SOAL MCQ EM -tanggal 8 Desember 2011-

1. Laki2 28 tahun disengat lebah, didapatkan tanda red rash dan wheals pd seluruh
tubuh, tensi 120/70, nadi 100, RR 22. indikasi pemberian adrenalin pd pasien
ini...
a. diarrhea
b. hoarseness
c. rhinitis
d. lip swelling
e. wheals
2. Wanita usia 22 th gatal di seluruh tubuh dan wheals. tensi 110/70, nadi 80, RR
22. terapi g diberikan...
a. adrenalin
b. chlorperinamine
c. hdrocortisone
d. !"
e. salbutamol
#. Wanita 22 th, alergi kacang,seluruh tubuh bengkak dan gatal kemerahan.$
110/70, ! 80, RR 22, "a%2 &0'. "tlh terapi kondisi membaik, langkah
selan(utna).
a. discharge ke*+ dan beri antihistamin
b. discharge dgn antihistamin dan adrenalin obser,asi 2- (am
c. antihistamin dan .ollow up spesialis
d. antihistamin dan steroid dan obser,asi - (am
e. discharge dan berikan adrenalin in(eksi
-. Wanita setelah makan, terapat bercak merah dan wheals di seluruh tubuh. $
&0//0, ! 120, RR #0. "etelah diberi epine.rin $ 110/70,! 100, RR 20. 1ana(emen
selan(utna...
a. di21R"2kan, .ollow up di ward
b. 3R" diberi antihistamin dan steroid
c. 3R" dgn .ollow up ke dokter spesialis
d. 1R" dulu stlh dilihat dktr spesialis baru 3R"
e. obser,asi beberapa (am di 4*5
0. a 20 .o woman lost control o. her car and hit a tree while at speed o. /0 mph,
she has large laceration on the parietal scalp and some bruises on the right chest
wall. 6er *7" score is 1-/10 and she is speaking in sentences. "he has gi,en a
high 8ow %2 ,ia .acemask. Which is the single most appropiate immediate
treatment...
a. cer,ical spine immobili9ation
b. chest tube insertion
c. 7$ scan o. the brain
d. endotracheal intubation
e. :; access
/. +ria #0 thn, skidded on wet road while riding his motorbike at speed 70 mph.
Large hematoma on temporal scalp, some bruises on the right chest wall and
abdomen, and de.ormed right tight. *7" 11/10. *i,en high 8ow o<gen ,ia .ace
mask. :mmediate radiological in,estigation in initial resuscitation is...
a. 7$ abdomen
b. 7$ brain
c. =ra abdomen
d. =ra chest
e. =ra .emur
7. 3asus sama kk nomer /. *ambaran chest = ra seperti di gambar >7=R
kaakna paru kanan lebih besar, lebih hitam?. $indakan ang paling tepat
adalah...
a. needle decompression
b. chest tube
8. Laki2laki 20 thn (atuh dr sepeda motor. +asien merespon thd neri dan men(awab
inkoheren saat ditana.$ 102/&-, ! /-, RR 12, "a%2 &-'. pupil kiri 0mm,kanan
2mm. underling situation)
a. e<cessi,e 8uid
b. hiperkarbia
c. hipo,olemik dan brain hpo<ia
d. hpo<ia
e.peningkatan :7+
&. Laki2laki usia 28 th digigit an(ing pada le.t arm dan mengalami brisk bleeding.
what is the @rst managementA
a. appl direct pressure on the wound
b. attach to the monitor
10. B 20 .o man was in,ol,ed at a pub @ght a.ter drinking 7 glass. 6e open his ees
to ,erbal command, makes occasional disoriented comment. C+ 110//0, 6R 70,
RR 20. Which one is the single most appropriate management...
a. arranging .or de@niti,e airwa .ollowed b imaging
b. arranging imaging a.ter immobili9e the cer,ical
c. discarding him with relati,e to sleep oD at home
d. lea,ing him sampai e.ek alkoholna habis
e. monitor dengan posisi lateral decubitus sampai dia sadar
11. laki2laki 20 tahun terbakar, terdapat blister dan peeling pada kulit skrotum dan
2 cm patch on his penis. tensi 110/80, nadi 100, RR 22<. pasien sudah
menggunakan o2 high8ow dengan mask. langkah ang tepat...
