1.

A 50-year-old woman came with chief complain chest pain with onset less than 2
hours. There was a history of infarct myocardium, from physical finding we
found blood pressure 160/90 mmHg. Cardiac marker that had increased in this
patient was:
A. Troponin-I
B. Myoglobin*
C. CK-MB
D. LDH
E. CK
2. A 15 years old woman comes to hospital with chief complaint swelling and pain
in knee joint with fever, tachycardia since 2 weeks ago. Physical findings are
within normal limit, except body temperature 38oC. laboratory result shows
leucocytes 20.000/mm3. To establish the diagnose, we need to test :
A. LDH
B. SGOT
C. ASTO*
D. CK-MB mass
E. Troponin I
3. For the case above, we still need another additional laboratory test :
A. CRP*
B. LDH
C. SGOT
D. Myoglobin
E. CK-MB mass
4. A 64 years old man with severe hypertension, comes to ER with chief complaint
dyspneu with chest pain since 2-3 hours ago. The blood pressure is 190/110
mmHg, heart rate 180/min, irregular, breathing rate 35/min, ronchi is positive in
basal of lungs, there is cardiomegaly and lungs obstruction. Which lab test may
confirm the diagnose ?
A. CRP
B. CK-MB
C. NT-ProBNP*
D. Troponin T
E. Troponin I
5. A 48 years old female had mitrale septum valve surgery and a patch made of
Teflon was used. This condition often causes intravascular hemolysis. Therefore,
we need monitoring test. Monitoring test, we need is :
A. D-Dimer
B. Ferritin
C. Fibrinogen
D. Prothrombin time*
E. Fe serum
6. A 66 years old man comes to hospital with chief complaint dyspneu, especially
while exercising, has coughing, tachycardia. The patient has hypertension history.
From physical finding, we find systole murmur, and 3th heart sound (S3 gallop).
The less sensitive test to confirm this disorder is :
A. BNP*
 B. NT-ProBNP
C. Troponin T
D. Troponin I
E. Myoglobin
7. A 50-year-old man came to emergency unit with chief complain left chest pain
spreading to the left arm since 4 hours before and this was the first attack. The
pain onset was more than 20 minutes without chest trauma history. From ECG we
found ST elevation in V1-V3. After sublingual isosorbid dinitrate was given, the
pain still occurred. Laboratory test which is sensitive recommended to this case:
A. CK-MB activity
B. CK-MB mass*
C. Troponin-T
D. Troponin-I
E. NT-proBNP
8. A 55-year-old woman came to hospital with intermittent typical angina pectoris
since 3 days before. Pain episode duration was 5 minutes. Physical finding and
ECG were normal. There was diabetes mellitus history. Laboratory test
recommended to establish acute coronary syndrome was:
A. SGOT
B. Total-CK
C. CK-MB*
D. LDH
E. LDL
9. A 30 years old woman had mitral stenosis history. After balloning valvulotomy,
she got mitral reguirtation. One months after that, she feel fever which could not
be cured by antibiotic. Laboratory test that should recommended to her was:
A. hsCRP
B. ASTO*
C. Leucocyte
D. Rh F
E. LED
10. A pre-menopause woman come to laboratory to check whether she has risk
factors for cardiovascular disease. Laboratory test that should performed to her
was :
A. LDH
B. SGOT
C. Lipid profile*
D. Alkaline phosphatase
E. Gram staining
11. Myoglobin released from damaged muscle colors the urine dark red in
myocardial infarction, this condition as known :
A. anemia
B. myoglobinuria*
C. thalasemia
D. proteinuria
E. glycinemia
12. Assay of serum enzyme are more sensitive for myocardial injury such as
SGOT enzyme, this enzyme as a member of class :
A. transferase*
B. lyase
 C. hydrolase
D. isomerase
E. ligase
13. SGOT enzyme react ans catalyze :
A. oxidations and reductions
B. the hydrolysis cleavage of C-C; C-O; C-N; P-O bonds
C. transfer of groups from a donor molecule to an acceptor molecule*
D. geometric or structural changes within a single molecule
E. the joining together of two molecules, coupled to the hydrolysis of a
pyrophosphoryl group in ATP
14. LDH isoenzyme of serum catalyze reaction of lactate to form pyruvate with
coenzyme :
A. FMN
B. FAD
C. NADH
D. NAD*
