UNTUK SOAL 1-20 :

JAWABAN A, B, C, D BENAR UNTUK SETIAP PERTANYAAN.

ISILAH OPSI E DENGAN JAWABAN YANG TEPAT.

1. Biomarker/enzim jantung yang digunakan untuk mengetahui adanya nekrosis miokard

adalah :
A. LDH
B. SGOT
C. CK/CK-MB
D. Troponin T/I
E. ……………………………

2. Ciri khas dari suatu Angina pektoris tak stabil adalah :

A. Atypical angina
B. Angina crescendo
C. Angina waktu istrahat
D. Angina yang timbul waktu malam
E. …………………………………………………..

3. Pada penderita Stenosis Mitral dapat ditemukan kelainan fisis berikut ini :
A. Opening snap
B. Denyut nadi tak teratur
C. Bising presistolik dan protodiastolik
D. Bunyi jantung pertama (S1) mengeras
E. …………………………………………………………

4. Pada Sindroma Koroner Akut rangkaian proses patologis yang terjadi, mulai dari
timbulnya cedera endotel, terbentuknya garis lemak sampai terjadinya manifestasi klinis
adalah :
A. Pembentukan sel busa
B. Proliferasi sel otot polos
C. Pembentukan plak ateroma
D. Ruptur plak ateroma
E. …………………………………………

5. Indikasi kontra mutlak pemberian terapi trombolitik pada Iskemia Tungkai Akut adalah :
A. CVD/TIA 2 bulan terakhir
B. Diatesis hemorhagik aktif
C. Perdarahan saluran cerna 10 hari terakhir
D. Operasi neurologis 3 bulan terakhir
E. …………………………………………….
6. Yang termasuk tanda/gejala gagal jantung kanan adalah :
A. Desakan vena jugularis meningkat
B. Edema tungkai/perifer
C. Hepatomegali
D. Sianosis
E. …………………………

1
 7. Selain kardiak glikoside, obat-obat yang berguna untuk menanggulangi gejala gagal
jantung bendungan adalah :
A. Penyekat Enzim konversi angiotensin
B. Antagonis reseptor angiotensin
C. Diuretik hemat kalium
D. Furosemide
E. ………………………………………

8. Prinsip pengobatan penderita dengan gagal jantung bendungan adalah :

A. Mengatur pola hidup
B. Menurunkan pasca beban
C. Menurunkan prabeban
D. Menurunkan laju jantung
E. …………………………………………….

9. Tanda fisis tamponade jantung yang penting adalah :

A. Bunyi jantung redup
B. Pulsus paradoksus
C. Takikardia
D. Takipneu
E. …………………………………………………..

10. Gejala-gejala Syok Kardiogenik adalah :

A. Akral dingin
B. Depresi mental
C. Curah jantung menurun
D. Tekanan darah < 90 mmHg
E. …………………………………………

PILIH SATU JAWABAN YANG PALING TEPAT.

11. Seorang laki-laki,70 tahun dibawa ke IRD dengan keluhan sesak napas terutama waktu
berbaring disertai batuk ringan. Penderita pernah dirawat di ruang rawat intensif jantung
selama 10 hari. Selain pemeriksaan rutin dan EKG juga dilakukan pemeriksaan
ekokardiografi dan hasilnya : fraksi ejeksi 35%, akinesia septum dan apeks ventrikel kiri.
Pertanyaan : Apa persangkaan diagnosis anda sebelum melihat hasil rekaman EKG?
A. Edema paru akut
B. Kardiomiopati dilatasi
C. Reinfark miokard akut
D. Aneurisma ventrikel kiri
E. Gagal jantung akibat infark lama.

12. Seorang laki-laki, 65 tahun yang diketahui menderita hipertensi dan DM dibawa ke UGD
dengan keluhan sesak napas, lelah dan berdebar-debar. Ada riwayat orthopneu, tidak ada
nyeri dada. Pemeriksaan fisis : laju jantung 150/menit, ada krepitasi kedua basal paru.
Gambaran EKG : irama irregular dengan gelombang P yang tidak jelas.
Pertanyaan : Apa yang menyebabkan penderita ini mengeluh sesak napas?