a. .ollow up E5
b. .ollow up *+ patient
c. re.er to burn center
d. outpatient
e. re.er to general surgeon
12. B 20 .o man was sleeping when his house caught @re. 6e woke up coughing
and on his wa out his clothes caught @re. 6e was blisterring and peeling o. the
skin o. his .ace with some black soot around his central .acial area. 6e is alert but
@nding it diFcult to talk. 6e has cough with blackish sputum. C+ 110/80, 6R 100,
RR 2-. 6e has gi,en high 8ow %2. Bppropriate initial management...
a. appling dressing on the .ace
b. 7=R
c. de@niti,e airwa
d. :1 analgesia
e. burn centre
1#. B -1 .o woman has sustained sel. in8icted burns to her whole bod b igniting
hersel. a.ter pooring white spirit. which is the single most appropiate urgent
treatment to the le.t lower burnsA >gambar kedua kaki hitam kebakakar sampe
(ari2, bengkak?
a. amputation
b. bandage dressing
c. debridement o. wound
d. escharotom
e. skin gra.ting
1-. Laki2laki 08 thn recei,ing 7+R di 4*5. "tlh diberikan 2x shock 6R seperti
gambar E3*>E3* ;$?.apa langkah selan(utna...
a. beri amiodarone
b. beri amiodarone dn epine.rin
c. cek pulsasi
d. berikan shock ketiga
e.lan(utkan 7+R
10. 1an /2 .o. recei,ing cpr, he has been gi,en 2 shock, and at the end o. 2nd
ccle, monitor shows unchanged rhtm >E3* ;$?. the most appropiate
immediate action...
>di u(ian periode lalu soalna ini #rd shock bukan 2nd shock?
a. appl precordial thump
b. gi,e .ourth shock
c. gi,e i, amiodarone
d. gi,e 2nd dose adrenaline
e. resume chest compression
1/. Laki2 /- thn datang dengan chest pain, saat sedang dimonitor pasien merasa
unwell, lalu dia diberikan shock dengan anastesia. gambaran ekgna seperti
pada gambar >E3* kaakna itu gambar ;$ trus membaik tapi belum sinus?.
langkah selan(utna...
a. cek breathing
b. cek koneksi ke monitor
c. rasakan pulsasi carotis
d. ukur tensi
e. lakukan 12 lead ekg
17. B 0# .o man recei,ing 7+R in E5, immediatel a.ter deli,er the rst shock, his
heart rhtm on the monitor is as shown >E3* nggak tau gambaran apa.. dari
;$ (adi ;G mungkin?. What is the single most appropiate ne<t action...
a. check breathing
b. check pulse
c. gi,e 2nd shock
d. gi,e adrenaline
e. resume chest compression
18. pada gambar E3* berikut ini >E3* "$ ele,asi pada lead :, a;L, ;2, ;#, ;-, ;0,
;/ dan $ in,erted pada lead ::, :::, a;L?. ang ter(adi pada pasien ini adalah...
a. acti,ation o. platelet
b. blocking arteri thrombus
c. @ssuring o. plaHue
d. pre,iousl criticall impaired mocard
e. ,asospasm induced b local in8ammation
1&. +ria /8 thn mengalami moderatel se,ere chest pain selama 0 (am, sweat dan
unwell. tensi 1-0/&0, nadi 120, RR 20<, gambaran ekg seperti gambar >E3* "$
ele,asi di lead ::, :::, a;L?...
a. anterior
b. anterolateral
c. anteroseptal
d. in.erior
e. posterior
20. +ria 70 th, berak darah hitam.$ 100/72,! 88, RR 2-. +ucat, lemas. $erapi awal
emergensi
a. GG+
b. i, ++:
c. i, ,asopressin
d. normal salin
e. darah % negati,e
21. gambar E3* seperti digambar >E3*"$ ele,asi di ;1,;2,;#,;-?. Brteri mana
ang terkena...
a. 7ircum8e<a
b. Le.t anterior descending
c. +osterior descending
d. Right
e. Le.t
22. B 00 .o man chest pain .or the last .ew hours, nauseus and unwell. C+ 1#0/80,
RR 20.
E3* seperti di gambar. >E3* "$ ele,asi di ;1 s/d ;/?. Which is the single most
appropiate emergenc management...
a. 7BC*
b. .acilitated +7:
c. glcopro.en :ib/ :::a receptor inhibitor
d. primar +7:
e. trombolsis
2#. a patient has a blood pressure 210/100 accompanied b se,ere headache,
nausea, and ,omiting. Which categor o. hpertension CE"$ describe the
presentation...
a! h"#ertens$%e emergenc"
b. hpertensi,e urgenc
c. uncomplicated hpertension
d. transient hpertension
e. chronic hpertension
2-. a /7 .o man is brought to E5 b ambulance a.ter a sncopal episode. 6e was
well be.ore the e,ent, e<cept .or mild chronic hpertension. 6e .ell on pa,ement
striking his head so paramedics place him in a cer,ical collar and strapped him to
spine board. 6e complains o. low back pain, which he attributes to spine board.
