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MCQ FMS 4
Batch 2016

1.A woman came with a complaint of white grayish fishy odor. What causes this condition?
Decrease population of lactobacillus

2. A child came to the doctor and is diagnosed with sepsis bacteria and there’s gram
negative bacteria. What is the virulence factor in the bacteria?
Lipopolysaccharide

3. A man is diagnosed with Staphylococcus aureus virulence, what enzyme is the virulence
factor?
A. Hialuronidase
B. Protein M
C. Streptolysin
4.

5. A 1-year-old baby was admitted with symptoms of meningitis, the gram stain of CSF fluid
show many neutrophils and gram positive lancet-shaped diplococci. Which transmission
is the most possible source of infection for Streptococcus pneumonia?
A. Food poisoning
B. Ingested spore
C. Respiratory droplet
D. Contact with contaminated animal
E. Contaminated food

6. Which of the bacterial components is least likely to have antigen for research?
A. exotoxin
B. ribosome
C. cell wall
D. capsule
E. flagella

7. What is the medium well for clostridium?

Anaerobic blood agar

8. A 9-year-old boy with the signs and symptoms of pertussis (whooping cough). Onset is
20 days prior to visit. Mother is quite certain that her son is vaccinated. What is the
diagnostic test needed?
A. Send a nasopharyngeal aspirate for B. pertussis culture
B. Send blood for serological test
C. Send for both serology & culture
D. Do nothing

9.
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10.

11. A young boy came with sore throat, rash, bright red tounge, pharyngitis. What
properties can cause this?
A. Gram positive, cocci in cluster, beta-hemolytic ( s. Pyogenes)
B. Gram positive, cocci in cluster, alpha-hemolytic
C. Gram positive, diplococci lancefield group
D. Gram negative, coccobacili cell coated
E. Gram Negative, bacilspora producing.

12. Which part of the Bacteria (Neisseriagonorrhoeae) structure has an immunogenic

effect?
Outer membrane protein

13.
14.
15.

16. PasienTBC pas di chest x-ray ada right lobe nodule. Sel mana yang menghasilkan
nodule?
A. T Cells
B. B Cells
C. Monocytes
D. Neutrophils
E. Macrophages

17. Laki2 ada painful purulence urethral discharge, udh 3x ngalamin. Stain shows internal
gram negative diplococci. The reason is because of lack protection from these previous
infection ( gonorheae)
A. IgA sth
B. delay hypersensitivity
C. pilin and opa protein
D. B cell deficiency

18. A person is diagnosed with viral disease for 10 days, there’s a high ratio of IgM to IgG.
What is the cell that is involed in the synthesis of immunoglobulin?
A. T lymphocytes
B. B lymphocytes
C. Macrophages
D. Monocytes
19.

20. The role of MHC class 2 towards graft rejection

A. Receptor IL 2, so macrophages kill donor cell
B. T helper that activates cytotoxic T cells
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C. Induce production of antibody which blocks graft protein

D. IgE
E. ILF 8
21.

22. A 25-year-old woman came because of high fever continuously for 4 days, fully
conscious, headache, pain in her eyes, muscle, and bone, felt discomfort on her abdominal,
red spot on legs & hands, her gum easily bleed, doctor said she’s infected by RNA virus.
Kenavirusnyaapa?( dengue)
A. Filoviridae
B. Flaviviridae
C. Coronaviridae
D. Picornaviridae
E. Orthornyxoviridae

23. A man with flu-like syndrome, enlarged liver and spleen, white patches on tonsil and
palate. This disease is associated with nasopharyngeal carcinoma. Which is the possible
effect to the infected cell?(EBV infection)
A. Latency of B lymphocytes
B. Replication in cytoplasm
C. Persistent infection
D. Cytophatic
E. Transformation
24.

25. Anakberenang, kena conjunctivitis. Mekanismenyaapa?

Conjunctivitis via gastrointestinal ?