2
 A. Emboli paru
B. Fibrilasi atrium
C. Bendungan paru.
D. Hipertensi pulmonal
E. Disfungsi ventrikel kanan

13. Seorang laki-laki, 45 tahun berkunjung ke poliklinik dengan keluhan sesak napas dan
nyeri dada waktu beraktifitas. Pemeriksaan fisis : TD : 110/85 mmHg, laju jantung
90/menit. Hasil ekokardiografi : area orificium katup aorta <0,70 cm2.
Pertanyaan : Tindak lanjut apa yang paling tepat dilakukan pada penderita ini ?
A. Angiografi koroner.
B. Konsul ahli bedah jantung
C. Evaluasi ekokardiografi 6 bulan kemudian
D. Uji latih jantung untuk menyingkirkan adanya PJK
E. Pemberian obat kardiak glikosida. diuretik dan vasodilator

14. Seorang perempuan, 50 tahun masuk ke ruang IRD dengan keluhan sesak napas sejak
seminggu yang lalu. Sesaknya makin lama makin memberat. Ada riwayat terapi radiasi
pasca mastektomi sejak setahun terakhir. Pemeriksaan fisis : TD 90/50 mmHg, DJ
120/menit, P 24/menit, suhu badan 37,52 C. Gambaran EKG menunjukkan low voltage dan
ada pulsus alternans. Thoraks foto kesan kardiomegali. Dianjurkan pemeriksaan
ekokardiografi.
Pertanyaan : Maksud pemeriksaan ekokardiografi untuk mendeteksi adanya?
A. Vegetasi
B. Efusi perikard.
C. Kardiomiopati
D. Radang perikard
E. Myxoma atrium kiri

15. Seorang anak laki-laki, 10 tahun masuk rumah sakit karena biru pada bibir dan ujung jari
tangan. Keluhan ini sudah ada sejak balita. Gejalanya memburuk bila sang anak menangis
atau bermain. Pada pemeriksaan fisis : perawakan tubuh kurang berkembang, aktivitas
ventrikel kanan meningkat, terdengar bising ejeksi sistolik 3/6 di sela iga-IV kiri.
Pertanyaan : Diagnosis yang paling mungkin adalah ?
A. Tetralogy of Fallot
B. Aortic valve stenosis
C. Pulmonic valve stenosis
D. Eisenmenger’s syndrome
E. Transposition of Great Artery

16. Seorang penderita laki-laki, 60 tahun masuk rumah sakit dengan keluhan cepat lelah bila
bergiat. Ada riwayat serangan jantung sebulan yang lalu. Pemeriksaan fisis : TD 145/80
mmHg, DJ 115/menit, P 32/menit. DVJ R+4 posisi baring 30o. Gambaran EKG menunjukkan
adanya elevasi segmen ST 2 mm dan gelombang Q patologis di sandapan V1-V5. Diagnosis
sementara adalah gagal jantung bendungan.
Pertanyaan : Apa yang menjadi penyebab gagal jantung tersebut diatas?
A. Aneurisma aorta
B. Infark lama yang luas

3
 C. Aneurisma ventrikel kiri.
D. Ada infark ventrikel kanan
E. Ada robekan muskulus papillaris

17. Seorang laki-laki, 65 tahun dirujuk dari daerah, masuk UGD dengan diagnosis infark
miokard akut. Telah diberi oksigen dan aspilet. Sepuluh menit setelah dirawat di UGD TD
menjadi 80/40 mmHg, DJ 45/menit. Lima belas menit kemudian penderita merasa pusing
dan akhirnya kejang-kejang dan tidak sadar.
Pertanyaan : Gambaran EKG yang paling mungkin pada kondisi terakhir adalah ?
A. Takikardia supraventrikel
B. Fibrilasi ventrikel.
C. Takikardia nodal
D. Fibrilasi atrium
E. Blok AV total

