Seleksi Imo Soal
August 6, 2022 | Author: Anonymous | Category: N/A
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CEREBROVASCULAR DISEASE 1. A 7676-year year-old -old man with with hyperten hypertension sion compl complained ained of a sever severe e hea headache dache.. Over Over the the cou course rse of 15 15 minutes, he became gradually unable to move the right r ight side of his body and had diculty spea!ing. "y the #me he reached the emergency department, he was arousable, but obtunded. $e was wea! on the right side and aphasic. %hich of the following is the most li!ely diagnosis& A. 'ubarachnoid hemorrhage
C
". (idbrain hemorrhage ). *utaminal hemorrhage +. acunar infarc#on of the le posterior limb of the internal capsule . /schemic stro!e of the le middle cerebral artery
0. A 76-year-old man with h hypertension ypertension and diabetes complained complained of a severe headache. On arrival to the emergency department, he was stuporous, wea! on the right side, and aphasic. %hich of the following is the most appropriate step in the evalua#on of this pa#ent& A. ) ". (2/
A
). (agne#c resonance angiography +. )atheter angiogram . 'pinal tap and blood cultures 3. %hich of the following poses the greatest ris! for a basal ganglia hemorrhage& A. )igare4e smo!ing ". $ypertension ). *oorly controlled diabetes
"
+. $ypercholester $ypercholesterolemia olemia . )erebral amyloidosis . /n which of the following following loca#ons is a hypertensive intracerebral hemorrhage /8 /89& 9& A. *utamen ". *ons ). )erebellum +. (idbrain . halamus
D
HEADACHE 1. A 24-year-old, 24-year-old, obese woma !rese"ed w#"$ a %-wee& $#s"ory o' $eada($es. )$ey were !rese" 'or mos" o' "$e day ad were des(r#bed as se*ere, "$robb#+, ad "$ro+$o" $er e"#re $ead. S$e de#ed ay aras or s!e(#'# ( "r#++er. S$e o"ed "$a" w$e s$e seeed, s$e los" *#s#o 'or se*eral se(ods. A C) o' $er bra# was ormal. $#($ $#($ o' "$e 'ollow#+ #s "$e mos" l#&ely d#a+os#s/ d#a+os#s/ A. 0ass les#os (as#+ #(reased #"ra(ra#al !ressre
C
B. S#s *eos "$rombos#s C. Id#o!a"$#( #"ra(ra#al $y!er"es#o D. A"y!#(al m#+ra#e $eada($es E. Cls"er $eada($es
2. A 2-year-old 2-year-old woma !rese"ed w#"$ e!#sodes o' b#la"eral *#sal loss. S$e sa#d "$a" "$ey mos" o'"e o((rred w$e s$e (o+$ed, seeed, or la+$ed. S$e also re!or"ed a !lsa"#le $eada($e 'or "$e !as" 'ew mo"$s "$a" was oly m#ldly #m!ro*ed w#"$ !a# med#(a"#os. A C) o' "$e bra# was ormal. $#($ o' "$e 'ollow#+ !$ys#(al eam#a"#o '# d#+s #s mos" l#&ely "o be see # "$#s !a"#e"/ A. 3a!#lledema B. B#"em!oral $em#ao!s#a C. Dowbea" ys"a+ms
