SOAL NEURO 5 desember 2011
CASE :
A 28 yo woman come to neurologist,
complaining headache pulsating on
left side accompanied by vomiting and
phonophobia. Headache like this have
been experienced since last week,
reccuring frequency 3x/day. No
abnormality on physical examination.
1. Very possible diagnose in this
patient is:
a) Tension headache
b) Migrain with aura
c)MIgrain without aura
d) Cluster Headache
e) Neuralgia trigeminus
2. Medikamentous therapy :
a) Ergotamin
b) Antihistamin
c) Steroid
d) Azatioprin
e) None of the above
3. Possible precipitating factor from
disease:
1. Fatigue
2. Climate
3. Food containing MSG
4. Menstruate
CASE :
A 30 yo man, admitted to neurologist
complain of pain in right side cheek
felt like electrical suddenly since last
week, with duration of 10 seconds.
Outside of attack the patient didn’t
feel pain at all. Pain triggered while he
was brushing teeth. No abnormality of
physical examination
4. Very possible diagnosis :
a) Tension headache
b) Migrain with aura
c)MIgrain without aura
d) Cluster Headache
e) Neuralgia trigeminus
5. Drug of choice :
a) Ergotamine
b) Morphine
c) Carbamazepin
d) Minor Tranquilizer
e) None of the above
CASE :
A 76 yo woman, complained a dull, left
sided headpain with some radiation of
the discomfort to the right side of the
head. He had no nausea pr vomiting
with the pain, but had lost 10 pounds
over previous 2 months. His eritrocyte
sedimentation rate was 102 and he
was mildly anemic. An investigation
for malignancy revealed no signs of
lymphoma, carcinoma, or leukemia.
6. Diagnosis of this :
a) a) Tension headache
b) Migrain with aura
c) MIgrain without aura
d) Cluster Headache
e) Giant cell arthritis
7. Correct statement according to
disease :
a) Healed with carbamazepin
b) Reliable to therapy of
hormonal
c) Associated with polymialgia
rheumatic complex
d) Associated with allodinia
 e) Triggered by food containing 12. The appropriate diagnosis for this
thiamin patient is :
a) neuritis optic
8. SAME WITH ABOVE b) Mielitis Akut
c) Multiple Sclerosis
9. Management : d) Encephalitis
a) Steroid e) Devic’s disease
b) Carbamazepin
c) Ergotamine
d) Morphine CASE :
e) Surgery A 60 yo man has a history of 2 years
of progressive memory impairment.
CASE : Within the past 7 months he has been
A 30 yo man come to the hospital with confused and world finding difficulty
chief complain weakness on the left when speaking
side of the body, which was happened
after he got fever, numbness of the 13. The most likely diagnosis is
side of weakness body, eyesights a) Creatfield Jacob disease
complaints such as double and blurry b) MUltiinfarcts dementia
vision. Patient also complaint that he c) Alzheimer disease
was always urinate. He has d) Normal pressure
experienced the same condition a year hydrocephalus
ago. From neurologic examination e) Binswanger’s disease
paralysis on the left side of his body,
spastic type, paresthesis, diplopia and 14. The patient undergoes head CT
Lhermitte’s sign (+) scan and reveled ….. on :
a) Frontal Lobe
10. The other examination to support b) Parietal and Temporal Lobe
diagnose : c) Occipital and Parietal Lobe
a) MRS d) Subcortical parts of the brain
b) MRI e) Limbic gyrus
c) CT-scan
d) X-Ray 15. Which of the following medication
e) EEG may effort progress of patient
deterioration :
11. Differential diagnosis for this a) Donapezil
patient, except b) L- Dopa
a) Neuritis optic c) Rapeldone
b) Devic’s disease d) Prednisone
c) Myelitis Transversa e) Vit. B12
d) ADE
e) Encephalitis CASE :
A 55 yo woman has a history of right
hemiparesis which occural suddenly 2
months ago. Since 2 days later, she
become anorexia and getting
difficulties in her daily communications
16. The most possible diagnose :
a) Creatfield Jacob disease
b) Alzheimer disease
c) Normal pressure
hydrocephalus
d) Binswanger’s disease
e) Vascular dementia
17. She also possible has :
a) Agraphia
b) Acalculia
c) Aphasia
d) ….
e)…..
