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Sample UKOM Sp.PD Practice Questions

Try these sample questions to review concepts for the UKOM Sp.PD exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old male on day 5 of illness with confirmed dengue virus infection presents with severe lethargy, abdominal pain, and persistent vomiting. Physical examination reveals blood pressure 100/70 mmHg, pulse 98 bpm, tender hepatomegaly, and gall bladder wall thickening with mild ascites on ultrasound. Laboratory evaluation shows hematocrit 52% (baseline 40%), platelet count 24,000/µL, AST 1,920 U/L, ALT 1,650 U/L, total bilirubin 3.2 mg/dL, and international normalized ratio (INR) 1.6. He is confused and irritable. Which classification best defines this presentation according to WHO and Indonesian internal medicine guidelines?
A.Dengue fever with typical warning signs
B.Severe dengue with expanded dengue syndrome
C.Dengue shock syndrome in compensation stage
D.Acute viral hepatitis A coinfection with uncomplicated dengue
Explanation: This patient meets criteria for severe dengue manifested as Expanded Dengue Syndrome (EDS), characterized by severe organ impairment—in this case, severe acute hepatic injury (AST/ALT >1,000 U/L) and acute encephalopathy alongside plasma leakage. While plasma leakage and warning signs are present, profound hepatic transaminitis and central nervous system involvement represent atypical, severe organ involvement (EDS) requiring aggressive monitoring and supportive intensive care. Treatment centers on careful, titrated isotonic crystalloid resuscitation while guarding against fluid overload and managing acute liver dysfunction.
2A 35-year-old military officer returning from service in Papua presents with high fever, jaundice, dark tea-colored urine, and impaired consciousness (Glasgow Coma Scale score 9). Peripheral blood smear with Giemsa stain demonstrates ring forms of Plasmodium falciparum with 12% parasitemia. Laboratory testing confirms serum total bilirubin 8.4 mg/dL, serum creatinine 3.6 mg/dL, and blood glucose 42 mg/dL. What is the immediate first-line parenteral antimalarial therapy recommended by WHO and Indonesian Ministry of Health guidelines?
A.Intravenous artesunate 2.4 mg/kg at 0, 12, and 24 hours, then daily until oral therapy can be tolerated
B.Intravenous quinine dihydrochloride loading dose 20 mg/kg infused over 4 hours, followed by maintenance infusions
C.Intramuscular chloroquine 5 mg base/kg every 6 hours
D.Oral dihydroartemisinin-piperaquine (DHP) crushed via nasogastric tube
Explanation: Intravenous artesunate (2.4 mg/kg IV administered at 0, 12, and 24 hours, then once daily) is the drug of choice for severe falciparum malaria. It reduces mortality significantly compared with intravenous quinine, achieves faster parasite clearance, and carries a much lower risk of hypoglycemia. Once the patient regains consciousness and is able to swallow, a complete 3-day oral course of artemisinin-based combination therapy (ACT, such as dihydroartemisinin-piperaquine) plus single-dose primaquine is completed.
3A 24-year-old woman admitted on day 14 of untreated fever and stepped diarrhea is diagnosed with typhoid fever confirmed by blood culture positive for Salmonella enterica serovar Typhi. Four hours after admission, she develops acute, severe generalized abdominal pain, marked tachycardia (130 bpm), hypotension (85/50 mmHg), abdominal guarding, rigidity, and absent bowel sounds. An upright chest radiograph reveals free air under the right hemidiaphragm. What is the most critical immediate combined management step?
A.Initiate aggressive crystalloid fluid resuscitation, broad-spectrum IV antibiotics (ceftriaxone plus metronidazole), and emergent surgical laparotomy