A
D. O(lomo"or er*e !als#es E. A''ere" !!#llary de'e(" %. A 1-year-old 1-year-old woma !rese"ed w#"$ e!#sodes o' b#la"eral *#sal loss ad a se*ere !lsa"#le $eada($e. A C) o' "$e bra# was ormal. $#($ o' "$e 'ollow#+ #s "$e e" mos" m os" a!!ro!r#a"e s"e! # "$e e*ala"#o o' "$#s !a"#e"/ A. Bra# 0RI w#"$ (o"ras" B. 0R a+#o+ram C. 0R *eo+ram D. Lmbar !("re "o measre o!e#+ !ressre E. 0easre #"rao(lar !ressre
D
4. A 42-year-old 42-year-old woma (om!la#ed o' a $eada($e o "$e r#+$" s#de o' $er $ead. I" was "$robb#+ ad asso(#a"ed w#"$ *om#"#+, !$oo!$ob#a, ad doble *#s#o. O eam#a"#o, $er r#+$" eye was de*#a"ed dowward ad o"ward ad "$ere was m#ld !"os#s. $#($ o' "$e 'ollow#+ #s "$e mos" l#&ely d#a+os#s/ A. Ver"ebral ar"ery d#sse("#o
B. Caro"#d ar"ery d#sse("#o C. Bas#lar m#+ra#e D. O!$"$almo!le+#( m#+ra#e E. 5am#l#al $em#!le+#( m#+ra#e
D
42-year-old woma !rese"ed w#"$ a "$robb#+ $eada($e, doble *#s#o, ad "##"s. S$e $ad a 5. A 42-year-old w#debased, a"a#( +a#" ad a s&ew de*#a"#o. S$e was "#red ad (o'sed o me"al s"a"s eam. )$e !a"#e" re!or"ed $a*#+ se*eral s#m#lar e!#sodes # $er %6s. A bra# 0RI s$owed se*eral os!e(#'# ( $y!er#"es#"#es # "$e w$#"e ma""er m a""er.. $#($ o' "$e 'ollow#+ #s "$e mos" l#&ely d#a+os#s/ A. Commo m#+ra#e B. 0#+ra#e w#"$ ara C. 0#+ra#e w#"$ bra#s"em ara D. Id#o!a"$#( #"ra(ra#al $y!er"es#o E. 5am#l#al $em#!le+#( m#+ra#e
C
E3ILE3S7 1. A 28-year-old 28-year-old woma !rese"ed w#"$ ml"#!le e!#sodes o' al"ered be$a*#or. Ea($ e!#sode las"ed 'or abo" 2 m#"es, ad was asso(#a"ed w#"$ l#!-sma(&#+ mo*eme"s ad re!e"#"#*e l#mb mo*eme". )$e !a"#e" d#d o" remember remember "$ese e*e"s, b" was able able "o a"#(#!a"e "$em, say say#+ #+ "$a" s$e 'el" 9b""er'l 9b""er'l #es # mys"oma($: ad a sese o' 'ear be'ore "$ey o((rred. Some"#mes s$e sa#d s$e smelled br#+ rbber as well. $#($ o' "$e 'ollow#+ #s "$e mos" l#&ely d#a+os#s/ A. 5o(al aware se#re B. ;eeral#ed-ose" se#re C. 5o(al "o b#la"eral "o#(e(": ad w#ll o lo+er le" $er # "$e +ara+e. He was d#a+osed w#"$ de!ress#o a" 1? years old a'"er a s#(#de a""em!" ad $as bee "a&#+ ser"ral#e s#(e "$a" "#me. )$e !a"#e" sa#d $e 'el" +rea" abo" $#s ew wor& 'or a ma>or #"era"#oal (o+lomera"e ad a e!os@ $e #s wr#"#+ abo" a 'ormer em em!loyer !loyer.. He loo&ed arod "$e room ss!#(#osly, ss!#(#osly, s!o&e ra!