Blok 7 Pembahasan

7/24/2019 Blok 7 Pembahasan

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1-10 Blom

Azzahra S Intansari (11-20)

11. Parathyroid hormone is important in regulating calcium homeostasis. Which of the

following mechanisms is the direct action of parathyroid hormone?a. Controls the rate of 25 hydro!ycholicalciferol formation

". Controls the rate of calcium transport in the mucosa of small intestine #indirect$

c. Controls the rate of formation of calcium "inding protein

d. Controls the rate of formation of 1,25 dihydroxyholialiferol

e. %timulates renal tu"ular phosphate rea"sorption #hrsny "loc&s$

http'((www.prep)usmle.com(forum(thread(51*+)(

P, has + maor actions.

1. ,he first action is to increase renal calcium resorption and phosphate e!cretion. /n

the &idney P, "loc&s rea"sorption of phosphate in the pro!imal tu"ule while

promoting calcium rea"sorption in the ascending loop of enle distal tu"ule and

collecting tu"ule.

2. P, promotes a"sorption of calcium from the "one in 2 ways. ,he rapid phase

"rings a"out a rise in serum calcium within minutes and appears to occur at the leel

of the osteo"lasts and osteocytes. When P, "inds to receptors on these cells the

osteocytic mem"rane pumps calcium ions from the "one fluid into the e!tracellular

fluid.

,he slow phase of "one resorption occurs oer seeral days and has 2 components.

irst osteoclasts are actiated to digest formed "one and second proliferation of

osteoclasts occurs. /nterestingly mature osteoclasts lac& P, mem"rane receptors3

actiation and proliferation appear to "e stimulated "y cyto&ines released "y actiated

osteo"lasts and osteocytes or "y differentiation of immature osteoclast precursors that

possess P, and itamin 4 receptors.

+. ,he third maor action of P, is conersion of 25-hydro!yitamin 4 to its most

actie meta"olite 125-dihydro!yitamin 4-+ 125-#6$2 4+7 "y actiation of

en8yme 1-hydro!ylase in the pro!imal tu"ules of the &idney.

12. /nsulin is the mayor control for "lood glucose leel. Which of the following is the

most li&ely to produce the greatest increase in insulin secretion?

a. 9mino acids

!. Amino aids and "l#ose

c. 9mino acids and somatostatin

d. :lucose and somatostatine. :lucose and glucagons

/, dr.%W;
http://www.prep4usmle.com/forum/thread/51734/http://www.prep4usmle.com/forum/thread/51734/http://www.prep4usmle.com/forum/thread/51734/


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9&si fisiologis /nsulin

1.


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http'((www.sridianti.com(per"edaan-antara-hipofisis-anterior-dan-posterior.html

ipofisis posterior yang mengeluar&an hormon posterior terdiri dari aringan glial dan

termini a&sonal. Pada dasarnya menyimpan hormon yang disintesis dalam "adan sel

neuron supraopti& dan paraentri&ular di hipotalamus. /ni tida& menghasil&an hormon

sendiri tida& seperti hipofisis anterior. ipofisis posterior mengeluar&an dua hormon3

ormon antidiureti& #94$ yang merupa&an regulator dari olume plasma dan

o&sitisin yang memili&i pengaruh terhadap &ontra&si uterus dan menyusui.

15. 9 )>-year old man has puffy s&in and is lethargic. is plasma thyroid stimulating

hormone ( ,% concentration is low and increases mar&edly when he is gien thyrotropin-

releasing hormone ( ,@. Which of the following is the most li&ely diagnosis?

a. yperthyroidism due to a thyroid tumor". yperthyroidism due to an a"normality in the hypothalamus

c. yperthyroidism due to an a"normality in the thyroid

d. &y$erthyroidism d#e to an a!normality in the hy$othalam#s(hy$o 'ali

m'sdny*)

e. yperthyroidism due to an a"normality in pituitary

https'((www.academia.edu())>DE)E(9;9,6


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ipotalamus gagal memprodu&si ,@ sehingga se&resi ,% menadi rendah.

1>. 9 large dose of insulin is administered intraenously to a patient. Which of the following

sets of hormonal changes is most li&ely to occur in the plasma in response to insulin

inection?

a. +& inrease, "l#a"on derease, e$ine$hrine no han"e

". : no change glucagon increase epinephrine increase

c. : increase glucagon increase epinephrine increase

d. : decrease glucagon increase epinephrine increase

e. : decrease glucagon decrease epinephrine no change

/, dr.%W;

/ne&si insulin mem"uat se&resi glucagon menadi menurun #&era antaganis$

sedang&an hormone epinephrine hanya diguna&an dalam &ondisi fire fight fright #&ondisi

terdesa&$. 9dapun hal-hal yang mening&at&an : plasma '

1. ypothalamus ia :@ dan somatostatin.

2. 9sam amino ia nuclei Aentromedial hypthalamus.

+. %tress(trauma mening&at&an : tapi tida& pertum"uhan.). %trenuous e!ercise.

5. ypoglycemia.

>. ,idur teradi pening&atan &adar ma!imal : setelah 1 am tidur dalam # deep

sleep( slow wae sleep $

pening&atan &adar : mediated "y lim"ic system ( serotonin.*. %omatomedin negatie feed "ac&.

Pada &eadaan ine&si insulin menanda&an insulin #mening&at &adarnnya$ yang

menanda&an "ahwa glu&osa dalam darah rendah &arena glu&osa diru"ah menadi

gli&ogen. al ini "erarti : a&an menig&at.

1*. ,ransport of hormone can "e in free form and(or "ound to plasma proteins. Which of the

following hormone is largely un"ound to plasma proteins?

a. Cortisol

". ,hyro!in ( ,)

c. 94d. Hstradiol

e. Progesterone

I.dr. S

,ransport ormone

Protein hormoneswater solu"le

Circulates as its hormone form.

%teroids thyroid hormones lipid solu"le

1. free ' 1 J

2. "ound ' DDJ


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K BP -BP

,ransport of cortisol

9. ree ' )J in plasma.

B. Bound ' D>J.

1. al"umin '15J non specific low affinity reersi"le

2. cortisol "inding protein #CB:$

specific.

1E. ,he action of hormone can "e influenced "y the leel of plasma proteins in "lood. Which

of the following changes would "e e!pected to occur with increased "inding of a hormone

to plasma proteins?a. /ncrease in plasma clearance of the hormone

". 4ecrease half life of hormone

. Inrease hormone ati/ity

d. /ncrease in degree of negatie feed"ac& e!erted "y the hormone

e. /ncrease in plasma reseroir for rapid replenishment of free hormone

http'((pusta&a.unpad.ac.id(wp-

content(uploads(2010(05("iosintesisFse&resiFdanFme&anismeF&eraFhormon.pdf

Pada hormon polipeptida pengi&atan plasma dapat mening&at&an wa&tuparuh

hormon dalam sir&ulasi3 uga dapat mempermudah pengirimannya &e

dalam aringan target.