26. Ada anaksakit, sakitnya asymptomatic, bisasampe nasopharynx cancer, intinyadiakena

EBV. Truscomplikasinyabisaapa? Jawabannya
A. Hepatomegaly
B. T lymphoma
E. Caposi sarcoma
(bcd akulupamaaf ya)

27.

28. 25 y.o man demamtinggidengandarahkeluardarihidungnya. dia juga nausea, vomitting,

sever arthalgia. dokter noted red spots ditangandia. hasil lab : platelets decreased, ns-1
negative, ... . pathogen nyaapa ?
a. single stranded enveloped RNA virus
b. double stranded DNA virus
c. unenveloped RNA virus
d. unenveloped DNA virus
e. retrovirus
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29. A traveller shortly experiencing high fever, difficulty in swallowing liquid,

disorientation, and hydrophobia. He was bitten by an unusual aggressive dog. He was dead
soon afterwards. By brain biopsy, investigator found a lyssavirus. What prophylactic is
effective :
A. Conjugated pathogen
B. Killed pathogen vaccine
C. Recombinant vaccine
D. Attenuated vaccine
E. Acellular vaccineSa

30. A boy was taken to pediatrician after experiencing high fever, malaise and anorexia
followed by painful bilateral swelling on cheeks (Mumps), he has no received all his
vaccinations. Which of the following prevention would be related to this disease?

Live attenuated virus

31. Boy with low grade fever and runny nose for 3 days. Has rash starting from the face
lowering to the trunk. The disease is self timing. Which of the following pathogens is
responsible for this disease?
Poxviridae
Flavviridae
Togaviridae (Rubivirus)
Adenoviridae
Hepadnaviridae

32.
33.

34. Boy terkenainfeksi virus. Gimanadeteksinya?

antigen assay

35. A man who suffered a viral infection was a given a prophylaxis antibiotic by his doctor.
He refused it. What is your comment? Agree, because viral infection is self-limiting disease.

36. female has herpes and prescribed a drug earlier. What drug to give?
A. Acyclovir
B. Foscarnet
C. Trifluridine
D. Amantadine
E. Ritonavir

37.

38. A 32-year-old women had 3 days history of fever, headache, retro-orbital pain, myalgia,
and a petechial-rash. She also had nose bleeding, leucopenia and thrombocytopenia.
Serology investigation was positive for IgM anti-dengue and if tested using Antigen
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Japanese Encephalitis is positive also. Which is of the following is responsible for this
condition ?
a. TH cells
b. Adjuvant
c. Nonspecific Ab
d. Similar epitope on Ag
e. Genetic similar between species

39. Anti HIV +. Reaksiimunygpertamasaat ada HIV

Basophil
Monocyte
Eosinophil
Neutrophil
Leukocyte

40. Wanita 40 tahundatangdengankelihanmual, tidaknafsumakan.

Setelahdilakukancekyaitu ascaris lumbricoides. Adaptive immune system
untukhelminthes?
Cytotoxic t cell
.
CD4+/TH17
CD4+/TH1
CD4+/TH2

41. Ada ibu2 33 tahundemam 4 hari. Jointnyasakit, ada merah2dipalmnya. CBC

nyanunjukin thrombocytopenia samaleukocytopenia, hematocrit normal. NS-1 anti dengue
negative. Penyakitnyadarigigitannyamuk. Kira-kiratesapabuat check penyakitnya. Antigen
detection

42. Pemeriksaanparasit 4 flagel anterior, 1 flagel posterior (T. Vaginalis) apa?

A. Culture swab
B. Wet mount

43. Infeksidari MO dibawah ini sebagaikarakteristik immunodeficiency

E.coli
.
bordetella pertussis
pneumocystis carinii (pneumonia that is caused by protozoa, which
frequently occurs in HIV pts)
mycobacterium tuberculosis

44. Orang ada swelling di eyelid sejak1thndariafrika. Calabar

swelling.(Loiasis)Transmisilwtserangga?
A. Glossina
B. Simulium
C. Chrysops
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45.