#dly, ad !a(ed, say#+ "$a" $e ss!e("s $#s w#'e may be s!y#+ o $#m 'or $#s $#s 'ormer boss. )o#(olo+y )o#(olo+y s(ree#+ was !os#"#*e 'or mar#>aa. mar#>aa. $#($ o' "$e 'ollow#+ #s "$e mos" l#&ely d#a+os#s/ A. B#!olar d#sorder B. S($#o!$re#a C. Caab#s se d#sorder D. Ad>s"me" d#sorder E. Dels#oal d#sorder 2. A 28-year 28-year old ma was bro+$" "o "$e emer+e(y de!ar"me" by "$e !ol#(e a'"er be#+ 'od (l#mb#+ ! "$e '# re es(a!e o' $#s e-+#rl'r#eds e-+#rl'r#eds b#ld#+. He was #"ese, w#"$ !ressred s!ee($, s(ream#+ "$a" "$e !ol#(e $a*e &#da!!ed $#s w#'e ad are "$rea"e#+ "o &#ll $er $er.. He $as bee sear($#+ 'or 4 days s"ra#+$". $#($ o' "$e 'ollow#+ "rea"me"s #s #d#(a"ed a" "$#s "#me/ A. Olaa!#e B. L#"$#m C. Val!roa"e D. Lamo"r#+#e E. Olaa!#e ad l#"$#m %. $#($ o' "$e 'ollow#+ labora"ory "es"s #s re#red be'ore s"ar"#+ a !a"#e" o l#"$#m/ A. 3la"ele"s B. Absol"e lym!$o(y"e (o" C. L#*er '("#o "es"s D. Serm (rea"##e E. 3o"ass#m le*el
4. A 4?-year-old 4?-year-old ma w#"$ b#!olar d#sorder !rese"ed w#"$ abdom#al !a#. H#s serm amylase was ? UL ad serm l#!ase was 6 UL. $#($ o' "$e 'ollow#+ med#(a"#os #s mos" l#&ely res!os#ble 'or $#s !rese"a"#o/ A. Val!roa"e B. L#"$#m C. Carbamae!#e D. )o!#rama"e E. e"#a!#e 8. A 21-year-old 21-year-old ma !rese"ed "o "$e (l##( 'or "rea"me" o' de!ress#o. He re!or"ed s# de!ress#*e e!#sodesda"#+ ba(& "o a+e 18. He also des(r#bed a 2-wee& !er#od o' de(reased eed 'or slee!, #(reased l#b#do, ad#(reased +oal-d#re("ed a("#*#"y a" a+e 26, w$#($ led "o $#s oly !sy($#a"r#( $os!#"al#a"#o. He (rre"lyre!or"ed de(reased eer+y, eer+y, !ass#*e s#(#dal "$o+$"s, ad de!ressed mood w#"$ a$edo#a. $#($ o' "$e 'ollow#+ med#(a"#os #s mos" a!!ro!r#a"e a" "$#s "#me/ A. Halo!er#dol B. Vela'a#e C. Ser"ral#e D. Lras#doe E. Bs!#roe . $#($ o' "$e 'ollow#+ sym!"oms #s =O) !ar" o' "$e d#a+os"#( (r#"er#a 'or a ma#( e!#sode/ A. Irr#"ab#l#"y B. 0ore "al&a"#*e "$a sal C. I(rease # (o(e"ra"#o D. De(reased eed 'or slee! E. Im!ls#*e be$a*#or . $#($ o' "$e 'ollow#+ med#(a"#os #s #d#(a"ed 'or "$e !re*e"#o o' de!ress#*e e!#sodes # b#!olar d#sorder/ A. Le*e"#ra(e"am B. Val!roa"e C. )o!#rama"e D. Carbamae!#e E. Lamo"r#+#e ?. A %?-year-old %?-year-old woma was bro+$" "o "$e emer+e(y de!ar"me" by $er $sbad w$o sa#d "$a" s$e $as o" sle!" 'or "$ree days. S$e was #rr#"able w#"$ !ressred s!ee($, ad $ad s!e" F86,666 # "$e las" wee& "o be(ome a 9!ar" ower: o' a ew res"ara". res"ara". S$e sa#d $er bs# bs#ess ess !ar"ers $a*e bee "a!!#+ "a!!#+ $er !$oe l#es, ad s$e !las "o 9'# d ad +e" "$em.: $e "$e !sy($#a"r#s" re(ommeds $os!#"al#a"#o 'or "rea"me"