18. Seorang wanita, 20 tahun datang ke poliklnik jantung dengan keluhan berdebar-debar dan
rasa mau jatuh sejak beberapa hari terakhir. Gejala ini tidak pernah terjadi sebelumnya.
Juga tidak pernah sakit dan minum obat-obat tertentu. Pemeriksaan fisis : TD 110/80
mmHg, DJ 160/menit P 24/menit. Diagnosis kerja aritmia jantung.
Pertanyaan : Jenis aritmia jantung yang diderita oleh wanita ini adalah?
A. Fibrilasi atrium
B. Blok AV derajat tiga
C. Takikardia ventrikel
D. Takikardia supraventrikuler.
E. Ekstra systole ventrikel maligna

19. Anda diminta untuk mengawasi pelaksanaan uji latih jantung terhadap penderita laki-laki,
65 tahun dengan keluhan nyeri dada waktu bergiat disertai rasa sesak napas. Tidak ada
riwayat nyeri dada dan sesak napas waktu istrahat. Pemeriksaan fisis : TD 120/85 mmHg,
DJ 80/menit regular, DVJ 5 cm H2O, tidak ada ronki di paru. S1 normal tapi S2 tunggal.
Terdengar bising sistolik kresendo-dekresendo di sela iga-2 kiri yang menjalar ke leher.
Anda akhirnya membatalkan pelaksanaan uji latih jantung tersebut.
Pertanyaan : Berdasarkan pemeriksaan fisis, apa diagnosis yang mungkin?
A. Defek septum atrial
B. Kardiomiopati hipertrofik
C. Stenosis katup aorta berat.
D. Stenosis katup pulmonal sedang
E. Stenosis katup mitral yang sedang

20. Seorang penderita laki-laki 60 tahun didiagnosis sebagai gagal jantung bendungan berat.
Pada pemeriksaan fisis ditemukan adanya ronki basah kasar dikedua lapangan paru dan
terdengar bunyi jantung S3 gallop. Hasil pemeriksaan foto toraks terlihat adanya
gambaran edema paru bilateral.
Pertanyaan : Obat apa yang paling berpotensi mengurangi rasa sesak dan ronki paru?
A. ISDN oral 3 x 10 mg
B. Captopril oral 3 x 25 mg
C. Propranolol injeksi 10 mg
D. Spironolakton tablet 3 x 25 mg

4
 E. Injeksi furosemide intravena 40-80 mg.

21. Seorang perempuan 55 tahun yang mengeluh sakit uluhati dan sesak napas datang ke
UGD untuk memeriksakan dirinya. Pemeriksaan fisis : DVJ R+6, hepatomegali 3 jari
bawah arkus kosta kanan dan edema tungkai sejak 2 hari terakhir. EKG : Elevasi segmen
ST 2 mm di sandapan II,III,aVF. Foto toraks: tak ada tanda bendungan paru.
Pertanyaan : Kelainan apa yang mendasari temuan klinis pada penderita ini?
A. Efusi perikard
B. Hipertensi pulmonal
C. Infark ventrikel kanan
D. Aneurisma ventrikel kiri
E. Trombosis atrium kanan

22. Seorang penderita laki-laki 60 tahun diantar ke UGD dalam keadaan pingsan yang
dialamainya untuk pertama kali. Pada pemeriksaan fisis: TD 110/95 mmHg. DJ 100/menit
Terdengar bisisng ejeksi sitolik yang kasar pada ruang sela iga -2 kanan yang menjalar ke
regio karotis.
Pertanyaan : Bagaimana perangai bunyi jantung ke-2 pada penderita ini sesuai dengan
diagnosis yang ditegakkan?
A. A3 dan P2 pecah terfiksasi
B. Intensitas S2 menurun
C. S2 pecah dan melebar
D. P2 mengeras
E. Normal

23. A 59-year-old man complains of sever chest pain that radiates to his back. His brachial
pulses appear unequal. He appears hemodinamically stable. On chest radiography he has a
widened mediastinum.
Question : Which of the following is the best next step?
A. Perform serial ECGs
B. Initiate aspirin and heparin
C. Initiate thrombolytic therapy
D. Obtain CT of chest with contrast
E. Measure serial cardiac enzyme levels