/, dr.%W;

AS A 34A6IS3 7 &34S

I 9mines peptides and proteins circulate in free form whereas steroids and thyroids

hormones are "ound to transport proteins

8 indin" of hormones to arrier $roteins has a $rofo#nd im$at on the hormone

learane rate from the ir#lation

I ,he meta"olic clearance rate of hormone defines Luantitiely its remoal from plasma

I ,he interaction of hormones with their target tissues is apparently followed "y

intracellular degradation of the hormone
http://pustaka.unpad.ac.id/wp-content/uploads/2010/05/biosintesis_sekresi_dan_mekanisme_kerja_hormon.pdfhttp://pustaka.unpad.ac.id/wp-content/uploads/2010/05/biosintesis_sekresi_dan_mekanisme_kerja_hormon.pdfhttp://pustaka.unpad.ac.id/wp-content/uploads/2010/05/biosintesis_sekresi_dan_mekanisme_kerja_hormon.pdfhttp://pustaka.unpad.ac.id/wp-content/uploads/2010/05/biosintesis_sekresi_dan_mekanisme_kerja_hormon.pdfhttp://pustaka.unpad.ac.id/wp-content/uploads/2010/05/biosintesis_sekresi_dan_mekanisme_kerja_hormon.pdf


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1D. 9 5>-year old man as deeloped the syndrome ofina$$ro$riate Anti di#reti hormone

secretion due to carcinoma of the lung. Which of the following physiological responses

would "e e!pected?

a. /ncreased plasma osmolality

!. Ina$$ro$riately lo% #rine osmolality (relati/ely to $lasma osmolality)

c. /ncreased thirstd. 4ecreased secretion of anti diuretic hormone from the pituitary gland #ustru

hiperse&resi 94$

e. 4ecreased water rea"sorption in renal tu"ules #ustru mening&at&an rea"sorpsi$

http://archive.kaskus.co.id/thread/8833696/0/siadh-syndrome-of-

inappropriate-anti-diuretic-hormone

Masalah utama dalam S!"# adalah ke$a$alan untuk menekan

secara maksimal sekresi vasopresin. %ele&ihan !"# ini

men$aki&atkan retensi air dan ekspansi volume' yan$ menye&a&kan

penin$katan &erat &adan dan ter(adinya natriuresis.

)smolalitas serum turun di &a*ah nilai normal. #iponatremia

&iasanya tidak ter(adi kecuali pasien menerima &e&erapa sum&er air

&e&as. +atriuresis ter(adi karena penurunan rea&sorpsi natrium di

tu&ular proksimal' yan$ secara sekunder &ermakna untuk perluasan

volume cairan ekstraselular.%/94 - pathophysiology

94-induced water retention

4ilutional hyponatremia

Aolume e!pansion -M secondary natriuresis

%odium and water loss

Potassium loss

@esult' Huolemic hyponatremia

@educed serum osmolality

/ncreased urine osmolality

/ncreased urine sodium

20. 9 20-year old woman is not haing menstrual cycle. er plasma progesterone

concentration is found to "e minimal. Which of the e!planation for the low leel of

progesterone?

a. = secretion is eleated

". = secretion is suppressedc. % secretion rate is suppressed #?$

d. o or$#s l#te#m (*)
http://archive.kaskus.co.id/thread/8833696/0/siadh-syndrome-of-inappropriate-anti-diuretic-hormonehttp://archive.kaskus.co.id/thread/8833696/0/siadh-syndrome-of-inappropriate-anti-diuretic-hormonehttp://archive.kaskus.co.id/thread/8833696/0/siadh-syndrome-of-inappropriate-anti-diuretic-hormonehttp://archive.kaskus.co.id/thread/8833696/0/siadh-syndrome-of-inappropriate-anti-diuretic-hormone


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e. igh inhi"in concentration in plasma has suppressed progesterone synthesis

Galo menurut a&u &an hormone progesterone dihasil&an oleh &orpus luteum adi &alau

&orpusny hilang ma&a hormone progesetron yang dihasil&an uga rendah.

Irinne 9arina (21-:0)

21. 9 55-year old man suried from stro&e a month ago. ;ow he is paraly8ed at his right

side "ody. Which area in "rain that was affected "y his stro&e?

a. 9mygdala

". ypothalamus

c. ypocampus

d. 6eft hemis$here

e. @ight hemisphere

%um"er '

https'((www.scri"d.com(doc(1E)1*15D2(%tro&e-"agian-hemisfer-&iri-dan-&anan-doc!

22. 9 stro&e patient suffers e!pressie aphasia. ,he therapist teaches him to sing in order

to communicate his needs. What symptoms did he e!hi"it "efore therapy?

a. Nna"le to understand any spo&en or isual information

". Nna"le to differentiate gustatory sensation

. ;nderstand s$o'en and %ritten lan"#a"e !#t #na!le to ex$ress the res$onses in

normal syntax

d. Nnderstand the spo&en and written language "ut una"le to e!press his emotion

correctly

e. Nna"le to recall his long time memory
https://www.scribd.com/doc/184171592/Stroke-bagian-hemisfer-kiri-dan-kanan-docxhttps://www.scribd.com/doc/184171592/Stroke-bagian-hemisfer-kiri-dan-kanan-docx


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%um"er ' /, %istem =uhur %W; #%lide 12$

2+. 9 stro&e patient suffers e!pressie aphasia. Which is the most li&ely damaged area in his

"rain?

a. 9mygdale

!. roa


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2).


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e. Capa"le of dis-coordinating of disparate "ehaiors to achiee that goal

%um"er ' /, %istem =uhur %W; #%lide *+$

,he intracellular recording of cardiac cells.

@esting mem"rane potential -50 ->0 -E0

Capacity for diastolic depolari8ation Qes yes ;o

/ntrinsic rate of depolari8ation D0 )5 none

2>. Cell a would most li&ely to "e found in thea. Sinoatrial (SA) node

". 9trial muscle

c. 9trioentricular #9A$

node

d. Pur&ine fi"ers

e. Aentricular muscle


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%um"er '

/, Cardioascular 1

#Hle&trofisiologi$ 4 # %lide +D$

2*. Pacema&er actiity is e!hi"it "y

a. Cell 9

". Cell B

c. Cells C

d. Cells A and

e. Cells 9 and C Potensial 9&si pacu #pace ma&er 9P$ teradi di %9 node dan 9A ;ode. Cell 9

menunu&&an %9 node &arena /ntrinsic rate-nya D0 #;o.2>$ sedang&an Cell B

merupa&an 9A node &arena /ntrinsic rate-nya )5 #%esuai gam"ar di pem"ahasan

no.2>$.

