Tim Akademik ANANTARA 2015

Divisi SL (Soal Latihan)

Fakultas Kedokteran Universitas Padjadjaran

ANANTARA
BHP II

1. Mrs. X is a 35-year-old, pregnant woman with 4 daughters. Mrs. X wants to fulfil her
husband's wish to have a boy. But after she was examined on the 12th weeks by Dr. Y
, that she will have another daughter. She asks Dr. Y to help her having an abortion,
and Mr. X agrees.
Who should decide to have a child?

A. The wife, she face the risk of pregnancy

B. The husband, he is the leader in the family
C. Both parents, they have the same responsibility
D. Both parents and their doctor who knows the physical condition
E.

2. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
When a doctor is examining the victim:

A. The victim must be treated as evidence

B. The victim must be treated as a patient
C. The victim must be treated according to the doctor
D. The victim must be treated as requested by the police
E. The victim must be treated as evidence and as a patient

3. Which technology is appropriate treatment for thalasemia?The following are some

technologies:

A. Cloning
B. Eugenetika
C. Gen Therapy
D. Genetic Experiment
E.

4. Intrauterine fetal reduction is:

A. A method to synthesize organ from stem cells

B. A method to select best embryo to be transferred
C. A method to ensure that the embryo can grow normally inside the womb
D. A method to avoid conceiving embryo with high probability of genetic
disorder
E. A method to terminate several embryos already transferred in the uterus in
order to avoid complication of multiple pregnancy
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

5. Mrs. X is a 35-year-old, pregnant woman with 4 daughters. Mrs. X wants to fulfil her
husband's wish to have a boy. But after she was examined on the 12th weeks by Dr. Y
, that she will have another daughter. She asks Dr. Y to help her having an abortion,
and Mr. X agrees.
The preference to choose specific gender for baby is related with this issue:

A. Eugenics
B. Euthanasia
C. Discrimination
D. Professionalism
E. Beginning of life

6. A 25-year-old male was diagnosed as having colorectal cancer and on genetic analysis
he was confirmed to suffer from hereditary gene mutation for this cancer. If his
brother and his children were to be screened for colorectal cancer,
which of the followings is the bioethical issue of this case?

A. Genetic counseling would be very important

B. Confidentiality would be the most important issue
C. Informed consent of the counseling process would be an issue.
D. Health insurance would cover the cost of the screening program
E. In social context, these people would not face any difficulty in finding a job

7. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
Copulation is:

A. Penis penetration into the vagina followed by an ejaculation

B. Penis manipulation/masturbation by a partner
C. Penis touching the vagina without ejaculation
D. Penis penetration into the vagina or anus
E. Not defined or elaborated in KUHPidana

8. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
If the victim has a husband and the case was consensual, the case means

A. This is not a crime

B. This is a crime, if the husband presses charges against both
C. This is a crime, if the husband presses charges against the man.
D. This is a crime, and the police can continue with the investigation
E. This is a crime, if the husband presses charges against the wife/woman
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

9. Mrs. J is a 24-year-old woman, who provides her family history to the midwife on her
first prenatal visit. Mrs. J's father, his two brothers, and her paternal grandmother have
all been diagnosed with Huntington's Disease (HD). In the discussion about this
family history, the midwife asks if she has considered the option of genetic testing to
determine if she has inherited the gene mutation for this disorder. The midwife also
asks if she is concerned about the possibility that her baby could be at risk to develop
HD. She indicates that she knows that there is a lot of research going on to find a cure
and that she believes something will be developed that will help her father to recover.
She also does not want to have any testing, as she has read about people who have
experienced discrimination in their jobs after they had the test. She tells the midwife
that she does not want to have any testing for herself or her baby.
Modell and Citrin suggest there should be a balance between utilitarian and libertarian
interests with regard to genetic testing. How the balance of these two perspectives
would influence Mrs. J case?

A. Mrs. J has the right not to do genetic testing for her and her baby
B. Mrs. J should inform at risk family members about the risk for genetic
disorder
C. Mrs. J has the right not to tell her spouse about her family history of genetic
disorder
D. Mrs. J has right not to do the genetic testing because it might change her life
decision
E. Mrs. J has the right to privacy and autonomy, but should also responsible for
the genetic health for future children; thus, she might considering perform genetic testing for
her baby

10. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
The most convincing evidence:

A. Statement from the accused

B. Expert’s statement/Visum et Repertum
C. Statement from the witness and expert
D. Statement from the witness or the victim.
E. Statement from the accused and the wirtness

11. Mrs. J is a 24-year-old woman, who provides her family history to the midwife on her
first prenatal visit. Mrs. J's father, his two brothers, and her paternal grandmother have
all been diagnosed with Huntington's Disease (HD). In the discussion about this
family history, the midwife asks if she has considered the option of genetic testing to
determine if she has inherited the gene mutation for this disorder. The midwife also
asks if she is concerned about the possibility that her baby could be at risk to develop
HD. She indicates that she knows that there is a lot of research going on to find a cure
and that she believes something will be developed that will help her father to recover.
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

She also does not want to have any testing, as she has read about people who have
experienced discrimination in their jobs after they had the test. She tells the midwife
that she does not want to have any testing for herself or her baby.
Mrs. J decision for not having genetic testing for Huntington's Disease, is consistent
with the way of thinking from which perspective?