C+ is 100/00, 6R 80</minute. Which o. the .ollowing is the best course o. action...
a. analgesic, E7*, and outpatients re.erral to cardiologist
b. E7*, cardiac en9me, admit .or telemetr monitoring
c. lateral abdominal =2ra with aortogram i. inconclusi,e
d. intra,enous 8uid, morphine, 7$ abdomen
e! $mmed$ate s&rg$cal cons&ltat$on' m&lt$#le large bore () *&$d' t"#e and
crossmatch blood
20. a oung .emale presents to E5 with a *7" score o. / a.ter being t2boned b
large pickup truck on her side o. ,ehicle. :nitial head 7$ is negati,e .or bleed.
+upils were initiall normal and reacti,e to light but now are bilaterall dilated
and sluggish. Which one o. the .ollowing therapies would at LEB"$ bene@cial .or
this patient...
a. 1 L normal saline bolus
b! (nt&bat$on and h"#er%ent$lat$on to kee# +CO2 less than 2, mm-g
c. 1annitol 1 g/kg :; bolus
d. Ele,ation o. the head o. the bed to #0 degrees
e. Gurosemide 0,#20,0 mg/kg :;
2/. a pre,iousl health 20 .o woman with no medical histor presents to E5
complaining - h o. substernal chest pain, shortness o. breath, dspnea on
e<ertion, and not .eeling well during the past .ew das. "he denies illicit drug use
or alcoholism. ;ital sign are remarkable .or a C+ o. &2//0, 6R 1#0, RR #0, $a<
101.0IG. E7* shows normal sinus rhtm with nonspesi@c $2wa,e changes. 7hest =
ra is normal. :n addition to o<gen, which one o. the .ollowing represent the
CE"$ initial treatment regiment...
a. aspirin, nitroglcerin, check troponin and moglobin le,el
b. aspirin, C blocker, check $"6
c! () *&$d' analges$c' emergent echocard$ogram
d. aspirin, nitroglcerin, emergent ,entilation per.usion >;/J? scan
e. :; 8uid, lora9epam, antacids
27. Kang "BLB6 pada hipoglikemi...
a. counter regulator hormone are released at hipoglicemi
b. hipoglicemi cause both autonomic and neuroglicopenic
c. pasien hipoglikemi pada umumna datang dengan B1", lethargi, con.usion
d. hipoglicemi is diagnosed when the blood glucose le,el L /0
e. glucagon is ine.ecti,e .or treating alcohol induced hipoglicemic
28. $erapi mana g CE!BR pada pasien anak dgn 53B...
a. pemberian cairan harus banak dan cepat
b. berikan bolus insulin 0,1 unit/kg sebelum diberikan in.us insulin
c. in.us insulin harus dihentikan bila glukosa turun men(adi 2002200
d. cerebral edema dapat ter(adi /28 (am setelah terlihat perbaikan klinis
e. suplementasi kalium tidak dibutuhkan ketika anak msh asidosis meskipun
serum kalium normal
2&. B 27 .o man complains o. chest palpitation and light headacheness .or the past
hour. 6e has no past medical histor and not taking an medication. 6e drinks #
beer occasionall on the weekend and does not smoke cigarettes. 6is heart rate
is 180</mnt, C+ 110/0/, "at %2 &&'. Bn E7* re,eals narrow comple< tachcardia
at a rate o. 180 that is regular and without discreanable + wa,e. Which o. the
.ollowing is the most appropiate medication to treat this dsrithmia...
a. digo<in
b. lidocain
c. amiodaron
d. adeno<in
e. bretlium
#0. B ## .o man was drinking hea,il at the bar present at E5 a.ter getting into a
@ght. a bstander tells the paramedics patient was punched and kicked multple
time, blowed to the head with a stool. in the E5 his C+ 100/70, 6R &0, RR 1#. sat
%2 100 on nrbm. laseration on right side o. head with draws arm to pain. others
was doesnt mo,e. ou asked Huestion and he (ust moans. which .ollowing is the
most appropiate ne<t step in managementA
a. prepare .or intubation
b. suture repair o. head laseration
c. administer mannitol
d. bilateral burr holes
e. neurosurgical
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