{"_id":"annales-2016-qi-1","enonce":"A study was carried out by drawing lots from the electoral lists 5,000 subjects aged 40 to 60.  Whether or not these subjects had diabetes was investigated by taking their medical history, treatments taken and measuring their fasting blood glucose. Which of the following is correct about this study?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"This is a cross-sectional study"},{"idx":1,"correct":false,"proposition":"This is a randomized study"},{"idx":2,"correct":true,"proposition":"This is an observational study"},{"idx":3,"correct":true,"proposition":"This study will estimate the prevalence of diabetes in this population"},{"idx":4,"correct":false,"proposition":"This study will estimate the case fatality associated with diabetes in this population"}],"type":"qi"}
{"_id":"annales-2016-qi-3","enonce":"Primary enuresis is when:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"The child is over 5 years old"},{"idx":1,"correct":false,"proposition":"This enuresis has no identified cause"},{"idx":2,"correct":true,"proposition":"The child was never clean at night"},{"idx":3,"correct":false,"proposition":"The child sleeps too much"},{"idx":4,"correct":false,"proposition":"The child gets up at night to drink"}],"type":"qi"}
{"_id":"annales-2016-qi-4","enonce":"A 3-year-old child is brought to the emergency room by his parents for diarrhea for 2 days associated with a fever at 40 ° C.  You learn that he returned from Senegal 3 days before. Which additional examination(s) do you think are etiologically justified in view of the whole clinical picture?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"A blood culture"},{"idx":1,"correct":false,"proposition":"Malaria serology"},{"idx":2,"correct":true,"proposition":"A rapid diagnostic test for malaria"},{"idx":3,"correct":true,"proposition":"A search for parasites in the stool"},{"idx":4,"correct":true,"proposition":"A stool culture"}],"type":"qi"}
{"_id":"annales-2016-qi-5","enonce":"As part of the procedure before the Conciliation and Compensation Commission (CCI), following a medical accident, compensation from the National Office for Medical Accident Compensation (ONIAM) can be obtained if one or more conditions are met.  Which one(which)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Prior application of the administrative responsibility of the hospital"},{"idx":1,"correct":true,"proposition":"Harm directly related to medical care"},{"idx":2,"correct":true,"proposition":"The absence of culpable liability"},{"idx":3,"correct":true,"proposition":"Damage with a Violation of Physical or Mental Integrity (AIPP) greater than or equal to 25%"},{"idx":4,"correct":true,"proposition":"A cessation of professional activities greater than or equal to 6 months over a period of 12 months"}],"type":"qi"}
{"_id":"annales-2016-qi-6","enonce":"A 3-year-old child with normal psychomotor development is usually able to:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Reproduce a round"},{"idx":1,"correct":true,"proposition":"Reproduce a stroke"},{"idx":2,"correct":false,"proposition":"Reproduce a diamond"},{"idx":3,"correct":false,"proposition":"Reproduce a square"},{"idx":4,"correct":false,"proposition":"Reproduce a cross"}],"type":"qi"}
{"_id":"annales-2016-qi-7","enonce":"When a mother has gestational diabetes, there is an increased risk of:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Post-term delivery"},{"idx":1,"correct":false,"proposition":"That the newborn is hypotrophic (small for gestational age)"},{"idx":2,"correct":true,"proposition":"Dystocia"},{"idx":3,"correct":true,"proposition":"Free bilirubin jaundice in newborns"},{"idx":4,"correct":false,"proposition":"Neonatal hyperglycemia"}],"type":"qi"}
{"_id":"annales-2016-qi-8","enonce":"A 10-month-old infant with normal psychomotor development should:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Standing with support"},{"idx":1,"correct":true,"proposition":"Repeat a syllable"},{"idx":2,"correct":true,"proposition":"Seated by yourself"},{"idx":3,"correct":true,"proposition":"Moving on the ground"},{"idx":4,"correct":true,"proposition":"Worrying at the sight of an unfamiliar face"}],"type":"qi"}
{"_id":"annales-2016-qi-9","enonce":"What is (are) the complication(s) associated with prematurity?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Ulcerative-necrotizing enterocolitis"},{"idx":1,"correct":true,"proposition":"Retinopathy"},{"idx":2,"correct":true,"proposition":"Periventricular leukomalacia"},{"idx":3,"correct":false,"proposition":"Dilation of the bronchi"},{"idx":4,"correct":false,"proposition":"The atrioventricular canal"}],"type":"qi"}
{"_id":"annales-2016-qi-10","enonce":"You are seeing a 12-year-old obese teenager. The body mass index curve shows a rebound in adiposity at age 3. There is an acceleration of the stature growth curve. On examination, you will see purple stretch marks on the flanks and thickened, rough skin on the neck. His parents report that he is constipated. Which additional exam(s) do you prescribe?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"TSH, T4"},{"idx":1,"correct":false,"proposition":"Urinary free cortisol"},{"idx":2,"correct":false,"proposition":"Plasma IGF 1"},{"idx":3,"correct":false,"proposition":"Testosteronemia"},{"idx":4,"correct":true,"proposition":"None of the previous exams"}],"type":"qi"}
{"_id":"annales-2016-qi-11","enonce":"A child who has just been born is said:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Premature if born at a gestational age less than 37 weeks of amenorrhea"},{"idx":1,"correct":true,"proposition":"Hypotrophic if its measurements are strictly less than at least two standard deviations from the reference curves"},{"idx":2,"correct":true,"proposition":"Post-mature if born at a gestational age greater than or equal to 42 weeks of amenorrhea"},{"idx":3,"correct":false,"proposition":"Newborn in the first three months of life"},{"idx":4,"correct":true,"proposition":"Very premature if born at a gestational age of less than 32 weeks of amenorrhea"}],"type":"qi"}
{"_id":"annales-2016-qi-12","enonce":"All newborns should be routinely screened for:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Cystic fibrosis"},{"idx":1,"correct":false,"proposition":"Congenital diabetes"},{"idx":2,"correct":true,"proposition":"Congenital hypothyroidism"},{"idx":3,"correct":true,"proposition":"Congenital adrenal hyperplasia"},{"idx":4,"correct":false,"proposition":"Thalassemia"}],"type":"qi"}
{"_id":"annales-2016-qi-13","enonce":"At the maternity discharge examination, a healthy full-term child must have:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"A closed posterior fontanel"},{"idx":1,"correct":true,"proposition":"A popliteal angle less than or equal to 90°"},{"idx":2,"correct":false,"proposition":"A disappearance of automatic walking"},{"idx":3,"correct":true,"proposition":"An eye chase"},{"idx":4,"correct":false,"proposition":"A smile-response"}],"type":"qi"}
{"_id":"annales-2016-qi-14","enonce":"A 55-year-old patient with breast cancer with bone metastases under pamidronate treatment consults you. She has had endooral bone exposure for several weeks, following the avulsion of a mobile tooth. She has no other medical history. You mention the diagnosis(s) of:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Osteoradionecrosis"},{"idx":1,"correct":true,"proposition":"Bone metastasis"},{"idx":2,"correct":false,"proposition":"Osteoma"},{"idx":3,"correct":true,"proposition":"Osteochimionecosis"},{"idx":4,"correct":false,"proposition":"Ameloblastoma"}],"type":"qi"}
{"_id":"annales-2016-qi-15","enonce":"A 56-year-old patient, a tobacco user since the age of 16, consults you because of the appearance for 1 month and a half of lingual ulceration. The elements that guide you towards the diagnosis of squamous cell carcinoma are:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Peripheral halo erythematosus"},{"idx":1,"correct":true,"proposition":"Lesional induration"},{"idx":2,"correct":true,"proposition":"Contact bleeding"},{"idx":3,"correct":false,"proposition":"Feverish"},{"idx":4,"correct":true,"proposition":"Indurated homolateral group II cervical lymphadenopathy"}],"type":"qi"}
{"_id":"annales-2016-qi-16","enonce":"In a displaced right zygomatomaxillary fracture, you are looking for hypoesthesia in the following territory(s):","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Upper right eyelid"},{"idx":1,"correct":false,"proposition":"Tip of the nose"},{"idx":2,"correct":true,"proposition":"Teeth number 11, 12 and 13"},{"idx":3,"correct":true,"proposition":"Right half of the upper lip"},{"idx":4,"correct":false,"proposition":"Cornea of the right eye"}],"type":"qi"}
{"_id":"annales-2016-qi-17","enonce":"The walls of the orbit consist of:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Sphenoid bone"},{"idx":1,"correct":true,"proposition":"The ethmoid bone"},{"idx":2,"correct":true,"proposition":"Zygomatic bone"},{"idx":3,"correct":true,"proposition":"The maxillary bone"},{"idx":4,"correct":true,"proposition":"Frontal bone"}],"type":"qi"}
{"_id":"annales-2016-qi-18","enonce":"The uvule:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Helps to delimit the isthmus of the throat"},{"idx":1,"correct":true,"proposition":"May be hypertrophic and responsible for snoring"},{"idx":2,"correct":true,"proposition":"May be bifid in a submucosal slit"},{"idx":3,"correct":true,"proposition":"Is essential in the mechanisms of swallowing"},{"idx":4,"correct":false,"proposition":"Is devoid of any muscle structure"}],"type":"qi"}
{"_id":"annales-2016-qi-19","enonce":"Ameloblastoma:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Is an odontogenic tumor"},{"idx":1,"correct":false,"proposition":"Is a non-epithelial tumor"},{"idx":2,"correct":true,"proposition":"Is characterized by local aggressiveness"},{"idx":3,"correct":true,"proposition":"Is prone to recurrence"},{"idx":4,"correct":true,"proposition":"Gives a multilocular lytic radiological image"}],"type":"qi"}
{"_id":"annales-2016-qi-20","enonce":"With which diagnosis(s) is compatible the following assessment: serum calcium 2.80 mmol \/ L; phosphoremia 0.6 mmol\/L (normal values 0.80 to 1.45); PTH 3 pmol\/L (normal values 1.2 to 5.8)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Primary hyperparathyroidism"},{"idx":1,"correct":false,"proposition":"Secondary hyperparathyroidism"},{"idx":2,"correct":false,"proposition":"Vitamin D poisoning"},{"idx":3,"correct":false,"proposition":"Paraneoplastic hyperparathyroidism"},{"idx":4,"correct":false,"proposition":"Myeloma"}],"type":"qi"}
{"_id":"annales-2016-qi-21","enonce":"What examination(s) can you request for the diagnosis of corticotropic deficiency in a patient who has had corticosteroid therapy at a dose of 1 mg\/kg\/day of prednisone for 4 months?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"ACTH dosage only"},{"idx":1,"correct":true,"proposition":"ACTH and cortisol assay at 8 h"},{"idx":2,"correct":false,"proposition":"Renin dosage"},{"idx":3,"correct":true,"proposition":"Ordinary synacthene test"},{"idx":4,"correct":false,"proposition":"24-hour urinary free cortisol"}],"type":"qi"}
{"_id":"annales-2016-qi-23","enonce":"Among the following proposals, which non-pharmacological therapeutic (s) can (s) be prescribed in the chronic phase of osteoarthritis (at a distance from a flare-up)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Landfill"},{"idx":1,"correct":true,"proposition":"Adapted physical activity"},{"idx":2,"correct":true,"proposition":"Crenotherapy"},{"idx":3,"correct":true,"proposition":"Muscle building"},{"idx":4,"correct":false,"proposition":"Immobilization"}],"type":"qi"}
{"_id":"annales-2016-qi-24","enonce":"A 76-year-old patient, living alone in a single-storey house, had surgery for a total hip replacement on the right. She has lost weight by 1 kg since the procedure. However, she keeps a good appetite, is not afraid of falling and walks with a cane on the left. She plans to have cataract surgery. She consults 3 months after the intervention for pain in the right hip. What is (are) the sign(s) you are looking for in favor of a prosthesis infection visible on a prosthetic hip X-ray?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"A peri-prosthetic border"},{"idx":1,"correct":false,"proposition":"Parrot beaks"},{"idx":2,"correct":true,"proposition":"Osteolysis"},{"idx":3,"correct":true,"proposition":"Endorsed geodes"},{"idx":4,"correct":true,"proposition":"Periosteal appositions"}],"type":"qi"}
{"_id":"annales-2016-qi-25","enonce":"Diabetic retinopathy, at the stage of \"rare micro-aneurysms\":","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Is associated with macular edema"},{"idx":1,"correct":false,"proposition":"Contraindicates the rapid achievement of strict normoglycemia"},{"idx":2,"correct":false,"proposition":"Indicates laser photocoagulation in preparation for pregnancy"},{"idx":3,"correct":false,"proposition":"Must be checked at three months"},{"idx":4,"correct":true,"proposition":"May be observed as soon as diabetes is diagnosed"}],"type":"qi"}
{"_id":"annales-2016-qi-26","enonce":"Orthostatic proteinuria:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Disappears after 2 hours of clinostatism"},{"idx":1,"correct":true,"proposition":"Observed during puberty"},{"idx":2,"correct":false,"proposition":"Persists after age 25"},{"idx":3,"correct":false,"proposition":"Is associated with high cardiovascular risk"},{"idx":4,"correct":true,"proposition":"Is not pathological"}],"type":"qi"}
{"_id":"annales-2016-qi-28","enonce":"Hypoglycemia in type 2 diabetes:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Are a potential side effect of all anti-diabetics"},{"idx":1,"correct":true,"proposition":"On sulfonamide, are more common in cases of renal failure"},{"idx":2,"correct":false,"proposition":"On metformin, are more common in heart failure"},{"idx":3,"correct":true,"proposition":"Are facilitated by taking alcohol"},{"idx":4,"correct":false,"proposition":"Are responsible for the majority of cardiovascular events in diabetics"}],"type":"qi"}
{"_id":"annales-2016-qi-29","enonce":"Obesity:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Concerns 15% of the adult French population"},{"idx":1,"correct":true,"proposition":"Is considered a low-grade inflammatory disease"},{"idx":2,"correct":true,"proposition":"Is accompanied by an increase in lean body mass"},{"idx":3,"correct":false,"proposition":"Is associated with decreased resting metabolism"},{"idx":4,"correct":true,"proposition":"With a well-followed diet, the expected weight loss is of the order of 15% at 2 years"}],"type":"qi"}
{"_id":"annales-2016-qi-30","enonce":"What is (are) the pathology(s) associated with a \"white\" scintigraphy in the presence of an increased free T4?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"De Quervain's thyroiditis"},{"idx":1,"correct":true,"proposition":"Iodine overload"},{"idx":2,"correct":false,"proposition":"Graves' disease"},{"idx":3,"correct":false,"proposition":"Multinodular goiter"},{"idx":4,"correct":true,"proposition":"Factitious thyrotoxicosis"}],"type":"qi"}
{"_id":"annales-2016-qi-31","enonce":"On a systematic count carried out in a 63-year-old patient, you find: leukocytes 7.2 G \/ L; neutrophils 47%; lymphocytes 45%; monocytes 8%;  haemoglobin 14.4 g\/dL; VGM 89 fL; CCMH 33 g\/100 mL; platelets 755 G\/L. You mention:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Iron deficiency"},{"idx":1,"correct":false,"proposition":"Taking corticosteroids"},{"idx":2,"correct":true,"proposition":"An asplenism"},{"idx":3,"correct":true,"proposition":"An essential thrombocythemia"},{"idx":4,"correct":false,"proposition":"Active smoking"}],"type":"qi"}
{"_id":"annales-2016-qi-32","enonce":"A 74-year-old woman has the following blood count: leukocytes 2.1 G\/L; neutrophils 0.7 G\/L; lymphocytes 1.4 G\/L; hemoglobin 8.5 g\/dLv VGM 104 fL; blisters 567 G\/L. The myelogram returns to a marrow of normal richness with 3% blasts and signs of dysmegakaryopoiesis. Which diagnosis(s) evokes this table?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Acute myelogenous leukemia"},{"idx":1,"correct":true,"proposition":"A 5q- syndrome"},{"idx":2,"correct":false,"proposition":"Refractory anemia with excess blasts"},{"idx":3,"correct":false,"proposition":"A myeloproliferative syndrome"},{"idx":4,"correct":true,"proposition":"Myelodysplastic syndrome"}],"type":"qi"}
{"_id":"annales-2016-qi-33","enonce":"Metabolic adaptations observed during a hunger strike include:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Stimulation of gluconeogenesis"},{"idx":1,"correct":false,"proposition":"A brake of adipocyte lipolysis"},{"idx":2,"correct":true,"proposition":"A decrease in resting energy metabolism"},{"idx":3,"correct":true,"proposition":"Nitrogen savings"},{"idx":4,"correct":true,"proposition":"Increased ketogenesis"}],"type":"qi"}
{"_id":"annales-2016-qi-34","enonce":"A 28-year-old patient comes to your consultation for a gradual installation fatigue over several weeks. She is out of breath at the effort and is very embarrassed in her activity as a cleaning lady. The clinical examination finds only a mucocutaneous pallor. A first assessment finds: leukocytes 7.6 G \/ L, neutrophils 62%, eosinophilic polynuclear 2%;  lymphocytes 33%; monocytes 3%; haemoglobin 9.7 g\/dL; VGM 76 fL; CCMH 31.2 g\/dL;  platelets 633 G\/L; reticulocytes 67 G\/L. Which of the following results explains the abnormalities of the blood count?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Ferritinemia increased"},{"idx":1,"correct":true,"proposition":"Lowered ferritinemia"},{"idx":2,"correct":false,"proposition":"Increased serum iron and normal transferrin"},{"idx":3,"correct":false,"proposition":"Collapsed vitamin B12"},{"idx":4,"correct":false,"proposition":"Hb A2 at 10.2% on hemoglobin electrophoresis"}],"type":"qi"}
{"_id":"annales-2016-qi-35","enonce":"As part of the monitoring of synthetic antithyroid therapy, it is interesting to measure:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Creatinine"},{"idx":1,"correct":false,"proposition":"CPK"},{"idx":2,"correct":true,"proposition":"Blood count"},{"idx":3,"correct":false,"proposition":"CRP"},{"idx":4,"correct":true,"proposition":"Transaminases"}],"type":"qi"}
{"_id":"annales-2016-qi-36","enonce":"Excess glucocorticoids cause:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Hyperglycaemia"},{"idx":1,"correct":false,"proposition":"Hypercalcemia"},{"idx":2,"correct":false,"proposition":"Hyperprotidemia"},{"idx":3,"correct":true,"proposition":"Hypokalemia"},{"idx":4,"correct":false,"proposition":"Hypernatremia"}],"type":"qi"}
{"_id":"annales-2016-qi-37","enonce":"Polyclonal gammopathy:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Is common during lupus"},{"idx":1,"correct":true,"proposition":"Is common during sarcoidosis"},{"idx":2,"correct":false,"proposition":"Is usually seen during type 2 diabetes"},{"idx":3,"correct":false,"proposition":"May occur during AL amyloidosis"},{"idx":4,"correct":true,"proposition":"May occur during chronic liver disease"}],"type":"qi"}
{"_id":"annales-2016-qi-39","enonce":"When monitoring differentiated papillary thyroid cancer with lymph node invasion, it is customary to use the following monitoring parameters:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Abdominal ultrasound"},{"idx":1,"correct":true,"proposition":"Cervical ultrasound"},{"idx":2,"correct":true,"proposition":"Iodine whole body scintigraphy"},{"idx":3,"correct":false,"proposition":"Bone scintigraphy"},{"idx":4,"correct":false,"proposition":"Thoraco-abdominopelvic CT"}],"type":"qi"}
{"_id":"annales-2016-qi-40","enonce":"The clinical symptomatology of Willebrand disease is dominated by:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"A petechial purpura"},{"idx":1,"correct":true,"proposition":"Epistaxis"},{"idx":2,"correct":true,"proposition":"Meno-metrorrhagia"},{"idx":3,"correct":false,"proposition":"Hemathosis"},{"idx":4,"correct":false,"proposition":"Muscle hematomas"}],"type":"qi"}
{"_id":"annales-2016-qi-43","enonce":"Malignant humoral hypercalcemia: B. Is due to hypersecretion of ","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Is one of the causes of hypercalcemia of myeloma"}],"type":"qi"}
{"_id":"annales-2016-qi-44","enonce":"Regarding primary amenorrhea, which is (are) the exact proposal(s)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"It is characterized by the absence of secondary sexual characteristics after 16 years in young girls"},{"idx":1,"correct":false,"proposition":"It is more common than secondary amenorrhea"},{"idx":2,"correct":true,"proposition":"It can be linked to a central cause"},{"idx":3,"correct":true,"proposition":"It requires in its etiological assessment a dosage of gonadotropins"},{"idx":4,"correct":true,"proposition":"Associated with an absence of secondary sexual characteristics, it may be due to a syndrome"},{"idx":5,"correct":true,"proposition":"de Turner"}],"type":"qi"}
{"_id":"annales-2016-qi-45","enonce":"What is (are) the exact proposal(s) regarding menopause?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"It is characterized by a stop of the rules"},{"idx":1,"correct":true,"proposition":"She is suspected in front of climacteric signs"},{"idx":2,"correct":false,"proposition":"His progestogen treatment will reinstate withdrawal hemorrhages"},{"idx":3,"correct":false,"proposition":"It must lead to the prescription of a bone densitometry"},{"idx":4,"correct":true,"proposition":"Its risks are mainly osteoporosis"}],"type":"qi"}
{"_id":"annales-2016-qi-46","enonce":"Regarding the semiology of sensitivity, what following statement(s) is (are) true?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Sensory extinction is seen in parietal lobe involvement (parietal syndrome)"},{"idx":1,"correct":false,"proposition":"Romberg's sign testifies to the involvement of small amylin nerve fibers"},{"idx":2,"correct":false,"proposition":"Involvement of the left ulnar nerve can cause hypoaesthesia of the first 3 fingers of the left hand"},{"idx":3,"correct":true,"proposition":"Involvement of a thalamus causes contralateral hypoaesthesia in all modes (thalamic syndrome)"},{"idx":4,"correct":true,"proposition":"Alternate sensory syndrome is a sign of brainstem involvement"}],"type":"qi"}
