3. A 45 year old female, complaint severe pain on right forearm kalau move.

The pain felt about 1

hour ago after fall from chair. 1st process that happen in injury ?

a. Inflammatory

b. Soft callus formation

c. Hard callus formation

d. Remodeling

e. Angiogenesis

4. A 39 year old female fell pain on her left hand for 2 days. Patients complaints about malaise, fever,
stiffness of hand joint in the morning for 1 hour. Physical examination shows nodules on PIP and MCP
of both ring and little finger. What test must be examined for the patient?

a. Rheumatoid Factor

b. Uric acid serum

c. Complete Blood count

d. BMD

e. X-Ray

5. a 17 years old boy was thrown while riding a bicycle with an outstretched hand and experienced a
fracture, on ER and examination reveals inability to actively extends the wrist, what might have been
the site of a fracture that caused the muscle weakness?

a. Hook of hamate

b. midshaft of humerus

c. scaphoid

d. clavicle

e. shaft of radius

6. hematoma develops in the area of fracture, what is the probable origin of the hematoma ?

a. proximal palmar arch

b. posterior circumflex humerus artery

c. profunda brachial artery

d. ulnar artery antebrachii posterior,

e. radialartery

9. A 45 year old male, pain on his right hell every time after tennis. Tennis 3x / week in 5 years.
Physical examination : normal skin, full painless on ROM of right ankle, thickening of tendon and
tenderness on palpitation. Lab result :Hb 14,9 %, leukocyte 9000/dL, ESR 10, CRP 5, uric acid 9 mg/dL.
Most cause of tendon pain?

a. Gouty

b. Overuse

c. Rheumatoid

d. Impingement

e. Instability

10. A 20 year old male complaint about pain on his outer left ankle being slipped on his foot. Physical
examination : bruise, tenderness, increase left ankle inversion, and positive anterior Drawer sign. Best
management ?

a. Rest

b. Immobilization

c. Compression

d. Elevation

e. Surgery

11. A 30 year old man, present with pain and wound in left anterior thigh region after car accident.
The doctor said that he needs surgery to repair the muscle. What is the most probable condition?
A. Contusion
B. Transection
C. Strain
D. Delayed muscle soreness
E. Compartment syndrome
12. A 52 year old man present with heel pain for about 1 month. He runs approximately 20 miles
weekly. The pain is most severe when first standing and walk after sitting or lying down. Palpation of
medial plantar increase the pain. The patient walks with limp. What is the most probable cause of the
patient's problem?
A. Articular cartilage degeneration of calcaealcuboid joint
B. Decreased peripheral vascular perfusion
C. Impingement of first sacral nerve.
D. Inflammation of origin plantar fascia
E. Increased peripheral vascular perfusion
13. A 47 year old man comes to the physician cause of 2 years history of left knee pain. He had pain
when moving but now he feels pain also at rest. When age 16, he sustained fracture at the left
proximal tibia and undergo open reduction and ____ fixation at that time. His left knee ____ swollen
without history of locking or catching. Examination show varus left knee, bower (-).

a. non union of his prion fracture

b. patella tendinitis

c. pos traumatic

d. tear of the anterior cruciate ligament

e. tear of the medial meniscus

14. a 52 year old man has had heel pain. He runs approximately 20 miles weekly. Pain is most severe
when he first stands up and walks after sitting or lying down. Palpation ___ plantar surface and the
heel increase pain. He walks with limp. Cause of the pain?
a. Articular cartilage degeneration of the calcaneus joint

b. decrease peripheral vascular perfusion

c. increase peripheral vascular perfusion

d.

e. infarct of the origin of the plantar fascia

15. Fracture di T-12 mid shaft. Normal lab result, normal vitamin D level. Imaging buat diagnosis?

a. Bone Scan

b. Spine X-Ray

c. Hormone analysis

d. Bone Densitometry
e. PET-scan

16. Four days fever, pain di proximal left tibia. Abismaen soccer, masihbisajalan normal, tapiada
swelling.Pathogen yang mungkin?

a. Streptococcus pyogenes

b. Staphylococcus aureus

c. Streptococcus pneumone

d. Salmonella sp.

e. Pseudomonas aeruginosa

17. 62 year old, 90 kg, 165 cm. Pain in right knee for 3 months. Pain causes discomfort and dull. Has
periodic spasm of thigh and leg. Pain is worse after walking long or climbing stairs and disappears at
rest. Right knee twisted 30 years ago, didn't walk for 3 weeks. Probable cause of pain?
A. Mechanical disorder
B. Secondary degeneration disorder
C. Metabolic dysfunction
D. Primary osteoarthritis
E. Inflammation disorder
18. Fall on outstretch hand, PA deform. Xray shows distal radius metaphysis transversal fracture.
Undergoes close reduction and long arm plaster. What might be the complication?
A. Medial nerve palsy
B. Blood vessel injury
C. Malunion
D. Tendon injury
E. Compartment syndrome
19. Row cell, surround by empty space between bundle collagen ?