46. Lakilakiumur 35 tahundatangkeklinikdengankeluhan urethral discharge, uretritis,

prostatitis. setelahdilakukanpemeriksaanterdapat parasite dengan 4 flageldibagien
anterior dan 1 flageldibagian posterior utk attach to membrane. sakitnyaapaa?
a. ptriasis
b. candidasis
c. toxoplasmosis
d. tricomoniasis
e. lupa

47. Cowogakcacingan , eosinophil tinggi. Mediatornyaapa?

Prostaglandin / bradykinin

48.

49. Rizkykena hemorrhagic dengue fever, vector controlnyaapabiar dengue tidak spread
a. defecate on toilet
b. use sandals
c. drink lot of water
d. abitasi
e. hand hygene

50. Lela tinggaldi rural area terusterinfeksicacingdenganciriciritelur barrel shaped, with

polar shape on both side, penyakitapa yang bisamenjadikomplikasidariinfeksidiatas :
A. Dysentry
B. Malnutrition
C. Appendicitis
D. Prolapse recti(usually found in Trichuriasis)
E. Lupa

*an 18 yo girlhad suden hi fever for 5 days she also complains of headache, pain in her eyes
muscle, bone, and stomach; and twice of nose bleed, she was weak but fully consious. The
doctor noted some red spot on her hands. lab showed
trombocytopenia&haemoconcentration. the etiologic agent was spread by *satu kata g
kebaca* which is lab tes identification should u expect ?
a. increase titer of ASO
b. Broad base budding
c. Fourfold rise in antibody
d. positive monospot test
e. selective def. Ig A

51. Trichuristrichiuraobatnyaapa ?
Pyrantelpamoat single dose only
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Albendazole 100 mg
Mebendazole 300mg (DOC)
Metronidazole 500 mg
DEC

52. After backpacking in the mountains, a 24-year old man develops diarrhea. He
acknowledges drinking stream water without purification, and you suspect that he is
showing symptoms of giardiasis. Because you know that laboratory detection of cyst or
trophozoites in the feces can be difficult, you decide to treat the patient empirically with :
Chloroquine
Metronidazole
Cotrimoxazole
Emetine
Pentamidine

53 A young boy was diagnosed with multiple infection in unusual place through out his
whole body. Blood biochemistry shows severe deficiency in B-cell function. What lab test
should be done to find out B-cell defunction?
Flow cytometry
Immunologic skin test
Complete blood count
Protein electrophoresis
Polymerase chain reaction

54. Dendritic cell ngeluarinapa? (Anti viral state)

IL-2
IL-4 / IL-8
INF gamma
TNF
IFN alpha beta

55.
56.

57. Plasma cell is a specific type of immune cell which plays a major role in antibody
mediated immunity. What does plasma cell secrete? One type of antibody, two types of
antibody, more than 1 type of antibodies, it's own antigen?

58.
59.

60. Man with meningitis, given vancomycin and fluconazole. have HIV for 4 years. CSF was
taken for india ink. Most likely Virulance factor for this pathogenetic illness?Lps capsule

61. Ada orang dikepalanya ada scaly patches gitu. Terussi orang tsbpunyapeliharaan.
Penyebabpenyakitorangnyaapa? Jawaban : Microsporum Canis
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62. A patient had red spots on his hands which radiated to his trunk. It grew larger and
eventually popped, but it didn’t hurt. What tests should be done? ???