24. A 45-year-old woman with new-onset aortic regurgitation is found to have aortic
dissection of the ascending aorta and aortic arch by echocardiography exam. She is
relatively asymptomatic.
Question : Which of the following is the best management?
A. Surgical correction
B. Oral warfarin therapy
C. Percuteneous aortic angioplasty
D. Serial echocardiography every 6 months
E. Oral atenolol and monitor the dissection

25. A healthy 75-year-old man undergoing an ultrasound examination for suspected

gallbladder disease is found incidentally to have 6-cm abdominal aneurysm of the aorta.
Question : Which of the following is the best management for this patient?

5
 A. Urgent MRI
B. Beta-agonist therapy
C. Surgical repair of the aneurysm
D. Serial ultrasound examination every 6 months
E. Percutaneous angioplasty of the abdominal aorta

26. A 49-year-old smoker with hypertension, diabetes, and hypercholesterolemia comes to the
office complaining of pain in his calves when he walks 300 meters.
Question : What therapy might offer him the greatest benefit in symptom reduction and
in overall mortality?
A. Aspirin
B. Cilostasol
C. Pravastatin
D. Smoking cessation
E. Limb revascularization procedure

27. A 30-year-old man with chronic hypertension is seen in the clinic having run out of his
medication, clonidine. He has no complaints and has BP of 200/105 mmHg.
Question : Which of the following is the best management?
A. Change clonidine to an ACE inhibitors
B. Admit him to the hospital and initiate IV nitroprusside
C. Restart the clonidione and recheck the BP in 24-48 hours.
D. Refer to the social worker and don’t prescribe an antihypertensive agents
E. Send the patient into intensive cardiovascular care unit and restrict visitors

28. A 61-year-old man with CAD complains of progressive orthopnea and pedal edema. He is
hospitalized with a BP of 190/105 mmHg. Cardiac enzyme levels and ECG are normal.
Intravenous furosemide has been administered.
Question : What is the best next step?
A. Observe the patient
B. Start an ACE inhibitors
C. Start intravenous diltiazem
D. Check-up the levels of electrolytes
E. Prescribe beta-blockers to decrease MVO2

29. A 62 year-old man with CAD presents with syncope. His physical exam is normal except
for bradycardia and an irregular pulse. The ECG shows Wenckebach’s type AV block.
Question : Which of the following are you most likely to see on the ECG?
A. Tachycardia
B. Fixed 2:1 AV block
C. Progressive PR shortening
D. Dropped beat after PR lengthening
E. Progressive lengthening of the PR interval

30. A 69-year-old woman complains of easy fatigue and episode of presyncope. On

examination of the JVP, there are irregular “a-waves”. The ECG has fixed PP and RR
interval but varying PR intervals.
Question : Which of the following conditions is the most likely caused by?

6
 A. A drug effect
B. A reentry phenomenon
C. Surgical removal of an atrium
D. A heart rate is under 60 beats/min
E. Independent beating of atria and ventricle

31. A 16 year-old boy is found to have hypertension on routine evaluation. On examination,

the BP in his arms is higher than in his legs by more than 10 mmHg.
Question : Which of the following is the most likely diagnosis?
A. Normal variant
B. Aortic insufficiency
C. Ventricular aneurysm
D. Coarctatio of the aorta
E. Severe juvenile diabetes

32. The echocardiogram of 22-year-old woman reveals Barlow,s syndrome

Question : Which of the following is the most common physical finding in this patient?
A. Diastolic click
B. Diastolic rumble
C. Aortic regurgitstion
D. Late systolic murmur
E. Absent first heart sound

33. A 58-year-old man whom you have followed dies suddenly, spurring you into doing some
research on sudden death.
Question : Which of the following is the most likely cause for this patient?
A. CHF
B. Acute stroke
C. Pulmonary embolism
D. Electrolyte disturbances
E. Extensive coronary atherosclerosis

