Traumatology 11

1. man 30y/o. naik sepeda motor tanpa helm dan

bertabrakan dengan pohon. Saat kejadian,
penderita pingsan. Pada saat dibawa, bisa bicara
tapi nda ingat kejadiannya. Pada saat diRS
kesadaran menurun.
Neurologic examination : he could not open his
eyes spontan, tapi dengan rangsang nyeri.
Moaning with irregular words, his leg was flexed
with pain stimuli.
Left pupil bigger than right. Seen hematoma at his
face and bleeding from his nose.
Symptoms decrease consciousness occurred after
patient awake was .

4. BP 160/100 mmHg, HR 50 x/minute was sign of

a) body response to the stress trauma

b) sign of neurogenic shock
c) sign of hemorrhagic shock
d) decreased intracranial pressure
e) increased of intracranial pressure
5. the sign was called
a) cushings response
b) monro kellys doctrine
c) cushings syndrome

a) cushing syndrome

d) lucid interval

b) monro kellys syndrome

e) severe head injury

c) lucid interval

6. the sign above was body reaction for

d) cushing syndrome

a) decreased ICP

e) severe head injury.

b) increased ICP

2. the symptom above was caused by .

a) spinal cord injury
b) blood accumulation
c) secondary brain injury
d) concussion was occurred at the beginning
and then hematoma accumulate occurred
slowly
e) normal response was occur
3. the symptoms above was commonly found in
a) intracerebral hematoma
b) epidural hematoma
c) subdural hematoma
d) intraventicular hematoma
e) central contussion

c) maintain pressure of brain perfusion

d) increased CSF stream to the spinal
chamber
e) decreased CSF stream to the spinal
chamber
7. there was periorbital ecchymosis at the patient
which sign of .
a) Fracture of anterior cranial base
b) Fracture of basis cranii media
c) Fracture of basis cranii posterior
d) Facial trauma
e) Fracture of bilateral zygoma
8. the sign above was contraindication for
a) Examination of plan skull radiology
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b) Examination of CT scan

a) Complete spinal cord injury

c) Apply nasogastric tube

b) LMN injury

d) Apply nasogastric through the mouth

c) UMN injury

e) Apply orotracheal intubation

d) Severe destruction of bone components

9. GCS in patient was .

e) Mild destruction of bone components

a) E3V3M4
b) E2V3M4

13. spinal cord injury at level of .

c) E3V4M2

a) upper cervical

d) E2V3M2

b) lower cervical

e) E2V2M4

c) thoracal

10. there was possibility to the patient that the

hematoma was occur at .
a) Left hemisphere

d) lumbal
e) conus medularis

b) Right hemisphere

14. first day reflex bulbocavernosus (-) and in the

third day. Sacral Spare sign (+).

c) Cerebellum

What is the diagnosis

d) Intraventricular
e) bifrontal
11. laki-laki, 24 tahun, masuk UGD karena
kecelakaan lalu lintas. Tidak dapat menggerakkan
kedua tungkai pasca kecelakaan. Ditemukan jejas
pada kedua paha tanpa deformitas dan jejas pada
epichondrium kiri, penderita juga merasakan nyeri
pada bahu kiri tapi tanpa jejas.
Important examination

a) upper motor neuron complete spinal cord

injury
b) lower motor neuron incomplete spinal
cord injury
c)
d)
e) .

a) reflex physiologis

15. in the second day, the patient has hypovolemic

shock. BP 80/40. Hb 6 gr/dl.

b) reflex pathologis

Your suspicion is .

c) rectal touch

a) Aorta trauma

d) lab

b) Kidney trauma

e) light touch and pin prick test.

c) Duodenum trauma

12. in this patient, the bulbocavernosus reflex is

(+), which is mean .

d) Pelvis trauma
e) Spleen trauma
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16. principal management of spinal trauma .

