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A 67 year old man came with chief complaint of blurred on both eyes since 2 years ago. There was no redness, pain, or trauma. No family history of blindness. The visual acuity of the right eye was 6/20 and the left eye 6/24. The IOP of the right eye was 35 while the left eye 32. Anterior segment was quiet, the lens was clear, and the fundus showed cup disc ratio 0,8 with rim thinning and cupping bilaterally. What mechanism might be involved in visual loss?

A 15 year old boy comes to a doctor complaining he can not breath from his right side of nose since 1 year ago. The symptom s also accompanied by massive epistaxis. He sometimes experiences runny nose with serous discharge. He has no fever nor weight loss. Anterior rhinoscope finds normal nasal septum, there is a easily bleed reddish white mass at right posterior side of nose. What is the most likely diagnosis?

A 28 year-old man presents decrease sense of smell and nasal congestion for 4 months. Doctor diagnoses him with chronic rhinosinusitis. What is the pathophysiology of hyposmia?

A 51 year-old stay-at-home mother who presented to the ED with severe right eye pain that started 2-3 hours prior. She also noticed blurry vision from that eye and rainbow-colored halos around lights around the same time. Accompanying symptoms include acute nausea. She has vomited twice since feeling the eye pain. Denies prior episodes. Denies flashes, floaters or diplopia. There is mild redness in the Right eye. No prior eye surgeries and trauma. There is family history of cataract from his mother. Her right eye was in severe pain, we can only observed her right pupil was mid dilated, sluggish to respond to light. Left pupil round and reactive to light. What is your most likely diagnosis on her Right eye?

What is the neural pathway of itch sensation?

20 years old female present with acute redness in the eye, associated with pain. It was noted when She wakes up in the morning. She already had several episodes of red eyes. Visual acuity revealed 20/20 in both eye. The redness is blanching after phenilephrine instillation. What is the most possible underlying mechanism of this case?

Mrs Tuti went to the beach 2 day ago. She did not use the at sun block cream to prevent from the ultraviolet radiation. At Home, she felt her skin dry and itch. She went to her phycisian and was given the moisturizer cream. What is the protect mechanism of the skin to the ultra violet radiation?

A 34-year-old man was brought to emergency department after being falling from ladder and hit his head. The patient complains that he cannot smell anything after the accident (anosmia). Where is the location of brain that he get anosmia?

A 25-years-old woman had sexual intercourse 1 month ago. She complained that there was ulcer on her vagina. The ulcer had disappeared without treatment. But now, suddenly appears red spots that spread throughout her body that was not itchy nor pain, no fever. Laboratory finding VDRL 1: 80. What is the most appropriate diagnosis?

A 8-year-old girl went to clinic with complaining about her right ear feel very fullness, like water filling since 1 day ago. Physical examination on right ear reveals tympanic membrane was intact, retraction (+) and there is a clear fluid shadow and air bubbles. Left ear was normal. The patient got coughs and colds since three days ago. Based on the pathophysiology of middle ear inflammation, what is the main cause for the inflammation?  otitis media

A 30-year-old woman comes to emergency room, complaining of feeling of spinning. The symptom was provoked by head changing positions. There were latency, fatigability and habituation of symptom. What is the most likely pathogenesis happened to this patient?

A 28-year-old man comes to your clinic with complaint about hearing level of left ear is decreased and he has history of otorhea since he was child. Another complain is runny nose, nasal congestion, cough, and trouble of tasting at the left tongue. Ear examination was found a secret mucous-pus out of the middle ear through the tympanic membrane subtotal perforation. What is the complication that has been occurred on this case above?

Which of the following condition that indicate a disorder of genome instability or DNA repair?

A man comes to the emergency room after traffic accident. He has no decrease conciousness and had moderate head injury. A week after the accident he has diplopia and hirschberg test shown the left eye 150 esotropia. During the further examination of the patient above, it is noted that the patient also had lagophthalmos in his left eye and causing watery of the eye. Which structure is most likely to involved?

A 8-year-old girl went to clinic with complaining about her right ear feel very full, like water filling since 1 day ago. Physical examination on right ear reveals tympanic membrane was intact, retraction (+) and there is a clear fluid shadow and air bubbles. Left ear was normal. The patient got coughs and colds since three days ago. Based on the pathophysiology of middle ear inflammation, what is the main cause for the inflammation?