%um"er ' /, Cardioascular 1 #Hle&trofisiologi$ 4

2E. Cells lac&ing fast ;a current during phase 0 of the cardiac action potential include

a. Cell 9

". Cell B

c. Cells Cd. Cells A and

e. Cells 9 and C


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lac&ing fast ;a current during phase 0 of the cardiac action potential teradi pada

potensial a&si pacu ( pacema&er. %el yang "ertugas se"agai pacema&er ada %9 dan 9A

node. Cell 9 dan Cell B menunu&&an %9 node dan 9A node. # %esuai awa"an no.2*$

%um"er ' /, Cardioascular 1 #Hle&trofisiologi$ 4 #%lide +2-++$

2D. 9n e!perimental record o"tained from an anestheti8ed dog

,he e!perimental interention at time 1 most li&ely represents'

a. Hlectrical stimulation of the "om"er sympathetic nere roots

". Hlectrical stimulation of the superior cerical ganglion

c. 9dministration of a R-adrenergic "loc&ing drugs

d. Stim#lation of the ri"ht /a"#s ner/e

e. 9dministration of a cholinergic "loc&ing drug

+0. ,he interention at time 2 most li&ely represents

a. Hlectrical stimulation of the sacral sympathetic nere roots

!. 4letrial stim#lation of the s#$erior er/ial "an"lion (Cardia Sym$atheti

er/e)

c. 9dministration of a sympathetic "loc&ing drugs

d. %timulation of the right agus nere

e. 9dministration of cholinergic "loc&ing nere/ni untu& menawa" soal 2D dan +0


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%um"er '

https'(("oo&s.google.co.id("oo&s?

idS0E5+B0T8U;/CpgSP9*E>dLS,heKinterentionKatKtimeK1KmustKli&elyKrepr

esentshlSensaSVeiSn)WAf*Nc>Gu9,!0o=/4gedS0CBwT>9Hw99S

onepageLfSfalse

3. Arif a#fal Ilham (:1-=0)

+1.

+2.

++.

+). ,he phase of the response action potential that is associated with the oltage gated

calcium current is

a. Phase 0

". Phase 1

. hase 2

d. Phase +

e. Phase )

Pem"ahasan

9&si potensial dalam "e"erapa fase. ase depolarisasi #fase 0$ adalah fase awal dari potensial

a&si yang tim"ul pada saat &anal ;aK mem"rane sel terstimulasi untu& mem"u&a. ase
https://books.google.co.id/books?id=0853B0QzZNIC&pg=PA786&dq=The+intervention+at+time+1+must+likely+represents&hl=en&sa=X&ei=Jn4WVf7UFc6KuATx0oLIDg&ved=0CBwQ6AEwAA#v=onepage&q&f=falsehttps://books.google.co.id/books?id=0853B0QzZNIC&pg=PA786&dq=The+intervention+at+time+1+must+likely+represents&hl=en&sa=X&ei=Jn4WVf7UFc6KuATx0oLIDg&ved=0CBwQ6AEwAA#v=onepage&q&f=falsehttps://books.google.co.id/books?id=0853B0QzZNIC&pg=PA786&dq=The+intervention+at+time+1+must+likely+represents&hl=en&sa=X&ei=Jn4WVf7UFc6KuATx0oLIDg&ved=0CBwQ6AEwAA#v=onepage&q&f=falsehttps://books.google.co.id/books?id=0853B0QzZNIC&pg=PA786&dq=The+intervention+at+time+1+must+likely+represents&hl=en&sa=X&ei=Jn4WVf7UFc6KuATx0oLIDg&ved=0CBwQ6AEwAA#v=onepage&q&f=falsehttps://books.google.co.id/books?id=0853B0QzZNIC&pg=PA786&dq=The+intervention+at+time+1+must+likely+represents&hl=en&sa=X&ei=Jn4WVf7UFc6KuATx0oLIDg&ved=0CBwQ6AEwAA#v=onepage&q&f=falsehttps://books.google.co.id/books?id=0853B0QzZNIC&pg=PA786&dq=The+intervention+at+time+1+must+likely+represents&hl=en&sa=X&ei=Jn4WVf7UFc6KuATx0oLIDg&ved=0CBwQ6AEwAA#v=onepage&q&f=falsehttps://books.google.co.id/books?id=0853B0QzZNIC&pg=PA786&dq=The+intervention+at+time+1+must+likely+represents&hl=en&sa=X&ei=Jn4WVf7UFc6KuATx0oLIDg&ved=0CBwQ6AEwAA#v=onepage&q&f=false


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@epolarisasi #fase 2$ lihat di gam"ar. %edang&an fase ) merupa&an fase istirahat #rentang

wa&tu antara 2 potensial a&si$ merupa&an fase dimana ta& ada perpindahan ion di mem"rane

sel.

%um"er '

http'((indonesia.digitalournals.org(inde!.php(&aridn(article(download(**E(**E

;ote ' Galau ada tam"ahan atau &esalahan mohon di"eritahu&an. ,erima &asih

+5. Phase 0 of the slow response action potential is mediated "y

a. Cali#m

". %odium

c. Potassium

d. Chloridee. ydrogen

Pem"ahasan

4engan soal nomor +) uga masih "ingung dengan awa"annya maaf "anget soal pa& hardy

susah "inggo


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+>. 9rteriography of a patientOs left renal artery shows narrowing of the arteryOs radius "y

50J. What is the e!pected change in "lood flow through the stenotic artery?

a. 4ecrease to X

". 4ecrease to Y

c. 4ecrease to 1(E

d. erease to 1>1?

e. Nnchanged

Pem"ahasan

,ida& tahu pastinya daripada asal tapi awa"an dari soal ini ada di Lui8let dan Circulation

dari inet

%um"er '

https'((Lui8let.com(15)1)*>*(physio-"rs-e!am-+-flash-cards( https'((improingedcaredotorg.files.wordpress.com(201+(0E(circulation-mcLs-1-une-

0).doc

+*. What is the direction of fluid moement and the net driing force?

a. 9"sorption3 > mmg

". 9"sorption3 D mmg

c. iltration3 > mmg

d. iltration3 D mmg

e. here is not fl#id mo/ement

Pem"ahasan

Gurang tahu pasti mengenai hal ini


16/73

%um"er '

http'((www.elseieradantage.com(samplechapters(D*E0+2+0+))*0(D*E0+2+0+))*0.p

df

+E. /f Gfis 0.5 ml(min(mmg what is the rate of water flow across the capillary wall?

a. 0.0> ml(min

". 0.)5 ml(min

c. )0.5 ml(min

d. D.0 ml(min

e. 1E.0 ml(min

Pem"ahasan


17/73

,ida& tahu caranya

%um"er '

http'((www.pathwaymedicine.org(starling-forces

+D. Blood flow to which organ is not controlled primarily "y meta"olic factors #local

meta"olites$?

a. %&in

". =ungsc. eart

d. Brain

e. %&eletal muscles during e!ercise

Pem"ahasan

,ida& tahu S.S ,api %&eletal


18/73

)2. 9 patient e!periences orthostatic hypotension after a sympathectomy. ,he e!planation for

this is

a. 9n e!aggerated response of the rennin-angiotensin-aldosterone system

". 9 suppressed response of the rennin-angiostensin-aldosterone system

c. 9n e!aggerated response of "aroreceptor

d. An s#$$ressed res$onse of the !aroree$tor mehanism

%um"er' https'((Lui8let.com(15)1)*>*(physio-"rs-e!am-+-flash-cards(

)+. ,he greatest pressure drop in the circulation occurs across the arterioles "ecause

a. ,hey hae the greatest surface area

". ,hey hae the greatest cross-sectional area

c. ,he elocity of "lood flow through the is the highest

d. ,he elocity of "lood flow through them is the loweste. hey ha/e the "reatest resistane

%um"er' https'((Lui8let.com(15)1)*>*(physio-"rs-e!am-+-flash-cards(
https://quizlet.com/15414767/physio-brs-exam-3-flash-cards/https://quizlet.com/15414767/physio-brs-exam-3-flash-cards/https://quizlet.com/15414767/physio-brs-exam-3-flash-cards/https://quizlet.com/15414767/physio-brs-exam-3-flash-cards/


19/73

)). Pulse pressure is

a. ,he highest pressure measured in the arteries". ,he lowest pressure measured in the arteries

c.