a) life saving
b) prevent secondary injury
c) stabilization
d) alignment
e) transportation
17. vacuum mattress is contraindicated in .
a) Pelvic fracture
b) Multiple fracture in lower extremity
c) Severe thoracic trauma
d) Head trauma
e) Spinal trauma
18. conditions below include UMN trauma, except
.
a) Brown sequared syndrome
b) Anterior cord

c) Total transaction of spinal cord

d) Decrease or loss motor power while
normal pain and temperature sensation on
the affected side.
e) Normal motor power while decreases pain
and temperature sensation on normal side.
21. 65 y/o woman, feelsnumbness and tingling on
index and thumb finger esp night since 2 years
ago. Weakness when holding things, but still can
do housework. Wasting thenar muscle (-). No
palpable tumor, no scar. No tenderness, same
temperature with the other hands.
Possible diagnose .
a) Ulnar vessels and nerve problem
b) Carpal tumor syndrome
c) Median nerve problem because cooking
d) Ulnar nerve injury
e) Radial nerve disruption because of trauma
22. what are the risk factor

c) Posterior cord

a) Osteoporosis

d) Conus medularis

b) Osteoporotic

e) Cauda equine syndrome

c) Synovium atrophy

19. condition below can lead to hypovolemic

shock, except .
a) Head
b) thorax
c) pelvic
d) abdominal
e) femur
20. conditions below related to brown-squared
syndrome, except .

d) Osteophyte
e) Tendon atrophy
23. treatment for this case
a) Antibiotic injection
b) Wrist splint
c) Diverse transversal carpal ligament
d) Open surgery
e) Endoscopic release

a) MOI : stab wound

24. if patient get thenar muscle atrophy.

b) Lateral mass fracture

Treatment
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a) Steroid injection

d) ..

b) NSAID

e) ..

c) Rest and NSAID

29. man, working at construction, hit by machine.

d) Wrist splint

Whats possible diagnosis

e) Open surgical division

25. 35 y/o man, has traffic accident come to
hospital with knee ecchymosis. Hip joint slightly
flexion, adduction, internal rotation.
a)

a) Open fracture proximal at phalanx hallux

b) Fracture median phalanx 1st toes
c) Fracture distal phalanx 1st toes.
30. treatment

b)

a) Buddy tapping, rest and immobilization

c) Anterior hip dislocation

b)

d) Posterior hip dislocation

c)

e)

d) Buddy tapping and antibiotic

26. what is the additional sign

a) Leg length discipancy
b) Unlimited range movement
c) Galeazzi sign (-)
d) Head of femur protrude inguinal
e) Heal of femur protrude lateral
27. what is the management for this patient
a) Traction countertraction
b) Mich maneuver
c) Kotcher maneuver

e)
31. in X ray result, communitive fracture at
interphalangeal joint.
Appropriate treatment .
a)
b) Kischer wire
c) Buddy tapping
d) Casting
e) Splinting
32. 28 y/o man play badminton and do jumping
smash. Cant dorsiflexion.

d) Simpson technique

a)

e) Pravin technique

b)

28. the effect of different treatment of children in

neck femoral fracture .
a) Vessel in the lig. Teres
b) Vessel in the retinacula
c) Intraosseus vessel

c)
d) Achilles tendon rupture
e)
33. what is the injury mechanism from the patient
problem?
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a) violent plantarflexion of flexi foot as in the

fall from height
b) direct trauma at 1st digit
c) twisting mechanism at the interphalanges
of the hallux
d) weightbearing foot because extended knee
e) sudden unexpected plantarflexion on the
ankle joint
34. what is the treatment for case above?
a) ...

c) Significant extra peritoneal bladder

rupture and a concern by the urology team
that the complication rate of treatment are
unacceptably high.
d) Intraperitoneal bladder rupture
e) pie in the sky bladder
37. in the blunt trauma patient with the pelvic
fracture in whom no urine returned to catheter
placement.
What is the best method to evaluate urethral injury

b) kessler technique

a) Retrograde orthography

c) debridement

b) CT with intravenous contrast material and

clamping of the urethral catheter.

d) casting
e) splinting
35. a patient shallow laceration (<1cm)
in renal. what is injury grade according
American association of Trauma
Scale?
a) I
b) II
c) III
d) IV
e) V
36. which of the following is neither relative nor
an absolute indication for open repair of bladder
injury .
a) Significant extraperitoneal bladder rupture
in a patient scheduled to undergo
laparotomy for associated intra abdominal
injuries by the general surgery team.
b) Significant extra peritoneal bladder
rupture in a patient scheduled for open
anterior repair of pelvic fracture by the
orthopaedic surgery team

c) Flexible cystoscopy in the operating room

d) Percutaneous antegrade cryptography
e) Use the urethral sound
38. there are distinct clinical and physiological
difference between high flow and low flow
priapism. Which of the following statement are
true .
a) Priapism of 12 or more hours after
intracavernosus pharmacotherapy is
generally high flow
b) Low flow is generally painful after 6
hours.
c) A corporal aspirate of dark blood that is
hyperbaric and epidotic is classic low flow
priapism
d) Trauma after penile or straddle injury
more often leads to ischemic rather than
arterial priapism
e) The least invasive way of diagnosing low
flow priapism is with phalloarteriography.
39. on the physical finding of torsio of the
spermatic cord is
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a) High riding testis

b) Absence of the cremasteric reflex
c) Transverse lie of the testis
d) Absent Doppler sound
e) Inflammatory hydrocele
40. After manual detorsion of spermatic cord.
which of the following is appropriate
management?

