Soal Final Gastro Lengkap

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a 25 yr old woman come to clinic with main complain of right upper abdominal pain .. what organ that possibly causing the main complain 1. What is the organ that might be suffering in this patient except: a. Stomach b. Duodenum c. Liver d. Gall Bladder e. Asc. Colon 2. A 24 y.o woman was admitted to the hospital with jaundice since the last 7 days. She… reported the darkening of her urine for 3 days before admission. On x-ray examination without use of contrast medium there are seen multiple calcified-stones in the right upper quadrant . According to the above scenario, which one of the biliary system involve. a. Liver b. Gall bladder c. Pancreatic duct d. Common duodenal duct e. Common hepatic duct 3. Our throat divides into two separate tubes; the windpipe and the gullet. What prevents food from entering the windpipe? a. The uvula b. The tongue c. The trachea d. The epiglottis e. The oesophagus 4. Where does the partly-digested food (in liquid form) go after it leaves the stomach? a. The gullet b. The appendix c. The small intestine d. The large intestine e. Sigmoid colon 5. A 20 y.o boy came to the clinic department complaining of right lower quadrant from sleep last night. This chief complaint is

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Transcript of Soal Final Gastro Lengkap

a 25 yr old woman come to clinic with main complain of right upper abdominal pain.. what organ that possibly causing the main complain

1. What is the organ that might be suffering in this patient except:a. Stomachb. Duodenumc. Liver d. Gall Bladdere. Asc. Colon2. A 24 y.o woman was admitted to the hospital with jaundice since the last 7 days. She reported the darkening of her urine for 3 days before admission. On x-ray examination without use of contrast medium there are seen multiple calcified-stones in the right upper quadrant. According to the above scenario, which one of the biliary system involve.a. Liver b. Gall bladderc. Pancreatic ductd. Common duodenal ducte. Common hepatic duct3. Our throat divides into two separate tubes; the windpipe and the gullet. What prevents food from entering the windpipe?a. The uvulab. The tonguec. The trachead. The epiglottise. The oesophagus4. Where does the partly-digested food (in liquid form) go after it leaves the stomach?a. The gulletb. The appendixc. The small intestined. The large intestinee. Sigmoid colon5. A 20 y.o boy came to the clinic department complaining of right lower quadrant from sleep last night. This chief complaint is associated with nausea and episodes of vomiting. The patient also reports that he has chills. What is the organ structure might be suffering in this patient?a. Appendix vermiformisb. Oesophagus (abdominal part)c. Duodenumd. Stomache. Pancreas6. What the organs the located retroperitoneal (lie behind peritoneum)?a. Ileum, jejunum (intraperitoneal)b. Transverse and sigmoid colon(intra)c. Asc. And desc. Colond. Abdominal part of oesophaguse. Both right and left lobe of liver7. Mouth or oral cavity divided into two area, vestibule and oral cavity proper. Which of the following statement is correct due to vestibule?a. Space behind alveolar processesb. Space between cheeks and alveolar processesc. Hard and soft palate as roofd. Large space in the oral cavitye. Tongue located in this area8. Which one of the following is incorrect about liver?a. Smallest solid organ in bodyb. Lies in right lower quadrantc. Consist of 4 lobesd. Vena cava inferiore. Hepatic duct9. Which one of the following statements is NOT the characteristics of oesophagus?a. Nonkeratinized stratified squomous epithelium b. Lymphocytes in lamina propriac. Mucous glands in submucosa d. Stratified musclee. Mesothelium10. Which of the following gastric juice component is not produce by chief cell??a. Pepsin b. Lipasec. Amylased. Pepsinogene. Hydrochloric acid11. .Peyer patches is a mass of lymphatic nodule on lamina propria of the:a. Gasterb. Duodenumc. Yeyenumd. Ileume. Colon12. The