Kompre nih boss pt.2

An 18-months old boy was brought by his mother to a pediatrician for routine check-up. He was apparently well and his examinations were all normal. He has completed basic vaccination except rotavirus and pneumococcal vaccine. He came from a middle socio-economic family. Her mother wanted to know if he still needed any immunization. What is your advice to the mother?

A 55 year old man come to your clinic in Surabaya with family history his father has rectal tumor, so he decided to have screening. What first test do you suggest to him?

What kind of laboratory examination results that can help us make a diagnose of a 27-year-old man that came to the dermatology clinic with some lumps on his arms and body which were pain on pressure. His skin examination found some erithematous nodule, shiny, and ill defined border, with no fluctuation/ fluid inside and no wound. On his elbow palpation there was painfull nerve enlargement.

A 39-year-old woman has a history of frequent nose bleeds and increased menstrual flow. On physical examination, petechie and purpura are present on the skin of her extremities. Laboratory studies show normal partial thromboplastin time, prothrombin time, and platelet count, and the blood smear showed Giant platelet. This patient most likely has a derangement in which of the following steps in hemostasis?

A -24 year old man came to the eye clinic with redness and blurred vision in his left eye since 1 week ago. The patient had history of foreign body sensation when riding his motorcycle since 1 week and gradually had dropped vision. The patient was in pain and mucopurulent secretion. The visual acuity was hand movement. During examination there was white lession in the cornea with conjunctiva and ciliary injection. What test should we do to confirm the defect in the cornea?

Mrs. Dora, 23 years old, came to neurology clinic with complaint of tingling sensation on first to fourth fingers of both hands since 6 weeks ago. At first, the tingling only appeared during night and resolved by shaking her hands. The tingling was worsened and felt the whole day. Mrs. Dora had a hobby of playing badminton routinely 3 times a week and riding a motorcycle for daily transportation. What is the most possible diagnosis for this patient?

A 45 year old female with rheumatoid arthritis came with fatigue with hemoglobin level was 8.6 g/dl. Blood smear showed many lymphocyte and microcytic hypochromic anemia. What is the possible diagnosis?

A 7-year-old girl had runny nose that developed a wide yellowish honey coloured scab around her nose and mouth since 2 weeks ago. Her parents consulted with their family physician whether they should ignored this condition because it was related to the changing weather and would disappear by itself and that there is no need to give any medication. As the family’s physician, what information would you give to the parents about this disease?

A 25-year-old women came to ENT clinic in Siloam hospital with a chief complaint of runny nose, reduced smelling, nasal congestion, with a greenish discharge which smell bad since 6 month ago. She had taken flu tablets for this condition. On anterior rhinoscopy doctor found hypotrofic conchae media and inferior, greenish secret, crust with bad smell. What is diagnosis for this condition?

A 33-year-old, P3, presents with vaginal spotting and a foul-smelling vaginal discharge. She reports heavier bleeding with sexual intercourse. Her past medical history is not significant for any chronic condition. Her coitarche at 15 with her current partner. She had abnormal pap smear 3 years ago but has not been seen by a gynecologist since that time. What might be the risk factor for this patient?

A 28 year-old G1P0 comes to your clinic for prenatal check-up. She is at 10 weeks gestation now. She complains that she can’t eat well due to nausea and vomiting. Her tall is 165 cm with weight now is 50 kg, previously before pregnant she was 53 kg. She is worried about her weight. What is the recommendation of weight gain in this patient?

A 25-year old girl came to her physician consulting her multiple nodules around 1.1 to 2.0 cm scattered dominantly in the extremities and torso. The physical examination found cafe-au-lait, irregular borders in her skin beside multiple nodules. The biopsy from one of her nodules showed a benign neoplasm. What is the best diagnosis for her?

A 21 year old male came with fatigue with Hb 8.1 g/dl. There is history of transfusion in his family. MCV was 61. Blood smear showed target cells. What do you recommend to him?

A 5-year-old is brought to doctor because of snoring and sleep deprivation. Turns out he breathes through mouth and there is abnormality of his face. He also has recurrent upper respiratory infection and effusion otitis media. What is the diagnosis of this patient?

A 19 year-old woman presents at 10 week gestation with an episode of light bleeding following intercourse. On examination there is a red area on the cervix and blood is evident in the vagina but not in the cervical os. The os is closed. Her pulse and blood pressure are normal. What is the most likely cause of her bleeding?

A woman, 20 years, G2P2A0, post-partum 1 hour ago, brought by shaman to Posyandu because the placenta was not born. General state looks weak, pale, and cold extremities. What is the most appropriate management?

A 26 year old woman (gravida 1, para 0, abortus 0) at term is admitted in labor with an initial cervical examination of 7 cm dilatation, 80% effacement and the occiput at -1 station. Estimated fetal weight is 3500 gram. After 4 hours, cervical examination is fully dilated, fully effaced with the occiput at station 0 with position as shown in picture below. There are four contractions in a 10 minute period, each with an adequate strength. Which part of cardinal movements that is failed to occur in this final head position?