34. A 75-year-old woman is evaluated for refractory hypertension. She is taking three different
antihypertensive drug, including a thiazide diuretic, an ACE-inhibitor, and a bets-blocker,
but her BP is still 180/105 mmHg. Someone finally auscultates her abdomen and detects a
bruit.
Question : What is the most appropriate diagnostic examination?
A. Abdominal ultrasonography
B. Intravenous pyelography
C. Abdominal angiography
D. Creatinine clearance
E. Renal arteriography

35. On a routine office visit, a 45 year-old man is found to have abnormal levels of lipid
profile. The level of LDLc was 230 mg/dL, triglyceride was 280 mg/dL and serum level of
HDlc was 30 mg/dL His meager attempts a diet and exercise do not alter his lipid profile
significantly, and he is started on simvastatin.

7
 Question : Besides simvastatin you can choose the more potent agent to optimize the
improvement of lipid profile of this patient. Which drug?
A. Ezitimibe
B. Gemfibrozil
C. Fenofibrate
D. Nicotinic acid
E. Bile-sequestering resin
36. A 48-year-old man who is obese and diaphoretic presents to the emergency department
complaining of a crushing substernal pressure sensation since four hours ago. An
immediate ECG is performed and reveals ST-elevation in leads V1-V4. A CXR does not
show mediastinal widening or other abnormalities.
Question : What is the most important drug should be administered to this patient?
A. Morphine sulfat
B. Acetyl salicylic acid
C. ADP-receptor antagonist
D. Tissue plasminogen activator
E. Low molecule weight heparin

37. A 65-year-old man complains of left-sided chest pain with exertion. The pain always
resolves with rest and, if needed, sublingual nitroglycerine. He describe the pain as
substernal pressure with a bit of a burning sensation. The pain remains localized and not
radiate to the arms, shoulders or jaws. An ECG stress test is performed to confirm
diagnosis.
Question : What do we expect to see in ECG by ECG-stress test?
A. ST-segment elevation in one or two contagious leads
B. ST-segment depression in two contagious leads
C. Q-wave pathologic >0.04 sec. in only one lead
D. T-wave inversion in precordial leads
E. Prolonged QT-interval

38. A 50-year-old man complains of angina that occurs at gradually diminishing levels of
physical exertion as well as two recent episodes of syncope while golfing. On physical
examination he has a narrow pulse pressure, and his carotid pulse is delayed and weak.
Auscultation reveals a systolic ejection murmur heard best in the second right interspace.
Question : What is the next most appropriate diagnostic step?
A. ECG
B. Chest X-ray
C. Exercise ECG test
D. Echocardiography
E. Cardiac catheterization

39. A 52-year-old male presents to ER with a history several days of dyspnea, occasional
fevers, and new-onset syncope. On physical exam: T 38.2oC, pulse 30/min, RR 26/min and
BP 70/40 mmHg. He is ill-appearing and diaphoretic. Lungs are clear. S1 and S2: normal,
and a II/VI sysytolic murmur heard at the apex radiating to the axilla. ECG shows third
degree AV-block.
Question : What is the most likely diagnosis?
A. Pericardial effusion

8
 B. Bacterial endocarditis
C. Acute mitral regurgitation
D. Acute anterior MCI with cardiogenic shock
E. Acute Inferior MCI with right ventricle infarction

40. A 35-year-old female admitted to the hospital for hemoptysis and 1-month history of
progressive shortness of breath. The cardiac exam shows a loud opening snpa at S1, and a
low-pitched diastolic murmur that is loudest at the apex.CXR shows Kerley-B line. A
diagnosis of MS is made. Echo : dilated left atrium and a mitral orifice size of 1.1 cm2. The
mitral leaflet has minimal calcification. There is no MR.
Question : What is the appropriate management?
A. Surgical valvulotomy
B. Mitral valve replacement
C. Balloon mitral valvuloplasty
D. Mitral valve reconstruction
E. Antibiotic prophylaxis, and diuretics

41. A 38-year old woman without a past history of medical illness presented with mild
exertional dyspnea and fatigue of one-month’s duration. The BP was 90/60 mmHg, HR
was 95/min , and the rhythm by the ECG was irregularly irregular. Physical exam: S1 was
accentuated, S2 was loud and heard over a wide area, and OS was heard.
Question : The other physical abnormality can be found in this patient is?
A. Friction rub
B. Deficite pulse
C. Alternating pulse
D. Holosystolic soufflé
E. Systolic ejection click