20/73

A if 1,2,: are orret

if 1,: are orret

C if 2,= are orret

if only = orret

4 all orret

)>. Characteristics of omeostasis

1. 4ffetors may ha/e o$$osin" ations

2. e"ati/e feed!a' is the $roess that $re/ent han"e (Inhi!it)

:. ositi/e feed!a' is the $roess that $er$et#ate han"e (Stim#late)

=. 7eed for%ard ontrol is o#tside stim#li that alter the normal feed!a' res$onse

awa"' 4

www.angelo.edu/faculty/cadkins/homeo.docEffectors bring about the change specified by the integrating center (e.g., skeletal muscle, glands, &

organs). Effectors provide the means for acting on the control centers response to a stimulus, either

depressing it (negative feedback) or enhancing it (positive feedback).

Negative Feedback: regulatory mechanism in which a change in a controlled variable triggers a

response that opposes the change, thus maintaining a steady set point for the regulated

factor. This is the most common etrinsic control system to maintain homeostasis (i.e. it is

homeostatic).

Positive Feedback! is the opposite of negative feedback"" The action of the effector amplifies the

changes that first stimulated the effectors. There are no antagonistic factors.

)*. ,he languages of communication are

1. hysial (: !enar ma'a 1 #"a !enar)

2. Chemial

:. iolo"ial

=. 4letrial

awa"'4

http'((www.academia.edu(>ED+55E(


21/73

%e"elumnya soal ini da& diperinci language of commucation disini secara umum

atau &omuni&asi sel atau gmn.

)E. ,he factors of communication

1. S$eed#


22/73

awa" ' 4

/, Hndo&rin dr. %W; al. 15D

50. 9ctiated : protein interacts with effectors proteins to alter their actiities this process of

communication occur in

1. H!tracellular compartment

2. /ntracellular compartment

+. /nterstitial compartment

). /ntracellular compartment

#r Ilmi Sofiah (51-?0)

51. : protein actiates against receptor comple! then cleared phospatidylinositol

)5"iphosphate. Cyclosporine "loc&ing this pathway. What &ind of secondmessengers.

1. C9


23/73

Nntu& /P+ dan 49: pathway dapat dia&es di'https'(("oo&s.google.co.id("oo&s?idSW1aey4)>&/CpgSP950*lpgSP950*d

LScyclosporineK"loc&ingKdagKpathwaysourceS"lotsSPte"5*6m/asigSe

:4n"crC!s!A>d1&-NW4u/hlSensaSVeiS*-

&!AaL)o=Fug,logBgedS0CBgT>9Hw9w chapter 1* page 50*


24/73

1. &y$oalaemia

2. yper&alemia

:. &y$o'alemia

). ypernatremia

awa"an ' B. 1 dan +

5>. ,rypsin is considered as an

1. 9utocrine

2. Hndocrine

+. ;eurocrine

=. 4xorine

awa"an' 4

@eaction meta"olism dalamtu"uhmanusia'

#C6$! K 02ZM C62 K 20 K H5*. %um"er C6 diperoleh tu"uh melalui sistem

a. i"estif

". Gardioas&uler

c. @espirasi

d. Nrinarius

e. 0. Berdasar&anrea&si di atas mana&ahpernyataan"eri&utyang palingtepat

a. ,ermasu&ana"olisme&arenamenghasil&anenergi

!. ermas#''ata!olisme'arenamemeahmole'#l C&

c. ,ermasu&rea&sihidrolisis&arenamenghasil&an air

d. ,eradi di dalamintisel

e. @ea&sio&sidasimerupa&anpem"entu&anmole&ul yang "esar

irin #s$ita (?1-0)

>1. asila&hir meta"olism energia&anmenghasil&an


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a. 50J panas K 50J 9,P

!. 5B $anas 25B A

c. *5J 9,P K 25J panas

d. 50J 9,P K 25J panas K 25J &era internal

e. 25J 9,P K 50J panas K 25J &era internal

awa" ' /,


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>+. Proses produ&si 9,P yang memerlu&ano&sigen paling "anya&dalamprosesnyayaitu

a. Gonersi&reatinin-fosfat

". :li&olisisanaero"c. osforolasianaero"

d. Si'l#s're!s

e. =ipofisis

awa" ' /,


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Gonersi&reatinin-fosfat gli&olisisanare"o" fosforolasianaero"dan lipolysis

tida&memerlu&an 62. 4ari pilihanawa"an di

atasygmemerlu&ano&sigenhanyasi&lus&re"s.

>). Proses fosforilasio&sidatif"erlagsung di

a. %itoplasma

". ;ucleus

. 3ito'ondria

d. @i"osom

e. %el

awa"' /, 5. Pernyataan"eri&ut yang "enartentangtermoregulasia. 3er#$a'anhasilsam$in"dari$anasa'i!at $roses meta!olism

". 4iaturolehpusatsuhu di hipofisis

c.


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d. ,eradiperpindahanpanassecararadiasi

e. Perpindahanpanas&one&simelalui&ulit

awa"'

%um"er '

/, Pengaturan%uhu,u"uh- dr. 9h(;9% #%lide +$

http'(("udisma.net(2015(0)(pengertian-dan-proses-meta"olisme-&ar"ohidrat.html

>>. Pening&atansuhutu"uhterlalutinggidapatmenye"a"&an

a. enat#rasi $rotein

". 9&tiasi meta"olism lam"at

c. /nfe&si

d. Gata"olismetida&teradi

awa" ' /, Pengaturan%uhu,u"uh 9(;9% #%lide )$


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Ber&eringat9dimengalamimencret-mencret feses yang di&eluar&an"erupacairansaa

tanpalendirdandarahse"anya& 1 gelas dam mencretsampai E &ali dalamsehari.%aat B9B

&otoranlangsung&eluartanpaharusmengeandantanpaada rasa mules.

>*. Proses defe&asiteradipada organ

a. Golondan rectum

". /leum dam anus

. et#m dan an#s

d. /leum dann rectum

e. Golondan anus

awa" '

/, aaldigestif dr.B% #%lide 50$

>E. ungsi&olondalamhalse&resiyaitu

a.


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e.


31/73

e. 4efe&asidandigesti

awa" '

http'((www.sam.org.8a(inde!.php(sam(article(iew(52)+(+E55

http'((www.who.int(elena(titles(""c(8incFdiarrhoea(en(

Pada gastroenteritis teradi&erusa&an di selepitel"agian "rush "order

dariintestinumsehinggafungsia"sor"sinyaterganggu.4an

fungsise&resinyaugatergangguuntu&meng&ompensasiperadanganpadaselepitelusus.Pe

m"erian8in&diguna&anuntu&memper"ai&istru&tur( mempercepatper"ai&anselepitel di

usussehinggafungsia"sor"sidanse&resi.

Azzahra Afifah (1-F0)

*1. i&a &ondisi 9di "erlanut tanpa pem"erian oralit dapat teradi

a. Hdema

". Aomitus he"at

c. :astroenteritis &ronis

d. ehidrasi

e.