B.Perform urgent diagnostic colonoscopy to locate and clip mucosal bleeding ulcers
C.Administer high-dose oral ciprofloxacin via nasogastric tube and observe for 24 hours under serial abdominal exams
D.Place a percutaneous abdominal pigtail drain under ultrasound guidance and withhold systemic antibiotics pending sensitivities
Explanation: Intestinal perforation (most commonly in the antimesenteric border of the terminal ileum at the site of necrotic Peyer patches) is the most lethal complication of typhoid fever, typically occurring in the third week of illness. Free air under the diaphragm signifies hollow viscus perforation with peritonitis. Immediate management requires aggressive intravenous crystalloid resuscitation for septic shock, broad-spectrum parenteral coverage covering Salmonella and enteric anaerobes/Gram-negatives (e.g., ceftriaxone plus metronidazole), and emergent exploratory laparotomy for surgical repair.
4A 42-year-old sanitation worker in Jakarta presents during the rainy season with 6 days of high remittent fever, severe bilateral calf pain, headache, and dark jaundice. Physical examination shows bilateral conjunctival suffusion without purulent discharge, jaundice, hepatomegaly, and marked calf muscle tenderness. Laboratory findings show hemoglobin 11.2 g/dL, leukocytes 18,500/µL with 88% neutrophils, platelets 42,000/µL, total bilirubin 14.8 mg/dL (predominantly direct), AST 112 U/L, ALT 98 U/L, BUN 68 mg/dL, and serum creatinine 4.1 mg/dL. Urinalysis shows proteinuria and microscopic hematuria. What is the definitive diagnosis and drug of choice?
A.Weil syndrome (severe leptospirosis); Intravenous penicillin G or ceftriaxone
B.Acute hepatitis A virus infection; Oral tenofovir disoproxil fumarate
C.Falciparum malaria with blackwater fever; Intravenous artesunate
D.Hemolytic uremic syndrome; Plasma exchange therapy alone without antibiotics
Explanation: The classic triad of jaundice, acute kidney injury, and hemorrhagic diathesis following flood/rodent-contaminated water exposure, accompanied by conjunctival suffusion and intense calf tenderness, is diagnostic of Weil syndrome (severe icteric leptospirosis caused by pathogenic Leptospira interrogans). Disproportionate hyperbilirubinemia with only modest transaminase elevation is typical. The recommended treatment is intravenous penicillin G (1.5 million units IV every 6 hours) or intravenous ceftriaxone (1–2 g IV daily) for 7 days, along with renal replacement therapy if indicated.
5A 32-year-old man with newly diagnosed advanced HIV infection (CD4+ count 24 cells/µL) is admitted with subacute headache, nausea, low-grade fever, and neck stiffness. Lumbar puncture demonstrates an opening pressure of 280 mmH2O. India ink examination of cerebrospinal fluid (CSF) reveals encapsulated budding yeast cells, and CSF cryptococcal antigen is strongly positive (titer 1:1,024). Induction antifungal therapy with liposomal amphotericin B and flucytosine is commenced. When should antiretroviral therapy (ART) be initiated in this patient?
A.Delayed until 2 to 6 weeks after starting effective antifungal therapy and clinical improvement
B.Immediately within the first 24 to 48 hours of antifungal therapy
C.Delayed for at least 6 months until CSF fungal cultures remain negative on maintenance fluconazole
D.Simultaneously at day 7 together with prophylactic high-dose dexamethasone