{"_id":"annales-2016-qi-47","enonce":"What following statement(s) is (are) true regarding the semiology of the cerebellum?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"The Stewart-Holmes maneuver highlights a delay in contraction of agonist muscles"},{"idx":1,"correct":false,"proposition":"Static cerebellar syndrome is linked to damage to the cerebellar hemispheres"},{"idx":2,"correct":true,"proposition":"Hypermetry of the right upper limb may be due to damage to the right cerebellar hemisphere"},{"idx":3,"correct":true,"proposition":"There is hypotonia in cerebellar syndrome"},{"idx":4,"correct":false,"proposition":"The voice may be paretic in case of cerebellar damage"}],"type":"qi"}
{"_id":"annales-2016-qi-48","enonce":"A 55-year-old patient comes to consultation for vision disorders, he has had two traffic accidents because he did not see the priorities on the right. You will focus your clinical examination on the exploration of the visual field. Regarding this patient, what is (are) the exact proposal(s)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"He may have a right homonymous lateral hemianopsia"},{"idx":1,"correct":true,"proposition":"He may have bitemporal hemianopsia"},{"idx":2,"correct":true,"proposition":"If his lesion is intracranial, it may be in left retrochiasmatic"},{"idx":3,"correct":true,"proposition":"If his lesion is intracranial, it may be at the level of the chiasma"},{"idx":4,"correct":false,"proposition":"If his lesion is intracranial, it may be at the right occipital level"}],"type":"qi"}
{"_id":"annales-2016-qi-49","enonce":"An alternate syndrome:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Refers to hemispheric brain damage"},{"idx":1,"correct":false,"proposition":"Corresponds to involvement of a long pathway homolateral to the lesion and a contralateral cranial nerve"},{"idx":2,"correct":true,"proposition":"There is an alternate sensory syndrome in Wallenberg syndrome"},{"idx":3,"correct":true,"proposition":"May be caused by a brainstem infarction"},{"idx":4,"correct":true,"proposition":"May include diplopia"}],"type":"qi"}
{"_id":"annales-2016-qi-50","enonce":"The peripheral nerve(s) most often compressed in case of prolonged immobilization is (are):","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"The median nerve at the carpal tunnel"},{"idx":1,"correct":true,"proposition":"The ulnar nerve at the elbow"},{"idx":2,"correct":false,"proposition":"The fibular nerve in the popliteal fossa"},{"idx":3,"correct":true,"proposition":"The radial nerve in the humeral gutter"},{"idx":4,"correct":false,"proposition":"The sciatic nerve in the lower third of the thigh"}],"type":"qi"}
{"_id":"annales-2016-qi-51","enonce":"False food routes can be prevented by:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"The taking of meals by the patient himself"},{"idx":1,"correct":false,"proposition":"The use of liquid food"},{"idx":2,"correct":false,"proposition":"The lying position, on the right side during meals"},{"idx":3,"correct":true,"proposition":"The use of a notched glass"},{"idx":4,"correct":true,"proposition":"Anteflexion of the head when swallowing"}],"type":"qi"}
{"_id":"annales-2016-qi-52","enonce":"Regarding Parsonage-Turner syndrome, quote the exact proposal(s):","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Initial pains are centered on the shoulder"},{"idx":1,"correct":false,"proposition":"The motor deficit is present from the beginning"},{"idx":2,"correct":false,"proposition":"The motor deficit concerns the C8-T1 roots"},{"idx":3,"correct":false,"proposition":"Sensory disorders are important"},{"idx":4,"correct":true,"proposition":"Amyotrophy is classic in the evolution"}],"type":"qi"}
{"_id":"annales-2016-qi-53","enonce":"What is (are) the typical clinical sign(s) to consider treatment without additional examination in case of vulvovaginal mycosis?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Vulvovaginal pruritus"},{"idx":1,"correct":true,"proposition":"Erythema vulvaris"},{"idx":2,"correct":false,"proposition":"Speculum examination: lilac collar"},{"idx":3,"correct":false,"proposition":"Greyish leucorrhoea"},{"idx":4,"correct":false,"proposition":"Inguinal lymphadenopathy"}],"type":"qi"}
{"_id":"annales-2016-qi-54","enonce":"Regarding typical absence epilepsy, what is (are) the exact answer(s)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"The definition is clinical and electroencephalographic"},{"idx":1,"correct":false,"proposition":"Is characterized by generalized peak wave discharges at 6 Hz"},{"idx":2,"correct":false,"proposition":"Often has atonic seizures"},{"idx":3,"correct":true,"proposition":"EEG discharges are synchronous and symmetrical"},{"idx":4,"correct":true,"proposition":"May be associated with generalized tonic-clonic seizures"}],"type":"qi"}
{"_id":"annales-2016-qi-55","enonce":"Which of the following proposals can (which) correspond to dysautonomic impairment?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Fragile and brittle appendages"},{"idx":1,"correct":true,"proposition":"Orthostatic hypotension"},{"idx":2,"correct":false,"proposition":"Headaches"},{"idx":3,"correct":true,"proposition":"Constipation"},{"idx":4,"correct":false,"proposition":"Anorexia"}],"type":"qi"}
{"_id":"annales-2016-qi-56","enonce":"Zollinger-Ellison syndrome is related to hypergastrinemia secondary to gastrinoma.  In which condition(s) should this diagnosis be evoked? nor ","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"In case of multiple duodenal ulcers"},{"idx":1,"correct":true,"proposition":"In case of recurrent duodenal ulcer or resistant to medical treatment"},{"idx":2,"correct":true,"proposition":"In case of duodenal ulcer associated with gastric or jejunal ulcers"},{"idx":3,"correct":true,"proposition":"In case of duodenal ulcer associated with diarrhea"},{"idx":4,"correct":true,"proposition":"In case of duodenal ulcer occurring without taking aspirin, nonsteroidal anti-inflammatory drug,"}],"type":"qi"}
{"_id":"annales-2016-qi-57","enonce":"What is (are) the exact answer(s) regarding the practical modalities of performing the immunological test for occult bleeding in the stool?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"It is necessary to follow a diet excluding foods rich in tryptophan three days before"},{"idx":1,"correct":true,"proposition":"It is the attending physician who gives the test to the patient"}],"type":"qi"}
{"_id":"annales-2016-qi-58","enonce":"What is (are) the condition(s) for performing a colonoscopy under general anesthesia?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Colonoscopy can be done in outpatient care"},{"idx":1,"correct":false,"proposition":"All antiplatelet therapy must be stopped before the examination"},{"idx":2,"correct":false,"proposition":"Anesthesia can be performed by the gastroenterologist"},{"idx":3,"correct":false,"proposition":"Colic preparation requires a purge over three days"},{"idx":4,"correct":true,"proposition":"A residue-free diet is prescribed for a few days before the exam"}],"type":"qi"}
{"_id":"annales-2016-qi-59","enonce":"Which of the following treatments has (have) a Marketing Authorization (MA) to help maintain abstinence?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Tiapride"},{"idx":1,"correct":true,"proposition":"Acamprosate"},{"idx":2,"correct":true,"proposition":"Naltrexone"},{"idx":3,"correct":false,"proposition":"Clonidine"},{"idx":4,"correct":true,"proposition":"Disulfiram"}],"type":"qi"}
{"_id":"annales-2016-qi-60","enonce":"What characteristic(s) is suggestive of cirrhotic ascites?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Ascites of citrin appearance"},{"idx":1,"correct":false,"proposition":"Hemorrhagic ascites"},{"idx":2,"correct":true,"proposition":"Protein-poor ascites"},{"idx":3,"correct":false,"proposition":"Ascites of chylous appearance"},{"idx":4,"correct":false,"proposition":"Ascites rich in amylase"}],"type":"qi"}
{"_id":"annales-2016-qi-61","enonce":"Regarding the serum total PSA (Prostate Specific Antigen):","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Its increase involves performing endorectal prostate ultrasound as a diagnosis"},{"idx":1,"correct":true,"proposition":"Its dosage is not of interest for subjects whose life expectancy is less than 10 years"},{"idx":2,"correct":false,"proposition":"Its dosage must be carried out annually from the age of 50 as part of a mass screening"},{"idx":3,"correct":false,"proposition":"Its increase implies the systematic realization of the determination of its free fraction"},{"idx":4,"correct":true,"proposition":"Its increase should lead to discuss the realization of prostate biopsies"}],"type":"qi"}
{"_id":"annales-2016-qi-63","enonce":"The initial assessment of urinary incontinence systematically includes:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"An ECBU"},{"idx":1,"correct":false,"proposition":"A Pad-Test"},{"idx":2,"correct":false,"proposition":"A urodynamic balance sheet"},{"idx":3,"correct":false,"proposition":"Static and dynamic pelvic MRI"},{"idx":4,"correct":true,"proposition":"A measurement of the post-void residue by ultrasound"}],"type":"qi"}
{"_id":"annales-2016-qi-64","enonce":"Irritative clinical signs of benign prostatic hyperplasia include:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"A delay in starting urination"},{"idx":1,"correct":true,"proposition":"A pollakiuria"},{"idx":2,"correct":false,"proposition":"A weak urinary stream"},{"idx":3,"correct":false,"proposition":"The presence of lagging drops"},{"idx":4,"correct":true,"proposition":"An emergency room"}],"type":"qi"}
{"_id":"annales-2016-qi-65","enonce":"About the pathophysiology of renal colic, what are the true propositions?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"The pain is induced by irritation of the superior ureteral nerve"},{"idx":1,"correct":true,"proposition":"Intracavitary hyperpressure stimulates intrarenal synthesis of prostaglandin E2"},{"idx":2,"correct":true,"proposition":"Nausea and vomiting trigger the secretion of anti-diuretic hormone (ADH)"},{"idx":3,"correct":false,"proposition":"The dilation underlying the obstacle is related to the relaxation of ureteral smooth muscle fibers"},{"idx":4,"correct":false,"proposition":"The tensioning of the pyel-calycal cavities is responsible for a rapid decrease"},{"idx":5,"correct":false,"proposition":"glomerular filtration rate"}],"type":"qi"}
{"_id":"annales-2016-qi-66","enonce":"Regarding this X-ray section:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"This is an abdominal CT scan injected into coronal sections"},{"idx":1,"correct":true,"proposition":"This is an injected abdominal CT scan, at a late time"},{"idx":2,"correct":false,"proposition":"The left adrenal gland is visible"},{"idx":3,"correct":true,"proposition":"There is a left kidney tumor"},{"idx":4,"correct":true,"proposition":"The left renal vein is visible"}],"type":"qi"}
{"_id":"annales-2016-qi-67","enonce":"Normal sexuality includes the following phases:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"The excitement phase"},{"idx":1,"correct":true,"proposition":"The phase of desire"},{"idx":2,"correct":true,"proposition":"The orgasm phase"},{"idx":3,"correct":true,"proposition":"The plateau phase"},{"idx":4,"correct":true,"proposition":"The resolution phase"}],"type":"qi"}
{"_id":"annales-2016-qi-68","enonce":"In acute urethritis in men, clinical examination includes:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Research to interrogation of a contaminating report"},{"idx":1,"correct":true,"proposition":"A digital rectal exam"},{"idx":2,"correct":false,"proposition":"Scrotal transillumination"},{"idx":3,"correct":true,"proposition":"The search for urethral discharge"},{"idx":4,"correct":true,"proposition":"The search for rectal inflammation"}],"type":"qi"}
{"_id":"annales-2016-qi-69","enonce":"The presence of isolated leukocyturia without germs should suggest:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Urogenital tuberculosis"},{"idx":1,"correct":false,"proposition":"Urolithiasis"},{"idx":2,"correct":true,"proposition":"Interstitial cystitis"},{"idx":3,"correct":false,"proposition":"Diabetes mellitus"},{"idx":4,"correct":true,"proposition":"A bladder tumour"}],"type":"qi"}
{"_id":"annales-2016-qi-70","enonce":"The electrocardiographic signs of hyperkalemia are:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Sharp T-waves"},{"idx":1,"correct":true,"proposition":"Atrioventricular block"},{"idx":2,"correct":true,"proposition":"Shortening QT space"},{"idx":3,"correct":true,"proposition":"QRS lengthening"},{"idx":4,"correct":false,"proposition":"Increase in U-wave"}],"type":"qi"}
{"_id":"annales-2016-qi-71","enonce":"Which of these terms designates the suspension of all motor and language activity that can be observed following psychological shock?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Stupor"},{"idx":1,"correct":false,"proposition":"Dumbness"},{"idx":2,"correct":false,"proposition":"Amiemia"},{"idx":3,"correct":false,"proposition":"Negativism"},{"idx":4,"correct":false,"proposition":"Bradypsychia"}],"type":"qi"}
{"_id":"annales-2016-qi-72","enonce":"What is (are) the positive symptom(s) of schizophrenia?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"The delirium of persecution"},{"idx":1,"correct":false,"proposition":"The alogy"},{"idx":2,"correct":true,"proposition":"Hallucinations"},{"idx":3,"correct":false,"proposition":"Emotional blunting"},{"idx":4,"correct":false,"proposition":"Dams"}],"type":"qi"}
{"_id":"annales-2016-qi-73","enonce":"In generalized anxiety disorder, anxiety is associated with:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Muscle tension"},{"idx":1,"correct":true,"proposition":"Psychasthenia"},{"idx":2,"correct":false,"proposition":"Pessimism"},{"idx":3,"correct":true,"proposition":"The hustle and bustle"},{"idx":4,"correct":true,"proposition":"Sleep disorders"}],"type":"qi"}
{"_id":"annales-2016-qi-74","enonce":"Social phobia includes:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Fear of being alone"},{"idx":1,"correct":true,"proposition":"Avoidance of feared situations"},{"idx":2,"correct":false,"proposition":"Lack of awareness of the morbid nature of the disorders"},{"idx":3,"correct":true,"proposition":"A fear of being observed by others"},{"idx":4,"correct":false,"proposition":"A feeling of inferiority"}],"type":"qi"}
{"_id":"annales-2016-qi-75","enonce":"Lithium is:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Used in the form of salts"},{"idx":1,"correct":false,"proposition":"An antiepileptic drug"},{"idx":2,"correct":true,"proposition":"A thymoregulator"},{"idx":3,"correct":false,"proposition":"An antidepressant"},{"idx":4,"correct":true,"proposition":"A metal"}],"type":"qi"}
{"_id":"annales-2016-qi-76","enonce":"School phobia in children and adolescents:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Concerns 3 to 5% of 12 to 19 year olds"},{"idx":1,"correct":false,"proposition":"Most often involves erythrophobia"},{"idx":2,"correct":true,"proposition":"Is associated with poor academic performance"},{"idx":3,"correct":true,"proposition":"Leads to a major risk of dropping out of school"},{"idx":4,"correct":false,"proposition":"Evolves into a social phobia in 65% of cases"}],"type":"qi"}
{"_id":"annales-2016-qi-77","enonce":"What therapeutic strategy(s) to recommend as a first line in the face of post-traumatic stress disorder in adults?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Debriefing"},{"idx":1,"correct":true,"proposition":"Psychotherapy"},{"idx":2,"correct":false,"proposition":"Benzodiazepine"},{"idx":3,"correct":false,"proposition":"Serotonin reuptake inhibitor"},{"idx":4,"correct":false,"proposition":"Hydroxyzine"}],"type":"qi"}
{"_id":"annales-2016-qi-78","enonce":"Among the possible proposals, which is (are) the possible cause(s) of pulmonary arterial hypertension?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Left heart failure"},{"idx":1,"correct":true,"proposition":"Taking benfluorex"},{"idx":2,"correct":true,"proposition":"Systemic scleroderma"},{"idx":3,"correct":true,"proposition":"Genetic origin"},{"idx":4,"correct":true,"proposition":"HIV infection"}],"type":"qi"}
{"_id":"annales-2016-qi-79","enonce":"A 72-year-old patient is hospitalized for the first acute pulmonary edema. Which of the following tests is (are) the one that may be useful to clarify the etiology of his left heart failure?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Determination of BNP"},{"idx":1,"correct":false,"proposition":"Stress test with oxygen consumption measurement"},{"idx":2,"correct":true,"proposition":"Echocardiography"},{"idx":3,"correct":true,"proposition":"Coronary angiography"},{"idx":4,"correct":false,"proposition":"Right catheterization"}],"type":"qi"}
{"_id":"annales-2016-qi-80","enonce":"Regarding heart failure, which is (are) the exact proposal(s)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Prevalence of heart failure increases with age"},{"idx":1,"correct":false,"proposition":"Heart failure with preserved ejection fraction is more common in young subjects"},{"idx":2,"correct":false,"proposition":"About one in 5 patients die 5 years after diagnosis"},{"idx":3,"correct":true,"proposition":"Sudden death is a common mode of death"},{"idx":4,"correct":true,"proposition":"Hospitalization for acute heart failure is a factor of severity"}],"type":"qi"}
{"_id":"annales-2016-qi-81","enonce":"A 65-year-old patient consults her doctor because she is increasingly short of breath during exercise. Which examination(s) can be requested as a first-line test for the diagnosis of heart failure?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"A BNP assay"},{"idx":1,"correct":false,"proposition":"A stress test"},{"idx":2,"correct":true,"proposition":"Transthoracic echocardiography"},{"idx":3,"correct":false,"proposition":"A cardiac MRI"},{"idx":4,"correct":false,"proposition":"Straight catheterization"}],"type":"qi"}
{"_id":"annales-2016-qi-82","enonce":"Which of the following proposals is (are) characteristic of the venous origin of a leg ulcer?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Location at the forefoot"},{"idx":1,"correct":true,"proposition":"Malleolar location"},{"idx":2,"correct":true,"proposition":"Presence of a phlebecatic crown of the plantar arch"},{"idx":3,"correct":false,"proposition":"Necrotic character"},{"idx":4,"correct":false,"proposition":"Tendon exposure"}],"type":"qi"}
{"_id":"annales-2016-qi-84","enonce":"What therapeutic is (are) indicated for chronic venous insufficiency at the malleolar ulcer stage and secondary to varicose disease?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Anticoagulant"},{"idx":1,"correct":false,"proposition":"Vasodilator"},{"idx":2,"correct":true,"proposition":"Class III elastic compression"},{"idx":3,"correct":true,"proposition":"Varicose vein surgery (stripping +\/- crossectomy)"},{"idx":4,"correct":true,"proposition":"Local care"}],"type":"qi"}
{"_id":"annales-2016-qi-85","enonce":"Regarding the interpretation of this electrocardiogram and among the following propositions, which one (are) accurate?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Sinus dysfunction"},{"idx":1,"correct":false,"proposition":"Second degree atrioventricular block"},{"idx":2,"correct":true,"proposition":"Atrioventricular dissociation"},{"idx":3,"correct":false,"proposition":"2:1 conductive atrial flutter to the ventricles"},{"idx":4,"correct":true,"proposition":"Third-degree atrioventricular block"}],"type":"qi"}
{"_id":"annales-2016-qi-86","enonce":"A 70-year-old patient presents to the emergency room for palpitations that have been progressing for a week. He is dyspneic when climbing a floor. The electrocardiogram shows fine QRS atrial fibrillation with a ventricular cadence of 130 per minute. Blood pressure is at 140\/90 mmHg, saturation (SpO) is at 92%. The rest of the clinical examination is normal. Chest X-ray is normal. Blood ionogram, urea and serum creatinine are normal. Which of the following immediate therapeutic proposals is (are) accurate?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Amiodarone venous"},{"idx":1,"correct":false,"proposition":"Same-day electrical cardioversion"},{"idx":2,"correct":true,"proposition":"Unfractionated heparin via venous route"},{"idx":3,"correct":true,"proposition":"Digitoxin via venous route"},{"idx":4,"correct":false,"proposition":"Venous furosemide"}],"type":"qi"}
{"_id":"annales-2016-qi-87","enonce":"A 66-year-old patient presents for consultation because her mother had age-related macular degeneration. She wishes to know which symptom(s) suggestive of this disease should lead her to consult urgently. What can you say to him?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Myodesopsias"},{"idx":1,"correct":true,"proposition":"Central scotomome"},{"idx":2,"correct":true,"proposition":"Metamorphopsies"},{"idx":3,"correct":false,"proposition":"Phosphenes"},{"idx":4,"correct":false,"proposition":"Bitemporal hemianopsia"}],"type":"qi"}
{"_id":"annales-2016-qi-88","enonce":"Which of the following ametropia can (may) lead to monocular diplopia?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Myopia"},{"idx":1,"correct":true,"proposition":"Reverse astigmatism"},{"idx":2,"correct":false,"proposition":"Presbyopia"},{"idx":3,"correct":false,"proposition":"Farsightedness"},{"idx":4,"correct":true,"proposition":"Irregular astigmatism"}],"type":"qi"}
{"_id":"annales-2016-qi-89","enonce":"A 74-year-old patient is referred to you for possible cataract surgery. What can be the functional sign(s) related to the development of a cataract?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Central scotomome"},{"idx":1,"correct":true,"proposition":"Decrease in visual acuity predominant by far"},{"idx":2,"correct":false,"proposition":"Myodesopsias"},{"idx":3,"correct":true,"proposition":"Photophobia"},{"idx":4,"correct":false,"proposition":"Phosphenes"}],"type":"qi"}