A. Communitarian theory
B. Libertarianism theory
C. Utilitarian theory
D. Individualism
E. Human right

12. The application of beneficence principles in context of multiple gestation caused by

ART:

A. The patient ask only female fetuses to be transferred

B. The doctor choose one best embryo to be transferred
C. The patient decides how many embryo has to be transferred
D. The doctor terminate some male embryos to prevent hemophilia
E. The doctor transferred more than 5 embryo in order to obtain higher
pregnancy success rate

13. The opinion that ART only suitable for rich infertile couple is against:

A. Justice principle
B. Altruism principle
C. Patient’s autonomy
D. Physician’s autonomy
E. Beneficence principle

14. To lessen the conflict regarding the embryo transfer policy and the risk of multiple
pregnancy, the physician should:

A. Do the preimplantation genetic diagnosis

B. Decide all embryo should be transferred
C. Cancel the embryo transfer process
D. Give extensive information
E. Do the fetal reduction

15. Need some effort from community to improve genetic structure. The following are
some technologies:

A. Cloning
B. Eugenetika
C. Gen Therapy
D. Genetic Experiment
E.
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

16. The ethical problem in ART may arise in:

A. Source of gametes if they weren’t from legally married couple

B. Source of gametes if they were cryopreserved from husband
C. Extracting sperm from the testes of azoospermic husband
D. Transferring one best embryo
E. Discarding dead embryo

17. Which technology is appropriate for human being?The following are some
technologies:

A. Cloning
B. Eugenetika
C. Gen Therapy
D. Genetic Experiment
E.

18. Which condition below has an ethical problem?

A. To ask a mother to give her oocyte to her infertile daughter

B. To do morphological selection of best embryos to be transferred
C. To do intrauterine insemination from frozen semen from husband
D. To do in vitro fertilization from sperm obtained from husband’s testis
E. To do oocyte collection in a female cancer patient before she commence
pelvic radiotherapy

19. Screening tests in neonates (newborn screening):

A. Mandatory
B. Low sensitivity
C. Only for research
D. Parents have the ability to refuse
E. Parents are responsible for evaluation

20. A 30-year-old woman is a carrier of thalasemic. She has been married for 4 years but
does not have any children. She is currently undergoing in-vitro fertilization and
wants to select an embryo that will be completely normal.
Which of the following is the most appropriate for this condition?

A. The doctor obey her request and ask permission to use the abnormal embryo
for research
B. The doctor should refuse the request and refer to the genetic counseling expert
C. The doctor should refuse the request and send the patient to other doctor
D. The doctor should explain about the problem and refuse the request
E. The doctor should respect and do her decision
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

21. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
In the case above, is there a violation of law?

A. It depends of the judge

B. Yes, there is a violation of law
C. No, it is not a violation of law
D. It depends on the government
E. It depends on the government and judge

22. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
Assumptions for this rape case:

A. There is no witness
B. The slit evidenced a penis penetration
C. A penis penetration cannot be determined
D. The slit did not evidence a penis penetration
E. A report from a victim cannot be held as evidence

23. Patient ask to the physician about genetic problems that would be happen to her fetus.
Examples for genetic probblems:

A. Huntington’s disease
B. Sickle cell anaemia
C. Cystic fibrosis
D. Down syndrome
E. All of above

24. A Genetic testing is justified:

A. If mandatory
B. Only for research
C. No need informed consent
D. Performed when the disorder is rare
E. If such testing will result to interventions that have been shown to reduce
morbidity and mortality when initiated in childhood

25. In ART, surrogacy means:

A. Asking a man to donate his sperm

B. Obtaining oocytes from oocyte bank
C. Selecting the best embryo to be transferred
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

D. Donating excess embryos to another infertile couple

E. Asking a woman to carry another woman’s fetus in her womb

26. Which technology may be used for stimulate microbe to produce insulin?The
following are some technologies:

A. Cloning
B. Eugenetika
C. Gen Therapy
D. Genetic Experiment
E.

27. The discussion prior to transfer of the embryo should include:

A. The possible complication that may arise from transferring more than one
embryo
B. The fate of excess embryo that will not be transferred at the moment
C. The number of the embryo that will be transferred
D. Only option a, b, and c are correct
E. All options are correct

28. A 30-year-old woman is going to be married. She has a cousin with major thalasemia.
She is asymptomatic and wants to know whether she is carrier or normal. You
perform her some tests. She comes with her fiancé and asking the result.
Which of the following is the most appropriate action done by the doctor?