Explanation: In cryptococcal meningitis in patients with advanced HIV, early initiation of ART (within 1 to 2 weeks) is associated with a significantly increased risk of severe central nervous system immune reconstitution inflammatory syndrome (CNS-IRIS) and increased mortality (COAT trial). WHO and national guidelines recommend deferring ART until at least 2 to 6 weeks after initiating effective antifungal therapy, once intracranial pressure is controlled and clinical response to induction therapy is documented.
6A 29-year-old HIV-infected male (CD4+ count 68 cells/µL, not taking ART) presents with a 2-week history of progressive dyspnea on exertion, dry non-productive cough, and low-grade fever. On examination, respiratory rate is 28/min, pulse oximetry shows oxygen saturation of 88% on ambient air, and chest auscultation reveals faint bilateral crackles. Arterial blood gas (ABG) on room air reveals pH 7.44, PaCO2 32 mmHg, and PaO2 58 mmHg (alveolar-arterial oxygen gradient >35 mmHg). Chest CT shows diffuse bilateral ground-glass opacities with perihilar predominance. Which therapeutic strategy is indicated?
A.Intravenous trimethoprim-sulfamethoxazole (TMP-SMX) PLUS adjunctive systemic corticosteroids initiated before or concurrent with antimicrobial therapy
B.Oral trimethoprim-sulfamethoxazole monotherapy without corticosteroids
C.Intravenous pentamidine monotherapy combined with empiric broad-spectrum cephalosporin
D.Intravenous ganciclovir combined with clarithromycin for presumptive atypical pneumonitis
Explanation: The clinical presentation and radiographic features are classic for moderate-to-severe Pneumocystis jirovecii pneumonia (PCP). In HIV-infected patients with moderate-to-severe PCP, defined by an arterial PaO2 <70 mmHg on room air or an alveolar-arterial oxygen gradient [P(A-a)O2] ≥35 mmHg, adjunctive systemic corticosteroids (oral prednisone or IV methylprednisolone) significantly reduce the risk of respiratory failure, clinical deterioration, and mortality. Corticosteroids should be initiated prior to or simultaneously with high-dose TMP-SMX.
7A 36-year-old woman with advanced HIV infection (CD4+ cell count 38 cells/µL) presents with a first-onset focal motor seizure involving the right arm followed by right hemiparesis and progressive lethargy. Contrast-enhanced brain MRI reveals multiple nodular, ring-enhancing lesions in the basal ganglia and corticomedullary junction with surrounding vasogenic edema and mass effect. Serum Toxoplasma IgG is positive. What is the recommended empiric first-line induction therapy?
A.Pyrimethamine plus sulfadiazine plus folinic acid (leucovorin)
B.Intravenous ganciclovir plus foscarnet
C.Intravenous acyclovir high-dose for 21 days
D.Whole-brain radiation therapy combined with high-dose intravenous methotrexate
Explanation: Cerebral toxoplasmosis is the most common cause of focal brain lesions in patients with advanced HIV/AIDS and CD4 <100 cells/µL. The presence of multiple ring-enhancing basal ganglia lesions and positive Toxoplasma IgG strongly supports the diagnosis. The first-line induction regimen is pyrimethamine plus sulfadiazine plus folinic acid (leucovorin to prevent bone marrow toxicity) for at least 6 weeks. High-dose trimethoprim-sulfamethoxazole (TMP-SMX) is the preferred alternative when pyrimethamine/sulfadiazine is unavailable.
8A 68-year-old woman is admitted from an assisted care facility with fever, altered mental status, and purulent urine. Her blood pressure is 74/42 mmHg, pulse 124 bpm, respiratory rate 26/min, and temperature 39.1 °C. She receives 30 mL/kg of balanced crystalloid solution over 2 hours. Despite fluid loading, her mean arterial pressure (MAP) remains 54 mmHg, and repeat serum lactate is 3.8 mmol/L. According to the Sepsis-3 consensus definitions, which clinical condition is present and which initial vasoactive agent is the first-line choice?
A.Septic shock; Norepinephrine infusion titrated to target a MAP ≥65 mmHg