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ralit di!eri'an #nt#' men""anti airan dan ele'trolit dalam t#!#h yan" ter!#an" saat

diare. ala#$#n air san"at $entin" #nt#' mene"ah dehidrasi air minum tida&

mengandung garam ele&trolit yang diperlu&an untu& mempertahan&an &eseim"angan

ele&trolit dalam tu"uh sehingga le"ih diutama&an oralit. Campuran glu&osa dan garam yang

ter&andung dalam oralit dapat diserap dengan "ai& oleh usus penderita diare.

9a$an oralit $erl# di!eri'an*

%egera "ila ana& diare sampai diare "erhenti.

3en"a$a har#s mem!eri oralit setia$ ana' diare*

Pada saat diare tu"uh ana& "anya& &ehilangan cairan dan ele&trolit. 4engan mem"eri&an

oralit cairan tu"uh dan ele&trolit yang hilang &arena diare "isa diganti&an.

*2. i&a &ondisi 9di disertai muntah ma&a respon &elenar salia saat regulasi getah

lam"ung "erupa

a. Se'resi !i'ar!onat #nt#' menetral'an asam

". %e&resi ptyalin untu& mencerna glu&osa

c. %e&resi mucus untu& mengurangi asam

d. 4iglusi salia untu& mencegah mual

e. H&sresi air untu& mengencer&an asam

%um"er ' http'((www.researchgate.net(

Pem"ahasan '

4i dalamsalia uga terdapat suatu sistem "ufer yang mampu menetralisir penurunan

p dalamrongga mulut.Bikarbonat


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*). ,he following ion#s$ is(are inoled in the neuronal action potential'

a. Sodi#m (a)

". Potassium #Ca2K$ seharusnya GK

c. Calium #Ca2K$ GK

d. Chloride #Cl[$ merupa&an inhi"it dalam a&si potensial

e. 9ll of the a"oe

%um"er ' /, ;; %istem saraf pusat dan

http'((www.physiologywe".com(dailyFLui8(physiologyFLui8FTB,a&@5&)C,yB,=VoG:a%8

dU1"82;*cLFneuronalFactionFpotential.html
http://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.htmlhttp://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.htmlhttp://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.htmlhttp://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.html


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Pem"ahasan '


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*5. 9t the pea& of the action potential the mem"rane potential is

a. H!actly at the ;a2K eLuili"rium potential # A ;a $

". Close to "ut more positie than the ;aK eLuili"rium potential #AnaK$

. Close to !#t less $ositi/e than the a e@#ili!ri#m $otential (Gna)

d. H!actly at 0mA

e. ,he same as the resting mem"rane potential #Arest$

%um"er ' /, ;; %istem saraf pusat danhttp'((www.physiologywe".com(dailyFLui8(physiologyFLui8FTB,a&@5&)C,yB,=VoG:a%8


Pem"ahasan '

Pada saat di punca& a&si potensial ma&a ger"ang ;atrium mulai tertutup dan a&an mem"u&a

ger"ang &alium.


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*>. 9t what mem"rane oltage do neuronal oltage gated ;aK channel "ecome actiated

a. *0

!. 50

c. 0 mA

d. K 50 mA

e. ;one of the a"oe

%um"er ' /, ;;-%istem %araf Pusat danhttp'((www.physiologywe".com(dailyFLui8(physiologyFLui8FTB,a&@5&)C,yB,=VoG:a%8


Pem"ahasan '

Potensial istirahat se"esar -*0 m a&an terstimulasi i&a perangsang se"esar -20-#-+0$ m

sehingga ger"ang "eroltase a&an ter"u&a pada -50-#-)0$ m


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**. ,he spi&e phase of the neuronal potential is due to'

a. he o$enin" of /olta"e "ated a hannels

". ,he opening of oltage gated GK channels

c. ,he closure of resting ;aK channels

d. 4ue to the closure of Cl channels

e. ;one of the a"oe

%um"er ' /, ;;-%istem %araf Pusat dan




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Pem"ahasan '

*E. ,he hyper polari8ation phase of the action potential is due to'

a. ,he opening of oltage gate Cl channels

!. he o$enin" of /olta"e "ated ' hannels

c. ,he closure of resting ;aK channels

d. ,he closure of Cl channels

e. ;one of the a"oe


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%um"er ' /, ;;-%istem %araf Pusat dan



,his hyperpolari8ation phase of the action potential is therefore due to GK ions diffusing

through oltage-gated GK channels.

*D. /n the 9;% the preganglionic neurons synapse with post ganglionic in the'

a. A#tonomi "an"lia

". Brain stem

c. %pinal cord

d. 4orsal rood ganglia

e. %&eletal muscle cells

%um"er ' https'((Lui8let.com(21>D05>D(autonomic-nerous-system-flash-cards(

%araf preganglion sinapsis dengan post ganglioni& di ganglia autonom &arena mengandung

"adan-"adan sel saraf preganglion.

E0. ,he effectors organs for the somatic motor nerous system are'

a. Cardiac muscle ' efe&tor saraf otonom

". %mooth muscle ' efe&tor saraf otonom

c. :lands ' efe&tor saraf otonom

d. S'eletal m#sle ' efe&tor saraf somati&

e. 9l of these a"oe
http://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.htmlhttp://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.htmlhttps://quizlet.com/21690569/autonomic-nervous-system-flash-cards/http://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.htmlhttp://www.physiologyweb.com/daily_quiz/physiology_quiz_QBTakR5k4CTyBTLXoKGaSzdZ1bz2N7cq_neuronal_action_potential.htmlhttps://quizlet.com/21690569/autonomic-nervous-system-flash-cards/


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%um"er ' /, ;; %istem %araf Pusat dan

%um"er '

https'((Lui8let.com(21>D05>D(autonomic-

nerous-system-flash-cards(

3andy #triy#di (F1-H0)

E1. Which of these characteristics descri"e the somatic motor neuron system?

a. 6ne neuron "etween C;% and s&eletal muscle

". Hffect can "e e!citatory or inhi"itoryc. Cell "odies in lateral part of the spinal cord

d. @eceptor molecules can "e nicotinic or muscarinic
https://quizlet.com/21690569/autonomic-nervous-system-flash-cards/https://quizlet.com/21690569/autonomic-nervous-system-flash-cards/https://quizlet.com/21690569/autonomic-nervous-system-flash-cards/https://quizlet.com/21690569/autonomic-nervous-system-flash-cards/


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e. 9ll of the a"oe

Penelasan tam"ahan'

omatic motor neurons, which originate in thecentral nervous system, pro#ect

theiraonsto skeletal muscles$%(such as the muscles of the limbs, abdominal, and intercostal

muscles), which are involved inlocomotion.