E. Coenzyme A
15. When ATP is rapidly being utilized as a source of energy for muscular
contractions, one molecule permits its concentration to be maintained, the
molecule is
A. ATP
B. GTP
C. ADP
D. Ion phosphate
E. Phosphagen*
16. The major lipid of mitochondria membrane in myocard is:
A. lysophospholipid
B. lecithin
C. lysolecithin
D. cardiolipin*
E. phospholipid
17. Lipid peroxidation is a source of free radicals to tissue damage and it may be
cause of :
A. Atherosclerosis*
B. Rhabdomyolisis
C. Cardimyopati
D. Heart failure
E. Thromboembolism
18. Major source of high energy ATP for myocard contraction are come from :
A. glycolysis aerob*
B. glycolysis anaerob
C. gluconeogenesis
D. lipolysis
E. lipogenesis
19. Thrombin is made from final common pathway of clotting involved activation
of :
A. fibrin
B. ion calcium
C. prothrombin
D. Hageman factor
 E. Proconvertin
20. A 59-year-old male with congestive heart failure caused by prolonged
hypertension was admitted in the hospital. He was than given steroid digitalis.
What specific test would you request from the Biochemistry laboratory?
A. CK-MB
B. LDH-H4
C. C-Troponin
D. Homocysteine
E. Atrial Natriuretic Peptide*
21. A 48-year old woman comes to ER with complaint of back pain that refer to
her chest for 5 min. It occurs in 3 hours ago. She feel weak with nausea. She has
a history of uncontrolled hipertension. In physical examination, her BP 170/100
mm Hg, HR 100/min, RR 28/min. ECG shows sinus ritme. A radiologic
photograph shows cardiomegali and aorta dilatation. Which one of the following
parts is to be correlated with her complaints?
A. Aorta
B. Aorta valves*
C. Pericardium
D. Myocardium
E. Pulmonary artery
22. What nervus is involved in her back pain ?
A. Nervus axillaris
B. Nervus phrenicus
C. Nervus subscapularis
D. Nervus splanchnicus thoracicus
E. Ramus cardiacus inferior dextra N.X*
23. What structures are connected by Ligamentum arteriosum botalli?
A. Ascendens Aorta with R. sinister of Pulmonary artery
B. Arcus Aorta with R. Dekster of Pulmonary artery
C. Arcus Aorta with R. Sinister of Pulmonary artery*
D. Descendens Aorta with R. Sinister of Pulmonary artery
E. Ascendens Aorta with R. Dekster of Pulmonary artery
24. The exact location of breast is
A. Subfascial (covered byFascia)
B. Under M. Pectoralis Major
C. Subkutan (under skin)*
D. Between Costa III and VII ventral
E. In linea medioclavicularis of ICS V
25. Which of the following structures is belong to Apertura Thoracalis Superior?
A. Corpus of Vertebra Thoracalis XII
B. Processus Xyphoideus
C. Manubrium Sterni*
D. Cartilaginis costa II
E. Scapula
26. Blood transported by the pulmonary veins returns to the :
A. Left atrium*
B. Right atrium
C. Right ventricle
D. Left ventricle
 E. Truncus Pulmonary
27. The following muscle which form the profunda layer of chest wall is :
A. M. Pectoralis Minor
B. M. subcostalis*
C. M. Intercostalis internus
D. M. Latissimus dorsi
E. M. Rhomboideus minor
28. The type of blood vessel that involved in leucocyte extravasation during
inflammation is :
A. Arteries
B. Arterioles
C. Venules
D. Capillaries
E. Spinchter pre capillary*
29. A 58-year old woman comes to hospital with chest pain and dyspnea during
activity. In physical examination, her BP is 170/100 mmHg and ronchi in basal
area of lungs. Chest X-ray shows cardiomegaly. ECG reveals inferior ischemia
and echocardiography shows Left Ventricle Hypertrophy (LVH). The following
statements that related with normally condition human is:
A. The endocardium of right atrium is thinner than left atrium
B. The endocardium of left ventricle is thicker than myocardium
C. The myocardium of right ventricle is thicker than left ventricle
D. The myocardium of left ventricle is thicker than right ventricle*
E. Both of myocardium of right and left ventricleis the same in thickness.
30. A man 59 years old has echocardiography result which shows left ventricle
hypertrophy (LVH). Which one of the following structure doesn't belong to left
ventricle ?