B.Sepsis without shock; Dopamine infusion titrated to target systolic blood pressure >120 mmHg
C.Sepsis-induced hypovolemia; Epinephrine infusion bolus followed by colloids
D.Refractory distributive vasoplegia; Phenylephrine continuous infusion
Explanation: According to the Sepsis-3 consensus guidelines, septic shock is defined clinically by persistent hypotension requiring vasopressors to maintain a mean arterial pressure (MAP) ≥65 mmHg and a serum lactate level >2.0 mmol/L despite adequate volume resuscitation. Surviving Sepsis Campaign (SSC) guidelines strongly recommend norepinephrine as the first-choice vasopressor over dopamine, epinephrine, or phenylephrine, as norepinephrine achieves effective vasoconstriction with lower arrhythmogenic potential.
9A 55-year-old male with septic shock secondary to acute necrotizing fasciitis is admitted to the intensive care unit. He has received adequate crystalloid loading. He is currently receiving norepinephrine at an escalating dose of 0.35 mcg/kg/min, but his mean arterial pressure (MAP) remains between 56 and 60 mmHg and serum lactate has risen to 4.2 mmol/L. Bedside echocardiogram shows preserved left ventricular systolic function with no outflow tract obstruction. According to Surviving Sepsis Campaign 2021 guidelines, what is the next best adjunctive vasoactive intervention?
A.Add vasopressin at a fixed dose of 0.03 units/min to reduce norepinephrine dosage and improve MAP
B.Discontinue norepinephrine and switch to high-dose dopamine infusion
C.Start a bolus of 500 mL of 10% hydroxyethyl starch solution
D.Initiate a continuous infusion of esmolol to reduce tachycardia
Explanation: Surviving Sepsis Campaign 2021 guidelines recommend adding vasopressin (at a fixed dose of 0.03 units/min) rather than escalating norepinephrine to very high doses alone when norepinephrine dosage is in the range of 0.25 to 0.5 mcg/kg/min. Vasopressin targets V1 receptors on vascular smooth muscle, counteracting relative vasopressin deficiency in septic shock and allowing a reduction in catecholamine requirements.
10A 45-year-old man with newly diagnosed smear-positive pulmonary tuberculosis started standard four-drug fixed-dose combination therapy (rifampicin, isoniazid, pyrazinamide, and ethambutol: 2HRZE) two weeks ago. Today he presents with marked nausea, anorexia, and scleral icterus. Physical exam shows jaundice without asterixis. Serum chemistry reveals total bilirubin 4.8 mg/dL, AST 390 U/L, and ALT 440 U/L (baseline transaminases were normal). Viral hepatitis serologies (anti-HAV IgM, HBsAg, anti-HCV) are negative. What is the most appropriate immediate action?
A.Immediately discontinue all potentially hepatotoxic anti-TB drugs (isoniazid, rifampicin, and pyrazinamide)
B.Continue the current regimen unchanged and recheck liver enzymes in 1 week
C.Stop only pyrazinamide while continuing full-dose isoniazid, rifampicin, and ethambutol
D.Replace the entire regimen with high-dose paracetamol and oral amoxicillin-clavulanate
Explanation: Drug-induced liver injury (DILI) is defined by transaminases >5 times the upper limit of normal (ULN) without symptoms, or >3 times ULN in the presence of hepatitis symptoms (nausea, anorexia, vomiting, jaundice), or total bilirubin >2 mg/dL. In this clinical scenario, all potentially hepatotoxic anti-TB medications (isoniazid, rifampicin, and pyrazinamide) must be discontinued immediately. The patient is monitored until symptoms resolve and transaminases drop to <2 times ULN, after which drugs are re-introduced sequentially (or non-hepatotoxic bridging regimens with ethambutol, an aminoglycoside, and a fluoroquinolone are used if clinically critical).