%um"er'http'((highered.mheducation.com(noella(Tui8Processing%erlet

http'((en.wi&ipedia.org(wi&i(


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%um"er' http'((highered.mheducation.com(noella(Tui8Processing%erlet

E). Which of these effect results from the stimulation of the parasympatic diision?

a. /ncreased heart rate and force

". /ncreased "lood flow to s&eletal muscle

c. /ncreased contraction of smooth muscle in the wall of the digestie tracts

d. /ncreased glucose in the "lood

e. Contraction of arrectorpili muscle

E5. Which of these functions is not affected "y parasympathetic stimulation?

a. %ecretion of tears

". %ecretion of sweat

c. %ecretion of insulin from the pancreas

d. %ecretion of thin watery salia

e. %ecretion of digestie glands

%um"er' http'((highered.mheducation.com(noella(Tui8Processing%erlet

Penelasan tam"ahan'
http://highered.mheducation.com/novella/QuizProcessingServlethttp://highered.mheducation.com/novella/QuizProcessingServlethttp://highered.mheducation.com/novella/QuizProcessingServlethttp://highered.mheducation.com/novella/QuizProcessingServlet


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%um"er' /, ;; ;eurologi Nmum 201) slide &e ED D0 D) D*

E>. %ome sympathetic preganglionic a!ons synapse in collateral ganglia the post ganglionic

a!on then passes through a

a. %pinal nere". %plachnic nere

c. %ympathetic nere


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d. %omatic nere

e.


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D0. 9n action potential spreads or is propagated through a muscle fi"er

a. By the myosin myofilament

". By the ,-,u"ules

c. By the cross "ridge

d. By the sarcoplasmic reticulum

e. Bt the actin myofilament

%um"er' http'((highered.mheducation.com(noella(


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d. istamine

e. %erotonin

%um"er ' Ghan 9cademy muscle

Galau di "u&u guyton memang tida& ada &alimat yang elas menyata&an ini

tapi dari /, dan secara &eseluruhan "u&u guyton dalam masalah &ontra&si otot hanya

mengguna&an asetil&olin "ah&an nama en8im nya adalah asetil&olinesterase.

D).


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D*. Hach actin and filaments is composed of

a. 9 single strand of actin molecules

b. T!o strands of actin molecules !rapped together

c. ,hree strands of actin molecules wrapped together

d. our strands of actin molecules wrapped together

e. undred of strand of actin molecules wrapped together

%um"er ' :uyton 12 Hd

DE. 9s actin and myosin filaments slide past each other during muscle contractiona. 9ctin filaments shorten while myosin filaments do not

".


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c. Hither actin or myosin filament shorten "ut not "oth at the same time

d. Both actin and myosin filaments shorten

e. #either actin nor myosin filaments shorten

%um"er ' :uyton Hd. 12

Qang memende& adalah %arcomere. 9ctin and


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a. ,he actin myofilaments

b. The troponin molecule

c. ,he sarcoplasmic reticulum

d. ,he sarcolemma

%um"er ' :uyton 12Hd

As%ir Gem!rinaldi (101-110)

101. Hnergy is released when

a. 94P is "ro&en down into 9,P and P

". 9,P is "ro&en down into 94P and P

c. 94P and P com"ine to form 9,P

d. 9,P and P com"ine to form 9,P

e. 9


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%um"er ' /, ;; reprodu&si pria

10+. 9 primary spermatocytes

a. 4iide "y mitosis to produce two secondary spermatocytes

". 4iides "y meiosis to produce four spermatocytes

c. 4iides "y meiosis to produce four spermatids

d. 4iides "y mitosis to produce two spermatids

e. 4iides "y mytosis to produce two spermatids


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um!er " T ++ reproduksi pria

10). Hach spermatid

a. 4iided "y meiosis to produce four sperm cells

". 4iides "y mitosis to produce four sperm cells

c. 4iides "y meiosis to produce two sperm cells

d. 4iides "y mitosis to produce two sperm cellse. 4ifferentiate into spern cells

%um"er ' /, ;; reprodu&si pria

105. ,he surge in = that occurs during the middle of the oarian cycle triggers

a. Nterine lining secretion directly

".


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lona&an &adar = dalam darah dan memicu teradinya oulasi #&eluarnya sel telur dari

foli&el dan oarium$ dan penurunan &adar estrogen.

%um"er ' /, ;; reprodu&si wanita slide +>

10>. ,he usual site of fertili8ation is the

a. Nterus

". 9mpula tu"a falopi

c. im"riae tu"a fallopi

d. 6arium

e. Corpus luteum


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Tempat pertemuan sperma dan o


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adi peralanan spermato8oa dari %eminiferous tu"ules3 epididymis3 as deferens3 ampulla3

eaculatory duct3 urethra

%um"er ' /, ;; @eprodu&si Pria slide &e +510

10E. Within the oary progesterone is produce "y the'

a. Corpus luteum

". %econdary follicles

c. ,ertiary follicles

d. Corpus al"icans

e. Primary follicles

um!er" T ++ (eproduksi >anita slide =7

10D. What hormone is responsi"le for the secondary se! characteristics found in women?

a. Hstrogen". Prolactin

c. Progesteron

d. %

e. =


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Hstrogen # hormon ini dihasil&an oleh te&a interna foli&el$

a. Pada fase pu"ertas mempengaruhi per&em"angan tu"a dan &elenar mamae serta

per&em"angan se&s se&under wanita". Pada fase proliferasi lapisan endometrium "er&em"ang le"ih te"al le"ih "anya& &elenar-

&elenar pem"uluh darah arteri dan ena

%um"er ' /, ;; @eprodu&si Wanita slide ++ dan

https'((www.academia.edu(*+)*+>>(ormonFreprodu&si

110. ow do "irth control pills #oral contracepties$ wor&?

a. ,hey preent the fertili8ed egg from traelling to the uterus for implantation

". ,he lower the amount of estrogen in the "ody

c. ,hey protect the time of oulation precisely and pregnancy can aoided

d. ,hey increase the amount of = and % which speeds up oulatione. ,hey inhi"it the release of % and = "y a negatie feed"ac& mechanism

preenting oulation
https://www.academia.edu/7347366/Hormon_reproduksihttps://www.academia.edu/7347366/Hormon_reproduksi


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%um"er ' http'((repository.usu.ac.id("itstream(12+)5>*ED(+*11)()(ChapterJ20//.pdf

3. iz'i arma%an (111-120)

111. ow do "irth control pills #oral contracepties$ wor&?f. ,hey preent the fertili8ed egg from traelling to the uterus for implantation

g. ,he lower the amount of estrogen in the "ody

h. ,hey protect the time of oulation precisely and pregnancy can aoided

i. ,hey increase the amount of = and % which speeds up oulation

. hey inhi!it the release of 7S& and 6& !y a ne"ati/e feed!a' mehanism,

$re/entin" o/#lation

Penjelasan " 1*+*(? +A0*" !irth control pills @also known as oral

contracepti


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uterus for implantation of the em!ryo. Progestin also makes the uterine

mucus that surrounds the egg more dicult for sperm to penetrate and,

therefore, for fertiliCation to take place. n some women, progestin inhi!its

o


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um!er 2 "

http"//www.medicinenet.com/oral)contracepti


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Berdasar&an :rafi& di atas menunu&&an penam"ahan ;atrium #%odium$ plasma a&an

mening&at&an solute( 8at terlarut #"erupa elestrolit contoh utama adalah sodium$

dalam plasma darah yang menga&i"at&an nai&nya osmolaritas CH%.