43. the examination to establish the diagnosis are

a) Angel and phren sign

b) Bag of worm
c) Transillumination positive test
d) Valsalva maeuver
e) String pearl/ rosario on epidydimis
44. management for this case

a) Color Doppler USG Examination

a) orchidectomy

b) Radionuclide Scan

b) reposition and orchidoplexy bilateral

c) Doppler Examination of the testis and

spermatic cord

c) berkmann-winkelmann operation

d) Discharge of the patient and arrangement of

an office re-evaluation in 1 week
e) Immediate scrotal exploration
41. the blood in hematocele is contained in which
of the following
a) The tunica albuginea

d) tuberculostatic and vasectomy

e) herniotomy
45. 3 hours old baby prolonged delivery by
fetopelvic proposition. Apgar score 6/8. Body
weight, 4200 gr, length 51 cm. Bulging center of
the head suture. no moro reflex at left side.
Diagnosis

b) Tunica vaginalis

a) caput succedenum

c) Colles fascia

b) subgaleal hematoma

d) Scarpas fascia

c) cephal hematoma

e) Campers fascia

d) subarachnoid hematoma

42. boy 2 hours after bed, edema, redness, pain at

his right testicle lebih tinggi dibanding yang kiri.
Whats the diagnosis
a) Orchitis
b) Right testicle torsion
c) Hydrocele
d)

e) epidural hematoma
46. what make in this patient no moro reflex
a) Brachial palsy type erb
b) Brachial palsy type klumpkee
c) Clavicle fracture
d) B+C
e) A+B+C

e)
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47. if this case is brachial palsy injury type

klumpkee. What could you find in your physical
examination .

51. causes of hypothermia in this baby

a) Preterm

a) grasp reflex is usually present

b) Small for gestational age

b) clawing hand

c) Prolonged resuscitation

c) there is waiters tip hand

d) B+C

d) in adduction

e) A+B+C

e) in pronation and internally rotated

48. according to fetal body weight, the cause of
birth injuries is .

52. estimated temperature after treatment .

a) 36.5-37.5
b) 36.5-37.1

a) Abnormal presentation

c) 36.6-37.1

b) LBW + prematurity

d) 36.6-37.6

c) Fetal macrosomia

e) 37.0-37.5

d) Large fetal head

e) Fetal anomalies
49. long term deficit
a) Progressive deformity

53. female 64 y/o decrease consciousness, no

history of fever nor hypertension, vital sign normal
except tachycardia, no meningeal sign, light reflex
(+) and has severe diarhea and vomiting since 3
days ago.what is the cause of decrease
consciousness in this patient

b) Muscle atrophy

a)

c) Limb contracture

b) imbalance electrolyte

d) Impaired growth of limb

c) ..

e) All correct

d) ..

50. a term baby girl, weight 2200gr, premature

rupture membrane, put in warmed .. was given
resuscitation for 10 minute with apgar score 4/5/7.
Temperature 36.1 C
Stage hypothermia .
a) Mild
b) Moderate
c) Severe
d) Cold stress
e) A+D

e)
54. For management, what IV we should give
a) Dextrose 40%
b) Dextrose 5%
c) NaCl 0.9%
d) KaEn
e) Mannitol 20 %
55. 45y/o woman decrese consciousness,
weakness extremities, cold sweating, no fever no
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head trauma, diabetic (take insulin) mild

hypertension. PE: BP: 140/90 HR: 90/min GCS
E2M5V3, Na 140 K 3.5 glucose random 50mg%
Cause of decrease of consciousness .
a) Hypoglycaemia

c) Crystalloid 10cc/kgBW/hour
d) Crystalloid 20cc/kgBW/hour
59. case invaginasi.
In physical examination we found

b) ..