42. A 59-year-old man is admitted to the hospital with 2 hours of crushing substernal pain
and ST-segment elevation in ECG,leads V2-V4. He undergoes cardiac catheterization with
primary coronary intervention and stent placement for a thrombotic lesion in the LAD.
Question : Which of the following drugs should he receive after angioplasty beside aspirin,
cilostasol and statin for at least 9 months?
A. Warfarin
B. Pethidine
C. Abciximab
D. Clopidogrel
E. ACE-inhibitors

43. A A 45 year-old woman with a history of MVP presents with acute onset of shortness of
breath and fever. Physical exam: a grade IV/VI systolic murmur at the apex and bilateral
pulmonary rales. CXR : bilateral pulmonary edema , there is no cardiomegaly.
Question : What is the most appropriate treatment to prevent recurrent symptoms?
A. Mitral valve reconstruction
B. Propranolol + furosemide
C. Mitral valve replacement
D. Furosemide + digoxin
E. Furosemide + nitrate

9
44. A 13-year-old boy is seen with complaints of cyanosis and dyspnea. The cyanosis has been
present since early childhood. As a child he squatted. A grade IV systolic murmur
accompanied by thrill is present in the second and third ICS just to the left of sternum.
The second at the base is single. Clubbing is present.
Question : What is the most likely diagnosis?
A. Pulmonic stenosis
B. Tetralogy of Fallot
C. Interventricular septal defect
D. Interatrial septal defect with PH
E. Interventricular septal defect with PH

45. A 62 year-old man is transferred to your hospital because of recurrent chest pain and
dyspnea 5 days after suffering a large myocardial infarction. On the day of arrival he is free
of chest pain but is still breathing with moderate difficulty. You obtain a CXR, which
confirms increased distended pulmonary vasculature, septal lines, and enlarged heart.
Question : What is your working diagnosis?
A. Acute mitral regurgitation
B. Unstbale angina pectoris
C. Acute pulmonary emboli
D. Myocardial infarctiom
E. Acute alveolar edema

46. A 75-year-old woman with hypertension develops fatigue and dyspnea on exertion. Her
blood pressure is 160/60 mm Hg and pulse 80/min. The second heart sound is diminished
and there is an early diastolic murmur that radiates from the right sternal border to the
apex.
Question: Which of the following characteristic arterial pulse findings in this patient ?
A. Pulsus tardus
B. Dicrotis pulse
C. Pulsus alternans
D. Pulsus paradoxus
E. Hyperkinetic pulse

47. A 64 year-old man with two previous myocardial infarctions develops short of breath at
rest and has difficulty lying down. His blood pressure is 95/70 mm Hg, pulse 100/min, and
JVP is 8 cm at supine position. The cardiac apex is dilated and displaced laterally, heart
sounds are normal, but there is a soft S3. Your clinical diagnosis is ischemic
cardiomyopathy.
Question: Which of the following characteristic pulse findings in this patient ?
A. Dicrotic pulse
B. Bisferiens pulse
C. Pulsus bigeminus
D. Hyperkinetic pulse
E. Delayed femoral pulse

48. A 42-year-old woman, who is an executive at a large company, is seen for her annual
evaluation. She is concerned about her risk for future cardiac events since a colleague was

10
 just diagnosed with angina. She has no other medical illness and is lifetime nonsmoker.
Her fasting lipid profile is T-chol 240 mg/dL, HDL 55 mg/dL, LDL 160 mg/dL, and TG 140
mg/dL.
Question: Which of the following is the most appropriate treatment for her dyslipidemia ?
A. Nicotinic acid
B. Lifestyle modification
C. Fibric acid derivatives
D. Bile acid-binding resins
E. HMG CoA reductase inhibitors