A. M. papillaris anterior
B. Chorda tendinae
C. Trabecula carnae
D. Mitralis valves
E. Tricuspidalis valves*
31. The following of histology characteristic that shows in normally coronary
artery is?
A. Adipose cells in tunica intima
B. No adipose cells in tunica intima*
C. Adipose cells in tunica media
D. Adipose cells in tunica adventitia
E. No adipose cells in tunica adventitia
32. The inner layer of a blood vessel wall, characterised by a simple squamous
endothelium supported by a thin layer of connective tissue, is the:
A. adventitia.
B. external elastic lamina.
C. media.
D. internal elastic lamina.
E. Intima*
33. The sino-atrial (SA) node, the atrio-ventricular (AV) node, and the Purkinje
fibers of the myocardium all consist of specialized:
A. Endothelial cells.
B. Fibroblasts.
C. Nerve cells.
D. Smooth muscle cells.
E. Cardiac muscle cells.*
34. The most abundant tissue element forming the media of small, muscular
arteries is:
A. cardiac muscle
B. smooth muscle*
C. collagen fibers
D. elastic fibers
E. cartilago
35. The muscular layer of blood vessels is called :
A. tunica intima
B. tunica media*
C. tunica adventitia
D. mesotelium
E. endothelium
36. Vasa vasorum are :
A. blood vessels of myocardium
B. nerves that supply blood vessels
C. nerves of the heart
D. blood vessels within the wall of blood vessels*
E. blood vessels of endocardium
37. Which of the following features is a normal component of epicardium but
NOT of endocardium?
A. adipocytes*
B. collagen
C. elastin
D. fibroblasts
E. simple squamous epithelial tissue
38. Intercalated discs :
A. include desmosomes
B. are found at the boundary between adjacent cardiac muscle cells.
C. Include gap junctions
D. may appear as dark or light bands by light microscopy.
E. All of above*
39. Where is the myocardium the thickest?
A. right atria
B. left atria
C. right ventricle
D. left ventricle*
E. both right and left ventricle
40. His bundle is located in :
A. right atria
B. left atria
C. inter-atrial septum
D. inter-ventriculare septum*
 E. atrioventriculare septum
41. A 30-year old schoolteacher is known to be a strict disiplinarian in the
classroom. She has angina pectoris of 6 month’ duration. On physical
examination, her BP is 135/85 mmHg. She is 168 cm tall and weights 82 kg.
Coronary angiography shows 75% narrowing of the anterior descending branch
of the left coronary artery. Angioplasty with stent placement is performed. Which
of the following is the major risk factor associated with these findings?
A. Obesity
B. Type A personality
C. Diabetes mellitus*
D. Sedentary lifestyle
E. Age
42. A 30-year old woman has smoked one pack of cigarettes per day since she was
teenager. She has had painful thromboses of the superficial veins of the lower
lega for 1 month and episodes during which her fingers become blue and cold.
Over the next year, she develops chronic, poorly healing ulcerations of her feet.
One toe becomes gangrenous and is amputated. Histologically, there is an acute
and chronic vasculitis involving medium-sized arteries. Which of the following is
the most appropriate next step in treating this patient?
A. Hemodialysis
B. Smoking cessation*
C. Corticosteroid therapy
D. Antibiotic therapy for syphilis
E. Insulin therapy
43. A 25-year old man dies suddenly and unexpectedly. At autopsy his heart is
enlarged from right ventricular dilatation. The left ventricle is normal. There is no
atherosclerosis, sectioning of the myocardium shows marked thinning of the right
ventricle, and microscopic findings include extensive myocardial fatty infiltration
and fibrosis, but no inflammation. Which of the following is the most likely cause
for his sudden death?