a) Cupping sign

c) hypertension

b) Pseudoportio

d) electrolyte imbalance

c) Target sign

e) cerebrovascular

d) Doughnut sign

56. based on the scenarion above, what the

possible diagnose
a) brain death
b) wernick encephalopathy
c) metabolic encephalopathy
d) hypertension encephalopathy
e) diencephalic coma

e) ..
60. 3 y/o baby vomit 5x/day. Watery stool >10 x/
day. Irritable, sunken eyes, dry mouth, pulse
152x/min, BR 48x/min, BP 70/40 mmHG, very
slowly skin pinch.
Score
a) 13
b) 14

57. 3 y/o boy admitted because of fever 3 days

ago. There was vomiting 5x and poor drinking
child. History of gum bleeding 1 day ago.

c) 15

Pemfis : unmeasurable pulse, unpalpable pulse,

cold extremities.

e) 17

d) 16

a) DHF I

61. A 5 days old baby was brought by her mother

to the hospital with vomiting of >10x/day &
watery stool of >5x/day without mucous nor
blood. There is shunken fontanella. The baby's
weight is 3000g & her birth weight is 3500g.

b) DHF II

What is the diagnosis?

Lab : hematocryte 45%, platelet count 80000.

Diagnosis

c) DHF III

a) Very severe dehydration

d) DHF IV

b) Severe dehydration

e) Dengue fever

c) Moderate dehydration

58. initial therapy

a) RL/ RA 100-200 cc 10-15 minutes
b) Crystalloid 5cc/KgBW/hour

d) Mild dehydration
e) No dehydration
62. treatment for case
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a) RL 24 hours

d)

b) RA 8 hours

e)

c) RL 8 hours
d) RA 24 hours
63. (lupa kes tp cerita dia lebih kurang mcm ni la)
ada seorang ibu yg sangat sedih kerana dia
mendapati anak dia tak bernafas. Lalu dibawalah
ibu itu ke UGD dengan penuh linangan air mata.
Doktor mendapati bahawa anak itu telah
meninggal. Yang peliknya, tidak ditemukan tanda2
respiratory distress. Dokter tu pon buat la autopsy,
lalu tidak jua ditemukan kelainan di situ. pening
punya pasal (mybe malas nak pikir dah kot) di pon
ckp la baby ni meninggal sebab "Sudden Infant
Dead Syndrome"?
Cause of SIDS

67. follow up for patient's brainstem function?

I.

pupil reflex

II.

corneal reflex

III.

oculocephalic reflex

IV.

gag reflex

68. the position has chyne stoke respiration type

due to
a) Brain cortical function
b) High intracranial pressure
c) Brain hematoma

a) Hypothermia

d) Brain stem hematoma

b) Put back in bed

e) Brain stem death

c) Breast feeding

69.

d) Rebreathing asphyxia

70.

e) Neonatum asphyxia

I, II, III correct A

64.

I, III correct B

65. man, unconsciouss, unresponsive.

II, IV correct C

Whats the diagnosis

All correct D

a) Delirium
b) Vegetative state
c) Lock on syndrome
d) Drowsiness
e) coma
66. whats GCS in this patient
a) 3-7
b)
c)

71. 50 y/o man come with blurred right eye. 3

hours ago he had accident ang got head injury.
Whats the correct statement of lens displacement

I.

Slit exam no lens

II.

Pain on the right eye

III.

Distance vision 1/60 cor S+1.00 D= 6/75

IV.

Near vision not disturbed

72. found in lens subluxation

I.

Decrease vision
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II.

Astigmatism

a) Glyserin oil

III.

Monocular diplopia

b) Coconut oil

IV.

Iridodenesis

c)

73. treatment for this case

I.

Extracapsular surgery with

II.

Intracapsular surgery with

III.

Extracapsular with IOL

IV.

Intracapsular with IOL

d) Kayu putih oil

e) Fried oil
79. Strong indication for elective tracheostomy,
according the Jacksons dyspnea grading is
a) I
b) II

74.

c) III

75. causes of lens dislocation

I.
II.

d) IV

Blunt injury

e) V

Accident

III.

Congenital ( marfan syndrome)

IV.