A 36-year-old man presents experienced extreme swelling of his legs and scrotum. The skin associated with the swollen areas is thick and scaly. The patient admits to an episode of fever associated with enlarged inguinal lymph nodes some time ago, but did not think much of it. Which one of the following is the BEST method to make that diagnosis?

A 25 year old female came with epistaxis since 2 days. There is history of fever 5 days ago. Cutaneous bleed was found in both extremities. The blood smear showed bluish color lymphocyte. What is her problem?

The histopathologic of a curettage biopsy from an ulcerative mass around Vertebra Thoracalis 12-L1 in a -2 year old baby girl showed necrosis caseousa,granulomas and Langhans cells.The best diagnosis for hers is:

Mr.X, 27 years old, was brought to the mental hospital by his father because he was found on the street as a vagabond (gelandangan) after he left his house 3 months ago. Previously, he often sat up all night, slept all day, and became very angry when his father tried to get him out of bed. He did not shave or took a bath for weeks. He smoked continuously, and ate very irregularly. He kept to himself (likes being alone) as much as possible and and rarely speaks with other people. What is your diagnosis?

A G1P0A0 woman, 39 weeks pregnant, has spontaneously gave birth in a clinic help by midwives. A baby girl is born, weighted 3500 grams. 30 minutes after the babys born, the placenta still has not released yet. The patient then referred to the hospital. The patient come with continous bleeding from the vagina, looks pale, cold sweat, and total bleeding is approximately 1.5L. What is the best diagnosis?

A newborn baby was born from a mother with positive HbsAg status with term gestation. The body weight is 2500 gram and physical examination was normal. What immunizations should be given for by this baby?

A 21 year-old male came to primary physician clinic with chronic intermittent diarrhea. His stools was foul smelling and slimy. He had returned from travelling from India six days ago. Which organism is most likely to be responsible for these symptoms?

A 24 year-old, G5 P4 woman, presents to Labour Ward at 29 weeks' gestation with contractions every 4 minutes. Her pregnancy has been uncomplicated and she has no significant past history. She has had no bleeding or leaking of fluid. Foetal heart monitoring is normal. Her cervix is 1 cm dilated and 1.5 cm long. Ultrasound reveals a 29-week size foetus in the frank breech presentation with normal amniotic fluid volume. Which of the following interventions has been shown to be of the GREATEST potential benefit to her foetus?

A 30 year-old woman have 1 child age 2 years old. Her gynecologic history is remarkable for irregular menses, menstruating every 4–8 weeks. She would like a more reliable form of contraception (currently using condoms) and would like to have predictable menses, but is very concerned regarding weight gain with various contraception methods. How would you counsel her regarding weight changes and contraception?

Mrs. F 22 years G1P0A0 gravid 40 weeks, came to the hospital with history of Diabetes Mellitus. Currently shes in phase 2 of the labor after the birth of the babys head, there is no external rotation. What is the diagnosis?

A laboratory examination of a leprosy patient after 4 months MDT therapy revealed bacterial index 6+ and morphological index 50%. What is your conclusion for this result?

A 57 year old man comes to a clinic complaining spinning sensation along with nausea and vomiting. He also complains about ringing and hearing loss in the right ear. Ear otoscopic examinations are within normal limit. What is the most likely diagnosis in this patient?

A 45-year-old woman whose husband raised pigs for home use was seen by her family doctor with symptoms of periorbital edema, weakness and muscle pain. Of the following, which parasite can cause this disease?

A 20-year-old primigravida presents at 39 weeks. She has been healthy up to this point. She has a headache, and a loss of appetite. Her face and hands are swollen. Her BP is 170/90mmHg, and she has 2+ protein. The fetus has a reassuring monitoring. Which of the following is the best treatment for her condition?

A 3 year old boy was brought to emergency department with weakness of his left leg. He had fever since 5 days ago. His mother said he never had immunization before. What is laboratory examination to support this diagnosis?

A 45-year-old female came to the out-patient clinic with bloody diarrhea with mucous 4-5 times daily since 3 days ago, abdominal cramp, and uncomfortable after defecation. She also had a low-grade fever. What is the possible pathogen in this case?

A woman, 45-years-old complaint of blurred vision while using her gagdet for about three months. She had no complaint with her vision while driving and no history of using glasses before. The most probable mechanism that cause her complaint is

A 17 years-old-girl, came to the DV clinic with a skin rash on her back, chest, arm and thigh since 1 week ago which was not so itchy. On examination doctor found many small patches of pink or red, flaky, oval- shaped erythematous rash appear on the torso following the rib line like christmas tree, upper arm and thigh, with fine scale and herald patch positive. What is the most likely diagnosis?