( Fibrocartilage)

20. Many randomly distributed cell in lacunae, homogenous matrix without capsule ?

( Hyaline cartilage )

21. Cessation growth of which site result no further longitudinal growth?

( Epiphyseal plate )
22. Tear of biceps brachii at its insertion of radial tuberosity. What tissue damage at tear site ?

a. Reticular

b. Elactic tissue

c. Loose aleolar

d. Regular dense connective tissue

e. Irregular dense connective tissue

29. Rhonda is 66 year old. She has had Rheumatoid Arthritis for 8 years. Diake ER with 6 hours of
severe throbbing headaches. She complain about visual blurring & double vision. She is anemic, ESR =
100 mm/hr. What is the most effective treatment ?

a. Foramax 10 mg daily 3 month

b. Diamox 250 mg 4x daily 2 week

c. Cyclophosphamide 2 mg daily 3 month

d. Prednison 60 mg daily 3 week

30. Sheila, 48 year old, has 2 month history of pain in finger. Some tenderness & joint
stiff.Pathogenesis ?

a. Pyogen infection

b. Metabolic disorder

c. Degenerative disorder

d. Autoimmune disorder

33. 40 year old female, came to hospital with chief complaint of pain on MCP-PIP joint for about 6
months, increased with activity. Stiffness occur in morning for about 60 min.

a. Gout arthritis

b. Osteoarthritis

c. SLE

d. Septic arthritis

e. Rheumatoid arthritis

34. Which medication most appropriate to delay joint destruction ?

a. Sodium diclofenac

b. Meloxicam

c. Alopurina

d. Corticosteroid

e. Methotrexate

35. 55 year old female, with 5 years postmenopause, BB = 50 kg, TB = 165cm, daily drink 1-2 cup wine,
dengan T score di spine -1,7 and femoral neck -1,5. Laludiatanya, suggest apa?

a. increase Ca intake and weight bearing exercise

b. increase weight

c. stop drinking alcohol

d. estrogen therapy

e. thyroid therapy

36. 8 year old girl, limp, had a history of injury. 2 years earlier ad mild trauma. Dari exam, ESR 48 mm
in the 1st hour, ada small pus di bagian anterior thigh. Dari radiografiadalystic lesion dansequestrum di
proximal methaphysis. Diagnose?

a. Acute Osteomyelitis

b. Chronic Osteomyelitis

c. Chronic purulent multifocal Osteomyelitis

d. Brodieabcess

e. Tuberculosa

37. 50 years old, unable to extend left leg after crash to a big tree. Left anterior thigh was hit by
dashboard. Nerve?
A. Femoral nerve
B. Tibial nerve
C. Peroneus superficialis nerve
D. Peroneus profundus nerve
E. Suralis
38. What muscle is impaired due to those nerve injury?
A. Biceps femoris
B. Gracilis
C. Peroneus
D. Rectus femoris
E. Adductor brevis
39. A 70 year old female, pain on her groin, fall in bathroom. Physical examination shows left thigh
shortens and externally rotated. Imaging fracture of left femur bone. Possible location of fracture ?
a. Middle femur
b. Distal femur
c. Collum femur
d. Corpus femur
e. Epicondylus
40. A 40 year old male fall down in tennis court with tremendous pain of left ankle joints and he
couldnt walk. Physical examination shows an irregular mass in the back of his mid calf area was
noted. Which muscle is the most likely impaired?
a. Tibialis anterior
b. Peroneus brevis
c. Gastrocnemius
d. Tibialis posterior
e. Flexor digitorumlongus
41. Which active movement of ankle is impaired in above condition?

a. Eversi

b. Inversi

c. Dorsoflexion

d. Plantarflexion

e. Normal

42. 25 year old woman, secretary, weakness of right had when has to hold on something for more
than 1 min. She has artrophy on thenar muscle &parastesia on the entire finger except the little
finger. Damage to which of the following nerves is most likely responsible?

a. Ulnar nerve
b. Radial nerve

c. Median nerve

d. Axilar nerve

e. Musculocutaneus nerve

43. A 50 year old woman shows a wrist drop after injury. She complaints about numbness of her
dorsal part of her hand and she could not extent her wrist. What nerve is likely injured?

a. ulnar nerve

b. radial nerve

c. median nerve

d. axillary nerve

e. musculocutanues nerve

44. A 12 year old boy is diagnosed with an upper brachial plexus injury after failing from a tree. He
cannot raise his arm by laterally 90 degree. What muscle is primarily responsible for this case?

a. tricepsbrachii

b. bicepsbrachii

c. coracobrachialis

d. deltoideus

e. teres major

45. Which nerve is the most affected ?

a. N. Medianus

b. N. Axillaris

c. N. Ulnaris

d. N. Musculocutaneus

e. N. Thoracodorsalis

46. The X-Ray photography showed a fracture of caput humeri

a. A. Suprascapularis
b. A. Thoracoacromialis

c. A. Circumflexahumeri posterior

d. A. Circumflexa scapulae

e. A. ProfundaBrachii

47. 5 years old boy presents with subacute onset of fever n pain over the distal end of his left femur.
His peripheral leukocyte count is 11000/ul and X-Ray of left femur reveals a round lytic focus of bone
surrounded by a zone of sclerosis. What is the diagnosis?