A. Cardiomyopathy*
B. Chagas disease
C. Hypertension
D. Long QT syndrome
E. Radiation therapy
44. A 68-year old woman has had increasing dyspnea for the past year. On
physical examination, her blood pressure is 140/90 mmHg. No murmurs or
gallops are heard. A chest radiograph shows prominent borders on the left and
right sides of the heart. Laboratory studies show serum glucose of 81 mg/dl,
creatinine of 1,6 mg/dl, total cholesterol of 326 mg/dl, triglyceride of 169 mg/dl.
Which of the following pharmacologic agents is most likely to be beneficial for
this patient?
A. Amiodarone
B. Glyburide
C. Nitroglycerine
D. Propanolol
E. Simvastatin*
45. A 50-year old man has sudden onset of severe substernal chest pain that
radiates to the neck. On physical examination, he is afebril, but has tachycardia,
hyperventilation, and hypotension. No cardiac murmurs are heard on
 auscultation. Emergent coronary angiography shows a thrombotic occlusion of
the left circumflex and anterior descending arteries. Which of the following
complications of this disease is most likely to occur within 1 hour of these
events?
A. ventricular fibrillation*
B. pericarditis
C. myocardial ruptur
D. ventricular aneurysm
E. thromboembolism
46. A 19-year old man has had a low grade fever for 3 weeks. On physical
examination, his temperature is 38.3oC, pulse is 104/min, respirations are 28/min,
and blood pressure is 95/60 mmHg. A tender spleen tip is palpable. There are
splinter hemorrhages under the fingernails and tender hemorrhagic nodules on the
palms and soles. A heart murmur is heard on auscultation. Which of the following
infectious agents is most likely to be cultured from this patient’s blood?
A. Viridans streptococci*
B. Trypanozoma cruzi
C. Coxsackievirus B
D. Candida albicans
E. Mycobacterium tuberculosis
47. A 27-year old woman has had a fever for 5 days. On physical examination, her
temperature is 38.2oC, pulse is 100/min, respirations are 19/min, and blood
pressure is 90/60 mmHg. A cardiac murmur is heard on auscultation. The
sensorium is clouded, but there are no focal neurologic deficits. Laboratory
findings include hemoglobin 13.1 g/dl; platelet count 233.300/mm 3; and WBC
count 19.200/mm3. Blood cultures are positive for Staphylococcus aureus.
Urinalysis shows hematuria. An echocardiogram shows a 1.5 cm vegetation on
the mitral valve. Which of the following conditions is this patient most likely to
develop?
A. cerebral arterial aneurysm*
B. dilated cardiomyopathy
C. abcess of the left upper lobe
D. polyarteritis nodosa
E. polycystic kidneys
48. A 49-year old is feeling well when he visits his physician for a routine health
maintanance examination for the first time in 20 years. On physical examination,
his vital signs are temperature, 37oC; pulse, 73/min, respirations, 14/min; and
blood pressure, 155/95 mmHg. He has had no serious medical problems and takes
no medications. Which of the following is most likely to be the primary factor in
this patient’s hypertension?
A. increased cathecolamine secretion
B. renal retention of excess sodium*
C. gene defects in aldosteron metabolism
D. renal artery stenosis
E. increased production of ANP
49. For the past 3 weeks, a 70-year old woman has been bedridden while
reduperating from a bout of viral pneumonia complicated by bacterial
pneumonia. Physical examination now shows some swelling and tenderness of
the right leg, which worsens when she raises or moves the leg. Which of the
following terms best describes the condition involoving the patient’s right leg?
 A. lymphedema
B. disseminated intravascular coagulation
C. trombophlebitis*
D. tromboangiitis obliterans
E. varicose veins
50. A 61-year old man had a myocardial infarction 1 year ago, which was the first
major illness in his life. He now wants to prevent another myocardial infarction
and is advised to begin a program of exercise and to change his diet. A reduction
on the level of which of the following serum laboratory findings 1 year later
would best indicate the success of this diet and exercise regimen?
A. cholesterol*
B. glucose
C. potassium
D. renin
E. calcium
51. A 55-year old man comes to hospital with high fever. In physical examination,
his temperature is 39oC and lymph nodes in the anterior of the neck are palpable,
there is pansistolic murmur in mitral area. No signs of infection in his skin. No
history of digestive and urogenital infections. Which of the following
microbiologic examination is likely to be recommended for this patient?
