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SOAL:

1. A 45-year-old woman with Crohn’s disease and a small intestinal fistula


develops tetany during the 2nd wk of parenteral nutrition. The laboratory
findings include Ca 8.2 meq/L; Na 135 meq/L; K 3.2 meq/L; C1 103 meq/L;
PO4 2.4 meq/L; albumin 2.4; pH 7.48; 38 kPa; P 84 kPa; bicarbonate 25 meq/L.
The most likely cause of the patient’s tetany is
a. Hyperventilation
b. Hypocalcemia
c. Hypomagnesemia
d. Essential fatty acid deficiency
e. Focal seizure

DIRECTIONS: Each item below contains a question or incomplete


statement followed by suggested responses. Select the one best response to
each question.

2. The most common physiologic cause of hypoxemia is


a. Hypoventilation
b. Incomplete alveolar oxygen diffusion
c. Ventilation-perfusion inequality
d. Pulmonary shunt flow
e. Elevated erythrocyte 2,3-diphosphoglycerate level (2,3-DPT)

3. With regard to wound healing, which one of the following statements is


correct?
a. Collagen content reaches a maximum at approximately 1 wk after injury
b. Monocytes are essential for normal wound healing
c. Fibroblasts appear in the wound within 24–36 h after the injury
d. The function of the monocyte in wound healing is limited to phagocytosis of
bacteria and debris
e. Early in wound healing, type I collagen is predominant

DIRECTIONS: Each item below contains a question or incomplete


statement followed by suggested responses. Select the one best response to
each question.

4. A teenage boy falls from his bicycle and is run over by a truck. On arrival in
the emergency room, he is awake and alert and appears
frightened but in no distress. The chest radiograph suggests an airfluid level in
the left lower lung field and the nasogastric tube seems to coil upward into the
left chest. The next best step in management is
a. Placement of a left chest tube
b. Immediate thoracotomy
c. Immediate celiotomy
d. Esophagogastroscopy
e. Removal and replacement of the nasogastric tube; diagnostic peritoneal lavage
DIRECTIONS: Each item below contains a question or incomplete
statement followed by suggested responses. Select the one best response to
each question.

5. Tissue injury or infection results in the release of tumor necrosis factor


(TNF) by which of the following cells?
a. Fibroblasts
b. Damaged vascular endothelial cells
c. Monocytes/macrophages
d. Activated T lymphocytes
e. Activated killer lymphocytes

6. A 40-year-old woman is found to have a 1- to 2-cm, slightly tender cystic


mass in her breast; she has no perceptible axillary adenopathy. What course
would you follow?
a. Reassurance and reexamination in the immediate postmenstrual period
b. Immediate excisional biopsy
c. Aspiration of the mass with cytologic analysis
d. Fluoroscopically guided needle localization biopsy
e. Mammography and reevaluation of options with new information

DIRECTIONS: Each item below contains a question or incomplete


statement followed by suggested responses. Select the one best response to
each question.

7. Omeprazole has been added to the H2 antagonists as a therapeutic


approach to the management of acute gastric and duodenal ulcers. It acts by
a. Blocking breakdown of mucosaldamaging metabolites of NSAIDs
b. Providing a direct cytoprotective effect
c. Buffering gastric acids
d. Inhibiting parietal cell hydrogenpotassium- ATPase
e. Inhibiting gastrin release and parietal cell acid production

8. Which of the following statements regarding benign prostatic hyperplasia


(BPH) is true?
a. The fibrostromal proliferation of BPH occurs mainly in the outer portion of the
gland
b. Assuming a voided volume greater than 100 mL, a peak urine flow rate of 30 mL/s
or less is good evidence of outflow obstruction
c. Suprapubic prostatectomy for BPH involves enucleation of the entire prostate and
eliminates the risk of future prostate cancer
d. Indications for surgery include acute urinary retention and recurrent urinary tract
infections (UTIs)
e. BPH is a risk factor for the development of prostatic cancer
9. Which of the following fractures is most commonly seen in healthy bones
subjected to violent falls?
a. Colles fracture
b. Femoral neck fracture
c. Intertrochanteric fracture
d. Clavicular fracture
e. Vertebral compression fracture

DIRECTIONS: Each item below contains a question or incomplete


statement followed by suggested responses. Select the one best response to
each question.

10. Which of the following statements regarding the Glasgow coma scale is
true?
a. It serves as a scale to assess the long-term sequelae of head trauma
b. A high score correlates with a high mortality
c. It includes measurement of intracranial pressure
d. It includes measurement of pupillary reflexes
e. It includes measurement of verbal response
Jawaban:
1. C
2. C
3. B
4. C
5. C
6. C
7. D
8. D
9. D
10. E

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