brunners glands are the mucous glands in submucosa of thea. Rectumb. Colonc. Duodenumd. Yeyenume. Ileum13. the central part of the liver lobules is?a. Sinusoidb. Portal areac. Portal veind. Central veine. Trigonum kiernann14. The following are considered as the characteristic of colon :1. Many goblet cell2. Small villi3. Crypt Liberkun4. Small Plica Circularis15. The epithelium of small intestine :1. Goblet cell2. Parietal cell3. Paneth cell4. Chief cel16. what the characteristics of the lagre intestinal1. many goblet cell2. short villi3. cript of liberkhun4. berlipat lipat17. An 15 y.o male with pernicious anemia lacks intrinsic factor, which is necessary for the absorbtion of cyancobalamin. Intrincsic factor produce by ?a. Osyntric cellb. Parietal cellc. G celld. D celle. S cell18. A 30 y.o policeman presents with the chief complaint of intermittent mid epigastric pain that isby antacids or eating. Gastric analysis reveals that basal and maximal acid output exceed normal values. The gastric acid hypersecreation can be explained by an increase in the plasma concentration of which of the following?a. Gastrin b. Histaminec. Somatostatind. Secretin(merangsang pancreas keluarkan bikarbonat)e. Enterogastrone(pancreas mengelearkan ion bikarbontat)19. A patient present with chronic cough..the patient also reports substernal burning pain that is most pronounced after ingestion coffee,chocolate,french-fries, and alcohol. which of the following is the most likely cause of GERD in this patient?a. Hiatal herniab. Delayed gastric emptyingc. Decreased esophageal motilityd. Decreased lower esophageal sphincter tonee. Decreased upper esophageal sphincter tone20. 28 y.o. man present emergency room with a 48-hours about diare with straetorea. Which of the following best accounts for the appearance of the excess fat of the stool?a. Delayed gastric emptyingb. Deceased bile salt pool sizec. Decreased gastric acid secretiond. Decreased gastric accommodatione. Decreased secretion of intrinsic factors21. After secretion of trypsinogen into to duodenum the enzyme is converted into its active form, trypsin. By which of the following?a. Enteropeptidaseb. Carboxypeptidasec. Pancreatic lipased. Chymotrypsine. An alkaline pH22. Which of the following is the mayor mechanism for absorbtion of protein from the small intestine?a. Na+- H+ exchangeb. Cotransport with sodiumc. Electrogenic transportd. Nacl absorptione. Solvent drag23. Young mother calls pediatric.Her infant defecat after every meal. Cause of these normal bowel movement in newborn :a. gastroileal reflexb. intestino-intestinal reflexc. gastrocolic reflexd. defecation reflexe. peristaltik rushes24. Positive diare and liquid stool intravenous and electrolite sdh diberi positif vibrio cholera water & nutrien absorption :a. most water from ingested foodb. the small intestine and colon have similar absorptive capacityc. osmotic equilibrition of chyme occurred in stomachd. the majority of absorption in the jejunume. cholera toxic inhibit sodium-couple nutrient transport25. which one of the following statement is correct about the saliva?a. pH 2 3 (6-7)b. secretion 1-1,5 l/hourc. containing IgA Antibodyd. one of its important contain is the protease e. containing disaccharide for hydrolyzing sucrose 26. which one of the following factor its possible to stimulate gastrin secretion?a. Hcl b. Secretin c. Calsitonine(rangsang saluran empedu untk megngelurkan bile salt)d. Vip(relaksasi otot polos spinkter dan hambat sekresi asam lambung)e. Nutrient proteins27. Which one of the following hormones to stimulate contraction of gallbladder ?a. Gastrin b. Glucagonc. Choleysitokinin d. Entrocrinee. Secretin28. Which one of the following enzymes is exoenzyme?a. Pepsinb. Trypsinc. Elastased. -amilasee. Carboxipeptidase29. Which one of the following is needed to convert biliverdin to bilirubin?a. Nadp+ + O2b. Carbonmonoxidec. hemeoxidased. Biliverdin reductasee. UDP- glucoronil transferase30. Bile salt primarily derived from :a. Trigliserideb. Phospholipidc. Hemeproteinsd. Cholesterole. Globin25 yo male come to health centre with diarrhea. He states that his stool was mixed with blood and mucose. Examination of his stool reveal paracyte with characteristic as follow : irregular, pear shaped, ectoplasm sharply separated from endoplasm, has one nucleus with small central compound..has karyosome, and endoplasm contain red blood cells31. Which one of the following organism is the most likely found in this men stool?A. Trophozoit of gardia lambliaB. Trophozoit of entamoeba coliC. Trophozoit of endolimax nanaD. Trophozoit of balantidium coliE. Trophozoit of entamoeba hitolytica32. What is the best diagnosis for the case above?A. GiardiasisB. AmebiasisC. ShigellosisD. IsosporasisE. Balantidiasis33. 25 yo male come to health centre with diarrhea. He states that his stool was mixed with blood and mucose. Examination of his stool reveal paracyte with characteristic as follow : fat granules, bilaterally symetric pear shaped, rounded on anterior part, pointed on posterior, 2 nuclei, 4 flagella, 2 axostlyes.34. Which one of the following organism is the most likely found in the girls stool?a. Tropozoite of E. hystoliticab. Tropozoite of balantidium colic. Tropozoite of E. Colid. Tropozoite of giardia lamdiae. Oocyst isospora coli35. What is the best diagnosis for the case above?A. GiardiasisB. AmebiasisC. ShigellosisD. IsosporasisE. Balantidiasis36. Hepatitis D is a defective virus that only replicates in the cells that are affected by :a. HIVb. HGVc. HAVd. HBVe. Herpes Simplex Virus37. The lab examination result of a hospital worker showed the present hepatitis virus B surface antigen (HbsAg ). Subsequent test revealed the presence of a antigen as well. The worker must likely : a. Is infective and has activehepatitisb. Is infective but does not have active hepatitisc. Is not infectived. Has a false-positive tes for hepatitise. Has both hepatitis B and C38. A Patient has all the gastrointestinal sympthoms with Hepatitis A Virus (HAV)et all the test for HAV-lgG & HAV-lgM are non reactive. A posible case at this infection is:A) Hepatitis B surface antigen (HBsAg)B) Hepatitis EC) Hepatitis DD) RotavirusE) Hepatitis C39. Other virus can also cause hepatitis, but their major manifestation clinically indistinguished from viral hepatitis. which of the virus below a. Molluscum contangiossumb. Corona virusc. Herpes simplex virus (HSV)d. Measles viruse. Varicella virus40. Which one of the followings is the property of HBV?a. lipid contain of envelopes containts HbcAgb. virion enveloped without envelopec. gastric acid is not stabled. HBV has 4 antigene. genome consist of double-striated DNA with an positive strand41. which one of the following is the characteristic of H. pylory?a. Non motile(motil aktif)b. On media skirrow growing within 2-3 day in temperature 35C(3-6)c. Have 4-7 sheated flagella arising from the only one end of the celld. Oxidase negative(aktif)e. Catalase negative(aktif)42. A patient 35 y.o come to a clinic with main complaint of acute stomach pain, subfebris, and diarrhea after consuming some seafood in the restaurant 6 hours ago. There were no anomaly in the endoscopy and plain abdominal photo and the microscopic examination of the feses revealed no blood. No history of NSAID before. In the puskesmas with not so good facility for diagnostic, what kind of activity should be done. Medical doctor to make diagnostic for this patient. a. Check the blood pressure and hematologic routineb. Do microscopic examination to the blood sample of the patientc. Do gram staining of urine sampled. Refer the patient to the hospitale. Check the gastric liquid by microscope43. High the possibility the cause of microbe for this patient is:a. Candida albicanb. Salmonella sppc. H. pylorid. Clostridium perferingense. M. tuberculosis44. a. Appendicitis acuteb. Peptic ulcerc. Carcinoma pancreaticd. Food poisoning by microbee. Intolerance of the lactose and sucroseA 45 y.o women, hospitalized due to difficulty