A. Blood culture*
B. Nasal swab
C. Skin swab
D. Serologic test
E. Faeces studies
52. A 55-year old man comes to hospital with high fever. In physical examination,
his temperature is 39oC and lymph nodes in the anterior of the neck are palpable,
there is pansistolic murmur in mitral area. No signs of infection in his skin. No
history of digestive and urogenital infections. In Echocardiography, it shows
vegetations in mitral valves. What is the most like cause of the infection of mitral
valves in this patient?
A. Human Herpes Virus dan Varicella Zoster Virus
B. Staphylococcus dan streptococcus*
C. Virus Coxsackie A dan Coxsackie B
D. Mycoplasma
E. Chlamydia
53. A 55-year old man comes to hospital with high fever. In physical examination,
his temperature is 39oC and lymph nodes in the anterior of the neck are palpable,
there is pansistolic murmur in mitral area. No signs of infection in his skin. No
history of digestive and urogenital infections. In Mannitol Salt Agar (MSA)
culture, it was found Staphylococcus aureus. Which one of test results is could
distinguish between Staphylococcus aureus another types of staphylococcus?
A. Catalase positive
B. Facultative anaerobe
C. Coagulase positive*
D. Anaerobic glucose fermentation
E. All strains produce golden pigment
54. A 30-year old woman comes to clinic with fever and chest pain. Her
temperature is 38,8oC , haemoglobin is 9, and leucocytes count is 12.000/ml. In
physical examination, it was found arthritis’s symptom and subcutaneous
 nodules, ECG with atrial fibrillation. In the last two weeks, she complaint of
fever and sore throat. Which one of the following test is likely to examined in this
patient?
A. Blood culture*
B. Synovial fluid culture
C. Nasal swab
D. Skin swab
E. Serologic test
55. A 55-year old man comes to hospital with high fever. In physical examination,
his temperature is 39oC and lymph nodes in the anterior of the neck are palpable,
there is pansistolic murmur in mitral area. No signs of infection in his skin. No
history of digestive and urogenital infections. In Mannitol Salt Agar (MSA)
culture, it was found Staphylococcus aureus. Which one of the following
characteristic is belong to Staphylococcus aureus?
A. Smooth colony
B. Irregular-formed colony
C. Baccilus bacteria
D. Pink-coloured in gram staining
E. Its cell wall contains teichoic acid*
A 34-year old man come to hospital with chief complain of chest pain since 3 days
ago. There is a history of fever. The result of Ro thorax and laboratory test are normal.
In culture of his blood, it reveals a significant bacterial colonies.

56. The most likely diagnosis of this patient is :

A. myocarditis
B. non- infective pericarditis
C. infective endocarditis*
D. coronary heart disease
E. congenital heart disease
57. The following of microorganism which most likely cause disease in this
patient is:
A. enterococcic
B. coagulase negative staphylococcus
C. candida albicans
D. aspergillus
E. viridans streptococcus*
58. The simple microbiology assay which could suggest for this patient is
A. PCR
B. ELISA
C. Electron microscopy
D. Gram staining*
E. ZN method of staining
59. Molecular assay which could performed to identify the microorganism in
this patient is :
A. Southern hybridization
B. Sequencing
C. Simple PCR*
D. PCR-RFLP
E. Multiplex PCR
60. A 45-year old come to hospital with abcess in his right arm. In
microscopically smear test, it was found small round microorganism with
positive gram staining. The most likely infective microorganism is :
A. M tuberculosis
B. Streptococcus viridans
C. N gonorrhoe
D. S aureus*
E. S typhi
61. The mucle in the heart that prevents AV collapse is called :
A. myocyte muscle
B. pacemaker muscle
C. papillary muscle*
D. septal muscle
E. fibrous muscle
62. In heart conduction system, the site that delay electrical signal to allow
complete atrial depolarization before ventricular depolarization occur, is called:
A. SA node
B. AV node*
C. His bundle
D. Purkinje fibers
E. Pacemaker bundle
63. Plateau phase is the characteristic of one particular type of heart cells. This
cell normally functions as:
A. mechanical contractile work*
B. electrical pacemaker work
C. protection of heart tissue
D. prevention of valve collapse
E. reduction of mechanical stress
64. Frank-starling mechanism shows that into some extent, distention of heart