Mrs. Anna had unintentionally touched the hot pan. She felt hot and pain. She used the special cream for the burning skin and getting better but she lost her touch sensation. What kind of somatosensory pathway will transfer the hot sensation (temperature sensation) to the cerebrum?

A 45-year-old female came with lump on her eyelid. Excision biopsy shows a xanthoma and foamy cells. What is the diagnosis for this patient?

A 56- year old male came to his physician with an ulcerative, darkly pigmented skin in his right heel. Neither painful nor pruritic was indicated at this area. The biopsy and the microscopic found that the lesion consists of characteristic proliferation melanoblast cells. The melanoblast cells formed a few nests with various size and shapes and they invaded from the epidermis until the dermis,more than 1 mm micron from the upper surface epithelial. The nuclei of the cells are found anaplastic. What is your best diagnosis for this case?

At the audiometry examination reveals air conduction (AC): 10 dB on the right ear (AD) and 65 db on left ear (AS). Bone conduction (BC): 5 dB on the right ear and 30 dB on the left ear. Based on this examination, the degree of hearing both ears is:

11 year-old boy who reports a 4-day history of irritation and itching, first in the Left eye followed by the Right eye one day later. Both eyes have also had a mild yellow discharge and mattering of the eyelids making it difficult to open the eyes in the morning. There is minimal eye redness but no foreign body sensation, flashes, floaters, decreased vision or diplopia. Not using any drops. No environmental exposures to the eyes. Both visual acuity are 20/20. Crusted dry flaky material on both eye, no follicles in inferior or superior fornix. What is the most probable diagnosis?

A 30-year old man presented with a small discrete papules and pustules in a periorificial region. He felt slight itchy. In anamnesis, the doctor found out that he has atopic dermatitis and often used steroid topical for his skin condition. What is the best treatment for the patient above?

A 32-year-old comes to a dermatologist for the evaluation of a rash over her knees. She first noticed the rash two weeks ago on the front of her knees and elbows. She denies any associated symptoms of itching or joint pains. No significant past medical history. She takes oral contraceptive regularly. Physical examination, bilateral, erythematous plaques with well-defined margins are observed over the anterior aspect of both knees and elbows. The plaques are covered with thick, silvery scales when on removal there are miniscule blood droplets. Which of the following is the most appropriate initial treatment for this patient?  psoriasis

The physician was doing Weber tuning fork examination for this patient. What will you find about the result of this examination from the case above?

A 60-year-old gentleman presented with generalized diffuse skin erythema associated along with pruritus and bilateral limb swelling for one month. He had fever for two days prior to presentations. He was afebrile but appeared dehydrated with tachycardia. Generalized erythema and scaly lesions were distributed throughout his entire body surface area. Palmoplantar keratoderma were noted on both of his feet. What is the diagnosis of this patient?

A 17 years old patient come to the dental clinic with chief complain painful on the jaw, fever and difficulties to open the mouth. Patient feel a pressure on the lower second molar tooth that come from the back. Intraoral examination show swelling and redness on the gum located behind the second molar. What is the etiology of this disease?

A 51 year-old stay-at-home mother who presented to the ED with severe right eye pain that started 2-3 hours prior. She also noticed blurry vision from that eye and rainbow-colored halos around lights around the same time. Accompanying symptoms include acute nausea. She has vomited twice since feeling the eye pain. Denies prior episodes. Denies flashes, floaters or diplopia. There is mild redness in the Right eye. No prior eye surgerie and trauma. There is family history of cataract from his mother. Her right eye was in severe pain, we can only observed her right pupil was mid dilated, sluggish to respond to light. Left pupil round and reactive to light. A further gonioscopy was performed and revealed Trabecular Meshwork was closed with synechia. What is your further diagnosis on her Right eye?

A 38 year-old man with HIV was admitted to the hospital because of a generalized pruritic skin rash of a 4 week duration. The rash started with a few mildly pruritic papules over his interdigital web and arms, then spread to the rest of his body. He denied any fever, chills, or shortness of breath. On physical examination he appeared to be malnourished with poor personal hygiene. There were thick, gray-brownish, hyperkeratotic, scaly, confluent plaques with areas of excoriation covering his neck, chest, trunk, axillary folds, extremities, and genitalia. Skin scrapping examination showed numerous pearl like, translucent, white, eyeless, oval, with 4 pair of legs mites. What is the correct diagnosis of this condition?