{"_id":"annales-2016-qi-90","enonce":"In front of an eye redness occurring in a few days, in the absence of eye trauma, what are the elements that could point to acute anterior uveitis in a 30-year-old patient?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Identical, limiting ocular history under local corticosteroid treatment"},{"idx":1,"correct":true,"proposition":"History of low back pain"},{"idx":2,"correct":true,"proposition":"History of parotitis"},{"idx":3,"correct":true,"proposition":"History of bipolar aphthosis"},{"idx":4,"correct":false,"proposition":"History of diabetes in the family"}],"type":"qi"}
{"_id":"annales-2016-qi-92","enonce":"A patient presents to the emergency room following a brawl two hours ago. He complains of pain in his right eye, and describes a decrease in visual acuity. What would be the eye lesions to be feared in this context?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Corneal wound"},{"idx":1,"correct":true,"proposition":"Subluxation or dislocation of the lens"},{"idx":2,"correct":true,"proposition":"Ocular hypertonia by recoil of the iridocorneal angle"},{"idx":3,"correct":true,"proposition":"Dehiscence or detachment of the retina"},{"idx":4,"correct":false,"proposition":"Internuclear ophthalmoplegia"}],"type":"qi"}
{"_id":"annales-2016-qi-93","enonce":"Polyclonal hypergammaglobulinemia is (one or more exact answers):","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"A marker of inflammatory syndrome"},{"idx":1,"correct":true,"proposition":"Common during systemic lupus erythematosus"},{"idx":2,"correct":false,"proposition":"Common in multiple myeloma"},{"idx":3,"correct":true,"proposition":"Common during Sjögren's syndrome"},{"idx":4,"correct":true,"proposition":"Common during sarcoidosis"}],"type":"qi"}
{"_id":"annales-2016-qi-95","enonce":"The biological marker(s) observed during macrophage activation syndrome is:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Thrombocytopenia"},{"idx":1,"correct":true,"proposition":"Hypofibrinogenemia"},{"idx":2,"correct":true,"proposition":"Hypertryglyceridemia"},{"idx":3,"correct":true,"proposition":"Hyperferritinemia"},{"idx":4,"correct":false,"proposition":"Hyperleukocytosis"}],"type":"qi"}
{"_id":"annales-2016-qi-96","enonce":"An increase in the blood level of eosinophils may be observed in the following situation(s):","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Hodgkin's disease"},{"idx":1,"correct":false,"proposition":"Malaria"},{"idx":2,"correct":true,"proposition":"Systemic vasculitis"},{"idx":3,"correct":true,"proposition":"Ascariasis"},{"idx":4,"correct":true,"proposition":"Adrenal insufficiency"}],"type":"qi"}
{"_id":"annales-2016-qi-97","enonce":"Of the following infections, indicate the one (s) due to Staphylococcus aureus.","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Toxic shock"},{"idx":1,"correct":true,"proposition":"Catheter infection"},{"idx":2,"correct":true,"proposition":"Pneumonia"},{"idx":3,"correct":true,"proposition":"Spondylodiscite"},{"idx":4,"correct":false,"proposition":"Erysipelas"}],"type":"qi"}
{"_id":"annales-2016-qi-98","enonce":"What is (are) the symptom(s) encountered during pertussis?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Fever"},{"idx":1,"correct":true,"proposition":"Cough for several weeks"},{"idx":2,"correct":true,"proposition":"Emetogenic coughing fits"},{"idx":3,"correct":true,"proposition":"Syncopal cough"},{"idx":4,"correct":false,"proposition":"Hemoptysis"}],"type":"qi"}
{"_id":"annales-2016-qi-99","enonce":"Which of the following viruses can induce congenital viral infections? D.","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Rubella virus"},{"idx":1,"correct":true,"proposition":"Cytomegalovirus (CMV)"},{"idx":2,"correct":true,"proposition":"Varicella zoster virus (VZV)"},{"idx":3,"correct":true,"proposition":"Herpes simplex virus (HSV)"},{"idx":4,"correct":false,"proposition":"Papillomavirus"}],"type":"qi"}
{"_id":"annales-2016-qi-100","enonce":"A pregnant woman (11 weeks of amenorrhea), recently immigrated, was for several hours in contact with a little boy who developed the next day a febrile rash suggestive of rubella. This woman immediately consults her doctor. It has no notion of a previous vaccination. The rubella serology performed the same day is positive (presence of IgG) according to the validated standards of the laboratory. What can be concluded about the risk of congenital rubella related to the described exposure (indicate the correct answer(s))?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"A rubella IgM assay on the same serum of the patient is necessary before any interpretation"},{"idx":1,"correct":false,"proposition":"Rubella serology on a second serum of the patient is necessary before any interpretation"},{"idx":2,"correct":true,"proposition":"The patient is protected against rubella infection"},{"idx":3,"correct":false,"proposition":"The patient has biological signs of primary rubella infection"},{"idx":4,"correct":false,"proposition":"Further testing is useful following current exposure"}],"type":"qi"}
{"_id":"annales-2016-qi-101","enonce":"Which proposal(s) is (are) the right proposal(s) concerning the action to be taken in the event of an accident involving exposure to blood by needlesticks?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Making the wound bleed"},{"idx":1,"correct":true,"proposition":"Clean the wound with running water"},{"idx":2,"correct":false,"proposition":"Use of hydroalcoholic solution"},{"idx":3,"correct":false,"proposition":"Dakin disinfection"},{"idx":4,"correct":false,"proposition":"Consultation with a referring physician to discuss the implementation of treatment"},{"idx":5,"correct":false,"proposition":"antiretroviral within one month"}],"type":"qi"}
{"_id":"annales-2016-qi-102","enonce":"In front of axillary lymphadenopathy, unilateral, fistulized, evolving for three weeks in a 55-year-old woman, which cause(s) among the following seems to you (seem) compatible with this diagnosis? C. Primary infection with ","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Syphilis"},{"idx":1,"correct":false,"proposition":"Breast cancer"}],"type":"qi"}
{"_id":"annales-2016-qi-103","enonce":"What is (are) the mechanism(s) involved in mononucleosis syndrome?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Proliferation of neutrophils"},{"idx":1,"correct":true,"proposition":"Activation of the lymphocyte immune response in response to an infectious agent in general viral"},{"idx":2,"correct":false,"proposition":"Monoclonal proliferation of a lymphocyte line"},{"idx":3,"correct":false,"proposition":"Proliferation of macrophage antigen-presenting cells"},{"idx":4,"correct":true,"proposition":"Activation of T cells"}],"type":"qi"}
{"_id":"annales-2016-qi-104","enonce":"Which of the following proposal(s) on smoking is (are) erroneous?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"The minimum board has 5 questions"},{"idx":1,"correct":false,"proposition":"Fagerström's test evaluates pharmacological dependence on nicotine"},{"idx":2,"correct":false,"proposition":"Tobacco is estimated to kill 70,000 to 80,000 people a year in France"},{"idx":3,"correct":false,"proposition":"Second-hand smoke is a causal factor in sudden infant death syndrome"},{"idx":4,"correct":false,"proposition":"Smoking during pregnancy increases the risk of low birth weight"}],"type":"qi"}
{"_id":"annales-2016-qi-105","enonce":"A 28-year-old woman, a non-smoker, underwent a chest x-ray as part of the assessment of a deterioration in the general condition associated with dyspnea and dysphonia. Which of the following proposals(s) is the right proposal(s)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Left inferior lobar atelectasis"},{"idx":1,"correct":true,"proposition":"Aortopulmonary window filling"},{"idx":2,"correct":true,"proposition":"Anterior mediastinal mass"},{"idx":3,"correct":true,"proposition":"Probable phrenic paralysis"},{"idx":4,"correct":true,"proposition":"Probable recurrent paralysis"}],"type":"qi"}
{"_id":"annales-2016-qi-106","enonce":"What are the right answers regarding this pulmonary function test?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"VEMS\/FVC post-bronchodilation ratio of 63"},{"idx":1,"correct":false,"proposition":"FEV1\/FVC ratio pre-bronchodilation at 73"},{"idx":2,"correct":false,"proposition":"Restrictive ventilatory disorder"},{"idx":3,"correct":false,"proposition":"Completely reversible obstructive ventilatory disorder"},{"idx":4,"correct":true,"proposition":"Significantly reversible obstructive ventilatory disorder"}],"type":"qi"}
{"_id":"annales-2016-qi-107","enonce":"During sarcoidosis, histological analysis of hilar lymphadenopathy conventionally shows epithelioid and gigantocellular granulomas. Which of the following conditions can (may) show a similar appearance?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Asthma"},{"idx":1,"correct":true,"proposition":"Common variable immunodeficiency"},{"idx":2,"correct":true,"proposition":"Lymphoma"},{"idx":3,"correct":false,"proposition":"Scleroderma"},{"idx":4,"correct":true,"proposition":"Silicosis"}],"type":"qi"}
{"_id":"annales-2016-qi-109","enonce":"Regarding the scanner cut below, what is (are) the exact statement(s)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"There is a subcarenary mass"},{"idx":1,"correct":true,"proposition":"There is a mass in the mediastinum"},{"idx":2,"correct":false,"proposition":"You first request a transparietal needle puncture to obtain a diagnosis of certainty"},{"idx":3,"correct":false,"proposition":"You mention the diagnosis of germ cell tumour"},{"idx":4,"correct":false,"proposition":"You mention the diagnosis of neurogenic tumor"}],"type":"qi"}
{"_id":"annales-2016-qi-110","enonce":"Which of the following can be a direct addressee(s) of a patient's cause of death?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"His beneficiaries, unless refused by the patient before his death"},{"idx":1,"correct":false,"proposition":"The patient's notary"},{"idx":2,"correct":false,"proposition":"The lawyer appointed by the patient's beneficiaries"},{"idx":3,"correct":false,"proposition":"The patient's attending physician"},{"idx":4,"correct":false,"proposition":"The doctor mandated by the death insurance company"}],"type":"qi"}
{"_id":"annales-2016-qi-111","enonce":"What is (are) the circumstance(s) that should lead the physician to check the medical-legal obstacle box on a death certificate:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Sudden death in young adults"},{"idx":1,"correct":true,"proposition":"Suicide by hanging"},{"idx":2,"correct":true,"proposition":"Highway accident"},{"idx":3,"correct":false,"proposition":"Natural death expected in hospital"},{"idx":4,"correct":true,"proposition":"Sudden death syndrome of the child"}],"type":"qi"}
{"_id":"annales-2016-qi-112","enonce":"Regarding the exchange of medical information, what is (are) the exact answer(s)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Physicians must ensure that professional secrecy is respected by their non-physician collaborators: secretaries and nurses"},{"idx":1,"correct":false,"proposition":"The sharing of medical information between healthcare professionals is limited to diagnostic information"},{"idx":2,"correct":true,"proposition":"Treating physicians may exchange information concerning a patient whom they treat together unless the latter objects to it."},{"idx":3,"correct":true,"proposition":"The transmission of medical information between doctors can lead to prosecution for non-compliance with medical confidentiality"},{"idx":4,"correct":false,"proposition":"A doctor can only provide medical information about a patient to another healthcare professional"}],"type":"qi"}
{"_id":"annales-2016-qi-113","enonce":"Which of the following proposals falls within the remit of the High Authority for Health (HAS)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Certification of health facilities"},{"idx":1,"correct":true,"proposition":"Development of clinical practice guidelines"},{"idx":2,"correct":false,"proposition":"Collect and track adverse drug and health product events"},{"idx":3,"correct":false,"proposition":"Give authorization for the establishment of a phase III randomized therapeutic trial"},{"idx":4,"correct":true,"proposition":"Management of indicators for the improvement of the quality and safety of care (IPAQSS)"}],"type":"qi"}
{"_id":"annales-2016-qi-114","enonce":"Which of the following people can be an investigator in a clinical research study?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"A general practitioner"},{"idx":1,"correct":false,"proposition":"A medical intern as part of his thesis"},{"idx":2,"correct":true,"proposition":"A public health physician"},{"idx":3,"correct":false,"proposition":"A midwife as part of her final thesis"},{"idx":4,"correct":true,"proposition":"A pharmacist"}],"type":"qi"}
{"_id":"annales-2016-qi-115","enonce":"About the national program of indicators for the improvement of the quality and safety of care (IPAQSS), which of the following proposals, which is (are) accurate?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"It is managed by the High Authority of Health (HAS)"},{"idx":1,"correct":true,"proposition":"It is based on indicators that are reported by the institutions"},{"idx":2,"correct":true,"proposition":"One of the indicators collected relates to the maintenance of the patient's record"},{"idx":3,"correct":true,"proposition":"It includes the nosocomial infections dashboard"},{"idx":4,"correct":false,"proposition":"Indicators collected by institutions under this program are confidential"}],"type":"qi"}
{"_id":"annales-2016-qi-116","enonce":"Which of the following measures constitutes a secondary prevention measure in oncology?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":false,"proposition":"Offer hepatitis B vaccination to all children"},{"idx":1,"correct":true,"proposition":"Offer a blood test in the stool regularly, from the age of 50"},{"idx":2,"correct":true,"proposition":"Have a mammogram regularly, from the age of 50"},{"idx":3,"correct":true,"proposition":"Regularly perform a cervico-vaginal smear"},{"idx":4,"correct":false,"proposition":"Promoting smoking cessation"}],"type":"qi"}
{"_id":"annales-2016-qi-117","enonce":"Which of the following areas of responsibility is covered by the Regional Health Agencies (RHAs)?","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Regional health security"},{"idx":1,"correct":false,"proposition":"Authorization to practice for liberal practitioners"},{"idx":2,"correct":true,"proposition":"The organization of the provision of care according to the needs of the population"},{"idx":3,"correct":true,"proposition":"Prevention actions in the region"},{"idx":4,"correct":false,"proposition":"Maternal and child protection"}],"type":"qi"}
{"_id":"annales-2016-qi-118","enonce":"Verapamil (Isoptine®) and diltiazem (Bitildiem®):","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Are brakers at the atrioventricular node"},{"idx":1,"correct":true,"proposition":"Are brakers of the atrial knot"},{"idx":2,"correct":false,"proposition":"The usual digestive effect is diarrhea"},{"idx":3,"correct":true,"proposition":"May cause edema of the lower limbs"},{"idx":4,"correct":false,"proposition":"Are inotropic indifferent"}],"type":"qi"}
{"_id":"annales-2016-qi-120","enonce":"Thiazide diuretics:","item":"annales-2016-qi","matiere":"annales-2016","propositions":[{"idx":0,"correct":true,"proposition":"Can be used in heart failure"},{"idx":1,"correct":true,"proposition":"May increase uricemia"},{"idx":2,"correct":false,"proposition":"May decrease serum calcium"},{"idx":3,"correct":false,"proposition":"May cause gynecomastia"},{"idx":4,"correct":false,"proposition":"Have a brutal and rapid effect on diuresis"}],"type":"qi"}
{"_id":"annales-2017-qi-III","enonce":"The Mini Nutritionna\/Assessment (or MNA) nutritional test:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Is a test with a total score out of 30 points","justification":""},{"idx":1,"correct":true,"proposition":"Is a test that defines malnutrition if the score is less than 23 5 points","justification":""},{"idx":2,"correct":true,"proposition":"Is a test that defines malnutrition if the score is less than 17 points","justification":""},{"idx":3,"correct":false,"proposition":"Is a test that requires the calculation of body mass index","justification":""},{"idx":4,"correct":true,"proposition":"Is a test that takes into account the presence of neuropsychological problems","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-III","enonce":"A woman of Martinican origin has just given birth. The child's father is also of Martinican origin. The child has a cleft lip and palate. With regard to regulatory newborn screening of this child, what is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Phenylketonuria is the only disease of amino acid and organic acid metabolism currently being screened for newborn in France","justification":"Now there is the MCAD deficiency"},{"idx":1,"correct":false,"proposition":"General screening test can detect hypothyroidism of pituitary origin","justification":""},{"idx":2,"correct":true,"proposition":"This couple can refuse the screening after information","justification":""},{"idx":3,"correct":true,"proposition":"Completion before 48 h of life decreases the sensitivity and\/or specificity of the screening test","justification":""},{"idx":4,"correct":false,"proposition":"Targeted screening for sickle cell disease is not indicated in this child","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-1","enonce":"A 14-month-old infant comes to see for repeated cold episodes. The nose runs, then he coughs day and night, wakes up several times at night and is sometimes very short of breath. These episodes have been monthly since the age of 6 months, when he had bronchiolitis that was easy to treat. It has good growth in staturo-weight and << everything is going well >> between episodes. On this day, you see only clear rhinitis. The rest of the exam is normal. What do you offer?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Continue nose washes","justification":""},{"idx":1,"correct":false,"proposition":"Do chest physiotherapy sessions","justification":""},{"idx":2,"correct":true,"proposition":"Prescribe a frontal chest x-ray","justification":""},{"idx":3,"correct":false,"proposition":"Starting a long-acting bronchodilator","justification":""},{"idx":4,"correct":true,"proposition":"Start inhaled corticosteroid therapy","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-2","enonce":"A 5-year-old boy, feverish at 38 ° C comes for respiratory discomfort with his chest X-ray requested by his doctor. He has had a cold for 3 days. In this context, which diagnosis(s) should be mentioned?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Left pleurisy","justification":""},{"idx":1,"correct":false,"proposition":"Interstitial lung disease","justification":""},{"idx":2,"correct":true,"proposition":"Myocarditis","justification":""},{"idx":3,"correct":true,"proposition":"Pericarditis","justification":""},{"idx":4,"correct":false,"proposition":"Lymphoma","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-3","enonce":"A 2-month-old girl comes for consultation in December for respiratory discomfort. You refer him to pediatric emergencies. What element(s) of your review led you to this decision?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"A heart rate of 120\/min","justification":""},{"idx":1,"correct":true,"proposition":"A catch of 2 feedings in the last 24 hours","justification":""},{"idx":2,"correct":false,"proposition":"Audible hissing sounds outside of auscultation","justification":""},{"idx":3,"correct":false,"proposition":"A flapping of the wings of the nose","justification":""},{"idx":4,"correct":true,"proposition":"A respiratory rate of 65\/min","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-4","enonce":"In a pregnant woman who had severe pre-eclampsia at 30 weeks of amenorrhea, which of the following is (are) correct about the use of low-dose aspirin?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"This treatment prevents any recurrence of pre-eclampsia","justification":""},{"idx":1,"correct":true,"proposition":"This treatment should be started preferentially before 15 weeks of amenorrhea","justification":""},{"idx":2,"correct":false,"proposition":"This treatment is administered according to the Doppler of the uterine arteries","justification":""},{"idx":3,"correct":false,"proposition":"This treatment includes 500 mg of aspirin","justification":""},{"idx":4,"correct":false,"proposition":"This treatment must be maintained until the end","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-5","enonce":"What are (are) the possible antihypertensive treatment(s) during pregnancy?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Calcium channel blockers","justification":""},{"idx":1,"correct":false,"proposition":"Diuretics","justification":""},{"idx":2,"correct":true,"proposition":"Central antihypertensives","justification":""},{"idx":3,"correct":true,"proposition":"Blockers","justification":""},{"idx":4,"correct":false,"proposition":"IEC","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-7","enonce":"What is (are) the factor(s) of poor prognosis of breast cancer?