Soal Infeksi Immunology 2019 [PDF]

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Soal infeksi immunologi 2019



1. The followings are the right thing about the tear film : a. Ph of about 7,2 b. An osmolarity of 302 mOsm/L c. Refractive index of 1.336 d. Ph of about 6,2 (Answer : A, AAO, section 8 2009-2010,page 57) 2. A women 18 yo came to policlinic with chief complain littlea lump in superior eyelid. Doctor diagnosed chalazion. The right thing about chalazion are : a. Required horizontal excison b. Can not be develop spontaneously as aresult of obst. c. Can be develoved spontaneously as a result of obstruction of the glands d. Should be treated with antibiotic e. May be caused astigmatism (Answer E, AAO 2009-2010, section 8, page 87) 3. A 51 yo woman consulted from dermatology departement with acute inflammatory vesicobullous of the skin and mucous membrane after taking salicylates. The following statement is true: a. The mild form of this condition is reffered to toxic epidermal necrolysis b. The term erythema multiform minor is used c. The incidence of this condition has been about 1 case per million per year d. A chronic inflammatory vesicobullous reaction of the skin and mucous membrane e. Later ocular complication are caused by cicatrization resulting in tear deficiency (Answer E, AAO 209-2010, section 8, page 384) 4. A 35 yo man came to ophthalmologist with complain of itching, blepharospasm, photophobia, blurred vision copious mucoid discharge. He has history of allergy to flowers and plants. What is true about this patient’s condition ? a. Hypersensitivity response is type III. b. The use of mast-cell therapy may be effective c. Hypersensitivity response is type II. d. Hypersensitivity response is type V e. Hypersensitivity response is type I (Answer E, AAO 2009-2010, section 8, page 406)



5. A patient came to policlinic with doctor’s diagnosed with Mooren ulcer. The following have been found in patients with Mooren ulcer is: a. Decreased level of IgA. b. Decreased concentration of plasma cell. c. Decreased concentration of lymphocytes in the conjunctiva adjancent to the ulcerated area d. Increased level of IgE. e. Deficiency of supressor T cells (Answer E, AAO 2009-2010, section 8, page 216) 6. The statemen below is related to Reiter syndrome : 1. HLA-B27 is found 1n 85%- 95% of patients 2. Prostatic culture is negative 3. The condition occurs most frequently in young adult males 4. Keratitis is the most common ocular disorder (Answer : A, AAO section 9, page: 151)



7. A 6 years old girl came to hospital with her mother with chief complain photophobia and blurring. From examination, it found KP, flare and cells in COA, posterior sinechiae. Since 6 months before she had gotten inflamination in both of her knees. She was diagnosed with Juvenile Idiopathic Arthritis. The true statements that are related to this patient : a. Ocular involvement is subdivided into pauciarticular onset type b. Ocular involvement is subdivided into systemic onset type c. Rheumatoid factor test could be negative d. Ocular involvement is subdivided into polyarticular onset type (Answer : B, AAO section 9, page 160-161) 8. A 37 years old man came to hospital with chief complain redness and photophobia since 3 month ago. From examination, we found VA 6/9 PH 6/6 in both eyes, KPs and flares in COA in both eyes. He was diagnosed with Anterior Uveitis in Right and Left Eyes. Treatment for this patient are : a. Corticosteroids b. Immunomodulatory medication c. Cyclopegic d. Antibiotic e. All above



(Answer : B, from AAO section 9, pages 147-149) 9.



Which of the statement below are related to Ankylosing Spondylitis 1. HLA-B27 is found in up to 90% of patients 2. Symptom of this disorder include lower back pain and stiffness after inactivity 3. Family members may also have Ankylosing Spondylitis or iritis 4. HLA-B27 is found less than 50% of patients (Answer : A, AAO section 9, pages 150)



10. A woman 42 years old from out of town came to the hospital with main complaints photophobia, hiperlacrimal,and swelling in left eye.. Slitlamp exam: a diffuse punctate epitheliopathy and partial ring infiltrate in the paracentral cornea. What is the diagnosis of this patient?



a. Herpetic Keratitis b. Acanthamoeba Keratitis c. Bacterial Keratitis d. Keratitis Exsposure e. Fungal Keratitis (Answer : B, AAO 2010-2011, section 8 page 187) 11. Therapy in these patients is : a. Corticosteroid Topikal b. Natamycin 5 % c. Antibiotik Topikal d. Antimicroba Agent e. Surgery (Answer : D, AAO 2010-2011, section 8 page 188) 12. Toxic Abuse may occur after long-term use of a drug. It can result in a dose dependent cytotoxic effect on the ocular surface. Which of these drugs below that often causes toxic? a. Aminoglycoside Antibiotic b. Levofloxacin Antibiotic c. Artificial Tears d. A and B correct e. Correct all (Answer : A, AAO 2010-2011, section 8 page 394)



13. A man 25 years old, usually wears glasses came to hospital for LASIK surgery. After serving his pachymetry, corneal thickness is only 400 microns. Where the examination is not support for these patients? a. OCT b. Pachymetry USG c. Perimetry d. OLCR e. Specular Microscope (dr. Anang Tribowo, SpM(K)) (Answer C, AAO 2010-2011, section 8 page 33) 14. In the visual process, All-trans-retinaldehyde is released and converted to all-trans-retinol by: a. Lecithin retinol acyltransferase b. Retinol dehydrogenase c. Isomerohydrolase d. Superoxide dismutase e. Na+ , K+,-ATPase (Answer: B,AAO 2009-2010,section 2,page 306) 15. The RPE metabolism requires very high energy, therefore within the cells occurs major biochemical pathway: 1)