18. CT – SCAN .. Bulan sabit
a) Epidural Hem.
b) Subdural Hem.
c) Subrachnoid Hem.
d) Interventricular Hem.
e) Intracerebral Hem.
19. CT-SCAN.. yg ventriclenya keliatan
a) Epidural Hem.
b) Subdural Hem.
c) Subrachnoid Hem.
d) Interventricular Hem.
e) Intracerebral Hem.
20.
A man 56 yo delivered to emergency
room with complained decreased of
awareness. This situation ws
complained from about 7 hours ago.
At home, initially the patient
complained with …. About 4 hours ago
and he become unconscious. GCS
examination is 3, pulse pressure
130/90 mmHg, pulse freq. 80x/sec.
The CT scan showed infarct cerebri.
Wht is the sign that can be found in
CT-scan exam.?
a) Area with mass
b) There is a hiperdense area in
the
hemisphere
c) Hiperdense area in lateral
ventricle
region
d) Hipodense area on the
hemisphere
cerebri
e) Hiperdense area which is
surrounded
by hipodense area in the
hemisphere
region.
21. Wht is the radiological
examination assess the condition of
the spinal cord using X-Ray modalities
with injection of contrast into the
spinal canal called the examination :
a) MRI-vertebra
b) Myelography
c) Angiography
d) CT-Scan Vertebra
e) X-Ray vertebra
22. A man 45 yo come to generl
practioner with complaints of severe
headache since last 2 days. Previously
he had often complained of headache
since last 1 year. Doctor suspected he
was suffering Increasing ICP. He has
skull X-Ray examination. Wht signs
that can be found in skull x-ray in
those conditions?
a) Mass effect
b) impressio digitatoe
c) Dysplacement of Gland.
Pinealis
d) Multiple coin lesion
appearance
 e) Change of size and shape of
the skull
23. Neuropsychiatric disorder account
for the largest burden of disease in the
world becos of:
a) The death cause
b) The disability derived
c) The numbers of suffered
d) Age groups
e) Sex involved
24. Neuropsychiatric disorder has
burden (DALY)
a) the 2nd largest after AIDS
b) ….
c) in development countries
d)…
e)….
CASE :
25 yo man, was brought to mental
hospital, becoz of restlessness, violent
behavior (throwing and destroying
everything in his house). In the last
month, the patient has been always
talking….. and has a delusion that he
is the God.
27. Providing supportive environment
(physical, psychological and social) to
the ptient from his family aand
neighbourhood after he returns home
is good preventive measure in the
stage of :
a) Primary prev.
b) Health promotion
c) Secondary prev.
d) Early diagnosis and prompt
treatment
e) Rehabilitation
CASE :
A 50 yo man, civil employee visited
health clinic in his office complining of
lost of desire to life, lost of
concentration, and decresed appetite.
His complaints has been happened in
the last 3 months. He viewed him self
negatively ( he feels he is nothing
doesn’t have future). Sometimes he
wants to feel his life.
28. Psychotherapy , providing by the
clinics physician is a part of the 5
Levels of prevention at the level of :
a) Health promotion
b) Specific protection
c) Early diag. and prompt.
Treatment
d) Disability limitation
e) Rehabilitation
29) Councelling facilities from
psychiater and physiology. Jika pd
kantor laki2 tsb diadakan sarana
konseling bagi pr pegawai untuk
mereka yg beresiko terkena gangguan
jiwa terutama ggn. Jiwa terselubung
(kecemasan dn depresi), mk bagian
tsb adlh bagian dr tindakan :
a) Health promotion
b) Specific protection
c) Early diag. and prompt.