About the UKOM Sp.PD Exam

The UKOM Sp.PD (Uji Kompetensi Dokter Spesialis Penyakit Dalam Indonesia / UK-DSPDI) is the national exit examination for eligible internal-medicine residents completing PPDS-1 in Indonesia, administered by Kolegium Ilmu Penyakit Dalam Indonesia. Current registration afterward follows the Konsil Kesehatan Indonesia and health-authority framework.

Exam sponsor: Kolegium Ilmu Penyakit Dalam Indonesia (KIPDI) / Konsil Kesehatan Indonesia (KKI). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Two-part national exit examination consisting of: Day 2: 200 multiple-choice questions delivered as a Computer-Based Test (CBT) across two sessions (100 items each). Day 3: Objective Structured Clinical Examination (OSCE) evaluating diagnostic, procedural, critical communication, and resuscitation competencies.

Time Limit

Two CBT sessions on Day 2 and an OSCE on Day 3; exact session and station durations were not published in the official sources reviewed.

Passing Score

Not published in the official sources reviewed.

Exam / Certification Fees

Not published in the official sources reviewed; confirm with the Kolegium.

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

20%

Tropik Infeksi & Pulmonologi

Tropical infectious diseases (severe dengue/EDS, severe malaria, typhoid complications, leptospirosis/Weil syndrome, HIV opportunistic infections, Sepsis-3) and pulmonology (tuberculosis DILI and MDR-TB, CAP/HAP, ARDS, COPD, pleural effusion).

15%

Gastroenterohepatologi

Gastrointestinal bleeding and ulcer hemostasis, H. pylori eradication, acute liver failure King's College criteria, viral hepatitis B and C antivirals, cirrhosis complications (varices, ascites, SBP, HRS), MASLD, acute pancreatitis step-up approach, and IBD.

20%

Nefrologi, Hipertensi & Kardiologi Medik

Acute kidney injury KDIGO criteria and dialysis indications, CKD progression and CKD-MBD, glomerulonephritis and lupus nephritis, electrolyte and acid-base emergencies, PERHI hypertension guidelines, heart failure GDMT, ACS management, and atrial fibrillation.

15%

Endokrin, Metabolik & Diabetes

Type 2 diabetes individualized management and PERKENI guidelines, DKA and HHS resuscitation protocols, euglycemic DKA, thyroid disorders and thyroid storm, myxedema coma, adrenal insufficiency and crisis, Cushing syndrome, and dyslipidemia.

30%

Hematologi-Onkologi Medik, Reumatologi & Geriatri

Hematologic disorders (AIHA, aplastic anemia, leukemias, multiple myeloma, ITP, TTP, VTE), oncologic emergencies (febrile neutropenia, TLS, hypercalcemia, SVC syndrome, MSCC); Rheumatology (SLE, APS, RA, scleroderma, spondyloarthritis, gout, myositis); and Geriatrics (CGA, frailty, sarcopenia, Beers criteria, falls, delirium).

Preparing for the UKOM Sp.PD Exam

What You Need to Know

  • Passing score: Not published in the official sources reviewed.
  • Assessment: Two-part national exit examination consisting of: Day 2: 200 multiple-choice questions delivered as a Computer-Based Test (CBT) across two sessions (100 items each). Day 3: Objective Structured Clinical Examination (OSCE) evaluating diagnostic, procedural, critical communication, and resuscitation competencies.
  • Time limit: Two CBT sessions on Day 2 and an OSCE on Day 3; exact session and station durations were not published in the official sources reviewed.
  • Exam / certification fees: Not published in the official sources reviewed; confirm with the Kolegium. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Frequently Asked Questions

What is the examination structure of the UK-DSPDI / UKOM Sp.PD?

The UK-DSPDI examination comprises two sequential assessment days: Day 2 is a nationwide Computer-Based Test (CBT) of 200 clinical multiple-choice questions delivered in two 100-item sessions, and Day 3 is an Objective Structured Clinical Examination (OSCE). The official sources reviewed did not publish session durations, station counts, or detailed station timing.

Who is eligible to take the UKOM Sp.PD examination in Indonesia?

Candidates must hold an Indonesian Medical Doctor (dr.) degree, maintain an active medical registration (STR), and have successfully completed all academic, clinical, and chief residency requirements of an accredited Indonesian university PPDS-1 Internal Medicine residency program (or recognized foreign specialist adaptation program), with formal endorsement from their Residency Program Director (KPS).

How is the passing score determined for the UKOM Sp.PD?

The current passing threshold, standard-setting method and component-level pass rules were not published in the official sources reviewed. Candidates should confirm the sitting-specific rules with Kolegium Ilmu Penyakit Dalam.

What is OpenExamPrep's UKOM Sp.PD practice bank and how should it be used?

This practice resource represents an independent English-language MCQ study adaptation developed by OpenExamPrep for resident physicians preparing for the Indonesian national internal medicine specialist exit examination. It covers the core clinical reasoning, diagnostic criteria, pharmacotherapeutics, and emergency protocols defined in Perkonsil No. 48 Tahun 2017 and the KIPDI curriculum for independent study and revision.