muscle will make :
A. the muscle contracts stronger*
B. the muscle contracts weaker
C. the muscle contracts constantly
D. the muscle contracts steadily
E. the muscle contracts then stops
65. Vasodilatation occur if vasodilatating factors occur. One of these factors is:
A. epinephrine
B. adrenalin
C. cathecolamin
D. nitrogliserin*
E. vasopressin
66. Interstitial fluid that comes from blood vessel goes back to vascular system
through:
A. vein system
B. lymphatic system*
C. arteriolar system
D. portal vein system
E. capillary system
67. While measuring blood pressure using sphygmomanimeter, korotkoff sound is
heard by using stethoscope. This sound results from:
 A. cuff pressure on brachial artery slowly released*
B. cuff pressure on radial artery slowly increased
C. cuff pressure on radial artery slowly released
D. cuff pressure on brachial artery slowly increased
E. cuff pressure on brachial artery kept steadily
68. Dizziness that happens shortly while standing after sitting or lying may result
from orthostatic hypotension. This phenomenon happens as failure of blood
pressure maintanance by:
A. baroreceptor reflex*
B. mechanoreceptor reflex
C. chemoreceptor trigger zone
D. mechanoreceptor zone
E. parasymphatetic reflex
69. In the heart, chronic systemic hypertension will force the heart tissue to
compesate. The most apparent structural damage as the result of prolonged
compesation occurs as:
A. decreased stroke volume
B. increased heart rate
C. reduction of valves area
D. ventricular hypertrophy*
E. ventricular dystrophy
70. In the blood, level of symphatetic nervous system and level of angiotensin II
give the same effect to blood pressure. If those two factors rise, the blood
pressure will:
A. fall
B. rise*
C. zero
D. constant
E. indeterminable
71. A 50 years old man come to the physician with increase of body weight in last
2 months. He is a manager of ABC company. His blood pressure is 150/100 mm
Hg. The level of blood cholesterol and triglycerid were increase. His BW was 70
kg and BH was 150 cm. He was rarely go to gym. He drink a coffe two times a
day and sometimes drink a whiskey. He like to eat sweats and rarely to eat fruits
and vegetables. The risk factor of diet which have minor impact to the insidence
of coronary artery disease is :
A. Hipertension
B. Sport activity
C. Blood cholesterol level
D. Manager of ABC company
E. Obesity*
72. A 50 years old man come to the physician with increase of body weight in last
2 months. He is a manager of ABC company. His blood pressure is 150/100 mm
Hg. The level of blood cholesterol and triglycerid were increase. His BW was 70
kg and BH was 150 cm. He was rarely go to gym. He drink a coffe two times a
day and sometimes drink a whiskey. He like to eat sweets and rarely to eat fruits
and vegetables. The risk factor of diet which have major impact to the insidence
of coronary artery disease is :
A. Dietary fiber
B. Coffee
 C. Alcohol
D. Sugar*
E. Smoking
73. Low-salt diet were given to patients with :
A. Obesity
B. Decompensatio Cordis*
C. Hepatitis B
D. Extrauterine pregnancy
E. Myxoedema
74. Foodstuff which can be added into low-salt diet was :
A. Baking Powder/Baking soda
B. Monosodium Glutamate
C. Corned beef
D. Meat and Fish (maximum100 gram/day)*
E. ABC soy sauce
75. In low salt diet, we can make food taste good by adding many kinds of spice,
except :
A. Sugar
B. Vinegar
C. Onion
D. Ginger
E. Mono sodium glutamate (MSG)*
76. In Low salt diet level II, the content of Sodium (Na) was:
A. 200-400 mg
B. 600-800 mg*
C. 1000-1200 mg
D. 1200-1400 mg
E. 1400-1600 mg
77. A 54-year old man has a history of coronary heart disease. His blood pressure
is 180/90 mmHg. The following of food stuff which not recommended to
consume by this patient is:
A. rice
B. MSG
C. Corned beef*
D. Meat and fish with max. 100g/day
E. Spinach
78. A 58-year old man has a history of cardiac failure. The hemodynamic change
in his kidney is correlated with retention of:
A. Potassium
B. Sodium*
C. Magnesium
D. Calcium
E. Ferrum
79. A 58-year old man has a history of cardiac failure. His diet should be:
A. high energy, especially for patient with obesity
B. high protein
C. contain vitamins and minerals*
D. high salt
E. high fat
80. A 45-year old man has died, because of coronary heart disease. The
component of trace element which has correlation with his death is :
