MCQ EM

1. Apa tugas Anda sebagai dokter di sebuah tempat layanan kesehatan primer saat menerima pasien baru?a. Mendaftar identitas pasienb. Segera melakukan pemeriksaan tanda-tanda vital untuk menentukan diagnosis kerjanyac. Segera melakukan pemeriksaan tanda-tanda vital untuk menentukan kondisi-kondisi yg

mengancam jiwa atau bukand. Segera melakukan pemeriksaan fisik dan diagnostic lengkap sebelum memutuskan diagnosis

dan tindakan definitivee. Segera menyiapkan ambulans untuk sewaktu-waktu merujuk pasien bila kondisi gawat

2. Yang manakah urutan lengkap sikap sebagai dokter umum di IGD:a. Sesegera mungkin melakukan resusitasi terkait kondisi kegawatan ABC pasien, berupaya

untuk menstabilkan dan dilanjutkan disposisi kepada sejawat tingkat definitive terapib. Segera menegakkan diagnosis definitive untuk treapi definitive secara cepatc. Bila kritis segera merujuk pasien ke tempat lain agar mortalitas IGD tidak tinggid. Yang penting segera dilakukan tindakan penunjang diagnostic agar diagnosisnya cepat

ditegakkane. Menenangkan hati keluarga pasien agar tidak panik

3. Anamnesa petugas ambulans dilakukan pada fase:a. Langkah ke 1 ambulansb. Langkah ke 2 ambulansc. Langkah ke 3 ambulansd. Langkah ke 4 ambulanse. Langkah ke 5 ambulans

4. Pertanyaan no. 3 di atas masuk dalam tindakan:a. Persiapanb. Klarifikasic. Primary surveyd. Secondary surveye. Reassesment survey

5. Di bawah ini adalah peralatan penunjang yg harus ada di ambulans, kecuali:a. Suctionb. Pipa oropharynxc. Ventilatord. Monitore. Bronchoscope

6. An 18 y.o woman with a history of hydrocephalus and ventriculoperitoneal shunt placement several years ago presents to your emergency department with a headache. It is positional, improving when she is recumbent. She is afebrile and is without any neurologic deficits. You order an unenhanced CT of the brain to exclude the possibility of a shunt malfunction and it demonstrated what radiologist described as “slit-like” ventricles. What is the most likely diagnosis?a. Overshunting of cerebrospinal fluidb. Shunt obstruction

c. Idiophatic intracranial hypertensiond. Shunt-associated meningitis with resultant cerebral edemae. Fracture of the shunt

7. What physical exam finding is a common early identification of multiple sclerosis?a. Hemiplegiab. Ataxiac. Sensory deficitsd. Cognitive deficitse. An afferent pupillary defect

8. A 23 y.o woman presents to your emergency department with diplopia. On exam, you note that her right eye fails to deviate medially when she looks left with concomitant nystagmus in the left eye. Anatomically where is the lesion?a. The 3rd nerve nucleusb. The occipital cortexc. The media longitudinal fasciculusd. The cerebellum

9. Which of the following statement is false?a. Blepharospasm is involuntary closing the eyelidb. All dystonic reactions involve outwardly reflex, directional movementc. Oromandibular dystonia is characterized by lips and mouth movementsd. Empirically treating presumed dystonia reactions with an antocholinergic agent like

diphenhydramine is reasonable10. An 82 y.o old man presents to your emergency department with urinary urgency and mild

confusion. An urinalysis performed by triage nurse is without evidence of infection. What test would be most useful in establishing a diagnosis for this patient problem?a. An urine cultureb. A complete blood countc. An unenhanced CT of the abdomen and pelvis is exclude nephrolithiasisd. An evaluation of the patient gait

11. Berikut kondisi di bawah ini termasuk dalam masalah renal emergency, kecuali:a. Encefalopatib. Aritmia karena hyperkalemiac. Asidosis metabolic beratd. Edema parue. Sepsis