Treatment
d) Disability limitation
e) Rehabilitation
30. The most uncommon organ
involved in caissons disease is :
a) Skin
b) Upper Thoracic spinal cord
c) Brain
d) Knee Joint
e) Peripher nerves
31. The most common symptoms
found in Caissons dis. Type I is :
a) Pitting Oedema
 b) Unconsciousness
c) Heart burns 40. the probable diagnose is :
d) Parapharesis a) Dermoid Cyst
e) Twitching b) Meningocele
c) meningomyelocele
32. Caisson Disease cant occur if the d) Subarachnoid cyst
person dive in : e) Crowson’s disease
a) 10 m depth
b) 15m depth 41. This patient, radiological exam
c) 20 m depth (head scan) has been done. Found
d) 25 m depth ventricle enlarge. The earliest
e) 30 m depth treatment is :
a) VP shunting
33. Condition below may cause b) VA shunting
Caissons Disease : c) External Drainage
a) A diving using a pure oxygen d) Excition of the cyst
(O2 e) Antibiotic with wound
100%) on 10 m depth management
b) A diving using a pure oxygen
(O2 42. a 45 yo man cme to the doctor
100%) on 20 m depth with complaints …., and anxiety.
c) A diving using a pure oxygen Ptient was diagonesed depression and
(O2 the doctor gave him trycylic
100%) on 30 m depth antidepressant drugs. Which of the
d) A diving using air following drug is trycylic
compression on antidepressant drugs?
10m depth a) Amoxapine
e) A diving using air b) Bupropion
compression on c) Irripramin
20m depth d) Paroxefine
e) Trazodone
34. The principles for
HyperbaricOxygen Therapy of Caisson 43. what is the side effect?
disease : a) Anorexia
…….. b) Anorgasmia
c) Agitation
CASE : d) GI disturbance
A 5 yo boy brought to emergency e) Postural Hypotension
room by his parents with complaint of
fever after rupture of the cyst between 44. Which is following drugs is
his eyes and a … drainage out. selective serotonin reuptake inhibitor
According to his mother, the cyst …. a) Amytriptilin
Since born and become large and b) Buproprion
large with the skin. c) Maprophilline
 d) Sertralline
e) Vanflaxine
45. Which of the following
antipsychotic agent is butrophenone
derivative?
a) Chlor……
b) Clozapine
c) …..
CASE :
…… Associated symptoms include
numbness…. Arms, vomiting, diarrhea.
No physical abnormalities. A mental
status exam. Reveals a… dysphoric
affect.
46. wht is d most likely diagnose :
a) Bullimia Nervosa
b) Anxiety Disorder
c) Depression episode
d) Somatization Disorder
e) Panic Disorder
47. Best treatment :
a) Aspirin
b) Benzodiazepin
c) Corticosteroid
d) Physical Exercise
e) Psychoterapy
48. Best likely prognosis :
a) Chronic Condition
b) Debitating
c) Worse
d) All true
e) All false
CASE :
A 24 yo man presents with new onset
blindness…. Is no psychologic
explanation. The patient says ….
Recently, after he was unable to sent
her mother to ….. addicted to drugs.
He dosnt seem to be bothered.
49. most likely diagnosis :
a) Somatiztion disorder
b) Anxiety disorder
c) Conversion disorder
d) Hypochondriasis
e) Social Phobia
50. Best treatment :
a) Hypnosis
b) anxiolytics
c) behavioral relaxation
d) All true
e) All flse
51. Which of the following is most
characteristic …. Conversion disorder?
a) Male predominan
b) higher socioeconomic status
c) Less education
d) Greater psychological insight
e) All false
52. which of the following in the most
effective …. With conversion
disorder?
a) Confrontation about
intentionally prod..
b) Explaining tht their
symptoms are not real
c) Reassurance tht a neurologic
cause is …
d) Suggestion tht symptoms will
improve
e) All false
53. a 28 yo man describe a
persistence ….. public. Although he
doesn’t have difficult
…………………………………….
a) …
B) ….
c) Social phobia
 d) Specific phobia
e) Post traumatic stress disorder
54. 40 yo woman presents with
complaints of not being able to leave
her house. For the pst 5 years, she has
had increasing difficulty travelling far
from home. She constantly worries
that she will not able to get help if she
“freaks out” . In fact, she had
numerous unprovoked episodes of
intense fear, associated with shortness
of breath, chest pain, diaphoresis, and
dizziness. That lasted fot 20 minutes.