49. A 65-year-old man developed an AMI several days ago. His course has been complicated in
the last 24 h by a pericardial friction rub and pleuritic chest pain, which has been difficult
to control with narcotics or steroids. BP is 70/50 mmHg. JVP is R+3 at supine position.
There is an electromechanical dissociation. No murmurs are audible.
Question: What is the most likely etiology of this patient’s acute difficulty?
A. External cardiac rupture
B. Ventricular septal rupture
C. Right ventricular infarction
D. Extension of an acute myocardial infarction
E. Acute myocardial infarction due to rupture of the papillary muscle

50. A 48 y.o black man who smokes 1 pack of cigarettes per day, drinks 3-4 beers each night
and has type-2 DM treated with metformin is referred for hypertension. His BP remains
190/100 mmHg despite atenolol 100 mg/day. You want to arrange his daily menu.
Question: What kind of substances can modestly lower his blood pressure?
A. Calcium and sodium
B. Fosfat and potassium
C. Calcium and potassium
D. Sodium and magnesium
E. Potassium and magnesium

51. Penderita dibawa ke Unit Gawat Darurat dengan kesadaran menurun. Gambaran ECG nya
seperti terlihat dibawah ini

Pertanyaan : Apa diagnosis yang paling mungkin?

A. Flutter ventrikel
B. Sinus bradikardia
C. Irama idioventrikuler
D. Junctional bradikardia
E. Pulseless electrical activity

52. Terapi awal yang dapat diberikan adalah?

A. Pemberian cairan infuse

11
 B. Pacu jantung transkutan
C. Resusitasi jantung paru
D. Lidokain intravena
E. Defibrillasi

53. Seorang penderita dibawa ke rumah sakit dengan kesadaran menurun danm kejang-
kejang. Gambaran EKG-nya seperti terlihat dibawah ini.

Pertanyaan : Apa diagnosis anda?

A. Takikardia supraventrikuler
B. Takikardia ventrikel
C. Fibrilasi ventrikel
D. Flutter ventrikel
E. Irama junctional

54. Tindakan awal apa yang penting anda lakukan?

A. Beri injeksi lidokain
B. Beri injeksi sulfas kinidin
C. Langsung lakukan defibrilasi
D. Lakukan RJP sambil persiapkan defibilator
E. Panggil petugas ICCU untuk menangani langsung

55. Penderita masuk rumah sakit dengan keluhan pusing, berdebar-debar dan pingsan.
Rekaman EKG seperti terlihat dibawah ini.

Pertanyaan :Diagnosis anda adalah ?

A. Fibrilasi ventrikel
B. Torsade d’pointes
C. Takikardia ventrikel
D. Takikardia supraventrikel
E. Fibrilasi atrium dan hiperkalemia

56. Tindakan atau pengobatan yang perlu dilakukan adalah ?

A. Injeksi CaCl2
B. Injeksi MgSO4
C. Difibrilasi sinkron
D. Injeksi amiodarone
E. DC shock + infuse kalium

12
57. Penderita masuk rumah sakit dengan nyeri uluhati dan pusing. Gambaran EKG seperti
terlihat dibawah ini.

Pertanyaan : Apa diagnosis anda?

A. Infark dengan second degree AV-block type I
B. Infark dengan second degree AV-block type II
C. VES dengan second degree AV-block type II
D. Infark dengan third degree AV-block
E. VES dengan third degree AV-block

58. Apa tindakan yang paling tepat?

A. Sulfas atropine + amiodarone
B. Pacu jantung sementara
C. Pacu jantung tetap
D. PTCA +Stenting
E. Sulfas atropine
59. Penderita masuk IRD dengan tidak sadar, nadi tak teraba. Gambaran EKG-nya seperti
terlihat dibawah ini.

Pertanyaan : Apa diagnosis yang paling mungkin?

A. Fibrilasi atrium
B. Torsade d’pointes
C. Takikardia ventrikel
D. Fine ventricular fibrillation
E. Coarse ventricular fibrillation

60. Apa tindakan awal yang tepat?

A. Injeksi lidokain
B. Pijat jantung luar
C. Defibrilasi sinkron
D. Defdibrilasi asinkron
E. Pacu jantung sementara

==================================================

13