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"The inflammatory character","justification":""},{"idx":1,"correct":true,"proposition":"The absence of estrogen hormone receptors","justification":""},{"idx":2,"correct":true,"proposition":"Vascular emboluses","justification":""},{"idx":3,"correct":false,"proposition":"The association of an important intraductal component with the infiltrating component","justification":""},{"idx":4,"correct":true,"proposition":"High histological grade","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-8","enonce":"In the most common form of trisomy 21 in the fetus, which is (are) the exact proposition(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"The measurement of nuchal translucency is usually increased","justification":""},{"idx":1,"correct":true,"proposition":"The free fraction of beta HCG is conventionally increased in the 1st trimester","justification":""},{"idx":2,"correct":false,"proposition":"PAPP-A (pregnancy associated placenta protein A) is classically decreased in the 2nd trimester","justification":""},{"idx":3,"correct":false,"proposition":"Alphafetoprotein in the 1st trimester is increased","justification":""},{"idx":4,"correct":true,"proposition":"All fetal cells are affected","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-9","enonce":"In newborns the risk of nuclear jaundice:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Is absent in full-term infants","justification":""},{"idx":1,"correct":true,"proposition":"Increases if jaundice begins before the 24th hour of life","justification":""},{"idx":2,"correct":false,"proposition":"Is less important in premature infants","justification":""},{"idx":3,"correct":false,"proposition":"Is linked to the neurotoxicity of conjugated bilirubin","justification":""},{"idx":4,"correct":false,"proposition":"Rarely engages long-term neurological prognosis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-10","enonce":"A 53-year-old patient consults you for abnormalities of the blood count which shows: leukocytes 18.4 G \/ L; neutrophils 5.4 G\/L; eosinophilic polynuclear 0.2 G\/L; lymphocytes 12.3 G\/L; monocytes 0.5 G\/L; haemoglobin 13.5 g\/dL; VGM 84 fL; blisters 256 G\/L. Clinical examination found isolated centimetric cervical lymphadenopathy. Matutes' score is 5\/5. How do you complete your balance sheet?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Thoraco-abdominopelvic CT scan with iodinated contrast medium injection","justification":""},{"idx":1,"correct":false,"proposition":"PET-scanner","justification":""},{"idx":2,"correct":true,"proposition":"Serum protein electrophoresis","justification":""},{"idx":3,"correct":true,"proposition":"Direct Coombs test","justification":""},{"idx":4,"correct":false,"proposition":"Lymph node biopsy with histological examination","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-11","enonce":"A 63-year-old patient consults you for intense asthenia. She has a mucocutaneous pallor. The clinical examination does not find hepatosplenomegaly. A first biological assessment shows: leukocytes 2.5 G \/ L; PNN 1.2 G\/L; lymphocytes 1.1 G\/L; monocytes 0.2 G\/L; Hb 8.3 g\/dL; VGM 109 fL; reticulocytes 22 G\/L; blisters 90 G\/L. Blood biochemistry finds: AST 23 IU\/L; ALT 27 IU\/L; total bilirubin 45 μmol\/L; free bilirubin 42 μmol \/ L; LDH 820 IU\/L; haptoglobin 0.1 g\/L. You mention:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Evans syndrome","justification":""},{"idx":1,"correct":true,"proposition":"Myelodysplastic syndrome","justification":""},{"idx":2,"correct":true,"proposition":"Biermer's disease","justification":""},{"idx":3,"correct":false,"proposition":"A MAT","justification":""},{"idx":4,"correct":false,"proposition":"Multiple myeloma","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-12","enonce":"ACE inhibitors can cause: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Functional acute renal failure (AIRD)","justification":""},{"idx":1,"correct":false,"proposition":"Hypokalemia","justification":""},{"idx":2,"correct":true,"proposition":"Bradykinin angioedema","justification":""},{"idx":3,"correct":false,"proposition":"Increased resistance of the glomerular efferent arteriole","justification":""},{"idx":4,"correct":true,"proposition":"A decrease in glomerular filtration pressure","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-13","enonce":"What lesion(s) can be observed on the renal biopsy during rapidly progressive glomerulonephritis?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Linear deposition of IgG in immunofluorescence","justification":""},{"idx":1,"correct":true,"proposition":"Granular deposits of IgG in immunofluorescence","justification":""},{"idx":2,"correct":false,"proposition":"Congo red birefringent fibrillar deposits","justification":""},{"idx":3,"correct":true,"proposition":"Extracapillary croissants","justification":""},{"idx":4,"correct":true,"proposition":"Microvascular lesions with fibrinoid necrosis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-14","enonce":"In the context of the constitution of an expert group before the marketing of a new molecule, in which of the following situations can an expert doctor have a link of interest?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"If he worked for 30 years in the industry developing the molecule until he retired 2 years ago","justification":""},{"idx":1,"correct":true,"proposition":"If he has been paid by the pharmaceutical industry to teach general practitioners","justification":""},{"idx":2,"correct":false,"proposition":"If it has already published results questioning the interest of this new molecule, as part of a research program funded by public funds","justification":""},{"idx":3,"correct":true,"proposition":"If he has been paid by the manufacturer to include patients in phase III trials that evaluated this new molecule","justification":""},{"idx":4,"correct":true,"proposition":"If the son of this doctor is a medical delegate for the industry marketing the molecule","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-15","enonce":"Areas of interest to indicators for improving the quality and safety of care (IPAQSS) include:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"The rate of methicillin-resistant staphylococci","justification":""},{"idx":1,"correct":true,"proposition":"Keeping the patient record","justification":""},{"idx":2,"correct":true,"proposition":"Operating compliance of PCRs in oncology","justification":""},{"idx":3,"correct":false,"proposition":"Screening for nutritional disorders","justification":""},{"idx":4,"correct":false,"proposition":"Surgical site infections","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-16","enonce":"Which of the following proposals on the roles played by Regional Health Agencies (RHAs) at the regional level is correct?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"They are responsible for health monitoring and security at the regional level","justification":""},{"idx":1,"correct":true,"proposition":"They are responsible for prevention and health promotion","justification":""},{"idx":2,"correct":false,"proposition":"They are responsible for university preventive medicine","justification":""},{"idx":3,"correct":true,"proposition":"They are responsible for providing care in each health territory of the region.","justification":""},{"idx":4,"correct":true,"proposition":"They are responsible for the accreditation of medical internship sites in the region.","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-17","enonce":"Which of the following study designs would allow us to study the relationship between coffee consumption and the risk of developing Alzheimer's disease?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"The follow-up of a cohort of several thousand patients with Alzheimer's disease","justification":""},{"idx":1,"correct":true,"proposition":"A study in which subjects with Alzheimer's disease and an equivalent number of subjects without dementia would be included","justification":""},{"idx":2,"correct":true,"proposition":"A study conducted on a population of subjects over 60 years of age free of dementia at baseline and followed for 10 years or more","justification":""},{"idx":3,"correct":false,"proposition":"A comprehensive study based on data on notifiable diseases","justification":""},{"idx":4,"correct":false,"proposition":"A study of the prevalence of coffee consumption in a representative sample of the general population","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-18","enonce":"Infantile hemangiomas:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Appear in the perinatal period","justification":""},{"idx":1,"correct":true,"proposition":"May have skin, subcutaneous or combination (cutaneous and subcutaneous) development","justification":""},{"idx":2,"correct":true,"proposition":"At risk of ulceration and superficial necrosis","justification":""},{"idx":3,"correct":false,"proposition":"Affect boys more frequently","justification":""},{"idx":4,"correct":false,"proposition":"Are rarer than vascular malformations","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-19","enonce":"Among the following examinations, which is the most efficient for the analysis of the morphology of a tooth root?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Orthopantomogram (dental panoramic)","justification":""},{"idx":1,"correct":false,"proposition":"Occlusal bitten cliché","justification":""},{"idx":2,"correct":false,"proposition":"Blondeau incidence (nose-chin-plate incidence)","justification":""},{"idx":3,"correct":true,"proposition":"Retro-alveolar image","justification":""},{"idx":4,"correct":false,"proposition":"Low-facing incidence","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-20","enonce":"Which of the following imaging tests shows the temporomandibular joints?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Dental panoramic picture (orthopantomogram)","justification":""},{"idx":1,"correct":true,"proposition":"Low-side incidence","justification":""},{"idx":2,"correct":true,"proposition":"Teleradiography of the skull in profile","justification":""},{"idx":3,"correct":true,"proposition":"Computed tomography of the face (CT)","justification":""},{"idx":4,"correct":true,"proposition":"Nuclear magnetic resonance imaging (MRI)","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-21","enonce":"For skin tumours of the face, please indicate the exact proposal(s):","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Tobacco is the main risk factor for developing basal cell carcinoma","justification":""},{"idx":1,"correct":true,"proposition":"Squamous cell carcinomas are more lymphophilic than basal cell carcinomas","justification":""},{"idx":2,"correct":false,"proposition":"Melanoma is a tumor exclusively with a cutaneous starting point","justification":""},{"idx":3,"correct":false,"proposition":"Melanomas are more common than basal cell carcinomas","justification":""},{"idx":4,"correct":true,"proposition":"The treatment of skin cancers is mainly based on surgery","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-22","enonce":"A professional hockey player fell on the ice with a mandibular impact. The orthopantomogram performed is as follows: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"There is a bifocal fracture of the mandible","justification":""},{"idx":1,"correct":false,"proposition":"One of the fracture features passes through the left mandibular neck","justification":""},{"idx":2,"correct":false,"proposition":"A fracture line passes through tooth No. 37","justification":""},{"idx":3,"correct":true,"proposition":"A fracture line passes behind tooth No. 33","justification":""},{"idx":4,"correct":true,"proposition":"Tooth No. 38 is missing","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-23","enonce":"Regarding the anatomy of the eyelids:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Lacrimal punctums are lateral","justification":""},{"idx":1,"correct":true,"proposition":"The elevator muscle of the upper eyelid is inserted on the tarsus","justification":""},{"idx":2,"correct":true,"proposition":"Both eyelids delimit the palpebral cleft","justification":""},{"idx":3,"correct":true,"proposition":"The orbicular muscle of the eye is innervated by the facial nerve","justification":""},{"idx":4,"correct":false,"proposition":"The upper eyelid lift muscle is innervated by the facial nerve","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-24","enonce":"You see a 6-month-old infant with no history before a one-month trip to Côte d'Ivoire (group 3 countries). What malaria prevention measure(s) are you prescribing for this infant?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"The use of an insecticide-treated net","justification":""},{"idx":1,"correct":true,"proposition":"The use of skin repellents","justification":""},{"idx":2,"correct":false,"proposition":"Chemoprophylaxis with chloroquine and proguanil","justification":""},{"idx":3,"correct":false,"proposition":"Chemoprophylaxis with atovaquone-proguanil","justification":""},{"idx":4,"correct":false,"proposition":"Chemoprophylaxis with artemeter-lumefantrine","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-25","enonce":"Which of the following occupations is associated with an increased risk of bladder cancer?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Plasterer","justification":""},{"idx":1,"correct":true,"proposition":"Dye industry worker","justification":""},{"idx":2,"correct":true,"proposition":"Foundry worker","justification":""},{"idx":3,"correct":false,"proposition":"Baker","justification":""},{"idx":4,"correct":false,"proposition":"Nurse","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-26","enonce":"In the context of a work stoppage relating to an occupational disease, indicate the exact proposal(s):","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"The occupational physician receives the obligatory employee during his return to work during his return to work.","justification":""},{"idx":1,"correct":false,"proposition":"The pre-recovery visit makes it possible to determine the date of consolidation of the disease","justification":""},{"idx":2,"correct":true,"proposition":"The pre-resumption visit makes it possible to plan a possible shift adjustment when work resumes","justification":""},{"idx":3,"correct":false,"proposition":"A systematic visit at the initiative of the occupational physician is planned one month after the resumption","justification":""},{"idx":4,"correct":false,"proposition":"The follow-up visit may be carried out by the attending physician at the request of the employer in the absence of the occupational physician.","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-27","enonce":"Which of the following can be seen in a woman with polycystic ovary syndrome? Indicate the correct answer(s):","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Hirsutism","justification":""},{"idx":1,"correct":true,"proposition":"Normal estradiol","justification":""},{"idx":2,"correct":true,"proposition":"Increased testosterone","justification":""},{"idx":3,"correct":true,"proposition":"Normal FSH","justification":""},{"idx":4,"correct":true,"proposition":"Increased prolactin","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-28","enonce":"In diabetic retinopathy:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Decreased visual acuity is early by macular edema","justification":""},{"idx":1,"correct":false,"proposition":"Retinal microaneurysms are mostly peripheral","justification":""},{"idx":2,"correct":true,"proposition":"In the absence of diabetic retinopathy, ophthalmological monitoring should be annual","justification":""},{"idx":3,"correct":true,"proposition":"The management of a diabetic involves glycemic and arterial blood pressure control","justification":""},{"idx":4,"correct":false,"proposition":"Laser photocoagulation treatment is indicated only for complicated stages of retinal detachment","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-29","enonce":"A patient is treated by his ophthalmologist for primary open-angle glaucoma. You are his general practitioner, he asks you for information about his disease. What is (are) the element(s) you can give it?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Central visual acuity is affected only late.","justification":""},{"idx":1,"correct":true,"proposition":"The main element of follow-up is the examination of the visual field.","justification":""},{"idx":2,"correct":false,"proposition":"Monitoring of the retinal periphery is a major component of monitoring.","justification":""},{"idx":3,"correct":true,"proposition":"The patient should warn any new doctor of his glaucoma because some local treatments have systemic effects.","justification":""},{"idx":4,"correct":true,"proposition":"Monitoring of intraocular pressure is useful but not sufficient to judge the effectiveness of treatment.","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-30","enonce":"In front of a non-traumatic acute neck pain in a 30-year-old woman, you can immediately realize in first intention?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"A prescription of NSAIDs","justification":""},{"idx":1,"correct":false,"proposition":"A physiotherapy prescription","justification":""},{"idx":2,"correct":false,"proposition":"Corticosteroid infiltration","justification":""},{"idx":3,"correct":false,"proposition":"Spinal manipulation","justification":""},{"idx":4,"correct":false,"proposition":"A flexible neck brace prescription","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-31","enonce":"A 30-year-old patient, of normal build and with normal physical activity and diet, has type 1 diabetes that has been evolving for 5 years. Indicate the exact proposal(s):","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"The daily dose of insulin is usually 0.5 to 0.7 units\/kg weight\/day","justification":""},{"idx":1,"correct":true,"proposition":"Insulin glargine is given once a day","justification":""},{"idx":2,"correct":false,"proposition":"Basal insulin should be discontinued in case of fasting examination","justification":""},{"idx":3,"correct":true,"proposition":"Rapid insulin can be used occasionally to correct hyperglycemia","justification":""},{"idx":4,"correct":true,"proposition":"The dosage of prandial insulin depends on the amount of carbohydrates ingested during the meal","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-32","enonce":"What is the correct answer(s) regarding the pathophysiology of asthma?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Activation of nerve fibers responsible for bronchodilation","justification":""},{"idx":1,"correct":false,"proposition":"Overexpression of interleukin 10 (IL-10) and TNFa","justification":""},{"idx":2,"correct":true,"proposition":"Inflammation TH2","justification":""},{"idx":3,"correct":true,"proposition":"Bronchial remodeling","justification":""},{"idx":4,"correct":false,"proposition":"Vascular remodeling","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-33","enonce":"A 15-year-old girl consults for coughing and wheezing. You learn from the interrogation that these symptoms are intermittent and occur preferentially at the end of the night and in the morning. Which exam(s) do you perform as a first-line test?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"ECG","justification":""},{"idx":1,"correct":false,"proposition":"Total IgE","justification":""},{"idx":2,"correct":false,"proposition":"D-dimer","justification":""},{"idx":3,"correct":false,"proposition":"Pertussis serology","justification":""},{"idx":4,"correct":true,"proposition":"Spirometry","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-34","enonce":"What is the exact proposal(s) regarding thyroid physiology?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"TSH stimulates thyroocyte proliferation","justification":""},{"idx":1,"correct":true,"proposition":"Triiodothyronine is the active hormone","justification":""},{"idx":2,"correct":true,"proposition":"Thyroid hormones increase bone turnover","justification":""},{"idx":3,"correct":false,"proposition":"Thyroid hormones are vasoconstrictors","justification":""},{"idx":4,"correct":true,"proposition":"Thyroid hormones increase gluconeogenesis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-35","enonce":"You asked for a TSH test in a 34-year-old woman, in front of weight loss. TSH is indosable. What additional examination(s) would you like before treatment?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Free T4 assay","justification":""},{"idx":1,"correct":false,"proposition":"Thyroglobulin testing","justification":""},{"idx":2,"correct":false,"proposition":"Determination of anti-thyroperoxidase antibodies","justification":""},{"idx":3,"correct":true,"proposition":"Determination of anti-TSH receptor antibodies","justification":""},{"idx":4,"correct":false,"proposition":"Thyrocalcitonin dosage","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-36","enonce":"Damage to the right trigeminal nerve can manifest as: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"An abolition of the right corneal reflex","justification":""},{"idx":1,"correct":false,"proposition":"Right facial paralysis","justification":""},{"idx":2,"correct":true,"proposition":"Amyotrophy of the right masseter muscle","justification":""},{"idx":3,"correct":false,"proposition":"A hypoaesthesia of the right masseterine notch","justification":""},{"idx":4,"correct":false,"proposition":"An agueusia of the anterior 2\/3 of the right hemi-tongue","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-37","enonce":"A 30-year-old motorcyclist patient is hospitalized following a road accident. Which immediate sign(s) is compatible with complete spinal cord syndrome level T10?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Motor deficit of the four members","justification":""},{"idx":1,"correct":false,"proposition":"Suspended motor deficit of the upper limbs","justification":""},{"idx":2,"correct":false,"proposition":"Normal sensitivity above the umbilicus","justification":""},{"idx":3,"correct":true,"proposition":"Acute urine retention","justification":""},{"idx":4,"correct":true,"proposition":"Abolition of tendon reflexes in the lower limbs","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-38","enonce":"A cerebral infarction in the territory of the left middle cerebral artery in a right-handed person may be responsible for the following sign(s). ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Aphasia","justification":""},{"idx":1,"correct":false,"proposition":"Horizontal diplopia","justification":""},{"idx":2,"correct":false,"proposition":"Left hemineglect","justification":""},{"idx":3,"correct":false,"proposition":"Left homonymous lateral hemianopsia","justification":""},{"idx":4,"correct":false,"proposition":"Right central facial paralysis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-39","enonce":"Regarding narcolepsy, what statement(s) is(are) accurate? ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Defined by a sudden loss of tone","justification":""},{"idx":1,"correct":false,"proposition":"Is characterized by excess irrepressible daytime sleepiness","justification":""},{"idx":2,"correct":true,"proposition":"May be associated with cataplexy","justification":""},{"idx":3,"correct":false,"proposition":"Temporal signal abnormalities are frequently found on MRI","justification":""},{"idx":4,"correct":false,"proposition":"There may be sleep paralysis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-40","enonce":"A 37-year-old man has been presenting urgently for a red and painful right eye for 24 hours. With correction, you measure a visual acuity of 12\/10 from afar and Parinaud 2 up close to both eyes. What are the possible etiologies of the symptoms described by this patient?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Allergic conjunctivitis","justification":""},{"idx":1,"correct":true,"proposition":"Scleritis","justification":""},{"idx":2,"correct":true,"proposition":"Foreign body in the conjunctival cul-de-sac","justification":""},{"idx":3,"correct":false,"proposition":"Intravitreal hemorrhage","justification":""},{"idx":4,"correct":false,"proposition":"Retinal vasculitis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-41","enonce":"A 62-year-old patient, hyperopic and of Asian origin, has a narrow iridocorneal angle. She has not yet received a preventive laser iridotomy. What factor(s) could (could) promote the occurrence of an acute hypertonia attack by closing the angle?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Taking morphine","justification":""},{"idx":1,"correct":false,"proposition":"Taking p aracetamol","justification":""},{"idx":2,"correct":true,"proposition":"Taking atropine","justification":""},{"idx":3,"correct":true,"proposition":"Instillation in the eyes of tropicamide","justification":""},{"idx":4,"correct":false,"proposition":"Instillation in the eyes of pilocarpine","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-42","enonce":"A 90-year-old man with chronic renal failure has a 60 mm major axis erythematous cupboard in the mid-thoracic region. The lesion is asymptomatic and has been evolving for 30 years. What diagnosis do you remember?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Bowen's disease","justification":""},{"idx":1,"correct":false,"proposition":"Plaque psoriasis","justification":""},{"idx":2,"correct":false,"proposition":"Superficial extension melanoma","justification":""},{"idx":3,"correct":true,"proposition":"Superficial basal cell carcinoma","justification":""},{"idx":4,"correct":false,"proposition":"Chronic lichenified eczema","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-44","enonce":"A 45-year-old man consults in front of the appearance of erythematous lesions infiltrated of the right cheek appeared for a few weeks. The general condition is preserved. What diagnoses can you evoke in front of this table? Cutaneous sarcoidosis Among these proposals concerning the bacterial species Escherichia coli, which is (are) accurate?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"This bacterial species is part of the family of enterobacteriaceae","justification":""},{"idx":1,"correct":true,"proposition":"It can be responsible for hemolytic uremic syndrome -","justification":""},{"idx":2,"correct":false,"proposition":"C.","justification":""},{"idx":3,"correct":false,"proposition":"It is sensitive to amoxicillin in less than 10% of cases","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-45","enonce":"Which of the following proposals on mother-to-child transmission of HIV is the right one: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"The risk of transmission is greater in the first trimester of pregnancy","justification":""},{"idx":1,"correct":true,"proposition":"Risk is related to maternal plasma HIV load during childbirth","justification":""},{"idx":2,"correct":true,"proposition":"Antiretroviral therapy should be started in the mother as soon as HIV infection is diagnosed","justification":""},{"idx":3,"correct":false,"proposition":"A caesarean section must be performed there to prevent transmission.","justification":""},{"idx":4,"correct":true,"proposition":"Antiretroviral therapy should be started at birth in the child to prevent transmission","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-46","enonce":"In the context of community-acquired acute pneumonia, what is the true proposition(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Hyponatremia is specific to legionellosis","justification":""},{"idx":1,"correct":false,"proposition":"B.","justification":""},{"idx":2,"correct":false,"proposition":"Pneumococcal pneumonia and legionellosis are notifiable diseases","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-47","enonce":"A 42-year-old woman with Hodgkin's disease started pneumocystosis prophylaxis with ® trimethoprim sulfamethoxazole (Bactrim) for 10 days. She presents to the emergency room with a picture of painful acute febrile exanthema accompanied by pharyngitis and burning eyes. The examination shows the following lesions. What diagnosis do you mention?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Syndrome de Stevens Johnson","justification":""},{"idx":1,"correct":true,"proposition":"Toxic epidermal necrolysis (Lyell's syndrome)","justification":""},{"idx":2,"correct":false,"proposition":"Pemphigus induced","justification":""},{"idx":3,"correct":false,"proposition":"Staphylococcal epidermolysis","justification":""},{"idx":4,"correct":false,"proposition":"Erythema multiforme","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-49","enonce":"In the face of a hemorrhagic syndrome, which is (are) the element(s) that point to an abnormality of primary hemostasis ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Mucocutaneous hemorrhages","justification":""},{"idx":1,"correct":true,"proposition":"Delayed bleeding","justification":""},{"idx":2,"correct":true,"proposition":"Petechial purpura","justification":""},{"idx":3,"correct":false,"proposition":"Hemarthrosis","justification":""},{"idx":4,"correct":false,"proposition":"Hematoma of the psoas","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-50","enonce":"A 23-year-old patient is hospitalized against a background of pancytopenia. You mention the diagnosis of acute pro-myelocytic leukemia in front of the presence of numerous bruises. Which abnormality(s) of hemostasis is (are) compatible with this diagnosis?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"A hypofibrinogenem","justification":""},{"idx":1,"correct":false,"proposition":"An increase in antithrombin levels","justification":""},{"idx":2,"correct":true,"proposition":"A decrease in factor V levels","justification":""},{"idx":3,"correct":true,"proposition":"An extension of the Cephalin Time + activateun","justification":""},{"idx":4,"correct":true,"proposition":"An increase in D-Dimer","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-51","enonce":"A 58-year-old patient, a 35-PA smoker, consults for progressive onset dyspnea during the last semester. This dyspnea is accompanied by a dry cough. Pulmonary and cardiac auscultation is unremarkable. Here are his EFRs. What is your conclusion(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Obstructive ventilatory disorder","justification":""},{"idx":1,"correct":false,"proposition":"FEV1\/FVC ratio pre-bronchodilation to III","justification":""},{"idx":2,"correct":false,"proposition":"Partially reversible restrictive ventilatory disorder","justification":""},{"idx":3,"correct":true,"proposition":"Restrictive ventilatory disorder","justification":""},{"idx":4,"correct":false,"proposition":"These EFRs are compatible with a GOLD II stage COPD","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-52","enonce":"Which of the following proposals regarding risk factors for lung cancer is the right one?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Exposure to asbestos is considered a risk factor","justification":""},{"idx":1,"correct":false,"proposition":"It is the primary current, which is the main carcinogenic risk factor related to passive smoking","justification":""},{"idx":2,"correct":true,"proposition":"The spouse (non-smoker) of a smoker has a 20-30% increased risk of lung cancer","justification":""},{"idx":3,"correct":false,"proposition":"Carbon monoxide (CO), resulting from incomplete carbon combustion, is considered a risk factor","justification":""},{"idx":4,"correct":false,"proposition":"Alkaline persulfates used by hairdressers are considered a risk factor","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-53","enonce":"Which of the following proposals regarding transudative pleural effusions is(are) accurate?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"They can be consecutive to bacterial pneumonia","justification":""},{"idx":1,"correct":true,"proposition":"They can be consecutive to a pulmonary embolism","justification":""},{"idx":2,"correct":false,"proposition":"They can be consecutive to viral pneumonia","justification":""},{"idx":3,"correct":false,"proposition":"They may be consecutive to metastatic effusion","justification":""},{"idx":4,"correct":true,"proposition":"They may be consecutive to pulmonary atelectasis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-54","enonce":"About cholitis, what is the exact proposal(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"It results in the successive appearance of three signs: pain, pruritus, jaundice","justification":""},{"idx":1,"correct":true,"proposition":"There is most often an increase in predominantly conjugated bilirubinemia","justification":""},{"idx":2,"correct":true,"proposition":"At first, there may be cytolysis greater than 5 times the upper limit of normal","justification":""},{"idx":3,"correct":true,"proposition":"It may reveal a pancreatic tumour","justification":""},{"idx":4,"correct":true,"proposition":"Endoscopic retrograde biliary disobstruction with sphincterotomy should be discussed urgently","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-55","enonce":"Secondary hypertension with low renin, hypokalaemia and kaliuresis > 20 mmol\/L may be linked to 11 ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Renal artery stenosis","justification":""},{"idx":1,"correct":true,"proposition":"Excessive consumption of licorice A deficiency of b-hydroxy-dehydrogenase","justification":""},{"idx":2,"correct":true,"proposition":"C.","justification":""},{"idx":3,"correct":true,"proposition":"Liddle's syndrome","justification":""},{"idx":4,"correct":false,"proposition":"21-hydroxylase deficiency","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-56","enonce":"In front of renal colic, what are the factors of gravity requiring a urological opinion (one or more possible correct answers)? Rossess, ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Single kidney","justification":""},{"idx":1,"correct":true,"proposition":"Pregnancy","justification":""},{"idx":2,"correct":true,"proposition":"Anuria","justification":""},{"idx":3,"correct":true,"proposition":"Fever","justification":""},{"idx":4,"correct":false,"proposition":"Haematuria","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-57","enonce":" What biological abnormality(ies) is present in systemic lupus erythematosus?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Presence of circulating immune complexes","justification":""},{"idx":1,"correct":false,"proposition":"Thrombocytosis","justification":""},{"idx":2,"correct":true,"proposition":"Coombs test positive","justification":""},{"idx":3,"correct":true,"proposition":"Spontaneous prolongation of the TCA","justification":""},{"idx":4,"correct":true,"proposition":"Polyclonal increase in gamma globulins","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-59","enonce":"About gastrointestinal stromal tumours (GIST), which is (are) the exact proposal(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"They most often develop in the muscular layer","justification":""},{"idx":1,"correct":true,"proposition":"The stomach is the most common primitive location of GIST","justification":""},{"idx":2,"correct":true,"proposition":"GISTs are frequently diagnosed incidentally during a digestive endoscopy","justification":""},{"idx":3,"correct":false,"proposition":"They do not metastasize","justification":""},{"idx":4,"correct":false,"proposition":"They are characterized in immunohistochemistry by the expression of c-kit (CD117)","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-60","enonce":"Which vessel(s) are directly related to the pancreas?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"The portal vein","justification":""},{"idx":1,"correct":true,"proposition":"The superior mesenteric vein","justification":""},{"idx":2,"correct":false,"proposition":"The inferior mesenteric artery","justification":""},{"idx":3,"correct":false,"proposition":"Gastroduodenal artery","justification":""},{"idx":4,"correct":true,"proposition":"Splenic vein","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-61","enonce":"About acromegaly: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"The absence of a decrease in GH during OGGH is characteristic","justification":""},{"idx":1,"correct":true,"proposition":"It is a cause of diabetes","justification":""},{"idx":2,"correct":true,"proposition":"It is a cause of heart failure","justification":""},{"idx":3,"correct":true,"proposition":"It is a cause of carpal tunnel syndrome","justification":""},{"idx":4,"correct":true,"proposition":"GIgAntism testifies to an onset of the disease before puberty","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-62","enonce":"Which of the following pathologies is (are) the cause(s) of high blood pressure? Indicate the correct answer(s): ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Pheochromocytoma","justification":""},{"idx":1,"correct":true,"proposition":"Primary hyperaldosteronism","justification":""},{"idx":2,"correct":true,"proposition":"Cushing's syndrome","justification":""},{"idx":3,"correct":true,"proposition":"Hypothyroidism","justification":""},{"idx":4,"correct":true,"proposition":"Primary hyperparathyroidism","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-63","enonce":"Which of the following factors is(are) a scannographic criterion(s) for severity of acute pancreatitis?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Dilation of the main pancreatic duct","justification":""},{"idx":1,"correct":false,"proposition":"A functional ileus","justification":""},{"idx":2,"correct":true,"proposition":"The presence of intrapancreatic necrosis","justification":""},{"idx":3,"correct":true,"proposition":"The presence of extrapancreatic necrosis","justification":""},{"idx":4,"correct":false,"proposition":"Cholelithiasis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-65","enonce":"Ms. X., aged 39, a right hemiplegic and aphasiac, was incenced for incapacity (impossibility of professional redeployment in the bank where she worked). For what objective(s) can it solicit the Departmental House of People with Disabilities?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Obtain a PCH (Disability Compensation Benefit)","justification":""},{"idx":1,"correct":true,"proposition":"Obtaining recognition as a disabled worker (ROTH)","justification":""},{"idx":2,"correct":false,"proposition":"Obtaining a disability pension (Pl)","justification":""},{"idx":3,"correct":true,"proposition":"Getting a disability card","justification":""},{"idx":4,"correct":true,"proposition":"Get a parking card","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-66","enonce":"A 70-year-old woman has been complaining of pruritus for 6 months and has had a generalized itchy rash for 15 days. The blood count finds a count of eosinophilic polynuclear 3. A skin biopsy is performed in the peribullous zone at 1,000\/mm (photo below). What will direct cutaneous immunofluorescence show?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Granular deposits of lgG and C3 at the dermal-epidermal junction","justification":""},{"idx":1,"correct":false,"proposition":"Linear IgA deposits along the dermo-e p idermal junction","justification":""},{"idx":2,"correct":true,"proposition":"Linear deposits of lgG and C3 along the dermal-epidermal junction","justification":""},{"idx":3,"correct":false,"proposition":"Intraepidermal deposits of lgG and C3 mesh","justification":""},{"idx":4,"correct":false,"proposition":"LgG deposits around vessels","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-67","enonce":"A 26-year-old patient has just returned from a 3-week stay in Indonesia where he tells you that he walked barefoot on the beaches a lot. He has the lesion below which is very itchy to the point of preventing him from sleeping. Which pathology is most likely? (only one exact answer) ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Cutaneous leishmaniasis","justification":""},{"idx":1,"correct":false,"proposition":"Erysipelas","justification":""},{"idx":2,"correct":true,"proposition":"Larva migrans cutaneous","justification":""},{"idx":3,"correct":false,"proposition":"Pyoderma","justification":""},{"idx":4,"correct":false,"proposition":"Cutaneous mycosis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-68","enonce":"A 42-year-old woman with no medical history comes to see you for a picture of nasopharyngitis with a fever above 38.5 ° C evolving for six days despite symptomatic treatment. There is a predominant bilateral purulent rhinorrhea on the right associated with pharyngitis. She complains of a unilateral headache located on the face, just above the right eye, which interferes with sleep. Orbital and periorbital examination is normal. What care seems acceptable to you in the first line? (one or more correct answers) ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Carrying out a microbiological sample","justification":""},{"idx":1,"correct":false,"proposition":"Amoxicillin treatment","justification":""},{"idx":2,"correct":false,"proposition":"Treatment with amoxicillin-clavulanic acid","justification":""},{"idx":3,"correct":false,"proposition":"Treatment with levofloxacin","justification":""},{"idx":4,"correct":false,"proposition":"Non-steroidal anti-inflammatory","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-69","enonce":"A 63-year-old patient is referred to you in a context of asthenia. She has already seen a doctor who prescribed serum protein 1 electrophoresis, the result of which is as follows. What diagnosis(s) do you evoke in front of these elements?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Giant cell arteritis (Horton's disease)","justification":""},{"idx":1,"correct":true,"proposition":"Chronic liver disease","justification":""},{"idx":2,"correct":true,"proposition":"Sjogren's syndrome","justification":""},{"idx":3,"correct":false,"proposition":"Myeloma at lgG","justification":""},{"idx":4,"correct":false,"proposition":"Light chain myeloma","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-70","enonce":"A 32-year-old patient consults for a cough. His chest x-ray is as follows. What abnormality(s) do you notice on the chest X-ray?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Hilar lymphadenopathy","justification":""},{"idx":1,"correct":true,"proposition":"Signs of pulmonary arterial hypertension","justification":""},{"idx":2,"correct":true,"proposition":"An interstitial syndrome","justification":""},{"idx":3,"correct":false,"proposition":"A pneumothorax","justification":""},{"idx":4,"correct":false,"proposition":"An airy bronchogramma","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-71","enonce":"A patient comes to the emergency room because he is worried about the appearance of these tongue lesions that he has noted for 48 hours. He has no history, does not complain about anything else. He is apyretic, his blood pressure is 120\/70 mmHg. Which exam(s)? Ask yourself ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Blood","justification":""},{"idx":1,"correct":false,"proposition":"Determination of vitamin B12 (cobalamin)","justification":""},{"idx":2,"correct":false,"proposition":"Microbiological","justification":""},{"idx":3,"correct":true,"proposition":"Blood count","justification":""},{"idx":4,"correct":false,"proposition":"Lingual swab for herpes virus","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-72","enonce":"Hypersexuality is frequently observed during certain disorders. Which one(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Manic syndrome","justification":""},{"idx":1,"correct":true,"proposition":"Frontal syndrome","justification":""},{"idx":2,"correct":true,"proposition":"Syndrome de Klein-Levin","justification":""},{"idx":3,"correct":false,"proposition":"Schizophrenic syndrome","justification":""},{"idx":4,"correct":false,"proposition":"Parkinson's disease treated with dopamine agonists","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-73","enonce":"Regarding denial of pregnancy, what is (are) the exact proposal(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"It is defined by the lack of awareness of pregnancy beyond 22 weeks of amenorrhea","justification":""},{"idx":1,"correct":false,"proposition":"It most often appears in women with a history of psychiatric disorders","justification":""},{"idx":2,"correct":false,"proposition":"Clinically, the usually observable manifestations of pregnancy are not apparent or absent","justification":""},{"idx":3,"correct":true,"proposition":"A differential diagnosis is pregnancy deliberately concealed from the entourage","justification":""},{"idx":4,"correct":false,"proposition":"Progression to puerperal psychosis is common","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-74","enonce":"What is(are) the typical characteristic(s) of hepatocellular carcinoma in sectional imaging?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Contrast taking at arterial time","justification":""},{"idx":1,"correct":true,"proposition":"Washing at portal time","justification":""},{"idx":2,"correct":false,"proposition":"Centripetal filling","justification":""},{"idx":3,"correct":false,"proposition":"Spontaneously hyperdense appearance on computed tomography","justification":""},{"idx":4,"correct":false,"proposition":"Lump contrast capture","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-75","enonce":"A 45-year-old man arrives at the emergency room with severe lower back pain. He is very stiff and has a fever. Which imaging test(s) do you think are useful to support your suspected diagnosis?