in swallowing. A tumor in her oesophagus located near the stomach-esophageal junction was found by endoscopice examination45. Type of tumor that could be found mostly at that location is a. Adenocarcinomab. Basal cell carcinomac. Squamos cell carcinomad. Undifferentiated carcinomae. Adenosquamos carcinoma46. The tumor occur at that location iniciated by metaplastic change and dysplastic change due to the present of chronic irritation by the stomach acid reflux the distal part of oesophagus that metaplastis change occurred is called :a. Atresia oesophagusb. Stricture oesophagusc. Varices oesophagusd. Barret oesophaguse. Burkitt oesophagusA 30 y.o womewn come to doctor with frequent epigastric pain. The doctor diagnose her as a chronic gastritis patient. Because she suffered from the disease in long period the doctor worried about the possibility of cancer development, and he asked her to visit a gastroenterologist to know the actual cause of the disease.47. Among the possible cause of the disease (chronic gastritis) which one of them having haighest possibility to develop stomach cancer.a. Gastric outlet obstructionb. Chronic functional dyspepsiac. Chronic infection by H. pylorid. Chronic chemical gastritis caused by bile refluxe. Chronic autoimmune gastritis of parietal cells 48. The endoscopy examination followed by biopsy of the gastric lesion was performed at the gastroenterology department. The pathologic examination of biopsy specimen found the cause of the chronic gastritis having a very high risk to develop stomach cancer, and the pathologist reports the present of intestinal metaplasia and dysplasia of the stomach epithelial. The conclusion is :a. Chronic gastritis is not severeb. Chronic gastritis is severe and stomach cancer already presentc. Chronic gastritis is severe but dont worry for development of stomach cancerd. Chronic gastritis is severe and high risk for the development of stomach cancerA 61 y.o woman came to doctor with hematemesis, melena, and frequent epigastric pain. She showed sign of anemia with 4gr% of hemoglobulin level. By endoscopic examination the diagnosis was ulcer in the stomach. 49. The incorrect statement about stomach ulcer is:a. Peptic ulcer in the stomach never cause perforationb. Ulcer penetration in acute ulcer reaches muscular layerc. The most cause of ulcer of stomach is H. pylorid. Term erosion is used if the ulcer penetration limited on mucous layere. The ulcer may cause massive bleeding if ulcer affected a big blood vessel50. Anemia due to :a. A long time of massive bleedingb. A slight bleeding in a long timec. Abnormal absorption of Fed. bleeding occured in short time but affected big blood vessee. vit. 12 deficiency 51. the possible differential diagnose for this case could be :1. chronic hepatitis2. cholelithiasis3. cirrhosis4. heamolytic anemia 52. jaundice may be due to :1. renal failure2. hyperglycemia3. severe erythrocyte hemolytic4. liver insufficiency53. type of jaundice of this case is :a. pre hepatic jaundiceb. post hepatic jaundicec. alcoholic jaundiced. haemolytic jaundicee. hepatocellular jaundice54. which one of the following tumor markers should be considered for this case :a. CA 72-4b. CA 15-3c. AFBd. POAe. CA 19-955. The routine position of plain abdominal radiography in case of acute abdomen is:a. Supine-erect-right lateral decubitusb. Supine- erect-left lateral decubitusc. Supine-prone-erectd. Supine-prone-lateral decubituse. Supine-prone-erect-lateral decubitus56. A 60 years old man with melena. Which of the following radiologic examination you recommended to be perfomed?a. Sialographyb. Barium enemac. Follow throughd. Broncographye. Gastroduodenography57. A 45 years old man with hematemesis melena. Esophagogram showing cobble-stone appearance. The most likely diagnosis is varises58. A women 65 years old was reffered to radiology department for gastroduodenography with the clinical history of haematemesis. Gastroduodenogram showed persistant filling defect with irregular border along the