63.
64.
65.
66. A 26-year old woman with AIDS develops cryptococcal meningitis. She refuses IV
medication. which of the following antifungal agents is the best choice for oral therapy of
the meningitis?
Amphotericin B
Ketokonazole
Nystatin
Fluconazole
Metronidazole

67. Pasien sepsis krnfungimia (systemic), true hyphae :

Amphotericin b
Ketoconazole
Caspofungi
Griseofulvin
Nystatin

68. 3 month old baby ada repeated bacterial infection. cumabisasembugdikasih antibiotic.
infection produce multiple disseminated granuloma. has high level of serum antibody
specific for various bacteria. CBC normal. defect nyadmn?
B cell
T cell
Neutrophil
Complement
Eosinophil

69. 12-year-old boy examination for determination his blood group. Examination shows
agglutinogen A and agglutinin B. Which is the following blood group of this boy ?
A
B
O
AB

70. Complement is required for?

Phagocytosis
NK mediated cytotoxicity
Erythrocyte lysis by lechitinase
Lupa
Lupa
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71. A man with 2-day history of fever, productive cough, pleuritic left-sided chest pain and
dyspnea. The doctor diagnosed him with pneumonia caused by gram + diplococcic with
many PMNs. Which following defense system is activated by that pathogenic agent?
Alternative complement.

72. The antigen presenting in MHC class II : Dendritic Cells

73. A man, 25 years old digigitanjing. kemungkinananjingnya rabies

makanyadokternyakasih anti-virus antibody. immune apaygke establish ?
Innate immune
Active humoral immune
Passive humoral immune
Active cell mediated immune
Passive cell mediated immune

74. Major changes in the antigenic of influenza structures ?Antigenic shift

75. Our findings show a septated hyphae. What drug should be given to the pts?
A Penicillin
B Voriconazole (Obat Jamur)
C Acyclovir
D Albendazole
E Metronidazole

76. The most important cell involved in destruction or virus infected cell?
B cell
NK cell
Helper T cell
Cytotoxic T cell
Macrophages

77. Pasiendtngdengankeluhansakitdibagian epigastric dan merasa acidic dimulut.

Dokterbilang hyper secretion asamlambung dan ada infeksidilambung.
Responimunnyaapa?
Humoral immune respon
Cellular immune respon
Innate immune respon
Adaptive immune respon
Protective immune respon

78. A 25 year old mother lg trimester pertamatruskena rabies, untuk prevent anaknyakena
rabies hrs dilakukanapa?Immunisation

79.
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80. Kalau tuberculin test positifberartiterjadiapa? (Delayed type

hypersensitivity)pilihan:cell-mediated immunity jalan, humoral-mediated immunity
jalan, …

81. Infeksisifilis secondary, dikasih ... penicillin, trskena fever dan chill, kenapagitu?
Ada penyakit lain
Salahobat
Dinding bakteri yang rusak melepaskan endotoxin
Reduce complementary pathway
Penicillin bikin bakterikluarin pyrogen exotoxin

82. If someone’s B and T cells can’t be detected, what structural damage might cause it?
Impairment of bone marrow (HSC)

83.

84. A patient comes to your clinic with fever for a week and looks dehydrated. You treat the
patient with fluids and IV antibiotic, but he continues to have fever. The result of the
bacterial culture reveals that the patient has severe infection caused by methicillin-
resistant staphylococcus aureus (MRSA). The antibiotic of choice to treat the patient is
Acyclovir
Vancomycin
Ketoconazole
Immunoglobulin
Pirantelpamoat

85.

86. Woman is admitted to the hospital with acute chest pains, on the second day it is
confirmed that she has myocardial infarction. Also on the secind day she sudders from
severe diarrhea. Bacterial culture of cut confirms salmonella. This type of infection is:
Hospital aquired

87.

88. Autoclave : 121°C, 15-20 mnit

89.
90.