A. increase of selenium intake*
B. decrease of selenium intake
C. deficiency of potassium
D. ferrum intoxication
E. deficiency of ferrum
81. A 25 year old woman come to hospital with dyspnoea and tachycardia. She
has a history of rheumatic fever previously. In chest X-ray, it was found a “double
contour” appearance. The radiologic appearance of this patient was caused by :
A. Enlargement of Right and Left Atrium
B. Enlargement of Right Atrium and Left Atrium was normal
C. Enlargement of Left Atrium and Right Atrium was normal*
D. Enlargement of Right Ventricle and Right Atrium
E. Enlargement of Right Ventricle, and Left Atrium was normal
82. A 25-year old woman come to ER with dyspnoea. Physical examination has
reveal diastolic murmur in left ICS V with irregular pulse. In chest X-ray (PA),
heart weist is prominent. EKG shows atrial fibrillation with axis to right. The
result of chest X-ray (PA) in this patient is caused by :
A. Enlargement of Right and Left Ventricle.
B. Enlargement of Left Ventricle and Right Atrium
C. Enlargement of Right Ventricle and Left Atrium*
D. Enlargement of Left Ventricle and Atrium
E. Enlargement of Right Ventricle and Atrium
83. The most safety Imaging modalities which can be used to evaluate
cardiovascular disease :
A. Conventional chest x-ray
B. Angiography
C. Magnetic Resonance Imaging
D. Doppler Ultrasound*
E. CT-Angiography
84. Regarding the heart on Errect Position of chest x-rays :
A. The left auricular appendage contributes to the normal left cardiac border.
B. The left atrium is posterior to the oesophagus.
C. The four pulmonary veins attach anteriorly in the left atrium
D. The left atrium lies to the right of the aortic root.
E. The mitral valve is place in the lower anterior aspect of the left
atrium.*
85. Signs of venous hypertention on Postero-Anterior position of chest x-rays :
A. Right descending pulmonary arteri is less than 17mm.
B. Blood flow to bases is more than to apices.
C. Upper lobe vessels is smaller than lower lobe vessels.
D. Cephalization*
E. Pruning
86. A 45 year old man came to hospital with dyspnea and oedema. In chest x-rays,
right diaphragm was elevated and right superior mediastinum was wider than
normal.
 A. Right diaphragm elevated was caused by congestive hepatomegaly.
B. The enlarge of right superior mediastinum was implicated of Superior
Cava Vein congestion
C. A & B as signs of right decompensatio cordis*
D. A & B as signs of left decompensatio cordis
E. All options are true
87. Hypertensive heart disease (HHD) appears in chest X-ray as:
A. double contour
B. cardiac apex bulges upward
C. prominent of pulmonary vessels
D. widening of aorta caliber*
E. cardiac waist widening
88. Batwing appearance in chest X-ray represent :
A. cor pulmonale
B. pericardial effusion
C. tetralogy of fallot
D. pulmonary hypertension
E. pulmonary oedema*
89. In case of L to R shunt, chest X-ray will show :
A. prominent of pulmonary knob
B. decreased of pulmonary vessels
C. enlargement of aorta caliber
D. perihilar haziness
E. kerley B-lines
90. Pulmonary artery hypertension will appear in chest X-ray as:
A. perihilar haziness
B. double contour of the right heart border
C. kerley B-lines
D. rapid cutoff of the right main pulmonary artery*
E. periphery vessel dilatation
91. A case 10 years and 6 moths of age visit OPD because pain of knee joint since
2 weeks ago. There was no history pain of joint before. On physical examination
is heard apical murmur. Chest x-ray result CTR 0.65. One of the ECG result is p
mitral. On echocardiography, we found mitral and aortic reguirtation. The
diagnose of this case according to WHO 2002-2003 is :
A. acute rehematic fever
B. recurrent attact without rheumatic heart disease
C. recurrent attact with rheumatic heart disease
D. rheumatic chorea
E. chronic valvulitis
92. Valve abnormality below are commonly seen in rheumatic fever:
A. mitral reguirtation + aorta reguirtation + pulmonal stenosis
B. aorta reguirtation + pulmonal stenosis
C. mitral stenosis + aortic stenosis + pulmonal stenosis
D. pulmonal stenosis
E. mitral stenosis + mitral reguirtation + aorta reguirtation
93. A boy, 5 y.o. looks dyspnea, temperature 39oC, RR 56/min, P 130/min, BP
100/70 mmHg. First and 2nd heart sound were normal. It heard apical pansystolic
murmur. Hb 10, WBC 18.000, PLT 340.000, ESR 50, CRP (+), ASTO 400/IU.