wall of stomach body. The most likely diagnosis is:a. Ulcerb. Diverticlec. Gastritisd. Polype. Malignant tumorFor question 58-60A 60 years old male patient, complains acute epigastric pain with postprandial nausea. Vomiting, weight loss and gastrointestinal bleeding were denied. Physical examination reveal no significant findings, only mild tenderness from epigastric area.59. The most likely diagnosis of this patient according to rome III criteria:a. Peptic ulcerb. Gastric tumorc. Epigastric pain syndromed. Post prandial fullness syndromee. Gastroesophageal reflux disease60. the most suitable diagnostic procedure for this patient that associated with the symptons:a. Barium meal because this is an initial simple procedureb. Endoscopy of lower GI tract because no symptom was appear to be upper GI tract diseasec. Endoscpy of upper GI tract because the age of this patient was appear to be one of alarm symptomd. Utrasonography of abdominal because the symptoms appear outside of upper GI tracte. No real to take diagnostic procedure because of acute symptoms61. the concept of alarm sign are:A. Indication to perform endoscopyB. The sign that appear as alarm for patient with dyspepsiaC. A board spectrum of symptom that appears as alarm to perform endoscopyD.A board spectrum of symptom that appears as alarm with dyspepsia p[atientE.A board spectrum of symptom that appears as alarm to perform endoscopy or USG62. Treatment according the temporary diagnosis, there are three types of antisecretory acid could be used. They are:a. Antacid, H2 receptor antagonis, and anxiolitic agentB. Proton pump inhibitor, promotility agent, antacidC. Antacid, H2 receptor antagonis, proton pump inhibitorD. H2 receptor antagonis, promotility agent, anxiolitic agentsE.H2 receptor antagonis, promotility agent, proton pump

For question 62-63Three months later, the patient above comes again complain of melena, from history taking he was suffering from rematoid arthtritis and using prednisone with non-steroid anti inflammatory drugs (NSAIDs) for a past few year. Upper GI tract reveal as peptic ulcer.63. Pathomechanism of gastroduodenal injury related to NSAIDa. inhibition of cyclo-oxygenase receptor with direct accumulation of NSAIDb. direct accumulation causing inflammation decreased of prostaglandin and neutrofil formationc. indirect accumulation causing inflammation decreased of prostaglandin and neutrofil formationd. direct inhibition causing inflammation increased of prostaglandin and neutrofil formatione. Indirect inhibition causing inflammation increased of prostaglandin and neutrofil formation64. Recommendation for this patient to avoid the complain, such as:a. discontinue NSAIDs and ulcerogenic drugsb. using PPI while NSAID continue or chang to COX-2c. identify high risk patient: >60 y.o, prior G.I bleed, high dose NSAID, ... steroidd. A & C choicee. B & D choice

For question 64-66A 25 years old male patient complain with nausea, vomiting, artralgia, anorexia and malaise within 2 weeks. After 7 days, patient have dark yellow urine and according his friends, yellow eyes was appear on his eyes recently. Physical examination reveal: sclera icteric and light pain palpable in upper hypocondrium dextra, laboratory: bilirubin total 16,8 mg%, Bilirubin direk 8,5mg% SGOT=250U/I, SGPT=400U/I65. Initial serologic marker can be done for common etiology:1. Anti HAV2. Anti HBsAg3. Anti HCV4. Anti HEV66. The common etiology of viral hepatitis are:a. HAVb. HBVc. HCVd. HAV, HBV, HCVe. HDV, HEV67. Therapy anti viral analog, nucleotide/nucleoside and interferon generally use in:a. Acute hepatitis Ab. Acute and cronic hepatitis Bc. Chronis Hepatitis Dd. Chronis Hepatitis B and Ce. Acute and cronis hepatitis C68. Diagnosis according anamnesis, physical examination and laboratory are:a. Ascitesb. Cirrhosis compensated c. Chronic Liver diseased. Cirrhosis decompensatede. Acute Hepatitis69. Complication can occur according diagnosis of the patient:1. Varices/bleeding2. Peritonitis bacterial spontaneous3. Hepatorenal syndrome4. Encelopathy hepaticum70. The general mechanism of ascites1. Portal Hypertension2. Hypoalbuminemia3. Decreasing of oncotic plasma4. Increasing of hydrostatic preassure