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"An X-ray of the lumbar spine from the front and profile","justification":""},{"idx":1,"correct":false,"proposition":"X-rays of 3\/4 of the lumbar spine","justification":""},{"idx":2,"correct":false,"proposition":"A CT scan","justification":""},{"idx":3,"correct":true,"proposition":"An MRI","justification":""},{"idx":4,"correct":false,"proposition":"A PET scanner","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-76","enonce":"Which of the following proposals for fluorescein eye drops is accurate? Fluorescein is a fluorescent eye drop, which essentially allows us to explore the","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Can be used to check the integrity of the corneal endothelium","justification":""},{"idx":1,"correct":true,"proposition":"Can be used to highlight a transfixing corneal wound","justification":""},{"idx":2,"correct":false,"proposition":"Can be used to highlight herpetic keratitis","justification":""},{"idx":3,"correct":false,"proposition":"Can be used as an anesthetic before removal of a corneal foreign body","justification":""},{"idx":4,"correct":false,"proposition":"Can be used to highlight dry eye","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-77","enonce":"Regarding the following iconography, which is (are) the exact proposal(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":" Arrow 1 denotes the ascending horacic aorta e","justification":""},{"idx":1,"correct":true,"proposition":"Arrow 2 designates the superior vena cava","justification":""},{"idx":2,"correct":false,"proposition":"Arrow 3 designates the left inferior pulmonary vein","justification":""},{"idx":3,"correct":false,"proposition":"There is a dissection of the ascending thoracic aorta","justification":""},{"idx":4,"correct":true,"proposition":"There is a proximal pulmonary embolism","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-78","enonce":"Regarding the use of adrenaline during cardiac arrest, which is the exact proposal(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"In case of asystole, the first dose is 1 mg intravenously","justification":""},{"idx":1,"correct":false,"proposition":"If no venous line is available, injection through the intubation tube is possible","justification":""},{"idx":2,"correct":false,"proposition":"Control of heart rate effectiveness 5 min after first injection","justification":""},{"idx":3,"correct":true,"proposition":"In case of asystole, the injection of adrenaline most often leads to ventricular fibrillation","justification":""},{"idx":4,"correct":false,"proposition":"In case of ventricular fibrillation, adrenaline administration should be started after the fifth external electric shock","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-79","enonce":"A patient benefits from aortic valve replacement with a new generation double-finned mechanical prosthesis. Its rhythm is sinus. Which of the following is (are) accurate in this patient?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"It must be treated with vitamin K antagonist for life","justification":""},{"idx":1,"correct":true,"proposition":"The effective target INR of vitamin K therapy is between 2 and 3","justification":""},{"idx":2,"correct":false,"proposition":"In case of labile INRs, it is possible to replace the antivitamin K with a direct oral anticoagulant","justification":""},{"idx":3,"correct":true,"proposition":"Antibiotic prophylaxis is essential before a dental avulsion","justification":""},{"idx":4,"correct":false,"proposition":"Vitamin K treatment should be suspended before dental scaling","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-80","enonce":"A patient consults you for a recent dyspnea of exertion. You find a heart murmur. What is (are) the argument(s) in favor of mitral insufficiency?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":" The tone of the breath is often in steam jet","justification":""},{"idx":1,"correct":false,"proposition":" The breath is diastolic","justification":""},{"idx":2,"correct":true,"proposition":"The irradiation of the breath is done towards the armpit","justification":""},{"idx":3,"correct":false,"proposition":"The breath is accompanied by the abolition of the 82","justification":""},{"idx":4,"correct":false,"proposition":"The breath is accompanied by a fixed doubling of the 82 in children","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-81","enonce":"Which of the following proposals concerning pharmacovigilance is true?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"It is based on spontaneous patient notification","justification":""},{"idx":1,"correct":true,"proposition":"It is based on spontaneous notification from health professionals","justification":""},{"idx":2,"correct":false,"proposition":"Spontaneous notifications cannot lead to the withdrawal of a medicinal product from the market","justification":""},{"idx":3,"correct":true,"proposition":"Accountability uses chronological and semiological criteria","justification":""},{"idx":4,"correct":true,"proposition":"Accountability estimates the causal link between a drug and an adverse reaction","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-82","enonce":"Indicate the true answer(s) regarding temporary use authorizations for a medicinal product ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Can be nominative or cohort","justification":""},{"idx":1,"correct":true,"proposition":"Are given for serious situations","justification":""},{"idx":2,"correct":false,"proposition":"Do not require clinical studies","justification":""},{"idx":3,"correct":false,"proposition":"Allow for early availability after marketing authorisation","justification":""},{"idx":4,"correct":false,"proposition":"Avoid the application for marketing authorisation","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-83","enonce":"Indicate the true answer(s) for pharmacological therapeutic monitoring based on pharmacokinetic parameters. Pharmacological therapeutic monitoring can be useful:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"To prevent auditory toxicity of aminoglycosides ","justification":""},{"idx":1,"correct":false,"proposition":"In order to prevent ineffectiveness of Tramadol","justification":""},{"idx":2,"correct":false,"proposition":"In order to understand the therapeutic success of morphine [>","justification":""},{"idx":3,"correct":true,"proposition":"To verify lithium adherence","justification":""},{"idx":4,"correct":true,"proposition":"To prevent ineffectiveness of tacrolimus","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-84","enonce":"Which of the following drug classes is(s) nephrotoxic at usual doses ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":" Aminoglycosides","justification":""},{"idx":1,"correct":false,"proposition":"Statins","justification":""},{"idx":2,"correct":false,"proposition":"Nonsteroidal anti-inflammatory drugs","justification":""},{"idx":3,"correct":false,"proposition":"Corticosteroids","justification":""},{"idx":4,"correct":false,"proposition":"Antiparkinsonians","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-85","enonce":"• Direct tubular toxicity.","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Synovitis"},{"idx":1,"correct":true,"proposition":"Erosions"},{"idx":2,"correct":true,"proposition":"Joint effusion"},{"idx":3,"correct":true,"proposition":"A pinching of the joint spacers","justification":""},{"idx":4,"correct":false,"proposition":"Inflammation of the epiphyses","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-86","enonce":"You receive in consultation a 28-year-old patient who performed a CT scan of the junction a posteriori thoraco-lumbar (between TS and L2) 2 months ago. She discovered that she was pregnant at the time of the scan. She asks for your opinion on the rest of her pregnancy ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"You reassure her, the FCETUS running little risk since outside the irradiation field","justification":""},{"idx":1,"correct":false,"proposition":"You reassure her because in view of the type of examination carried out, the dose received by the fetus is necessarily less than 10 mGy, threshold of appearance of radiation-induced risks in the unborn child","justification":""},{"idx":2,"correct":true,"proposition":"You reassure her because in view of the type of examination carried out, the dose received by the fetus is necessarily less than 100 mGy, threshold of appearance of radiation-induced risks in the unborn child","justification":""},{"idx":3,"correct":false,"proposition":"You request a dosimetric expertise and wait for the result before pronouncing an opinion","justification":""},{"idx":4,"correct":false,"proposition":"You explain the risks associated with the examination and discuss with her a possible medical termination of pregnancy","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-87","enonce":"The maximum passive joint amplitudes of this patient's right knee are represented by the photos below. Which of the following is (are) accurate? ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"The patient has an extension of 30°","justification":""},{"idx":1,"correct":false,"proposition":"The patient has a recurvatum of 30 degrees","justification":""},{"idx":2,"correct":true,"proposition":"The patient has a 30° injury","justification":""},{"idx":3,"correct":true,"proposition":"The patient has a joint stroke of 70 degrees","justification":""},{"idx":4,"correct":false,"proposition":"The patient has a flexion of 100°","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-88","enonce":"The maximum passive joint amplitudes of this patient's right knee are represented by the photos below. Which of the following is correct? Maximum flexion Maximum extension ° Indicate true response(s) regarding adverse effects of opioid analgesics: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Visual disturbances","justification":""},{"idx":1,"correct":true,"proposition":"Nausea","justification":""},{"idx":2,"correct":false,"proposition":"Diarrhoea","justification":""},{"idx":3,"correct":true,"proposition":"Itch","justification":""},{"idx":4,"correct":true,"proposition":"Acute urine retention","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-89","enonce":"In front of a clinical picture of agitation, which is (are} the exact proposal(s) on the use of antipsychotics for sedative purposes?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Are useful for all degrees of stirring severity","justification":""},{"idx":1,"correct":false,"proposition":"Decrease alertness","justification":""},{"idx":2,"correct":false,"proposition":"Are to be associated with benzodiazepines","justification":""},{"idx":3,"correct":true,"proposition":"Should not be prescribed for angle-closure glaucoma","justification":""},{"idx":4,"correct":true,"proposition":"Cannot be used in case of long QT","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-90","enonce":"What medication(s) can cause agitation in the elderly?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Corticosteroids","justification":""},{"idx":1,"correct":true,"proposition":"Antidepressants","justification":""},{"idx":2,"correct":false,"proposition":"Vitamin D","justification":""},{"idx":3,"correct":true,"proposition":"Benzodiazepines","justification":""},{"idx":4,"correct":true,"proposition":"Anticholinergics","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-91","enonce":"A 66-year-old man, with no particular history, is hospitalized after suddenly presenting a transient loss of vision in the right eye, spontaneously regressive after 3 minutes. The interrogation finds asthenia and temporal headaches for 3 weeks. Your clinical examination is normal. A biological assessment was performed: blood ionogram, blood glucose, renal function, normal blood count, CRP 67mg\/L. What do you urgently ask for before instituting a specific treatment?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Brain scan","justification":""},{"idx":1,"correct":false,"proposition":"Fluorescein retinal angiography","justification":""},{"idx":2,"correct":false,"proposition":"Microbiological","justification":""},{"idx":3,"correct":false,"proposition":"Determination of anti-cytoplasmic antibodies of neutrophils (ANCA)","justification":""},{"idx":4,"correct":true,"proposition":"None of these exams","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-92","enonce":"Which element(s) should evoke the secondary character of a bilateral Raynaud's phenomenon ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Occurring after 40 years"},{"idx":1,"correct":false,"proposition":"Revelation by an attack of the indexes and majors","justification":""},{"idx":2,"correct":true,"proposition":"Presence of telangiectasias"},{"idx":3,"correct":true,"proposition":"Thumb damage"},{"idx":4,"correct":true,"proposition":"Presence of retractile scars on the pulp of the index fingers","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-93","enonce":"You present the daughter of a palliative care patient at an advanced stage with family solidarity leave. Which statement(s) is the correct statement(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Is for a duration of 6 months","justification":""},{"idx":1,"correct":false,"proposition":"Is intended for any employee close to the patient","justification":""},{"idx":2,"correct":true,"proposition":"Is unpaid","justification":""},{"idx":3,"correct":true,"proposition":"Guarantees to return to work under the same conditions","justification":""},{"idx":4,"correct":true,"proposition":"Allows the daughter of the p atiente to say p dare to p lus of tem p s with her mother","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-94","enonce":"According to the law concerning the person of trust, which is (are) the correct statement(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"It has decision-making power","justification":""},{"idx":1,"correct":true,"proposition":"It must be obligatorily designated in writing","justification":""},{"idx":2,"correct":true,"proposition":"It is consulted when the patient is no longer able to express his will","justification":""},{"idx":3,"correct":false,"proposition":"Its designation is obligatory","justification":""},{"idx":4,"correct":false,"proposition":"It can be the private nurse or the patient's attending physician","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-95","enonce":"Concerning the characteristic(s) of breakthrough pain: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"They are characterized by quick installation","justification":""},{"idx":1,"correct":true,"proposition":"They are characterized by a short duration","justification":""},{"idx":2,"correct":true,"proposition":"They have variable intensity","justification":""},{"idx":3,"correct":true,"proposition":"They may have a neuropathic origin","justification":""},{"idx":4,"correct":false,"proposition":"They impose an increase in the background treatment of pain","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-96","enonce":"Which of the following proposals is(s) the risk factor(s) of complicated bereavement?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"A recent bereavement","justification":""},{"idx":1,"correct":true,"proposition":"Early loss of a first-degree relative","justification":""},{"idx":2,"correct":false,"proposition":"The advanced age of the bereaved","justification":""},{"idx":3,"correct":false,"proposition":"Social precariousness","justification":""},{"idx":4,"correct":true,"proposition":"The suddenness of death","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-97","enonce":"During the assessment of the extension of clinically localized cancers of the larynx and hypopharynx, which is (are) the recommended examination(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Esophageal endoscopy","justification":""},{"idx":1,"correct":true,"proposition":"Head and neck CT","justification":""},{"idx":2,"correct":false,"proposition":"Head and neck MRI","justification":""},{"idx":3,"correct":false,"proposition":"FDG PET","justification":""},{"idx":4,"correct":false,"proposition":"Bone scintigraphy","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-98","enonce":"In front of this table of palmar keratoderma evolving for 3 months, what diagnosis (s) is (are) to consider?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Hyperkeratotic scabies","justification":""},{"idx":1,"correct":false,"proposition":"Primary syphilis","justification":""},{"idx":2,"correct":true,"proposition":"Contact eczema","justification":""},{"idx":3,"correct":true,"proposition":"Syndrome de Sézary","justification":""},{"idx":4,"correct":true,"proposition":"Psoriasis","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-99","enonce":"Which of the following dual antihypertensive therapies is (are) most often discouraged?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Hydrochlorothiazide and furosemide","justification":""},{"idx":1,"correct":true,"proposition":"Acebutolol and verapamil","justification":""},{"idx":2,"correct":true,"proposition":"Amlodipine and diltiazem","justification":""},{"idx":3,"correct":true,"proposition":"Candesartan and spironolactone","justification":""},{"idx":4,"correct":true,"proposition":"Perindopril and valsartan","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-100","enonce":"Which diagnosis(s) is (are) classified as somatoform disorders?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Somatization","justification":""},{"idx":1,"correct":false,"proposition":"Post-traumatic stress disorder","justification":""},{"idx":2,"correct":false,"proposition":"Histerionic personality","justification":""},{"idx":3,"correct":true,"proposition":"Conversion disorder","justification":""},{"idx":4,"correct":true,"proposition":"Pain disorder No real difficulty here, we find the complete list of somatoform disorders in the College of Psychiatry Symptoms affecting several bodily domains before the age of 30 Neurological symptoms Pain without organic substrate maintained by stress Mistaken belief of having a non-psychiatric illness","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-101","enonce":"For polycystic ovary syndrome, indicate the correct answer(s) ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"This is the most common cause of dysovulation","justification":""},{"idx":1,"correct":true,"proposition":"It is often associated with resistance to the action of insulin","justification":""},{"idx":2,"correct":true,"proposition":"Acne is common","justification":""},{"idx":3,"correct":true,"proposition":"The presence of more than 12 follicles is a diagnostic criterion","justification":""},{"idx":4,"correct":false,"proposition":"It is associated with thyroid cysts","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-102","enonce":"A 3-month-old infant is brought by his parents to the pediatric emergency room for laryngeal dyspnea that has gradually worsened since the age of one month. Since delivery, the infant has not had a break in the staturo-weight curve, it is apyretic admission. In front of this laryngeal dyspnea, what etiology do you mention in the first place?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Laryngomalacia","justification":""},{"idx":1,"correct":false,"proposition":"A laryngeal diastema","justification":""},{"idx":2,"correct":false,"proposition":"Laryngitis","justification":""},{"idx":3,"correct":true,"proposition":"Subglottic angioma","justification":""},{"idx":4,"correct":false,"proposition":"A laryngeal foreign body","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-103","enonce":"One patient, aged 45, has chronic cholesteatomatous otitis. He asks you what risk(s) is (are) leaving this lesion in place? You answer that this exposes him to a risk of: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Peripheral facial paralysis","justification":""},{"idx":1,"correct":true,"proposition":"Conductive hearing loss"},{"idx":2,"correct":true,"proposition":"Perilymphatic fistula"},{"idx":3,"correct":true,"proposition":"Labyrinthitis"},{"idx":4,"correct":true,"proposition":"Meningitis"}],"type":"qi"}