 Chest X-ray point out CTR 0.6. which one data above support diagnose of
rheumatic fever:
A. BP
B. PLT
C. Hb
D. CTR
E. ASTO
94. A case 8 years of age was hospitalized due to pain of the knee and elbow joints
since 10 days ago. Oh physical examination, apical pansystolic murmur is heard.
Chest X-ray result showed CTR 0.65. One of the ECG result is p mitral. On
echocardiography, we found mitral and aortic reguirtation. To prevent recurrent
of this disease, the patient should:
A. treated with aspirin
B. treated with prednisone
C. treated with BPG monthly during 5 years
D. treated cefotaxime for 10 days
E. immunoglobulin
95. A baby 15 days of age was born spontaneously without crying soon with apgar
score 5/10, body weight 1900 grams, we order chest x-ray, ECG and
echocardiography examination. The result of echocardiography point out
moderate PDA. Statement below correlated with PDA:
A. there are LA and RA dilatation
B. mostly seen in preterm baby
C. on chest x-ray seen apex upturned
D. on ECG shown p pulmonal
E. is heard continues murmur on apical
96. Which is statement below as minor criteria to diagnose rheumatic fever?
A. carditis
B. arthritis
C. ASTO
D. CRP
E. Eritema marginatum
97. A girl, 6 y.o. send by a pediatrician due to cough without cyanotic. On
physical examination is heard ejection systolic murmur on upper left sternal
border. Echocardiography finding is ASD. Which is statement below are
correlated with this case:
A. 2nd heart sound: wide fixed split
B. frequently complicated with heart failure
C. murmur is heard due to blood rapid flow within atrial defect
D. ASD is congenital heart diseases that frequently seen
E. Murmur is heard on ICS 3-4 left sternal border
98. Tetralogi fallot is complex congenital heart disease consist of some
abnormality in heart such as :
A. coartacio aorta
B. PDA
C. ASD
D. Dextroposition aorta
E. RVH
99. A baby 3 months of age. Echocardiography is TGA. Which one of these
statements are related to TGA :
A. hemodynamic of circulation of TGA is series
B. the aorta originates from left ventricle
C. on chest x-ray, heart seen like peer-shaped
D. suspicious if giant neonates present cyanotic since birth
E. murmur is not vary.
100. Statement below correlated with VSD:
A. it heard systolic murmur
B. there is ventricle and left atrial dilatation
C. the defect closure could using amplatzer (AMPVO)
D. on chest x-ray seen apex upturned
E. type of CHD which is frequently found
101. A boy, 2 years old visits pediatric cardiology OPD. On physical
examination, it reveals single 2 nd Hs with murmur which best audible at
the II-III ICS left sternal border. Lateral X-ray findings retrosternal space
diasappears. Echocardiography findings is pulmonal stenotic. What kind
of murmur that we could find from this case ?
A. mid-diastolic murmur
B. pansystolic murmur
C. ejection systolic murmur
D. end-diatolic murmur
E. early diatolic murmur
102. Which is of the following factors that influences ductal closure:
A. prostaglandin (PGE2) level in circulation
B. indomethacin concentration
C. hypoxic after birth
D. maturity of the newborn
E. all statement above are correct
103. Which is of the following shunt commonly seen in fetal ciculation and
connect aorta to pulmonary artery?
A. ductus arterious
B. ductus venous
C. foramen ovale
D. placenta
E. ductus