For question 70-72A boy 6 years old complained abdominal pain, especially at right lower quadrant it had been felt 3 days ago and become severe now until the right leg was pain. The child had fever and sometimes vomiting. Micturation were in normal limit and bowel movement were less less today71. According to find the etiology of abdominal pain, the first step is to look for:a. Nutritional statusb. Genderc. History of medicine befored. Agee. Other complaining signs72. If there is Rovsings sign in physical examination, possibleof diagnosis is:a. Urinary tract infectionb. Gastritisc. Diverticulitisd. Appendicitise. Constipation73. The diagnosis adjunct must be done at first step is:a.BNOb.Colon in loopc.Abdominal USGd.Complete blood counte.IVPFor question 73-75A girl, 2 years of age had watery stool yesterday with less waste, she can drink less water but get vomiting. Her general condition was nervous. The girl has well nutrition.73.The girls possibly suffer from:a. severe dehydration diarrheab. mild-moderate dyhidrationc. Acute diarrhead. Chronic diarrheae. Persisttant diarrhea74. What is the most possible cause for diarrhea?a. Salmonella pretyphib. Shigellac. Fungid. Viruse. Fungi75. first line treatment in this case;a. antibacterialb. antiviralc. breastfeedingd. oral rehydratione. antifungal76. Common causes neonatal jaundice;a-physiologic jaundiceb-c-brest milk jaundiced-obstructive jaundicee-normal liver function not fully formed77. Physiologic jaundice;a- direct hyperbilirubinemiab- normal direct bilirubinc- direct n indirect hyperbilirubinemiad- caused by abnormality of the billiary tracte- completly disappear78. Obstructive Jaundicea. Diagnosed based on clinical pictureb. Has similarity with breast milk jaundicec. Always resolved completelyd. Without complicatione. Outcome is not influenced by early diagnosis and treatment79. Clinical picture of hepatitisa. Most Patient without symptomsb. Easy to differentiate from other etiology of hepatitisc. Auto immune process never cause hepatitisd. Always progress to chronic forme. Symptomatic therapy only 80. Viral hepatitis Aa. Main transmission is parenteralb. Always progress to chronic formc. Interferon is the drug of choiced. Incidence is influenced by social-economic, sanitation, and hygiene of societye. Never recover completely 81. Viral Hepatitis Ba. Never progress to chronic formb. Immunization soon after birth can reduce clinical ratec. Clinical picture is specificd. Parenteral transmission vary raree. Incubation period less than 4 weeks82. A 55 y.o woman complains nausea and vomiting. The doctor administer central and perifer action antiemetic drug of antiemetic drug. The drug isa. Domperidonb. Metoclopramidec. Cisaprided. Betahistinee. Fluphanezine83. A 17 y.o girl woman visit her family doctor because of diarrhea. The doctor gives non-specific anti-diarrhea with norcotoc effect. The drug is :a. Loperamideb. Norit c. Pectind. Attalpugitee. Carboabsorbance84. Women age 45 y.o visit her and complaint suffering from epigastric pain. The doctor treat her with proton blocker and antispasmodic. The drugs below has effect as proton blocker is :a. Cimetidineb. Ranitidinec. Cisaprided. Omeprazolee. Domperidon85. antispasmodic drug :a. papaverineb. ranitidinec. lanprazoled.domperidonee. loperamide86. 86. 44y.o housewife, is admitted to the ward with nausea and pain especially over the right upper abdominal. She has a history of fever and medication.in physical examination is unremarkable. The most appropiate investigation for this ptient is :a. MRIb. USGc. MRCPd. CT SCANe.Plain photo87. The patient with leucositosis and pain in right upper abdominal on palpation. What is the most appropriate diagnosis at this stage?a. Cholelithiasisb. Lateral inguinal herniac. Acute appendicitisd. Acute pancreasitise. HepatitisA 30 y.o female patient who present with bleeding per rectum is found at colonoscopy to hv colitis confirmed to the transverse n descending colon. A biopsy is performed. 