A 37 year old female came with fatigue since 6 months. There is no fever. The hemoglobin level was 7.3 gram/dl, leucocyte 2,400 and platelet 97,000. The reticulocyte count was increased. She had history hepatitis B infection. Stigmata cirrhosis was positive. What is the mechanism of her fatigue?

A 41 week gestation was born per vaginam, cyanosis, no breathing effort, HR 80x/min and covered by Meconium and amniotic fluid. Which of the following is the most appropriate management to do?

A 34 years old woman came to the physician with depression and sleep disorders problem. The doctor thinks she had a problem in some neurotransmitter. What is the mechanism of action of glutamate?

A baby is born with a rash identical. Questioning reveals that the mother had a febrile illness during the second trimester of pregnancy. Examination reveals diffuse raised purple skin lesions. There is no pallor, jaundice, or cyanosis. The eyes are cataract, the heart has a 3/6 systolic murmur, and there is enlargement of both the liver and the spleen. There is no lymphadenopathy. Of the following, the MOST likely diagnosis is?

A 54 year-old-man came to emergency room in Siloam hospital with a chief complaint of nose bleed since a couple hours ago. The bleeding was massive and the blood could be seen through the back of the mouth. The source of the bleeding could not be easily found. The patient also had a history of high blood pressure. What is the appropriate management of this patient?

What is the effect of myelination to the velocity conduction?

A 28-year-old female is involved in a car accident in which her spinal cord is damaged at the T6 level. Detailed testing of her sensory and motor systems reveals that her motor system is intact and she has no loss in pain or temperature sensation. However, she has lost fine touch, vibration, and proprioceptive sensation from the left side of her body below the T6 level. Therefore, she has damaged her:

A 47 year old male came with fatigue, nausea and vomit. From the physical exam there was enlarged lien S3. Hemoglobin 13 gr/dl, leukocyte was 28 thousand, platelet 231 thousand. From the bone marrow found all stage development of leukocyte and myeloblast. What is your possible diagnosis?

17-year-old male presents to a clinic complaining of severe sunburn to his face and forearms. He was playing soccer ball outdoors for less than one hour on a sunny day before noticing the sunburn. His past medical history is significant for acne vulgaris, which he is taking medication for. Physical examination reveals numerous comedones, papules, and pustules on his face, neck, and chest. There is significant scarring from previous episodes of acne. Confluent areas of erythema, warmth, and edema are evident on the patients face and forearms. Which of the following medications is the most likely causative agent of the sunburn?

Mrs Ida, 20 years old, post-partum for the first child 3 hours ago at the puskesmas. Come to the ER because of bleeding problem and pain at the delivery passage. From physical examination fundus level is at 2 fingers below the umbilical, strong contraction and there is a laceration at the perineum mucosa and the muscle. What is the degree classification of the laceration?

A 63 year-old man presents to the emergency room with a right hemiparesis and non-fluent aphasia that began acutely 45 minutes ago. Blood pressure is 160/90 mmHg, and there is no recent history of bleeding. A head CT scan shows no evidence of intracranial hemorrhage. Which of the following is the most appropriate therapy at this point?

A 44 year old woman (gravida 3, para 2, abortus 0), who now is at approximately 34 weeks gestation, developed vaginal spotting 2 hours prior to admission. Her two previous pregnancies were delivered due to cephalo-pelvic disproportion. On examination, there is two uterine contraction in 10 minutes, mild to moderate, lasting for about 30 seconds. Fetal Heart Rate is 140 and regular, on leopold examination it was breech presentation. Maternal vital signs are stable. You did an ultrasound revealed with placenta previa with highly suspicious that the placenta is invading the bladder. What is the most likely diagnosis?

A patient mentions to you she just had a positive pregnancy test and wonders if you can tell her when she is likely due. The LMP was 29 June 2018. Her expected date of confinement (EDC) is approximately which of the following?

A 35-year-old poultry farmer come to the hospital with fever and difficult to breathing since 3 days ago. He also complained of cough, cephalgia, myalgia, and shiver. A few weeks ago there were some dead poultry in his farm. Physical examination found a pale patient, blood pressure 140/80 mmHg, heart rate 130 bpm, respiratory rate 44 breaths per minute, temperature 400C. His throat was midly congested and exudates were present at nasopharynx. Chest examination showed symmetrical breath sounds on both side of the lung, increased tactile fremitus, dullness on percussion and on auscultation there were bronchial sound bilaterally with rales. What is the virus type that caused his disease?

55-year old male patient with a history of left ischemic stroke was brought to the Neurology Clinic with a history of two times focal seizures. Seizures started over the right extremities, eyes and head were forced to tilt to the right. Duration of seizure was 2 minutes. Before and after seizure, patient regained full consciousness. On laboratory examinations, no remarkable findings. Which is the most appropriate diagnosis for the case above?