What is the receptor of discriminative touch?

A 55 years old patient come the Dentist with the ulcerative inhomogene lession on the tongue. This lession has become bigger in the last 6 months. Patient smoke 12 cigarettes a day and regularly drink alcohol. Palpation on the regional lymphnode show multiple enlarge lymphnode on the neck. Patient has loss weight progressively. What ist the possible diagnosis?

Biopsy from a 0,4 cm vesicle of a 28 year old girl in her left forearm result shows the vesicle involve epidermal layer. What is the best diagnosis based on the microscopic appearance?

A man come with blurred vision since 2 days ago. There were also pain. There was no secret, history of contact lens user (+). Visual acuity examination showed he was able to read fingers in 6 meter. His visual acuity was..

A 27-year-old woman came to DV clinic with complaint of a pruritic, erythematous and contagious lesion that appeared three weeks prior on the dorsal surface of the right leg. Her physical and systemic examinations were normal. She had given an account of her recent trip to Sumba, which was one month ago, during which time she wore sandals. On examining the skin, we found a 5-6 cm linear, erythematous, serpiginous localized lesion characteristic of a papulonodular tip on the dorsal surface of the right foot. What is the correct treatment for the patient above?

A 56-year-old man came with redness on right eye since 1 day before he went to doctor. There was no impaired visual acuity on the right eye. He consumed aspilet regularly for coronary heart disease. What is the most common sign you can find on physical examination?

A 72 year-old-man post stroke (CVDNH) consulted to ENT department because can not made any conversation, doctors worried about total deafness. What is the appropriate objective hearing test for evaluating his hearing capability?

A patient with a recent head cold presents with a 2-day history of a left red eye. Today the right eye is also red. The patient complaints of a lot of watery discharge, burning, and slight blurring of the vision. She denies significant discharge or extreme itchiness. What treatment would you recommend?  keratitis

A 7 years old girl often felt pain while pulling her left ear. The pain worsened at nap time and night. It has been occurred for 5 days. She also complained headache, fever, cough, nausea and hearing decreased. Her mother took her to a doctor. An Otoscopic examination of left ear showed that the tympani membrane was erythema and bulging. Why is the tympani membrane bulging?

Female patient, 80 year-old, came to dermatology clinic with chief complaint of skin irritation and itching at the scalp. During her anamnesis, doctor found that the patient abandoned in poor hygienic conditions without any family. Her physical examination showed the presence of numerous lice on scalp and hair with microscopic view of multiple nits. What is the treatment recommendation for this patient?

A 60-year-old gentleman presented with generalized diffuse skin erythema associated along with pruritus and bilateral limb swelling for one month. He had fever for two days prior to presentations. He was afebrile but appeared dehydrated with tachycardia. Generalized erythema and scaly lesions were distributed throughout his entire body surface area. Palmoplantar keratoderma were noted on both of his feet. What is the most common underlying skin disease for the condition above?

A- 50-year-old complaint not seeing clearly while reading. This symptom already occured since 1 year ago but the patient had no history of wearing glassess and no complaint seeing distance. After examination the patient was given S+2,00 for reading and the problem was solved. What is the most likely diagnosis for the patient?

A 21 year old housemaid come to the clinic complain of itch and pain between her fingers on both hands for 1 week. On examination we found multiple papules, erythema, scales and erosion (polymorph). The working diagnosis of this patient is..

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?

Patient come with the swelling on the lower jaw area. Intraoral examination show multiple caries and radix on the posterior mandible teeth. Patient has uncontrolled diabetes. Moreover, pus come from the gum and submandible area. What is the diagnose?

A 9-year-old boy came to the clinic to check his visual acuity. The visual acuity on both eyes with correction 1,0. Right eye with lens S-5,50 and left eye with lens S-0,5. Anterior segment is within normal limit, funduscopy on both eyes are good. What is the diagnosis for this patient?

A 50 year old man has symptoms of hitting the fence or runs on to people while walking. The visual acuity was 6/6 but the IOP was 35 mmHg and funduscopy reveals enlargement of the cup disc ratio with cupping. These drugs could be used for the condition:

Mrs Anna had unintentionally touched the dry ice. She felt cold and pain. She used the special cream for pain and getting better but she lost her pressure sensation. What is the receptor of cold sensation?