o' a("e ma#a, "$e !a"#e" de(l#es ad says, 9I 'eel '# e. I do" wa" "o +o "o "$e $os!#"al.: $#($ o' "$e 'ollow#+ #s "$e mos" a!!ro!r#a"e (orse o' a("#o/ A. S"ar" l#"$#m ad see "$e !a"#e" # 1 wee& B. S"ar" *al!roa"e ad see "$e !a"#e" # 1 wee& C. S"ar" l#"$#m ad see "$e !a"#e" # 2 days D. S"ar" *al!roa"e ad see "$e !a"#e" # 2 days E. I*ol"ary !sy($#a"r#( adm#ss#o . A 41-year-old 41-year-old ma !rese"ed w#"$ #som#a. 5or "$e !as" 2 wee&s, $e des(r#bes slee!#+ % "o 4 $ors !er #+$" b" says "$a" "$a" $#s eer+y dr#+ dr#+ "$e day #s 9be""er "$a "$a sal.: He $as bee more more !rod("#*e a" wor& ad re(e"ly ob"a#ed se*eral ew (l#e"s 'or $#s (om!ay. He des(r#bes $#s mood as 9really +ood.: )$ere #s o re(e" *#ole" or sel'-#>r#os be$a*#or. He des(r#bes a !re*#os !sy($#a"r#( $#s"ory o' de!ress#o. 7o 7o o"#(e "$a" #s d#''# (l" "o #"err!" $#s ra!#d s!ee($. $#($ o' "$e 'ollow#+ des(r#bes "$e !a"#e"ss !a"#e" (rre" mood e!#sode/ A. 0a#a B. Hy!oma#a C. A&a"$#s#a D. 3sy($os#s E. =ar(ole!sy 16. 7o 7o are "rea"#+ a !a"#e" 'or b#!olar II ad are (alled by a erolo+#s" w$o #s see#+ yor !a"#e" 'or se#re d#sorder. S$e wa"s "o add Val!roa"e "o $#s re+#me ad #s le""#+ yo &ow so "$a" yo (a ad>s" ad mo#"or w$#($ med#(a"#o # $#s re+#me/ (bipolar) A. Lamo"r#+#e B. Ser"ral#e C. L#"$#m D. 3aroe"#e E. Cloa!#e 11. A 8-year-old 8-year-old ma w#"$ b#!olar d#sorder was +eerally able "o ea", s!ea&, or mo*e. He lay # bed mos" o' "$e day s"ar#+ a" "$e (e#l#+. I' $#s arms were mo*ed 'or $#m, $e wold lea*e "$em # "$e !os#"#o # w$#($ "$ey were !la(ed. $#($ o' "$e 'ollow#+ "rea"me"s #s #d#(a"ed a" "$#s "#me/ A. L#"$#m B. 0e"$yl!$e#da"e 0e"$yl!$e#da"e C. Olaa!#e D. Cloa!#e E. Lorae!am 12. A 6-year-old 6-year-old woma adm#""ed 'or de!ress#o w#"$ (a"a"o#( 'ea"res rema#ed sym!"oma"#( des!#"e "rea"me" w#"$ #"rams(lar lorae!am. S$e was o" ea"#+ or dr#&#+, ad $ad be(ome de$ydra"ed.
$#($ o' "$e 'ollow#+ "rea"me"s #s #d#(a"ed a" "$#s "#me/
(DEPRESSION)
A. 3e"obarb#"al B. Ge"am#e C. 3ro!o'ol D. Ele("ro(o*ls#*e "$era!y E. )ras(ra#al ma+e"#( s"#mla"#o 1%. A 48-year-old 48-year-old woma !rese"ed 'or "rea"me" o' de!ress#o. Des!#"e "r#als o' 'l oe"#e, or"r#!"yl#e, ad *ela'a#e, s$e (o"#ed "o 'eel de!ressed w#"$ a$edo#a ad low eer+y. eer+y. S$e $ad o" le'" $er $ose # se*eral wee&s ad $ad los" 26 !ods de "o o" ea"#+. $#($ o' "$e 'ollow#+ "rea"me"s #s a!!ro!r#a"e a" "$#s "#me/ (DEPRESSION) A. Ele("ro(o*ls#*e "$era!y B. Dloe"#e C. 3$eel#e D. L#"$#m E. 0e"$yl!$e#da"e
KEY ANS : 1. A 2. 3. 4. 5. . !. ".