{"_id":"annales-2017-qi-104","enonce":"Concerning the rapid diagnostic test (RDT) for screening in the context of angina. What is the real proposal(s)? D. Its positivity is in group A hemolytic bihemolytic streptococcus","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"It is made at any age","justification":""},{"idx":1,"correct":false,"proposition":"It has a specificity of 70%","justification":""},{"idx":2,"correct":true,"proposition":"The result is obtained after a duration of about 5 min","justification":""},{"idx":3,"correct":true,"proposition":"Its positivity is in favor of group A hemolytic B streptococcus","justification":""},{"idx":4,"correct":false,"proposition":"A shipment to the bacteriology laboratory is necessary to have the result","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-105","enonce":"About risk factors for ENT cancer ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"EBV is a risk factor for cavum cancer","justification":""},{"idx":1,"correct":true,"proposition":"HPV is a risk factor for tonsillar cancer","justification":""},{"idx":2,"correct":false,"proposition":"Tobacco is a risk factor for ethmoid sinus cancer","justification":""},{"idx":3,"correct":false,"proposition":"Wood dust is a risk factor for maxillary sinus cancer","justification":""},{"idx":4,"correct":true,"proposition":"Alcohol and tobacco are risk factors for tonsillar cancer It is a multiple choice to which the table is reapplied<< Four complications of chronic otitis to control>> seen page 119 .","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-106","enonce":"A patient consults for left sublobular induration. His GP ordered a head and neck MRI. He comes back to you with the MRI data. What can you tell him about the imagery below?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"It is a T1 sequence without gadolinium injection","justification":""},{"idx":1,"correct":false,"proposition":"The 1 corresponds to the right sphenoidal sinus","justification":""},{"idx":2,"correct":true,"proposition":"The 2 corresponds to the right parotid gland","justification":""},{"idx":3,"correct":true,"proposition":"There is a left parotid tumor","justification":""},{"idx":4,"correct":false,"proposition":"There is a tumor of the left submandibular gland","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-107","enonce":"Regarding the 1+2+3 Bouchon rule in the elderly:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"It is not usable in very old individuals (> 90 years)","justification":""},{"idx":1,"correct":false,"proposition":"It allows the calculation of comorbidities","justification":""},{"idx":2,"correct":true,"proposition":"The<< 3 >> corresponds to an acute pathogen","justification":""},{"idx":3,"correct":false,"proposition":"It helps explain atypical clinical presentations in the elderly","justification":""},{"idx":4,"correct":true,"proposition":"It helps explain the accumulation of diseases during aging","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-108","enonce":"Immobilization syndrome is a common complication in subjects over 75 years of age. Which of the following is true?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Associated with a risk of excess mortality","justification":""},{"idx":1,"correct":true,"proposition":"Increases the risk of dehydration","justification":""},{"idx":2,"correct":true,"proposition":"Occurs from the first hour of immobilization","justification":""},{"idx":3,"correct":false,"proposition":"Is explained by musculoskeletal aging","justification":""},{"idx":4,"correct":true,"proposition":"Increases the risk of venous insufficiency","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-109","enonce":"You see an 85-year-old patient in the emergency room for a fall from her height with a head trauma while she usually takes anticoagulant treatment with vitamin K antagonist. The clinical examination is normal and the INR is 6.2. Which of the following proposals do you think corresponds to his management in the emergency room before any examination?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"No indication for a brain CT scan","justification":""},{"idx":1,"correct":true,"proposition":"Immediate brain computed tomography","justification":""},{"idx":2,"correct":false,"proposition":"Brain computed tomography scheduled within 48 hours","justification":""},{"idx":3,"correct":false,"proposition":"Administration of vitamin K and concentrates of prothrombin complexes","justification":""},{"idx":4,"correct":true,"proposition":"Administration of vitamin K alone","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-110","enonce":"Age-related macular degeneration: ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Causes decreased peripheral vision","justification":""},{"idx":1,"correct":false,"proposition":"Is linked to abnormalities of the retinal pigment epithelium","justification":""},{"idx":2,"correct":true,"proposition":"May result in distorted images","justification":""},{"idx":3,"correct":true,"proposition":"Is confirmed at the fundus","justification":""},{"idx":4,"correct":false,"proposition":"Is favored by chronic alcoholism","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-111","enonce":"The Mini Nutritionna\/Assessment (or MNA) nutritional test:","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Is a test with a total score out of 30 points","justification":""},{"idx":1,"correct":true,"proposition":"Is a test that defines malnutrition if the score is less than 23 5 points","justification":""},{"idx":2,"correct":true,"proposition":"Is a test that defines malnutrition if the score is less than 17 points","justification":""},{"idx":3,"correct":false,"proposition":"Is a test that requires the calculation of body mass index","justification":""},{"idx":4,"correct":true,"proposition":"Is a test that takes into account the presence of neuropsychological problems","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-112","enonce":"About cervical swelling, what is (are) the exact item(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"A cyst of the thyroglossal tract is mobile to swallowing","justification":""},{"idx":1,"correct":false,"proposition":"Right supraclavicular lymphadenopathy may be indicative of kidney cancer","justification":""},{"idx":2,"correct":true,"proposition":"Superficial renitent swelling localized to the anterior edge of the sternocleidomastoid muscle is suggestive of an amygdaloid cyst","justification":""},{"idx":3,"correct":false,"proposition":"Brachial plexus schwannoma is a differential diagnosis of submandibular lymphadenopathy","justification":""},{"idx":4,"correct":true,"proposition":"Accessory nerve schwannoma is a differential diagnosis of spinal lymphadenopathy","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-114","enonce":"You had seen Mrs. V., 22 years old, for iron deficiency anaemia in connection with heavy periods. She was put on estrogen-progestin by her gynecologist and you prescribed martial replacement therapy. After 4 months of treatment you see it again with the following assessment: red blood cells %; 5.57 T\/L; hemoglobin 125 g\/L - hematocrit 39 VGM 70 fL; HCMC 32 g\/dL; leukocytes 5 g\/L - platelets 270 G\/L. Ferritin is at 40 ng\/mL (normal > 30). The CRP is 3 mg\/L. What is(are) your hypothesis(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Mrs. V. did not take her martial treatment","justification":""},{"idx":1,"correct":false,"proposition":"Mrs. V. has probable sickle cell disease","justification":""},{"idx":2,"correct":true,"proposition":"Mrs. V. has probable heterozygous thalassemia","justification":""},{"idx":3,"correct":false,"proposition":"Mrs. V. has not yet replenished her iron reserves","justification":""},{"idx":4,"correct":false,"proposition":"Mrs. V. has an added inflammatory pathology","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-115","enonce":"High-grade glioblastoma is discovered in an 80-year-old person, otherwise free of pathology and whose general condition is good. It is an incurable cancer disease, with a median survival of about 15 months, with a combination of high-dose corticosteroid therapy for antiedematous, radiotherapy and anti-angiogenic chemotherapy. The aim of treatments is to slow down the tumor evolution. ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"This is an acute care approach, delaying entry into palliative care","justification":""},{"idx":1,"correct":false,"proposition":"This is an unreasonable obstinacy, given the incurability of the disease and the poor prognosis.","justification":""},{"idx":2,"correct":true,"proposition":"This is an acute care approach, to be conducted within a palliative care approach","justification":""},{"idx":3,"correct":true,"proposition":"This is an acute care approach, the objectives of which must be discussed and validated with the patient.","justification":""},{"idx":4,"correct":false,"proposition":"This is comfort care, the objective of which is to avoid unnecessary suffering","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-116","enonce":"A 50-year-old patient consults you for a certificate of non-contraindication the practice of sport. You hear a diastolic heart murmur, maximal at the third left intercostal space, best perceived in the forward leaning position. What is(are) the possible cause(s) of this breath ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Aortic bicuspid"},{"idx":1,"correct":false,"proposition":"Mitral valve dystrophy","justification":""},{"idx":2,"correct":true,"proposition":"Ankylosing spondylitis"},{"idx":3,"correct":false,"proposition":"Rope break"},{"idx":4,"correct":true,"proposition":"Aortic annuloectasian disease","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-117","enonce":"Regarding imaging of pancreatic tumors, what is(are) the exact answer(s)?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"In front of jaundice, the first intention examination is the MRI to visualize the bile ducts","justification":""},{"idx":1,"correct":true,"proposition":"In case of suspicion of pancreatic cancer, it is the CT scan with injection of contrast medium that is the first-line examination","justification":""},{"idx":2,"correct":true,"proposition":"If pancreatic cancer is suspected, the CT scan should look for direct (tumor) and indirect (dilation of the bile ducts and\/or Wirsung's duct) signs.","justification":""},{"idx":3,"correct":false,"proposition":"The tumor of the pancreas is sometimes difficult to highlight in CT and it will then be necessary to complete with a retrograde cholangiopancreatography endoscopic (ERCP)","justification":""},{"idx":4,"correct":false,"proposition":"Most pancreatic cancers are diagnosed incidentally on imaging","justification":""},{"idx":5,"correct":false,"proposition":"abdominal performed for another indication","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-118","enonce":"A 6-month-old child has a break in the curve of his head circumference with a macrocrania. You ask him for a transfontanelar ultrasound. Which item(s) is the correct item(s)? Has.","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"This examination makes it possible to analyze the infratentorial compartment better than the supratentorial compartment","justification":""},{"idx":1,"correct":false,"proposition":"This examination is impossible, the fontanelles are closed at his age","justification":""},{"idx":2,"correct":true,"proposition":"This test can detect hydrocephalus","justification":""},{"idx":3,"correct":true,"proposition":"This test can detect an intracranial tumor","justification":""},{"idx":4,"correct":true,"proposition":"This examination has operator-dependent sensitivity and specificity","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-119","enonce":"What is the diagnostic criterion(s) to make the diagnosis of celiac disease without performing an intestinal biopsy? ","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":false,"proposition":"Anti-transglutaminase IgA greater than 10 times normal","justification":""},{"idx":1,"correct":false,"proposition":"anti-transglutaminase lgG greater than 10 times normal","justification":""},{"idx":2,"correct":false,"proposition":"Presence of anti-endom IgA at a significant level","justification":""},{"idx":3,"correct":false,"proposition":"Presence of anti-gliadin IgA at a significant level","justification":""},{"idx":4,"correct":false,"proposition":"Presence of a HLA DO2 or DO8 group This is an interesting MCQ, the appropriate answer is to be found in pediatrics. We distinguish","justification":""},{"idx":5,"correct":false,"proposition":"2 steps to the diagnosis of celiac disease","justification":""}],"type":"qi"}
{"_id":"annales-2017-qi-120","enonce":"What symptoms make you suspect rhegmatogenous retinal detachment?","item":"annales-2017-qi","matiere":"annales-2017","propositions":[{"idx":0,"correct":true,"proposition":"Phosphenes","justification":""},{"idx":1,"correct":false,"proposition":"Photophobia","justification":""},{"idx":2,"correct":true,"proposition":"Amputation of the visual field in the sector","justification":""},{"idx":3,"correct":true,"proposition":"Myodesopsias","justification":""},{"idx":4,"correct":false,"proposition":"Isolated central scotomome","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-1","enonce":"In front of a febrile roseoliform exanthema of the child, the main etiologies are (one or more exact answers):","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"A sudden exanthema","justification":""},{"idx":1,"correct":false,"proposition":"An epidemic megalerythema","justification":"Morbiliform"},{"idx":2,"correct":true,"proposition":"Rubella","justification":""},{"idx":3,"correct":false,"proposition":"Infectious mononucleosis","justification":"Morbiliform or scarlatiniform"},{"idx":4,"correct":false,"proposition":"Un syndrome de Kawasaki","justification":"Morbiliform or scarlatiniform"}],"type":"qi"}
{"_id":"annales-2018-qi-2","enonce":"About heart failure, which proposal(s) is true?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Cardiac auscultation may show a burst of B2 at the aortic focus in pulmonary arterial hypertension","justification":"At the pulmonary focus"},{"idx":1,"correct":true,"proposition":"Cardiac auscultation may reveal a murmur of mitral insufficiency related to the dilation of the mitral ring","justification":""},{"idx":2,"correct":false,"proposition":"Jugular turgor is a peripheral sign of left heart failure","justification":"right"},{"idx":3,"correct":false,"proposition":"Peripheral edema is soft, blue and painful","justification":"soft, white, painless, declivated (so to look for in the lower back in a lying patient) and taking the bucket (unlike inflammatory edema, for example during bacterial dermohypoderma)"},{"idx":4,"correct":true,"proposition":"Crackling or subcrackling rails are often bilateral","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-3","enonce":"A 70-year-old patient presents to the emergency room for chest pain and dyspnea. Give the exact proposal(s): ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"1 corresponds to the ascending aorta","justification":"Superior vena cava"},{"idx":1,"correct":true,"proposition":"2 corresponds to the esophagus","justification":""},{"idx":2,"correct":true,"proposition":"3 corresponds to the descending aorta","justification":""},{"idx":3,"correct":false,"proposition":"4 corresponds to a pulmonary embolism in the left pulmonary artery","justification":"right"},{"idx":4,"correct":false,"proposition":"4 corresponds to a dissection of the pulmonary artery","justification":"This is the thrombus"}],"type":"qi"}
{"_id":"annales-2018-qi-4","enonce":"What is the true answer(s) regarding the management of diffuse bronchiectasis in adults (outside the context of cystic fibrosis) responsible for repeated infectious episodes:","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Daily bronchial drainage"},{"idx":1,"correct":false,"proposition":"Systemic corticosteroid therapy"},{"idx":2,"correct":false,"proposition":"Pulmonary lobectomy","justification":"The breach is diffuse"},{"idx":3,"correct":false,"proposition":"Systematic quarterly antibiotic therapy","justification":""},{"idx":4,"correct":false,"proposition":"Anti-inflammatory treatment with fluoroquinolone","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-5","enonce":"You see a 70-year-old man in the winter. He has stage 1 dyspnea of mMRC associated with chronic cough without sputum. It presents a smoking of the order of 25 pack-years still pursued. He tells the notion of asthma in early childhood and has long suffered from seasonal grass pollen rhinitis. He has no other background. His pulmonary auscultation, the day you see him, is normal. It performs pulmonary function tests (EFR). Give the correct answer(s):","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Given these RFEs, the patient must be hospitalized","justification":""},{"idx":1,"correct":false,"proposition":"A methacholine bronchial hyperreactivity test should be performed","justification":"This is done when the suspiscion of asthma is very high despite a significantly non-reversible TVO."},{"idx":2,"correct":true,"proposition":"Clinical history and EFRs are consistent with asthma","justification":"Significant but not complete reversible TVO"},{"idx":3,"correct":true,"proposition":"Clinical history and EFRs are consistent with COPD","justification":"Significant but not complete reversible TVO"},{"idx":4,"correct":false,"proposition":"A treatment can only be put in place once smoking has been definitively stopped","justification":"We must indeed stop smoking but we start treating as soon as possible"}],"type":"qi"}
{"_id":"annales-2018-qi-6","enonce":"A 58-year-old patient comes to your hospital's emergency room for expectoration of two glasses of red blood during a coughing effort. She had never coughed up blood. She is on aspirin aimed at anti-aggregating for coronary artery disease. His clinical examination is normal, his blood pressure is 132\/79 mmHg, the heart rate is 80\/min. Chest X-ray does not show any abnormalities. Give the correct answer(s): ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"You hospitalize the patient","justification":""},{"idx":1,"correct":false,"proposition":"You set up a vascular filling","justification":"It is neither tachycardium nor hypotensive. So no filling at this stage."},{"idx":2,"correct":false,"proposition":"You prescribe an intravenous vasoconstrictor agent such as telipressin","justification":"His coronary artery disease contraindicates this treatment"},{"idx":3,"correct":true,"proposition":"You prescribe an injected chest CT scan with arterial time acquisition after checking for contraindications","justification":"The master examination in case of hemoptysis"},{"idx":4,"correct":false,"proposition":"You reassure the patient and explain that it is normal to bleed on antiaggregants","justification":"Not at all normal"}],"type":"qi"}
{"_id":"annales-2018-qi-7","enonce":"A 70-year-old woman consults for non-pruritic skin lesions that appeared several days ago, localized on the upper back (photo 1), in the scalp and in the axillary folds. She has been complaining for several months of painful oral lesions that interfere with feeding (photo 2). Nikolsky's sign is positive. His history includes high blood pressure treated with lercanidipine for 2 years and a drop treated with allopurinol for 1 year. What diagnosis do you mention? ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Pemphigus vulgaris","justification":"The picture is typical. It is a differential diagnosis of autoimmune bullous dermatoses."},{"idx":1,"correct":false,"proposition":"Bullous pemphigoid","justification":""},{"idx":2,"correct":false,"proposition":"Syndrome de Stevens-Johnson","justification":""},{"idx":3,"correct":false,"proposition":"Erythema multiforme","justification":""},{"idx":4,"correct":false,"proposition":"Fixed pigmented erythema","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-8","enonce":"You see a 65-year-old man in consultation with isolated dyspnea of stage II of the mMRC classification. He is diabetic treated with metformin. He is also treated for hypertension with an angiotensin II antagonist. He has a smoking evaluated at 20 packs-year stopped 10 years ago. No other environmental and occupational exposures are known. The clinical examination finds crackling at both bases on auscultation. The rest of the exam is normal. The blood ionogram is normal. Complete blood counts are normal. The autoimmune balance is normal. You have a chest CT scan and pulmonary function tests (joints). Among the following proposals, which diagnosis do you think is the most likely?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Emphysema"},{"idx":1,"correct":true,"proposition":"Idiopathic pulmonary fibrosis","justification":"Cross-linking at the bases is very suggestive of this diagnosis."},{"idx":2,"correct":false,"proposition":"Heart failure"},{"idx":3,"correct":false,"proposition":"Cystic fibrosis"},{"idx":4,"correct":false,"proposition":"Drug pneumonitis"}],"type":"qi"}
{"_id":"annales-2018-qi-9","enonce":"A 35-year-old woman has been presenting for a week with fever at 38.5 ° C, arthralgia of the knees and ankles and a rash on the legs (photo). Which of the following proposals, which diagnosis(s) do you retain?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Erythema multiforme","justification":""},{"idx":1,"correct":false,"proposition":"Ersipelas","justification":""},{"idx":2,"correct":true,"proposition":"Erythema nodosum","justification":"This is the typical photo of erythema nodosum"},{"idx":3,"correct":false,"proposition":"Fixed pigmented erythema","justification":""},{"idx":4,"correct":false,"proposition":"Rheumatoid purpura","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-10","enonce":"A 17-year-old girl consults for painful lesions of the labial commissures appeared 2 weeks before, which do not heal under topical corticosteroids. The rest of the exam is normal. Which of the following is the most likely diagnosis?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Candidiasis","justification":""},{"idx":1,"correct":false,"proposition":"Herpes","justification":""},{"idx":2,"correct":false,"proposition":"Syphilis","justification":""},{"idx":3,"correct":false,"proposition":"Dermatophytia","justification":""},{"idx":4,"correct":true,"proposition":"Impetigo","justification":"Lesions of crustose, meliceric and perioral appearance (or sitting on the face)."}],"type":"qi"}
{"_id":"annales-2018-qi-11","enonce":"A 55-year-old patient with hyperlymphocytosis at 25 G \/ L without cytopenia is referred to you with a diagnosis of chronic lymphocytic leukemia on lymphocyte immunophenotyping. On clinical examination, the patient is in excellent general condition and there is polyadenopathy 1.5-2 cm in diameter in all lymph node areas. What review is needed at this stage? (only one answer)","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"None","justification":"The diagnosis is made."},{"idx":1,"correct":false,"proposition":"A PET scanner","justification":""},{"idx":2,"correct":false,"proposition":"Echocardiography","justification":""},{"idx":3,"correct":false,"proposition":"A myelogram","justification":""},{"idx":4,"correct":false,"proposition":"A bone scan","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-12","enonce":"A 25-year-old man consults you because of abdominal pain. The examination is normal apart from a palpable spleen at the end of inspiration. The blood count shows: leukocytes 14 G\/L, PNN 8 G\/L, myelocytes 1 G\/L, metamyelocytes 1 G\/L, monocytes 1 G\/L, lymphocytes 3 G\/L and platelets 510 G\/L. You suspect chronic myeloid leukemia. What biological tests do you prescribe to confirm your diagnostic hypothesis? (one or more possible answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Leukocyte immunophenotyping on blood","justification":""},{"idx":1,"correct":false,"proposition":"Search for Jolly's body with a smear","justification":""},{"idx":2,"correct":true,"proposition":"Search for the BCR-ABL transcript","justification":"We think of an CML"},{"idx":3,"correct":false,"proposition":"Gumprecht's search for shadows","justification":""},{"idx":4,"correct":false,"proposition":"Search for a JAK2 mutation","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-13","enonce":"Which of the following statements about weakening osteopathy is?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Primary hyperparathyroidism preferentially affects the cortical bone","justification":""},{"idx":1,"correct":false,"proposition":"Treatment of hypothyroidism increases the risk of osteoporotic fracture","justification":""},{"idx":2,"correct":false,"proposition":"Cortisonic osteoporosis mainly affects the cortical bone","justification":"Trabecular bone"},{"idx":3,"correct":true,"proposition":"Estrogen deficiency is responsible for osteoclastic hyperactivity","justification":""},{"idx":4,"correct":false,"proposition":"Treatment with bisphosphonate increases osteoblast activity","justification":"Only teriparatide (FORSTEO) has this effect. It is indicated in case of two vertebral fractures."}],"type":"qi"}