48. What is the management?

53. 25 year old male, 1/3 proximal tibial fracture traffic accident. What is the most common
complication of the fracture?

a. Rupture tendons

b. Joint stiffness

c. Delayed union

d. Compartment syndrome

e. Degenerative arthritis

54. 32 year old construction workers arrives in the emergency department after working accident
tendon of the biceps brachii at the elbow has been severed by a laceration that extend 2cm, proximal
from the tendon insertion. Which of the following structure is injured?

a. Brachial artery

b. Musculocutaneus nerve

c. Profundabrachii artery

d. Radial nerve

e. Ulnar nerve

55. A 44-year-old man present with sudden, markedly inflammed and painful right great toe.Physical
examination shows remarkable swelling and erythema of the MTP I joint as well as small nodules on
the patient's external ear. Aspiration fluid demonstrates neddles shaped crystal. What is likely the
diagnosis?

a. OA

b. Omyelitis
c. Gout

d. RA

e. Omalacia

56. Which of the following agent would provice the most immediately relief for this patient?

a. Allopurinol

b. Aspirin

c. Colchicine

d. Probenend

e. Sulfinpyrazone

57. Ando, 10 years old boy has persistent draining sinus in his right leg. Antibiotic has consumed
continuously for 2 months. Radiograph shows a chronic osteomyelitis. What happen with antibiotic
did he consumed ?

a. insufficient antibiotic doses

b. involucrum

c. squestrum

d. lytic cell

e. bacterial resistance

61. Kalo body builder, yang nambahduluanapanya?

(waterdansitoplasma)

62. Back pain umur 30an terus BMD nyarentan

(back brace)

63. Ayu, 48 year old, has 4 month pain and swelling finger, tenderness, stiff joint.

a. increase T-cell infiltrate

b. increase plasma cell infiltrate

c. increase neutrophil infiltrate

d. decrease fibroblast production

e. decrease osteoblast production

64. 31 year old, pain in right wrist, no stiffness, develop rash, blood test helpful. Pathogenic
mechanism?

a. Antiplatelet

b. Antism antibody production

c. Reduce systemic lymphocyte production

d. Increase DNA synthesis

e. Destruction phospholipid membrane

69. Those nerve is a terminal branch of ?

a. fas. Lateralis and posterior

b. fas. Medialis and lateralis

c. fas. Posterior and anterior

d. fas. Anterior and lateralis

e. fas. Dorsalis and medialis

70. Med student motorcycle accident, wrist severe injured, bleed through radial artery. Muscle most
supply by this artery ?

a. Thenar mm

b. Hypothenar mm

c. Palmaris longus m.

d. Flexor carpi radialis m.

e. Flexor digitorumsuperficialis m.

75. 50 YO woman is taking aspirin 4x daily for her arthritis. She visits ur clinic and complains of
inconveniency cause by the drug. Which of the following statements by the woman that leasts you to
blieve that she is experiencing toxic side-effects from the drug?
a. My heart seem to beating fast
b. I am very thirsty
c. I have numbness and tingling in my legs
d. I hear a roaring sound in my ears
e. All things that I see are green
76. Some drugs like Methotrexate hydroxychloroquine or penicillamine are often used for managing
rheumatoid arthritis that is not controlled adequately with typical NSAIDs (e.g. aspirin, ibuprofen or
indomethasin). Which of the following statements best summarizes how those drugs differ from the
typical NSAIDs?
a. Activate the immune system to neutralize inflammatory mediators
b. Are primary therapy for gouty arthritis
c. Are remarkably free from serious toxicity
d. Provide much quicker relief of arthritis sign and symptoms
e. Able to slow, stop, and reverse joint pathology in Rheumatoid Arthritis
77. A 12 year old boy complaint fever, chills, local swelling pain at his left leg after accident 3 weeks
ago. X-Ray shows femur bone destruction, new bone formation. Clinical diagnosis of bone infection.
Evaluating the cause of illness ?

a. Acid-fast stain of skin specimen

b. Culture of wound aspiration

c. Thick & thin smear of blood

d. Direct mount microscopis

e. Serum toxic assay

78. Isolate was resistant to Oxacillin. Which of the following antimicrobial is the most appropriate?

a. Vancomycin

b. Erythromycin

c. Clindamycin

d. Metronidazole

e Chloramphenicol

79. A 24 year old male, fever, severe pain and swelling at his leg after open surgery. In dwelling
prosthesis for his leg purulent discharge from surgical wound. Pathogenesis agent?

a. Clostridium perfringens
b. Bactoroidesfragilis

c. Mycobacterium tuberculosa

d. Streptococcus pyogenes

e. Escherichia coli

- What is the abnormally called ?

( Cleft hand )

- What causes this abnormality ?

( Primary structural defect )