E D A D C E E
#. $ 1%.A 11.E 12.D 13.A
PARKINSONIS& 1. A ?6-year-old ?6-year-old ma !rese"ed w#"$ d#''# (l"y wal&#+. O*er "$e !as" 'ew mo"$s $e $ad a $ard "#me 9+e""#+ s"ar"ed: ad #" "oo& $#m m($ lo+er "o +e" ! 'rom a ($a#r. O eam, $e "oo& small, s$''l #+ s"e!s w#"$ l#""le +rod (leara(e ad $ad l#""le arm sw#+. He $ad a res"#+ "remor o' $#s r#+$" arm, w$#($ $e sa#d $ad bee !rese" 'or o*er 1 year. $#($ o' "$e 'ollow#+ #s "$e mos" l#&ely d#a+os#s/ A. Esse"#al "remor B. =ormal !ressre $ydro(e!$als C. )abes dorsal#s D. 3ar&#so d#sease E. Cer*#(al s!odylos#s s!odylos#s 2. $#($ o' "$e 'ollow#+ +a#"s #s mos" ($ara("er#s"#( o' 3ar&#so d#sease/ A. A w#de-based, lr($#+ +a#" B. A s$''l s$''l #+ +a#" w#"$ !oor arm sw#+ C. A s"#'', 9s(#ssor#+: +a#" D. A s"e!!a+e +a#" E. A +a#" +a#" a!ra#a, w$ere !a"#e"s (a m#m#( wal&#+ w$#le sea"ed, b" $a*e !oor 'oo" (leara(e w$e a("ally "ry#+ "o wal& %. $#($ o' "$e 'ollow#+ #s mos" ($ara("er#s"#( o' "$e "remor # 3ar&#so d#sease/ A. I" #m!ro*es w#"$ modera"e al(o$ol #"a&e B. I" worses w#"$ a("#o C. I" #s mos" m os" !roo(ed w$e !a"#e"s are as&ed "o $old "$e#r arms # 'ro" o' "$em D. I" #s a #la"eral, res"#+ "remor E. I" #s b#la"eral ad symme"r#( a" d#sease ose" 4. $#($ o' "$e 'ollow#+ !$ys#(al eam '# d#+s wold be mos" (o(er#+ 'or a d#sease o"$er "$a #d#o!a"$#( 3ar&#so d#sease/ A. U#la"eral (o+w$eel r#+#d#"y o' a arm B. Res"r#("#o o' *er"#(al +ae C. A de(reased bl#& ra"e D. Small $adwr#"#+
E. Hy!o!$o#a 8. $#($ o' "$e 'ollow#+ (od#"#os may !re(ede a d#a+os#s o' 3ar&#so d#sease, some"#mes by se*eral de(ades/ A. 3ro+ress#*e #+$" bl#dess B. S($#o!$re#a C. 0#+ra#es D. RE0 be$a*#or slee! d#sorder E. Iro-de'# (#e" aem#a . A((mla"#o A((mla"#o o' w$#($ o' "$e 'ollow#+ !ro"e#s derl#es "$e !a"$olo+y # 3ar&#so d#sease/ A. Hy!er!$os!$oryla"ed "a B. Do!a de(arboylase C. Al!$a-sy(le# D. Ca"e($ol-O-me"$yl "ras'erase E. Be"a-amylo#d
. I w$#($ o' "$e 'ollow#+ !a"#e"s w#"$ 3ar&#so d#sease wold ro!##role be (o"ra#d#(a"ed/ A. A 8-year-old 8-year-old ma w#"$ (oroary ar"ery d#sease B. A 81-year-old woma w#"$ !os"meo!asal sydrome C. A 8-year-old 8-year-old ma w#"$ ($ro#( real #s''# (#e(y D. A 4-year-old 4-year-old ma w#"$ m#ld deme"#a ad !arao#a E. A 2-year-old 2-year-old woma w#"$ de!ress#o ad a !r#or s#(#de a""em!"
?. A -year-old -year-old ma !rese"ed w#"$ s"#''ess ad d##ess w$e s"ad#+. O eam#a"#o, $e was a"a#(, w#"$ a w#de-based +a#", #"e"#o "remor, ad $ad $or#o"al >er& ys"a+ms. H#s blood !ressre was 1468 mmH+ ly#+ dow, w$#($ 'ell "o 66 mmH+ w$e $e s"ood !. $#($ o' "$e 'ollow#+ #s mos" l#&ely "o be see o $#s 0RI/ A. A"ro!$y o' "$e $ead o' "$e (ada"e B. Symme"r#(al $y!er#"es#"#es o' "$e +lobs !all#ds C. A"ro!$y o' "$e m#dbra# D. De+eera"#o o' !o"o(erebellar '# bers w#"$# "$e !os E. Hy!er#"es#"y o' "$e (or"#(os!#al "ra("
ANS KEY : 1. D 2. 3. $ D
4. $ 5. D . C
!. D ". D
OSPE
:A("A2 A*A& -"2A/ )9' O2:A/'( *9"A" -O;O*A'(A :O+//
Seorang ibu 65 th mengeluh nyeri kepala hebat. Ada riwayat HT td 1!"13! #aat dating. $enurunan ke#adaran
1. 1. Tip Tip of the basilar 2. Posterior communicating 3. Middle cerebral artery 4. Anterior communicating 5. Anterior cerebral artery
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