S#m!er I 1? dan 1 - - CAIA ;;& A 7;+SI +IDA6 1 dan 2-

&4

115. Bagaimana hu"ungan &onsentrasi ;aK plasma dengan olume cairan tu"uh?

a. enin"'atan 'onsentrasi a $lasma menye!a!'an $enin"'atan /ol#me

airan e'strasel#ler teta$i /ol#me airan intrasel#ler t#r#n

". Pening&atan &onsentrasi ;aK plasma menye"a"&an pening&atan olume cairan

tu"uh total #total "ody fluid$

c. Pening&atan &onsentrasi ;aK plasma hanya menye"a"&an pening&atan cairan

e&straseluler sedang&an cairan intraseluler tida& "eru"ah

d. Pening&atan &onsentrasi ;aK plasma tida& ada hu"ungan dengan olume cairan

e&traseluler dan intraseluler

enelasan

&y$ernatremia a#ses a loss of intraell#lar %ater into the 4C7 s$ae and

an !e assoiated %ith ell#lar shrin'a"e. /n the C;% this can "e catastrophic with

ensuing cell death or rupture of "lood essels. ,o protect against cell shrin&age

electrolytes enter into the /C usually in the first few hours. When hypernatremia

persists "eyond 2 or + days the cells "egin to generate intracellular osmolytes to

maintain intracellular fluid #/C$ osmolarity further and aoid water loss into the HC.

Berdasar&an penelasan gam"ar pada /, 1> dan 1* - * - C9/@9; ,NBN

49; N;:%/ :/;9= 1 dan 2- H@ "ahwa penam"ahan ;atrium #%odium$ pada

&ompartemen CH% a&an menyem"a"&an teradinya osmosis 26 dari C/% &e CH%.

%ehingga olume CH% nai& dan olume C/% turun. Pada &asus hipernatremia # a

clinical condition with plasma-;a K7 a"oe 1)5 m


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&4

http'((www.8uni.net(physiology("oo&(chapter2).html

http'((www.cleelandclinicmeded.com(medicalpu"s(diseasemanagement(nephrology(h

yponatremia-and-hypernatremia(4efault.htm

4ua orang nelayan ditemu&an terapung dilaut &arena &apalnya tenggelam + hari yang

lalu. Pada saat di"awa &e @% nelayan 9 dalam &eadaan lemas dan mengalami dehidrasi

sedang&an temannya B dalam &eadaan coma. ha$ter2=.html

11*. Bagaimana ele&trolit plasma nelayan 9?a. ;ormal

!. &y$onatremi

c. ypernatremic

d. ypo&alemia

enelasan nelayan 9 dalam &eadaan lemas dan mengalami dehidrasi sedang&an

temannya B dalam &eadaan coma.


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menye"a"&an &eadaan Hiponatremia. Geadaan iponatremia uga "isa dise"a"&an output

sodium "erle"ih melalui urin sedang&an input sedi&it. Geadaan hiponatremia dapat "eruung

dehidrasi.

S#m!er htt$>>%%%.z#ni/.net>$hysiolo"y>!oo'>ha$ter2=.html

11E. 9pa yang menye"a"&an nelayan B mengalami gangguan neurologic "ah&an pada saat

ditemu&an dia dalam &eadaan coma?

a. yponatremia

!. &y$ernatremia

c. ypo&alemia

d. yper&alemia

enelasan temannya B &arena tida& tahan haus "er&ali-'ali memin#m air la#t

namun haus tida& hilang "ah&an pda hari &edua B mulai gelisah &esadaran menurun dan

mengalami halusinasi dan pada hari &etiga dia mulai tida& sadar.6smolaritas air laut 2000-2)00 mHL(l &arena 'adar "aram yan" tin""i.

Geadaan ipernatremia dapat menye"a"&an defiit ne#rolo"is fo'al penurunan

&esadaran atau &eang.

Charateristis of hy$ernatremia Sym$toms related to the harateristis of

hy$ernatremia

Cognitie dysfunction and symptoms

associated with neuronal cell shrin&age

=ethargy o"tundation onf#sion a"normal

speech irrita"ility sei8ures nystagmus myoclonic

er&s

4ehydration or clinical signs of olume

depletion

6rthostatic "lood pressure changes tachycardia

oliguria dry oral mucosa a"normal s&in turgor dry

a!illae

6ther clinical findings Weight loss generali8ed wea&ness

S#m!er 9a$ita Sele'ta 9edo'teran 4disi IG !a"ian II

htt$>>emediine.medsa$e.om>artile>2=10H=-linialJa021

11D. Bagaimana hal diatas #item B$ teradi pada nelayan B?a. anya' min#m air la#t

". ,ida& &uat secara fisi& dan mental

c. %hoc&

d. Ge&urangan &alori tetapi tida& mengalami &e&urangan input cairan

enelasan temannya B &arena tida& tahan haus "er&ali-'ali memin#m air la#t

namun haus tida& hilang "ah&an pda hari &edua B mulai gelisah &esadaran menurun dan

mengalami halusinasi dan pada hari &etiga dia mulai tida& sadar.

6smolaritas air laut 2000-2)00 mHL(l &arena 'adar "aram yan" tin""i.

Geadaan ipernatremia dapat menye"a"&an defiit ne#rolo"is fo'al penurunan&esadaran atau &eang.

Charateristis of hy$ernatremia Sym$toms related to the harateristis of
http://www.zuniv.net/physiology/book/chapter24.htmlhttp://emedicine.medscape.com/article/241094-clinical#a0217http://www.zuniv.net/physiology/book/chapter24.htmlhttp://emedicine.medscape.com/article/241094-clinical#a0217


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hy$ernatremia

Cognitie dysfunction and symptoms

associated with neuronal cell shrin&age

=ethargy o"tundation onf#sion a"normal

speech irrita"ility sei8ures nystagmus myoclonic

er&s

4ehydration or clinical signs of olumedepletion

6rthostatic "lood pressure changes tachycardiaoliguria dry oral mucosa a"normal s&in turgor dry

a!illae

6ther clinical findings Weight loss generali8ed wea&ness

S#m!er 9a$ita Sele'ta 9edo'teran 4disi IG !a"ian II

htt$>>emediine.medsa$e.om>artile>2=10H=-linialJa021

120. Bagaimana &ondisi olume cairan tu"uh nelayan B &eti&a ditemu&an?a. ;ormoolemic(euolemic

". ypoolemic

. &y$er/olemi

enelasan temannya B &arena tida& tahan haus "er&ali-'ali memin#m air

la#tnamun haus tida& hilang "ah&an pda hari &edua B mulai gelisah &esadaran menurun dan

mengalami halusinasi dan pada hari &etiga dia mulai tida& sadar.

smolaritas air la#t 2000-2=00 m4@>l 'arena 'adar "aram yan" tin""i.

Clinical assessment of olume status allows differentiation "etween hypernatremichypoolemia with disproportionate water loss oer sodium and hy$ernatremi e#- or

hy$er/olemia res#ltin" from hy$ertoni sodi#m "ain. ,he maority of hypernatremic

neurologic patients will "e hypoolemic and in this conte!t C4/ must "e distinguished from

simple dehydration "y urine olume assessment and "iochemical analysis.

6ar#tan hi$ertonis adalah =arutan yang &onsentrasi 8at terlarutnya le"ih tinggi

di"anding&an dengan larutan di dalam sel. =arutan garam fisiologis "agi tu"uh adalah larutan

;aCl 0(DJ.
http://emedicine.medscape.com/article/241094-clinical#a0217http://emedicine.medscape.com/article/241094-clinical#a0217


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4ari slide di atas osmolaritas larutan ;aCl fisiologis tu"uh adalah +2) m6sm(l sedang&an

yang di&onsumsi nelayan B smolaritas air la#t 2000-2=00 m4@>l 'arena 'adar "aram

yan" tin""i, (m4@ E msm) artinya nelayan men"ons#msi lar#tan Sodi#m hi$ertonis

!erle!ih ma'a di"olon"'anHipernatremia Hiper$olemia.