88. which of the following statement about this patient is true?a. nonceaseating granuloma can be expected in up to 50% of the patient wif similardiseaseb. the inflammation process is likely to be confined to the mucosa n submucosac. superficial as opposed to linear ulceration can be expectedd. the inflammatory rxn is likely to be continuouse. microabcesses within crypts are common89. What is the most potential complication in this patient a. Toxic megacolon is common b. Perforation occurs in about 25% of patientc. Would be at no increase risk for the development of colon cancer d. Fistulas between the colon and segment of intestine, bladder, vagina, urethra, and skin may developede. Extraintestinal manifestation including uveitis and erithema nodosum would be exceedingly rare in this patient90. A 22 y/o student notice a groin in his right. The groin is accentuated when coughing and reduce back. What is the pathway of groin through spermatid cord in the cremaster muscle?a. direct inguinalb. femoralc.springliand. parietale. indirect inguinal

Patient 5 y/o, male. Admitted to the hospital with a bulge swelling in the groin and sometimes may extend into the right scrotum. The bulge may appear and then dissapear. Appear during straining, crying or coughing. There is no vomiting and no distention. Rectal touche is within normal limit.91. What is clinical diagnose?a. hydrocele uncommunicate dextrab. inguinal hernia reponible dextrac. femoralis hernia dextrad. orchitis dextrae. carcinoma of dexter testis92. . Differetial diagnosis for this case with use translumination test is:a. hydroceleb. incarcerata herniac. strangulate herniad. inguinalis herniae. testis carcinomaPatient 4 months years old, female. Admitted to the hospital with bulge(swelling) in umbilical region. There is no changing color of skin. In physical examination is normal. The bulge may appear during straining. There is no vomiting and no abdominal distention.93. what is the most likely diagnosis for this case?a. umbilical herniab. umbilical fistelc. ductus omphalomesenterium persistentd. omphalocelee. umbilical granuloma94. the correct answer for this case treatment isa. Will not close spontaneouslyb. Directly operate (cito)c. observe until age 3 to 4 yearsd. Incidence of incaracerata is highere. Eksisi granuloma95. Surgical management of this case isa. laparoectomy explorasib. eksisi luas granulomac. fistulectomyd. repair omphalocelee. repair hernia umbilicial96. Man 28 years old with BMI 25.7kg/m waist circumference 95cm came to the clinicbecause of heart burn especially after have meal. what you suggest him to take.a. have a soft mealb. have a small portion of meal but frequently.c. have a coffee after having a meald. have a meal early as possiblee. have a cold meal.97. college student,22 years old,always complaining for pain in the epigastric area. now, he loses his weight about 2 kg since 2 month ago. what do you suggest for him (intake) tp prevent another weight loss?a. avoid high protein foodb. avoid high carbohydrate food.c. have prebioticd. have immunonutrition supplemente. have high fiber food.98. Man 45 years old come to private clinic because of bloating and pain in the abdomen.To maintain the mucous intestinal,what nutrient should be given to this man?a. arginineb. probioticc. prolined. glutaminee. prebiotic99. Women 60 yo have a tumor in her stomach .Now she has jejenutube feeding. Food should be given slowly as it can.if she has abdominal fullness and crampy.waht sign stand for?a. refeeding syndromeb. untolerance syndromec. Chron's syndromed. Dumping syndromee. Tolerance syndrome100. Woman, aged 38 years, epigastric pain dat radiates to the back..nutrition that is suitable for hera. stop oral intakeb.fish oil supplementc. curcumine supplementd. liquid nutritione. eat small portion of meal frequently101. Top of Form102. Bottom of Form