She convinced that if she drives too
far from home, she will have an attack
and not be able to obtain help. Which
is the following is the most likely
diagnosis?
a) Generalized anxiety disorder
b) Panic disorder
c) Social phobia
d) Specific phobia
e) Post traumatic stress disorder
55. A 25 yo woman describes a long
life being “scared of heights”. She
becomes uncomfortable when higher
than 3 stories and knowing the height
og buildings. On finding herself at
significant elevation, she has severe
anxiety symptomps such as trembling,
lightheadedness, numbness and
tingling and a fear of dying. Which of
the most likely diagnosis?
a) Generalized anxiety disorder
b) Panic disorder
c) Social phobia
d) Specific phobia
e) Post traumatic stress disorder
56. a 56 yo woman comes to ER with a
chief complaints of “ I think iam going
crazy”. She states tht for the past 2
months, she has been experiencing
sudden episodes of palpitation,
trembling, shortness of breath and
feeling as if she is going to die. She hs
been to the ER in the past 2 weeks
convinced that she is having a heart
attack. However, the result of her
physical and lab exam hv been within
normal limits.
a) Generalized anxiety disorder
b) Panic disorder
c) Phobia disorder
d) Social phobia disorder
e) Somtoform disorder
57. The most common
psychopharmacologic treatment :
a) Halloperidol
b) …..
CASE :
A 27 yo woman lifelong history of
being scared of heights…….
58. Which of the following is the most
likely diagnosis?
a) Social phobia disorder
b) Specific phobia
c) Panic disorder
d) Agarophobia
e) Anxiety disorder NOS
59. Wht is psychotherapy that
necessary to this patient?
a) Psychodynamic therapy
b) Psychoanalitic therapy
c) Exposure therapy
d)…..
60. Contraindication of ECT is :
a) HTN
b) Respiratory disorder
c) Pregnancy
d) Glaucoma
 e) none of all above
61. The phenomena patient-doctro
realationship consist of the :
a) Only Transferance
b) Counter trnsferance
c) Resistention
d) Transferance and Resistance
e) Transferance and counter
transferance
62. Most important component to
establish doctor-patient relationship :
a) Organic Biologic Aspect
b) Social
c) Spiritual Aspect
d) Psychological Aspect
e) Culture Aspect
63. Classification used for mental
disorder in Indonesia were based on :
a) DSM III-R
b) DSM IV
c) DSM IV –TR
d) ICD 9
e) ICD 10
64. The criterion of mental disorder in
Indonesia was published by :
a) The Asian medical College for
Mental
Disorder
b) American Psychiatric
Association
c) The Royal British College for
Mental
Disorder
d) WHO
e) The Collegium of
Internationale
Neuropsychiatric
65. In assessing mental disorder , …..
diagnosesis used. The personality
disorder is assessed in :
a) Axis I
b) Axis II
c) Axis III
d) Axis IV
e) Axis V
66. Alexithymia is a disorder of :
a) Motor behavior
b) Personality disorder
c) Thought disorder
d) Mood disorder
e) Memory disorder
67. Verbigeration is a disorder of
a) Motor behavior
b) Personality disorder
c) Thought disorder
d) Mood disorder
e) Memory disorder
67. The man claimed that he is a
propher of the Almighty…. He always
hears voices saying so. Hering voices
with … external object in is called
a) Derealization
b) Halucination
c)Illution
d)Depersonalization
e)Ides of Refferences
68. The psychoptological symptom of
hearing voices with … external object
is the disorder of :
a)Awareness
b) Attention
c) Motor
d) Thought
e) Perception
69. Bizarre delution, was he hallmark
symptom of :
 a) Schizoaffective disorder
b) Schizophenia disorder
c) Dellusional disorder
d) Delirium
e) Dementia
CASE :
40YO woman, brought to Mental
institution because confusion. It
started a week ago, she always woke
at night and …. At day time. She also
sad, she also saw her passed way
mother came and talked with her. At
times, she couldn’t recognize, her
husband and sons. She had a history
of severe hypertension.