&4

htt$>>%%%.n!i.nlm.nih."o/>$m>artiles>3C151:???> ist#r!anes of

sodi#m in ritially ill ad#lt ne#rolo"i $atients a linial re/ie%

ona &a%a 9amilah (121-1:0)

121. Nntu& mengatasi &eadaan nelayan B cairan /A yang paling sesuai untu& di"eri&an

adalah?

a. /sotonic

!. &y$otoni

c. ypertoni&

d. Plasma e!pander

9lasan '

4ehidrasi hipertoni& #hipernatremi&$. ilangnya air le"ih "anya& daripada natrium. 4ehidrasihipertoni& ditandai dengan tingginya &adar natrium serum #le"ih dari 1)5 mmol(=$ dan

pening&atan osmolalitas efe&tif serum #le"ih dari 2D5 m6sm(=$. Garena &adar natrium serum
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513666/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513666/


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tinggi teradi pergeseran air dari ruang e&straas&uler &e ruang intraas&uler.Nntu&

meng&ompensasi itu ma&a di"eri&an cairan hipotoni& #cairan yang dianur&an adalah cairan

dengan &andungan sodium rendah$ agar &eseim"angam CH% dan C/% &em"ali seperti semula.

http'((www.&al"emed.com(Portals(>(2+F22)Pra&tis-%trategiJ20,erapiJ20CairanJ20pada

J204ehidrasi.pdf

Wanita ,ua dengan ipertensi @ingan

%eorang wanita tua umur >+ tahun dating &e Pus&esmas untu& pemeri&saan &esehatan rutin.

Pada pemeri&saan didapati hipertensi ringan #te&anan darahnya 155(D0 mmg$. 4ia

dianur&an untu& diet rendah garam. ,etapi setelah satu "ulan &emudian te&anan darahnya

tida& menurun.


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Penurunan te&anan darah untu& penderita pada &asus yaitu hipertensi ringan #te&anan

darahnya 155(D0 mmg$ adalah diet rendah garam \ 5 mg pada sum"er diatas dinyata&an )

mg adi masih dalam &adar normal adi tida& a&an sampai menye"a"&an hiponatremia dan

dapat menurun&an te&anan darah antara 2.) sampai 2.E millimeter mer&uri.

12+. yponatremia a&an memper"erat dehidrasi pada wanita dise"a"&an'

a. Penurunan se&resi 94 sehingga e&sresi air oleh ginal mening&at

". Pening&atan se&resi 94 sehingga e&sresi air oleh ginal mening&at

. smolaritas airan e'strasel#ler men#r#n menye!a!'an air !erosmosis 'e

intrasel#ler.

d. @asa haus hilang &arena lethargi

9lasan '

iponatremia adalah kondisi dimana kadar garam dalam ?* @natriumB le!ih

rendah daripada yang seharusnya. Dalam keadaan normal, konsentrasi natriumdalam ?* antara 2=E:29E milimol per liter, amka pada kondisi ini air akan

!erosmosis dari hipotonik ke hipertonik, sehingga menam!ah !erat dehidrasi.

12). ,anda yang paling &onsisten dari teradinya dehidrasi pada wanita ini adalah'

a. =ethargy

!. en#r#nan !erat !adan

c. Penurunan te&anan darah

d. Penurunan &onsentrasi ;aK plasma darah


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http"//www.repository.usu.ac.id/!itstream/27=9E8643/=2537/9/?hapterF75.pdf

Alasan :

,anda paling &onsisten dari dehidrasi adalah penurunan "erat "adan &arena &omposisi tu"uh

&ita iyu *0J cairan &ehilangn cairan otomatis a&an "erpengaruh terhadap "erat "adan sedang

lethargy #penurunan &esdaran$ tida& selamanya mengi&uti dehidrasi "egitu uga penurunante&anan darah dan tera&hir tida& selamanya iponatremia di &ondisi&an dengan dehidrasi.

125. Pem"erian ydrochlorothia8ide #C,$ yang "e&era mengham"at ;aCl cotransporter

di tu"ulus distalis menga&i"at&an'

a. Penurunan se&resi air oleh ginal

". Pening&atan se&resi air oleh ginal

. enin"'atan se'resi a oleh "inal

d. Penurunan se&resi ;aK oleh ginal

9lasan '

ydrochlorothia8ide is a diuretic #water pill$ used for treating high "lood pressure and

accumulation of fluid. /t wor&s "y "loc&ing salt and water rea"sorption in the &idneys th#s

a#sin" inreased o#t$#t of #rine ontainin" inreased amo#nts of %ater and salt

(di#resis). ,he mechanism of its action in lowering high "lood pressure is not well

understood. ,he com"ination of alsartan and hydrochlorothia8ide reduces "lood pressure

more that either drug alone.

12>. 4ehidrasi(hypoolemia pada pasien ini dise"a"&an pening&atan e&resi urine oleh

ginal &arena efe& dari'

a. Pening&atan 94 &arena hyponatremia

". Pening&atan aldosterone &arena hyponatremia

c. Pening&atan input air &arena haus

d. en#r#nan A7 (Atrial atri#reti 7ator)

9lasan '

,reatment with ;if-+0 was superior to &CK9m in num"er of patients controlled "ut the

decrease in


71/73

12*. %e"agai respons terhadap penurunan &onsentrasi ;aK di cairan e&traseluler'

a. 94 mening&at

". 94 menurun

. Aldosterone menin"'at

d. 9ldosterone menurun

9lasan'

,iga hormon yang paling penting mengatur ting&at rea"sorpsi ;aK dan Cl- #dan uga

mengatur "erapa "anya& &ehilangan air melalui urin$ yaitu 9ngio tensis // 9ldosteron

9trial ;atriureti& Peptide #9;P$ &eti&a tu"uh &ita dehidrasi angio tensin // aldosteron

menai&&an rea"sorpsi ;aK dan Cl- # dan air oleh osmosis dengan ele&trolit$.

12E. Penurunan olume cairan tu"uh diterima oleh "aroreceptor dan selanutnya diterus&an

&e ginal dan menye"a"&an'

a. enin"'atan se'resi renin oleh #xta"lomer#lar ells

". :inal mense&resi 9ngiotensinogen

c. %e&resi aldosterone menurun

d. 9ngiotensinogen diu"ah menadi aldosterone


72/73

%um"er "u&u ilmu penya&it dalam ilid 2 edisi &e-> "a" hipertensi.

12D. 6smolaritas didalam tu"uh dipertahan&an &onstan dengan cara'

a. Pengaturan se&resi air oleh ginal

!. en"at#ran se'resi a oleh "inal

c. Pengaturan input ;aK dengan diet

d. Pengaturan e&s&resi air oleh ginal


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1+0. 9ngiotensinogen diu"ah menadi angiotensin / oleh'

a. 9ldosterone

!. enin

c. 94

d. 9;(9;P

https"//!ooks.google.co.id/!ooksG

idHJ(iuj

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