a marathon. When doing marathon, his
BP were raised and can injure his kidney. What
renal autoregulation mechanism will prevent this
from happening?
A. Afferent Arteriole Dilatation
B. Afferent Arteriole Constriction
C. Efferent Arteriole Dilatation
D. Efferent Arteriole Constriction
E. Vascular smooth muscle dilatation
73. An old lady, lost 8 kg in past month. She is a
heavy smokers. She has history of kidney stones
removal 6 months ago. What will you found in
histology?
A. Thinning of basemembrane
B. Fibrosis
C. Sclerosis
D. Tubular cell with clear cytoplasm
74. 68 years old man, diare 2 hari, water frequency 6-
8x sehari, no bloody stool, urine saat di
Emergency Room hanya 30 cc. What is the
pathophysiology of his condition?
A. uropelvic obstruction
B. cystitis infection spread
C. tubular cell damage
D. loss of blood volume
E. glomerulosclerosis
75. In the histology appearance of genitourinary tract
there is gland that have many strands of smooth
muscle in intersitisial tissue. There is also several
glands hat have corpora amylacea (konkrement).
What is this?
A. Seminal vesicle
B. Prostat gland
C. Bulbourethral gland
D. External spinchter
76. 4 years old boy presents with peritibial edema. No
fever. Urinalysis shows proteinuria +4, no blood
cast, and oval fat bodies. What is the cause of
this idiopathic?
A. Minimal Change
B. Membranous nephritis
C. Membranous glomerulopathy
D. Focal Segmental Glomerulosclerosis
E. Membranoproliferative glomerulonephritis
78. A 21 years old male come into your private clinic
because of pus out in the morning. He has uncontrolled
sexually activity last week. Apa yang termasuk dalam
NGU infection?
A. Neisseria gonorrhea
B. Neisseria meningitidis
C. Treponema palidum
D. Serratia marcescens
E. Chlamydia trachomatis
80. Seorang ahli patologi sedang memeriksa jaringan
ginjal dengan mikroskop cahaya. Ia
mendapatkan struktur tubuler yang memiliki
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 brush border, inti maksimal 5, sitoplasma
asidofilik. Manakah struktur berikut ini yang
sedang diamati ahli patologi itu?
A. Tubulus kontortus distal
B. Tubulus kontortus proksimal
C. Ansa Henle segmen tipis
D. Ansa Henle segmen tebal
E. Duktus koligens

81. Soalnya 40 taun dateng ke ugd, back stabbing,

renal kena injury , apa mechanism yang terjadi
kalo renal blood flow injury ?

A. Increase RAAS activity

82. Males 62 year old, unconscious with intracranial

hemorrhage. 3 days fever at night and xray found
no abnormality. Urine leukocyte 5-10/hpf, nitrite +.
what is pathogenesis of the fever ?
A. short urethra
B. bacteria from blood stream
C. biofilm production from cathether
D. colon's bacteria at urethra
E. ascending infection from urethra to kidney

83. Seorang laki-laki 57 tahun datang dengan

keluhan bengkak di kedua kaki. tekanan darah
180/90, tempratur 37,5, dengan gallop S4, dan
rales pada paru nya. Creatinine 5,4, dan dia
anuria. Abnormality apa yang terjadi ?
A. decrease renin secretion
B. decrease mesangial proliferation
C. decrease Na retention
D. decrease GFR
E. decrease water excretion

84. A 23 years old lady came to the hospital. Her physical

examination revealed bp 220/120. She felt dizzy and
swelling on both legs. Her laboratory result shows
creatinine 5.5 and potassium 3.5. What is the possible
mechanism causing her condition?
A. Nitric oxide production
C. increase juxtaglomerular venous pressure
E. Activation of RAAS system
85. Orang Diabetes dan hipertensi, minum obat metmorfin
dan captopril, namun gejala belum hilang. Tidak mau
minum 2 obat, mau nya 1 doang. Diberi obat apa?
A. Methydopa
B. Captropil