Perforans (perforation)

76. the disease of foreign bodies in nasal cavity

cause by flies meggots
a) Nasal mitosis
b) Nasal meiosis
c) Nasal maggots
d) Nasal myasis
e) Nasal worms
77. Appropriate tracheal stoma position for
elective tracheostomy is
a) 1-2
b) 2-3
c) 3-4
d) 4-5
e) 5-6
78. rapid killing for foreign body at external
auditory canal, except

80. the complication may occurs from

inappropriate treated septal hematoma are
I.

Septal perforation

II.

Septal abscess

III.

Saddle nose

IV.

Conceal atrophy

81. the cardinal signs of menierre disease .

I.

Tinnitus

II.

Sensory neural hearing

III.

Vertigo

IV.

Severe pain

82. the statement below are related to the posterior

nasal bleed, except
a) Woodruffs plexus
b) Bellocs tampon
c) Sphenopalatine artery
d) Superior labial artery
e) Large in diameter vascular involvement
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83. the statement below are situation which need

urgent procedure, except

c) ..
d) Ant OCT

a) Coins of esopharyngeal foreign bodies

b) Caf coronary
c) Uncontrolled nasal bleed
d) Diphterie of the larynx
e) Grade lil Jackson dyspnoe
84. rapid killing for foreign body at external
auditory canal, except

e) Bio..
88.
89. diagnosis
a) Glaucoma resses angle
b) Pigmented glaucoma
c) Neovascular glaucoma

a) Glyserin oil

d)

b) Coconut oil

e)

c)

90. theres scar In trabecular meshwork more half.

d) Kayu putih oil

Treatment of this case are

e) Fried oil

a. Trabeculoctomy

85. mostly blood supplies in the nasal cavity from

external carotid artery

b. Baerveld shunt

Because

d. A + B

Only blood ethmoidal arteries are branches from

internal carotid artery

e. A+B+C

86. Kasus Glaukoma

alat untuk mengukur tekanan intraocular
a)
b) Tonometer
c) ..
d)
e) ..
87. alat untuk melihat scar pada trabecular
meshwork
a) Gonoscopy

c. Iridectomy

91. perempuan datang ditemani oleh suaminya.

Keluhan
Sebagai seorang dokter apa yang harus qta lakukan

a) Memberi informed consent pada suaminya

bahwa istrinya akan diobservasi
b)
c)
d)
e) ..
92. her mother has bleeding pervaginam (klo gak
salah).

b)
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TD 80/60, pulse 110 x/rate, respiration 20 x/

menit.
The examination we do, except .
a. ., Leopold, fetal heart rate
b. Setting IV line, ukur output dan input
c. Inspeculo examination
d. Vagina examination
e. Ultrasonography
93. perdarahan vagina, no pain, heal 5/5, no
contraction.
Diagnosis
a. Placenta previa

c) Branch vena occlusion

d) ..
e) Rhegmatous retina
96. 69 y/o man has sudden visual loss, segment
anterior normal. Milky white appearance, red
cherry spot.
Diagnosis
a) Central vena occlusion
b) Central artery occlusion
c) Branch vena occlusion
d) ..
e) Rhegmatous retina

b. Abruption placenta

97. cotton wool spot, red fovea spot.

c.

Diagnosis

d.

a) Central vena occlusion

e. Vasa previa

b) Central artery occlusion

94. pada abrutio placenta, etiologic yang paling

sering ..
a) Infeksi
b) External rotation
c) Trauma abdomen
d) Short placenta
e)

c) Branch vena occlusion

d) Branch artery occlusion
e) Rhegmatous retina
98. 60 y/o woman sudden inferonasal vision loss.
Control visual acuity 6/6. If patient diagnose with
rheugmatous retina detachment. Possible location
of retinal detachment
a) superotemporal retina, involved macula

95. patient, datang tiba-tiba mengalami penurunan

penglihatan, dan mengeluh floaters, photophobia,
.

b) superotemporal retina, macula still intact

has history of high myopia

d) inferonasal retina, macula still intact.

whats the diagnosis .

e) superior retina.

a) Central vena occlusion

b) Central artery occlusion

c) inferonasal retina, involved macula

99. a man come to ophthalmology outpatient clinic

with bloody appearance of his eye, which occur
suddenly 2 days before. Ophthalmology showed
conjunctival htperemia with clear cornea.
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This patient is likely to have .

a) Hyperemia
b) Conjunctival chemosis
c) Subconjunctival bleeding
d) Corneal edema
e) Conjunctivitis
100. cause of that case except
a) Vascular discharge
b)
c) Unknown
d) Infection
e) Prev. hypertension

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