91. After red blood cell transfusion, a patient have severe fever and chills. Which of the
following explains why
Direct targeted cell killing
Lupa
Cytokine mediated inflammation (immediate reaction)
Eosinophil mediated killing
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Lupa

92. In DiGeorge syndrom, the thymus fails to develop.

Karakteristikimunodefisiensiakibatsindrom ini?
Deficiency of B cell maturation
Deficiency of monocytes and tissue macrophages
Normal numbers of naive t cell that cannot be activated by antigens
(thymus is maturation site of naive T cells)
Deficiency of t lymphocytes and associated with defect cell mediated immunity
Deficiency of naive b cell and ... ( lupa. Pokoknyadiangaruhsamapembentukan
antibody)

93. Treatment and prevention for corynebacterium diptheriae ?

Antitoxin
Antitoxin and immunoglobulin
Antimicrobial for phrophylaxis
Antitoxin, antimicrobial, toxoid

94. A woman has assymetricalfacid paralytic (polio) on her right leg and looks thin, shorter
and wasted. She never had oral immunization before. What is the mechanism that cause
this problem :
The organism destroy the lower motor neuron
Mutation in gene coding of tyrosine kinase
Defect of IL-12
She got this illness via transplacental
Reccurent of pyogenic bacteria infection

95. Mycoplasma penumoniakasihobatapa? Macrolide (for atypical bacteria)

96.

97. A newborn with rhesus negative was delivered with jaundice and intra-uterine fetal
development retardation. it was diagnosed with rhesus incompatibility. immunoglobulin yg
mana ygkonsentrasinyatertinggidinewborn blood?
IgA
IgM
IgD
IgE
IgG

98. Autoimmune caused by ?

Immune response to a self antigen
Defect Antibody mediated immune response
Defect cell-mediated immune respons
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99. Anakbaru lahirdikasihvaksin DPT, tetapivaksinnyatidakbekerjasecaraefektif, apa yang

menyebabkanhaltersebutterjadi? Maternal Antibody

100. Gram + streptococcus , ada alergi beta lactame. Obatnyaapa? Macrolide

Author’s note:
a. A girl developed bacterial meningitis from Haemophilus influenza infection. She was
treated with cefatoxime. Why? This bacteria forms beta lactamase

b. In a hospital, many newborn is infected with staphylococcus. From a biological

survey, it was found that 2 of the nurses have many populations of Staphylococcus
in their nasopharynx. How can we prove their direct involvement in it?
Nasopharyngeal swab

c. Gram + diplococcus during staining. How to control this infection? Antibiotics.

d. HLA A,B,C HLA DQ,DR,DS. In resting T Cell, what MHC class 1 is expressed? All two
alleles of HLA A, B, C
e. A lab result shows uniform, septated hyphae with no yeast cells. What
microorganism is the causative agent? Aspergillusflavum

f. Infection with a thymus independent antigen. After 6 months, what will you find?
High titer of IgM

g. A tea farmer who works with bare feet was infected with worm infection.
Ancylostomiasis

h. A boy was suffering itch on his anus at night (Strongyloides infection). What causes
it? Migration of adult female worm while laying eggs.

i. Husband and wife with different rhesus. What complication does the second child
have? Major Histocompatibility Complex 2

j. A boyis having pseudo membrane coating of pharynx and tonsil. He has not been
vaccinated with DTP. Stain Albert/Neisser/Telorite. What is the virulence factor?
Exotoxins.

k. A man in Semarang had filariasis. What is the vector? Culex quinquefasciatus

l. A mosquito with lyre: Aedes

m. Vaccines in Hongkong are not the same with ones in Russia. What is it called?
Specificity.

n. A woman feels itch and redness in her vagina. Microscopic finding: a yeast-like etc.
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What will you find? Yeast-like

o. A child who suffers muscle rigidity etc. Virulence factor? Toxin (Tetanus)

p. A culture with MacConkey agar. A microorganism with fruity smell and causes
pneumonia. Answer: Klebsiellapneumoniae

q. An infection of gram positive cocci in chain. What lab investigation can you do to
know the etiologic agent? Anti streptolysin O (ASO)

r. HLA-DM is used to remove clip from : MHC Class II