12. Terapi penting/utama pada kondisi hyperkalemia berat adalah:a. Hemodialysisb. Terapi dextrose 40% dan insulinc. Terapi beta agonisd. Kalsium glukonas 10%e. Furosemide

13. Penyebab paling sering syok hipovolemik adalah:a. Dehidrasib. Perdarahan

c. Pneumothoraksd. Cidera spinale. Sepsis

14. Berikut di bawah ini merupakan tanda dan gejala awal syok hipovolemik, kecuali:a. Hipotensib. Takikardiac. Pulse pressure menyempitd. Rasa hause. Akral dingin dan basah

15. Syok yang mortalitasnya paling tinggi adalah:a. Syok kardiogenikb. Syok sepsisc. Syok anafilaksisd. Syok mekanike. Syok hipovolemik

16. A 71 y.o woman present wuth the acute onset of dyspnea, chest tightness, and diaphoresis 1 hour ago. She has long-standing hypertension and hypothyroidism. She is in obvious distress, sitting upright in bed. Her blood pressure is 187/98 mmHg, her heart rate is 119 bpm, and her respiratory rate is 28/minute. Oxygen saturation is 90% on ambient air/ rales are evident in both lungs, and there is third heart sound on auscultation of the precordium. The legs shows trace pitting pretibial edema. Optimal pharmacotherapy within the first 10 minutes would include oxygen as well as:a. Intravenous enalaprilat and sublingual nitroglycerinb. Aspirin and clopidogrelc. Aspirin and intravenous metoprolold. Intravenous furosemide and intravenous morphine sulfate

17. The next most logical treatment intervention for the patient in the previous question would be:a. Switch nitroglycerine route of administration to continuous infusionb. Judicious intravenous metoprolol to decrease myocardial oxygen demandc. Bolus of intravenous normal saline solutiond. Intravenous enalaprilat for acute afterload reductione. Dopamine infusion

18. Which of the following arrhythmias is peculiar in the sense that it should not be loaded with antiarrhytmic medications?a. Accelerated idioventricular rhytmb. Polymorphic ventricular tachycardiac. Torsade de pointesd. Monomorphic ventricular tachycardia

19. Which of the following complications of acute myocardial infarction presents in the first 3 to 5 days with acute-onset dyspnea, tachypnea, rales on lung examination, and a new holosystolic murmur at the base that radiates to the axilla?a. Free wall ruptureb. Papillary muscle rupturec. Ventricular septal rupture

d. Cardiac tamponade20. A 44 y.o old man presents with pleuritic central chest pain of 2 days duration, associated with

exertional shortness of breath; the pain is worse when supine and improves with sitting up. Expected ECG findings include:a. Diffuse ST-segment depression with PR-segment elevationb. Diffuse ST-segment elevation with PR-segment elevationc. Diffuse ST-segment elevation with PR-segment depressiond. Diffuse ST-segment elevation with inferior or reciprocal PR-segment depression

21. Obat yang dapat digunakan untuk semua kasus stable regular tachycardia adalah:a. Verapamilb. Diltiazemc. Amlodipined. Adenosinee. Propranolol

22. Pada A-Fib dengan shock, tindakan yang segera harus dilakukan adalah:a. Unsynchronized cardioversion 200 J monophasicb. Unsynchronized cardioversion 100 J monophasicc. Synchronized cardioversion 50 J monophasicd. Synchronized cardioversion 100 J monophasice. Synchronized cardioversion 200 J monophasic

23. Penurunan tekanan darah pada CVA akut boleh dilakukan apabila:a. BP 180/130 pada stroke ICHb. BP 180/110 pada stroke infarkc. BP 140/90 pada semua jenis stroked. BP 220/120 pada stroke infarke. BP 220/120 pada stroke ICH

24. Penyebab tersering kematian oleh karena sudden cardiac arrest adalah irama jantung:a. VTb. VFc. A-Fibd. SVTVe. PEA

25. Nitoglycerine pada tatalaksana acute pulmonary oedema adalah untuk memperbaiki:a. Kontraktilitasb. Afterloadc. Pre loadd. Heart ratee. Systemic vascular resistance