70. The most possible diagnose is :
a) Dementia
b) Delirium
c) Amnestic Organic
d) Disociation
e) Conversion
71. Impairment of memory especially
wht term and recent … was the sign of
: He looked very happy and energetic.
a) Dementia
b) Delirium
c) Amnestic Organic
d) Disociation
e) Conversion
CASE :
A 26 yo man brought to hospital
because he hardly … past week. He
had history of hospitalization in Mental
institution …. Times for the past 2
years. Sometimes he never talked and
not …. His body at all for several hours
72. The most possible diagnose is :
a) Paranoid Schizophrenia
b) Disorganized Schiz.
c) Catatonic Shiz.
d) Undifferentiated Schiz
e) Residual Schiz.
73. Blunted affect and negative
symptoms are the sign of :
a) Paranoid Schizophrenia
b) Disorganized Schiz.
c) Catatonic Shiz.
d) Undifferentiated Schiz
e) Residual Schiz.
74. Waxy flexibility can only be found
in :
a) Paranoid Schizophrenia
b) Disorganized Schiz.
c) Catatonic Shiz.
d) Undifferentiated Schiz
e) Residual Schiz.
CASE:
25 yo man was brought to ER becoz
he hardly slept over 2 months. He
talked a lot about everything,
commenting almost about everything
but sometime not related one another.
He even claimed tht he was the
smartes person who ever lived in this
world.
75. The most possible diagnosis is :
a) Psychozomatic
b) Schizophreni
c) Delusional disorder
d) Mania with psychotic feature
e) mania without psychotic
feature
76. If in the past he had a history of
retarder psychomotor, lack of energy,
difficult in concentrate, and
disturbance of sleep, then the
diagnosis should be :
 a) Schizoaffective disorder enjoyed wearing girls cloth. He even
b) Mixed type schizophrenia said to his parents that he wanted
c) Bipolar very much to be like girls at what ever
d) Dysthmia the consequences.
e) Cyclothymia
77. if the patient also claimed that he 81. The most possible diagnose :
always hear voices commenting a) Dual role transvertism
everything that he did in the past 2 b) Transvers feticishm.
months, the diagnosis should be : c) Transexualism
a) Schizoaffective disorder d) Masochism
b) Mixed type schizophrenia e) Pygmalion
c) Bipolar
d) Dysthmia 82. The diagnosis is the disorder of :
e) Cyclothymia a) Sexual deviation disorder
b) Paraphilia disorder
78. Anatomical abnormalities that c) Sexual dysfunction disorder
could be found in schizophrenic : d) …
a) Narrowing of the third e) …
ventricle
b) Bigger brain volume 83. What is the term for woman who is
c) Cortical hyperthropy hypersex called :
d) Enlargement of the fourth a) Female mania
ventricle b) …
e) Bigger hippocampus c) Nymphomania
d) Hypomania
79. All of the following are signs and e) Female paraphilia
symptoms of mania, except :
a) Euphoric 84. In sexual response cycle,
b) Expansiveness hypersexual is a phase of…
c) Quite a) Desire
d) Flight of ideas b) Organic
e) Decrese sleep c) Resolution
d) Excitement
80. We can find the term “La Belle in e) Enjoyment
Difference” in :
a) Panic disorder 85. Persistent tendency to look a
b) Post traumatic disorder people do the sexual activity, is the
c) Conversion disorder behavior …
d) Depression a) Voyeurism
e) Anxiety b) Exhibitionism
c) Feticism
CASE : d) Frotteurism
15 yo boy was brought to psychiatric e) Necrophilia
becoz he always acted like girls. He
86. A man rubbing his penis against
woman bottom and parts of fully
clothed woman to achive orgasm, is …
a) Voyeurism
b) Exhibitionism
c) Feticism
d) Frotteurism
e) Necrophilia