A. Does not tell her now and ask to come again alone
B. Does not tell her now, but refer her to the hematologist
C. Does not tell her now and ask to come again with her family
D. Ask first whether she wants the result explained in front of the fiancé
E. Explain the result and the consequences of the disease in front of them

29. Mrs. X is a 35-year-old, pregnant woman with 4 daughters. Mrs. X wants to fulfil her
husband's wish to have a boy. But after she was examined on the 12th weeks by Dr. Y
, that she will have another daughter. She asks Dr. Y to help her having an abortion,
and Mr. X agrees.
Dr. Y is facing a dilemma regarding Mrs. X's request, because it could contradict with
the doctor's oath, particularly this statement:

A. To consecrate my life to the service of humanity

B. To practice the profession with conscience and dignity
C. The health of my patient will be the first consideration
D. To maintain the honor and traditions of the medical profession
E. To maintain respect for human life from the time of conception

30. Which one of these ART practices is not allowed in Indonesia?

 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

A. Cryopreservation of excess embryo

B. Morphological selection of best embryo
C. Obtaining more than oocyte in in vitro fertilization
D. In vitro fertilization using cryopreserved wife’s oocyte
E. Insemination using sperm from commercial sperm bank

31. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
Hymen exam:

A. Intact hymen
B. The hymen was not intact
C. Does not determine virginity
D. There was penis penetration
E. There was no penis penetration

32. A 10-year-old Thalasemic patient, known for almost 5 years, received blood
transfusion twice a week. After few years her parents cannot continue the treatment
due to financial problem.
As her doctor, which of the following is the most appropriate for her condition?

A. Continue the treatment with your own money

B. Respect the decision and follow the parent's wish
C. Contact other family to try to persuade the parent
D. Find sponsor for the patient and continue the treatment
E. Try to persuade the parent by explaining the advantage of the treatment

33. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
Examining the victim:

A. has to be escorted by a nurse and police officer

B. is the same as a regular patient examination
C. has to be escorted by a psychiatrist
D. has to be escorted by a police officer
E. has to be escorted by a nurse

34. A type 2 DM woman has just delivered her baby with anencephaly disorder.
Which of the following statement is the most suitable management from the physician
to take care the baby?

A. Not giving resuscitation, since the baby with anencephaly only live for certain
hours
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

B. Give resuscitation and ventilator, as the best can be give

C. Not telling her family about the baby's disorder
D. Waiting for the mother to give decision
E. Not giving resuscitation is maleficence

35. Mrs. X is a 35-year-old, pregnant woman with 4 daughters. Mrs. X wants to fulfil her
husband's wish to have a boy. But after she was examined on the 12th weeks by Dr. Y
, that she will have another daughter. She asks Dr. Y to help her having an abortion,
and Mr. X agrees.
The value which might be used by Mr. and Mrs. X as their argument in the decision to
have an abortion is:

A. Justice
B. Autonomy
C. Beneficent
D. Do no harm
E. Fiduciary duty

36. An examination on a 21 year old rape victim who reported of being raped a week ago
in an empty house by a 25 year old man found that there is an opening on the hymen
with a slit on the left side which goes to the vagina wall. There is no blood and no
pain when touched.
Sex crime:

A. cannot happen between husband and wife

B. happens outside marriage boundaries
C. always happen without consent
D. can happen with consent
E. need hard evidence

37. According to the legislation of ART in Indonesia (Permenkes 39/2010), it is stated

that:

A. The unmarried couple has a chance to has offspring(s) from ART

B. No official except of marriage certificate needed in ART
C. ART is an option for basic infertility management
D. No oocyte or sperm donation is allowed
E. Surrogacy is allowed

38. Which technology may be used for asexual reproduction?The following are some
technologies:

A. Cloning
B. Eugenetika
C. Gen Therapy
D. Genetic Experiment
E.
 Tim Akademik ANANTARA 2015
Divisi SL (Soal Latihan)
Fakultas Kedokteran Universitas Padjadjaran

39. Mrs. J is a 24-year-old woman, who provides her family history to the midwife on her
first prenatal visit. Mrs. J's father, his two brothers, and her paternal grandmother have
all been diagnosed with Huntington's Disease (HD). In the discussion about this
family history, the midwife asks if she has considered the option of genetic testing to
determine if she has inherited the gene mutation for this disorder. The midwife also
asks if she is concerned about the possibility that her baby could be at risk to develop
HD. She indicates that she knows that there is a lot of research going on to find a cure
and that she believes something will be developed that will help her father to recover.
She also does not want to have any testing, as she has read about people who have
experienced discrimination in their jobs after they had the test. She tells the midwife
that she does not want to have any testing for herself or her baby.
From Utilitarian perspective, what should the physician do to her family if it turns out
that she diagnosed Huntington Disease from genetic testing?

A. Mrs. J has privacy right about her condition

B. Let Mrs. J decide whether or not to tell her family
C. Informing the risk family member that they may be at risk
D. Family members may not want to know about their risk for genetic disorder
E. Each person has a right to make a choices without being influenced by
physicians, including Mrs. J

40. Mrs. X is a 35-year-old, pregnant woman with 4 daughters. Mrs. X wants to fulfil her
husband's wish to have a boy. But after she was examined on the 12th weeks by Dr. Y
, that she will have another daughter. She asks Dr. Y to help her having an abortion,
and Mr. X agrees.
This group will consider the involvement of Mr. X in the process of decision making
as against women's reproductive right:

A. Feminist
B. Human right activist
C. Medical code of ethics
D. Non-government organization
E. Ministry of Women Empowerment