1. A man 18 years old comes to the doctor with complaint of diarrhea, 6-8 times per day.

He also has fever, abdominal pain, stomach cramp, nausea, vomiting, and discomfort
while eating. The stool and lab examination shows that he has watery diarrhea, blood
and mucus (-), fecal leukocyte (-), no increase of lactofein. After doing anamnesis, a
week ago, patient with his friends went travelling to Ranukumbulo lake. Patient didn’t
really pay attention to his hygiene because there is no clean place to wash his hands.
Organism that can cause the disease is…
a. S. aureus
b. Enterotoxigenic coli (ETEC)
c. Enterohemorrhagic coli (EHEC)
d. Enteroinvasive coli (EIEC)
e. C. dificille
2. What is the characteristic of the organism that cause the disease>
a. Secrete enterotoxin that’s heat stabile and heat labile, that binds to the
jejunum and ileum wall
b. Able to cause complications such as hemorrhagic colitis and HUS
c. Secrete cytotoxin that invades and colonizes on the distal part of intestine
epithelial cell
d. Symptoms that is caused by the organism is not self limited
e. The disease’ spectrum is mild and cannot get to more severe spectrum like
life-threatening cholera syndrome.
3. The best therapy for this case is
a. Antibiotics usage (fluoroquinolone or azithromycin) for resolving disease’
duration
b. Rehydration to replace fluid and electrolyte loss
c. Loperamid to decrease stool frequency is allowed
d. Probiotics when there is no severe diarrhea symptoms
e. No correct answer
4. A patient that has gone through long hospitalization complaints of prolonged diarrhea.
Patient has diarrhea 10-20 times per day with watery, slimy consistency, with
stomach cramp and fever. Patient has history of using antibiotics previously. After
doing examination, patient turns out to have diarrhea cause by antibiotics. Organism
that cause the symptoms is….
a. Clostridium perfingens
 b. Clostridium difficile
c. Clostridium septicum
d. Clostridium tetani
e. Clostridium botulinum
5. Most common antibiotics that can cause the complaint and cause outbreak in the
hospital is….
a. Clindamycin
b. Ampicillin
c. Ceftriaxone
d. Ciprofloxain
e. Amoxicillin
6. Which one of the following is the characteristic of Enterococcus?
a. Gram positive organism; single cell, short chain; beta hemolytic on BA
b. Catalase positive; non motile, aerobic and facultative anaerobic organism
c. Can cause complication like toxic shock syndrome and SSSS
d. Gram positive bacteria; non hemolytic bacteria, dan commonly cause UTI
e. All answers wrong
7. C. perfringens cause these infections except….
a. Traumatic gas gangrene
b. Necrotizing enterocolitis
c. Enteritis necroticans
d. Wound contamination
e. Cellulitis
8. Which of the statement is false about gas gangrene?
a. The growth of bacteria on gas gangrene needs aerobic condition
b. Predisposition factors such as crush type injury, open fracture long bone,
and laceration of large or medium arteries
c. Diagnosis is easily made because infection only occurs on areas that has
contact with surrounding air on the infected tissue
d. Spontaneous gas gangrene occurs on GI tract
e. Alfa toxin plays role in the virulence factor of the gas gangrene-causing
bacteria
9. A middle-aged man comes to the hospital with complaints of pain while urinating.
Pain on the penis has been a problem to him for a week. On the physical examination,
 doctor founds pustule on corpus penis with multiple lesion, unclear border, dirty, and
bleeds. Patient works as ferry ship captain for Jawa-Sumatra. Organism that cause the
complaints in this patient is….
a. Herpes simplex virus
b. Treponema palidum
c. Haemophilus ducreyi
d. Retrovirus
e. N. gonorrhoeae
10. The gold standard to diagnose the case is…
a. Aspiration of the lesion for culture
b. PCR
c. Dark field microscope
d. RPL, VDL, EIA
e. ELISA
11. A 35-year-old man comes with complaint of having fever since 2 weeks ago. Temp
38,5 C, hyperemic tongue and tremor, redness on body surface, watery diarrhea,
nausea, and vomiting. Examination that should be done :
a. Routine fecal analysis
b. Widal
c. Routine blood analysis
d. Routine urine analysis
e. Blood culture
12. A mother carrying her 6-year-old boy to the MD with complaints of itch in the anus.
On alloanamnesis, she say that the boy looks weak and has decreased in appetite. She
also notice scar due to scratching around the anus and notice a strange object that
looks like coconut flakes. What parasite cause the infection?
a. Necator americanus
b. Ancylostoma duodenale
c. Trichuris trichiura
d. O. vermicularis
e. Ascariasis
13. A 35-year-old man comes to emergency department with decreased consciousness
since yesterday. It comes with fever and worsening headache since a week ago.
 Patient just got back from Papua 2 weeks ago. The most recommended examination
is…
a. Routine blood analysis
b. Blood smear
c. Blood culture
d. Serology
e. Ureum, creatinine
14. A 35-year-old man comes with complaint of diarrhea since a month ago. Patient
complaints of weight loss and has taken medication but it doesn’t work. Patient also
complaint of decreased appetite because it hurts when swallowing. He had history of
heroine use. Cause of the disease is….
a. Human Imunodeficiency Virus
b. Eipstein Barr Virus
c. Cytomegalovirus
d. Mycobacterium tuberculosis
e. Human Papiloma Virus
15. A 31-year-old man comes with high fever about 5 days, with headache, muscle and
joint pain, nausea, vomiting, decrease appetite, and decreased urinary frequency. He
works as farmers and his rice fields had been attacked by rats lately. Physical
examinations shows a red eye, icteric, hepatosplenomegaly. What lab exam that
should be done?
a. Blood serology
b. Dark field microscopy
c. Widal test
d. Blood culture
e. Rumple leed test
16. A man comes with fever since 3 days ago, with chills. Fever comes back 2 days after.
A week ago, he and his friend went to the palm farm. Diagnosis?
a. Malaria
b. DHF
c. Demam typhoid
d. Cikungunya
e. Leptospirosis