Gluconeogenesis



2) Glycolysis 3) glycogenesis 4) Krebs cycle (Answer: C, AAO 2009-2010,section 2,page 306) 16. Which are of the following composition of the RPE is the major amount: a. Lipids b. Proteins c. Water d. Nucleic acids e. None above (Answer: C, AAO 2009-2010,section 2,page 306) 17. Patient a Woman 42 years old came with the chief of complain ocular pain usually worsen at night. Patient also complain eye redness and tender to the touch. From examination found the scleral edema



has violaceous hue and the dilated vessels cannot be moved with a cotton-tipped applicator. What is diagnosis of this patient? a. episkleritis b. skleritis c. conjunctivitis d. corneal ulcer e. endopthalmitis (Answer: A, AAO 2009-2010,section 2,page 48) 18. Patient diagnosed with corneal ulcer. From anamnesis found a history of trauma hitted by rice straw. Result of the corneal sensibility test is increase. What nerve is involved to this test? a. N.V1 b. N.V2 c. N.VII d. N.V3 e. N III (Answer: A, AAO 2009-2010,section 2,page 103-105) 19. Seorang penderita wanita 40 tahun datang ke poliklinik mata dengan keluhan kelopak mata bawah kiri terdapat benjolan sejak 4 bulan yang lalu, membesar dengan cepat.Tidak terdapat kemerahan ,benjolan tampak halus, mengkilat , diameter benjolan ± 5mm. Diagnosa banding pada penderita tersebut : a. Hordeolum, keratoacanthoma b. Khalazion, basal sel carcinoma tipe noduler* c. Keratoacanthoma,basal sel carcinoma tipescleroting d. Hordeolum,basal sel carsinoma tipe noduler 20. Pada pasien tersebut diatas sesuai dengan diagnosa saudara, tindakan yang dilakukan untuk menegakan diagnosa pasti adalah: a. Incisi + pemeriksaan mikrobiologi b. Excisi + sitologi c. Excisi + TB Dot d. Excisi + Histopatologi* e. Excisi metode mik 21. Bagian kornea yang paling tebal ialah a. Epitel kornea b. Lapisan bowman c. Stroma d. Membrane Descemet



e. Endotel kornea 22. hipopion adalah a. darah dalam bilik mata depan b. rendahnya tekanan intraokuler c. pus dalam bilik mata depan d. kondisi mata yang juling ke bawah e. kurangnya jumlah elektrolit dalam mata 23. konjungtivitis paling sering disebabkan oleh a. jamur b. virus c. bakteri d. protozoa e. trauma kimia



24. konjungtivitis alergi termasuk kedalam: a. Reaksi hipersensitivitas tipe 1 b. Reaksi hipersensitivitas tipe 2 c. Reaksi hipersensitivitas tipe 3 d. Reaksi hipersensitivitas tipe 4 e. Bukan Reaksi hipersensitivitas Seorang wanita 35 thn datang dengan keluhan mata kanan silau dan berair sejak 2 hari lalu. VOD 6/20, VOS 6/6. Pada pemeriksaan oftalmologi terdapat vesikel multiple pada palpebra inferior, injeksi konjungtiva dan silier, terdapat lesi dendritik pada epitel kornea; COA tenang, iris/lensa tak ada kelainan. 25. Manakah dari penyataan di bawah ini yang sesuai dengan penyakit yang diderita pasien? a. Sensibilitas kornea akan menurun pada mata yang terinfeksi b. Pemberian antibiotik sistemik dan topical akan perlu diberikan penyembuhan penyakit ini. c. Penyakit ini paling sering disertai dengan sekret purulenta. d. Biasanya di sebabkan karena irisan daun e. Disebabkan oleh Staphylococcus Aureus 26. Diferensial diagnosis yang paling tidak mungkin dari kasus di atas adalah: a. Herpes zoster Ophthalmica b. Acanthamoeba keratitis c. Neurotrophic keratopathy d. Keratitis akibat penggunaan soft contact lens e. Keratokonjungtivitis GO 27. Penyakit ini paling sering terjadi: a. Bilateral b. Unilateral c. Posterior



d. Anterior e. Interstitial 28. Penanganan pada pasien ini diberikan a. Antibiotic golongan sefalosporin local b. Antibiotic golongan makrolid local c. Anti jamur topical d. Anti jamur topical dan sistemik e. Antiviral topical dan sistemik 29. Kortikosteroid tetes dapat diberikan pada kasus: a. Ulkus kornea bakteri yang masih aktif b. Keratitis virus superficial c. Keratitis virus interstitial d. Ulkus kornea perforasi e. Keratokonjungtivitis Gonorrhea yang masih aktif 30. ulkus kornea adalah a. hilangnya sebagian epitel kornea b. hilangnya seluruh epitel kornea c. hilangnya lapisan epitel dan sebagian lapisan stroma d. hilangnya endotel hingga membrane descement e. semua diatas