{"_id":"annales-2018-qi-14","enonce":"A 50-year-old woman arrives at the emergency room for discomfort. She has no particular history but describes fatigue that quickly appeared. The clinical examination is normal apart from a conjunctival subictera. The blood count shows hemoglobin 90 g\/L, red blood cells 2.7 T\/L, hematocrit 27%, MCV 102 fL, MCHC 33 g\/dL, leukocytes 8 G\/L, neutrophils 5 G\/L, lymphocytes 2.3 G\/L, monocytes 0.7 G\/L. Which biological tests do you think are relevant to prescribe as a first-line treatment? (one or more possible answers)","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"C-reactive protein (CRP)"},{"idx":1,"correct":false,"proposition":"Serum iron"},{"idx":2,"correct":false,"proposition":"Serum protein electrophoresis","justification":""},{"idx":3,"correct":true,"proposition":"Reticulocytes","justification":"Hemolytic anemia is being tested."},{"idx":4,"correct":true,"proposition":"LDH"}],"type":"qi"}
{"_id":"annales-2018-qi-16","enonce":"Which of the following infectious diseases is(are) reportable in France?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Rubella"},{"idx":1,"correct":true,"proposition":"Plague"},{"idx":2,"correct":true,"proposition":"Tuberculosis"},{"idx":3,"correct":true,"proposition":"Legionellosis"},{"idx":4,"correct":false,"proposition":"Invasive pneumococcal disease"}],"type":"qi"}
{"_id":"annales-2018-qi-18","enonce":"A 62-year-old man with no medical history has a spontaneous deep hematoma of the psoas muscle. The CBC shows hemoglobin at 90 g\/L and platelets at 170 G\/L. Its hemostasis assessment is as follows: TCA ratio at 2, 1, TP at 78% and fibrinogen at 3.1g \/ L. Mixing the patient's plasma with normal plasma does not correct the TCA (Rosner index of 28 for a normal < 15). The determination of endogenous pathway factors reveals a factor VIII at 4%. What hypothesis(s) do you retain? (one or more possible answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"The presence of a lupus-type anticoagulant","justification":"Factor VIII is decreased"},{"idx":1,"correct":false,"proposition":"Constitutional hemophilia A","justification":"The addition of plasma did not correct it"},{"idx":2,"correct":true,"proposition":"The presence of an anti-factor VIII antibody","justification":""},{"idx":3,"correct":false,"proposition":"Willebrand disease type 1","justification":"The rate <10% is too low for a type 1"},{"idx":4,"correct":false,"proposition":"Acquired hemophilia B","justification":"Refers to factor IX and not factor VIII"}],"type":"qi"}
{"_id":"annales-2018-qi-19","enonce":"A patient is brought unconscious by firefighters to the emergency room following a road accident. She has a polytrauma for which a brain and thoraco-abdomino-pelvic CT scan are urgently performed. She has a fractured spleen that requires surgery. When she arrives, her husband tells you that she is about 8 weeks pregnant with amenorrhea. The radiation dose received is 10 mGy. What risk(s) is (are) related to the accident and the care?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Developmental delay","justification":""},{"idx":1,"correct":false,"proposition":"Brain malformation","justification":""},{"idx":2,"correct":true,"proposition":"Abortion","justification":"Law of all or laughs)"},{"idx":3,"correct":false,"proposition":"Stunting","justification":""},{"idx":4,"correct":false,"proposition":"Retroplacental hematoma","justification":"In the third quarter"}],"type":"qi"}
{"_id":"annales-2018-qi-20","enonce":"A patient comes to your office for a preconception consultation. She is 32 years old, nulligeste. She has been followed for a year for well-balanced high blood pressure on perindopril, one tablet a day. She has estrogen-progestin contraception, which she plans to stop at the end of her platelet. She weighs 81 kg for a height of 1 m 68. She consumes 5 cigarettes a day but would like to quit. What do you foresee at the end of the consultation? (One or more correct answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Rubella serology","justification":""},{"idx":1,"correct":true,"proposition":"Smoking cessation aid by nicotine replacement therapy","justification":""},{"idx":2,"correct":false,"proposition":"Cervico-uterine smear if it is more than one year old","justification":"3 years (5 years for HPV test)"},{"idx":3,"correct":true,"proposition":"Prescription of folate at a dose of 5 mg\/day","justification":"Obesity makes us tick this dosage"},{"idx":4,"correct":true,"proposition":"Discontinuation of perindopril treatment and switching to another antihypertensive drug","justification":"ACE\/ARA2\/Diuretics are contraindicated"}],"type":"qi"}
{"_id":"annales-2018-qi-21","enonce":"A 28-year-old woman consults for palpation of swelling in the upper outer quadrant of the right breast. She is worried because her mother and maternal aunt had breast cancer at 55 and 60 respectively. On clinical examination, you palpate a round and regular swelling of 15 mm, not adherent to the deep and superficial planes. There is no inflammation or skin retraction in the regard. No suspicious lymphadenopathy is palpated in the axillary and supraclavicular lymph node areas. Which exam(s) should be requested as a first intention?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"A breast ultrasound","justification":""},{"idx":1,"correct":false,"proposition":"A chest x-ray","justification":""},{"idx":2,"correct":false,"proposition":"A dosage of CA 15-3","justification":""},{"idx":3,"correct":false,"proposition":"A breast MRI","justification":""},{"idx":4,"correct":false,"proposition":"A mammogram","justification":"The breasts are too dense before the age of 30, so an ultrasound is done."}],"type":"qi"}
{"_id":"annales-2018-qi-22","enonce":"A 38-year-old woman consults 3 months after her third delivery for a contraceptive request. She had a caesarean section after her first two deliveries were vaginal. She has just stopped breastfeeding her child because she has to resume her professional activity. In her history, she reports uterine perforation during the insertion of an intrauterine device 7 years ago, phlebitis under plaster 10 years ago and cervical laser treatment 4 years ago for cervical dysplasia related to human papillomavirus infection. She does not smoke but << vape >> from time to time. The last cervical smear, performed in early pregnancy, was normal. What contraceptive method(s) is (are) conceivable for this woman?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Levonorgestrel intrauterine device","justification":""},{"idx":1,"correct":true,"proposition":"Copper intrauterine device","justification":""},{"idx":2,"correct":false,"proposition":"Transdermal patch releasing norelgestromin and ethinyl estradiol","justification":"She has a history of DVT"},{"idx":3,"correct":true,"proposition":"Tubal sterilization by laparoscopy","justification":""},{"idx":4,"correct":true,"proposition":"Subcutaneous device releasing etonogestrel","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-23","enonce":"Faced with a suspicion of metallic intraocular foreign body, which examination(s) do you propose urgently?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"An orbital scanner","justification":"The reference exam."},{"idx":1,"correct":false,"proposition":"An MRI","justification":""},{"idx":2,"correct":false,"proposition":"An X-ray of the orbit","justification":"We can't really see anything 🤷 ♂️"},{"idx":3,"correct":false,"proposition":"Fluorescein angiography","justification":""},{"idx":4,"correct":false,"proposition":"A measurement of intraocular pressure","justification":"This is contraindicated: by pressing, we increase the IOP, which is dangerous."}],"type":"qi"}
{"_id":"annales-2018-qi-24","enonce":"What is the exact proposal(s) concerning voluntary termination of pregnancy (IVG) in France?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"A woman under guardianship can request an abortion","justification":""},{"idx":1,"correct":true,"proposition":"A woman can request complete anonymity for the performance of an abortion","justification":""},{"idx":2,"correct":false,"proposition":"IUD placement is contraindicated in the immediate aftermath of a surgical abortion","justification":""},{"idx":3,"correct":false,"proposition":"Prostaglandins cannot be used in cases of hereditary porphyria","justification":"Is it for anti-progesterone:)"},{"idx":4,"correct":false,"proposition":"A psychosocial interview must be systematically carried out before the abortion is carried out","justification":"Only in minors. It is always proposed"}],"type":"qi"}
{"_id":"annales-2018-qi-25","enonce":"A chalazion :","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Is an infection of a pilosebaceous follicle of the eyelids","justification":"Inflammation"},{"idx":1,"correct":true,"proposition":"Is a resorption granuloma of a meibomian gland of the eyelids","justification":""},{"idx":2,"correct":true,"proposition":"Treated with corticosteroid ointment","justification":""},{"idx":3,"correct":false,"proposition":"Treated with systemic antibiotics","justification":"Stye (local route)"},{"idx":4,"correct":true,"proposition":"May require a surgical incision","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-26","enonce":"What are the possible etiologies of decreased visual acuity associated with eye redness (several exact responses)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Acute glaucoma crisis due to angle closure","justification":""},{"idx":1,"correct":true,"proposition":"Anterior uveitis","justification":""},{"idx":2,"correct":false,"proposition":"Central retinal artery occlusion","justification":""},{"idx":3,"correct":true,"proposition":"Neovascular glaucoma","justification":""},{"idx":4,"correct":false,"proposition":"Retinal vasculitis","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-27","enonce":"In case of myopia (one or more exact answers):","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":" The optical system formed by the eye is too convergent","justification":""},{"idx":1,"correct":false,"proposition":"Distance vision is better than near vision without correction","justification":"The opposite:)"},{"idx":2,"correct":true,"proposition":"Light rays focus in front of the retina","justification":""},{"idx":3,"correct":true,"proposition":"A divergent lens can be used for correction","justification":"Lowers the refractive power that is too strong in myopia (and glass convergent for hyperopia)"},{"idx":4,"correct":true,"proposition":"The risk of retinal detachment may be increased","justification":"As well as chronic glaucoma"}],"type":"qi"}
{"_id":"annales-2018-qi-28","enonce":"A 75-year-old patient has had left knee pain for several months. During interrogation, these pains are also present at night. The patient gets up 3 times a night to urinate. On clinical examination, the knee appears enlarged in volume compared to the opposite side. There is amyotrophy of the left thigh. Simple X-rays were performed regaining an osteolytic appearance. The patient brings you a TOM and an MRI of the left knee. What is the real proposal(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"A secondary localization of prostate origin typically has an osteolytic appearance on the X-ray and CT scan.","justification":"Osteocondensant in three out of four cases."},{"idx":1,"correct":true,"proposition":"The appearance of the cortical is suggestive of a malignant lesion","justification":""},{"idx":2,"correct":true,"proposition":"There are periosteal appositions","justification":"They are observed on the first scanner, infero-lateral:)"},{"idx":3,"correct":true,"proposition":"There is an invasion of soft parts","justification":""},{"idx":4,"correct":false,"proposition":"On the bone level, this lesion remains confined to the metaphysis","justification":"It extends everywhere"}],"type":"qi"}
{"_id":"annales-2018-qi-29","enonce":"You take care of an 83-year-old patient, well surrounded, on Day 2 of a knee replacement. The Redon drains were removed without problems. She has a knee increased in volume, very edematous and inflammatory. The scar is beautiful, non-inflammatory. What is the exact proposal(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Outpatient care is possible","justification":""},{"idx":1,"correct":true,"proposition":"The electrotherapy techniques practiced by the physiotherapist will aim to reduce edema","justification":"We are sceptical about this proposal. There is nothing on the new colleges, so we can forget 🙃 about it"},{"idx":2,"correct":true,"proposition":"The prescription of English cane could be made by the liberal physiotherapist after discharge from the hospital","justification":""},{"idx":3,"correct":false,"proposition":"Your physiotherapy prescription must mention the physiotherapy techniques to be used.","justification":""},{"idx":4,"correct":false,"proposition":"The adaptation of the home must be done after writing a file with the MDPH","justification":"The application will have to be made to the General Council to obtain an APA"}],"type":"qi"}
{"_id":"annales-2018-qi-30","enonce":"You are taking care of a 32-year-old patient, computer scientist, whose smoking is estimated at 15 packs \/ year, without medical or surgical history, victim of a road accident responsible for a severe spinal cord injury by cervical fracture C5 osteosynthesizer anterior on April 30, 2018. As weaning from mechanical ventilation was difficult, he was tracheostomized on May 21, 2018 after orotracheal intubation. Weaning was then carried out on May 29. When he arrived, he was eupneic. He has a right trochanter eschar, stage 4 with a loss of substance to the bone. The background of the eschar is fibrinous, and purulent secretions are very abundant without inflammatory skin signs. What is the exact proposal(s):","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Tracheal stenosis is a complication of prolonged orotracheal intubation","justification":""},{"idx":1,"correct":false,"proposition":"You prefer for the treatment of this pressure ulcer a combination of local antiseptics and dry dressings.","justification":"No antiseptic"},{"idx":2,"correct":false,"proposition":"The presence of this pressure ulcer contraindicates wheelchair placement","justification":"Not at all, it is necessary to mobilize the patient to avoid the development of a new pressure ulcer."},{"idx":3,"correct":false,"proposition":"The lesion being of spinal cord level C6 you expect anesthesia from the lateral edge of the forearm in anatomical position","justification":"C6 is healthy:)"},{"idx":4,"correct":true,"proposition":"The request for long-term illness can be made by the attending physician","justification":"It is even he who does it most of the time"}],"type":"qi"}
{"_id":"annales-2018-qi-31","enonce":"A 70-year-old patient falls down the stairs. He has trauma to his right ankle. In view of the following X-rays, which are the true proposition(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"The lateral collateral ligament is probably ruptured","justification":"The mechanism is in eversion so it is the medial that breaks"},{"idx":1,"correct":true,"proposition":"Tibio-tal ratios are normal","justification":""},{"idx":2,"correct":false,"proposition":"The distal tibio-fibular ligament is probably intact","justification":""},{"idx":3,"correct":true,"proposition":"There is a suprasyndesmotic fracture of the malleola. Side","justification":""},{"idx":4,"correct":true,"proposition":"There is a risk of major skin pain on the medial side of the ankle","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-32","enonce":"You prescribe a series knee articulated orthosis to one of your patients with a knee sprain. Check the correct prescription principle(s) for this type of medical device. ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"It is prescribed on a simple prescription","justification":""},{"idx":1,"correct":false,"proposition":"It is prescribed on a large apparatus form","justification":"It's a small ;)"},{"idx":2,"correct":false,"proposition":"It is refunded at 100% of its purchase price","justification":"65%"},{"idx":2,"correct":true,"proposition":"All specialists can prescribe it","justification":""},{"idx":2,"correct":false,"proposition":"Physiotherapists can prescribe it","justification":"It is articulated so no"}],"type":"qi"}
{"_id":"annales-2018-qi-33","enonce":"Regarding carpal tunnel syndrome, which is (are) the true proposition(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"It is most often idiopathic","justification":""},{"idx":1,"correct":true,"proposition":"It is more common during pregnancy","justification":""},{"idx":2,"correct":false,"proposition":"The electromyogram is essential for diagnosis","justification":""},{"idx":3,"correct":false,"proposition":"It can cause a deficit of the long flexor of the thumb","justification":"This is the short flexor"},{"idx":4,"correct":false,"proposition":"It may lead to an abolition of the pen-radial reflex","justification":"Radial pen = C6 = radial nerve"}],"type":"qi"}
{"_id":"annales-2018-qi-35","enonce":"You examine an ankle. Which characteristic(s) related to the anatomical structure pointed out is (are) correct?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"This is the tendon of the extensor muscle of the toes","justification":""},{"idx":1,"correct":false,"proposition":"This is the tendon of the fibular muscle","justification":""},{"idx":2,"correct":true,"proposition":"This is the tendon of the anterior tibial muscle","justification":""},{"idx":3,"correct":true,"proposition":"The corresponding muscle is innervated by the deep fibular nerve","justification":"Like all muscles of the anterior compartment of the leg"},{"idx":4,"correct":true,"proposition":"The corresponding muscle is innervated by the roots L4 and L5","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-36","enonce":"A young patient of 34 years comes to consult you for inflammatory low back pain that has appeared for 6 months. You suspect spondyloarthritis and have prescribed an MRI of the sacroiliac joints. What is (are) the exact proposal(s) regarding the MRI it brings you?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"This is a T1-weighted sequence","justification":""},{"idx":1,"correct":true,"proposition":"There is a saturation of the fat signal","justification":"T2 FAT-SAT"},{"idx":2,"correct":true,"proposition":"There is bilateral sacroiliitis","justification":""},{"idx":3,"correct":false,"proposition":"There is MODIC1 type L5-S1 disc disease","justification":"This classification is for disk degeneration"},{"idx":4,"correct":true,"proposition":"This is a coronal plan","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-38","enonce":"A 30-year-old patient arrives at the emergency room because he has just hurt his finger very much by grabbing the jersey of another player during a rugby 🏉 match. What is (are) the exact proposal(s) concerning the radiography of the hand that you have performed?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"We visualize a fracture of the base of the thumb","justification":""},{"idx":1,"correct":false,"proposition":"We visualize a fracture of a metacarpal","justification":""},{"idx":2,"correct":true,"proposition":"We visualize a phalanx fracture","justification":""},{"idx":3,"correct":true,"proposition":"Traumatic injury is the tearing of a long flexor tendon","justification":""},{"idx":4,"correct":false,"proposition":"Interphalangeal dislocation is seen","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-39","enonce":"In case of paralysis of the oculomotor nerve (III), you may encounter on examination: ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"A defect in elevation of the eye","justification":""},{"idx":1,"correct":false,"proposition":"A miosis","justification":"Mydriasis"},{"idx":2,"correct":true,"proposition":"A defect of adduction of the eye","justification":"Internal rectus muscle is innervated by the III"},{"idx":3,"correct":false,"proposition":"Exophthalmos","justification":"The ptosis will give a false enophtalmos rather"},{"idx":4,"correct":true,"proposition":"A ptosis","justification":"The eyelid levator"}],"type":"qi"}
{"_id":"annales-2018-qi-40","enonce":"A 62-year-old patient has a history of essential hypertension treated as monotherapy for 2 years and active smoking (45 packs-year). For about two weeks, he has been complaining of daily headaches that settle willingly in the second part of the night. At first, they gradually faded during the morning. For about 3 days, they have been constant. These headaches are described as diffuse in helmets, fluctuate in intensity, are accentuated by physical activity. He also complains of inappetence and nausea that are also gradually evolving. The patient is apyretic. What syndrome do you evoke in front of this painting?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Migraine sickness","justification":""},{"idx":1,"correct":false,"proposition":"Daily chronic headaches","justification":""},{"idx":2,"correct":false,"proposition":"Meningeal syndrome of infectious origin","justification":""},{"idx":3,"correct":true,"proposition":"Intracranial hypertension","justification":"This is the typical picture"},{"idx":4,"correct":false,"proposition":"Meningeal syndrome related to subarachnoid hemorrhage (SAH)","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-41","enonce":"A 59-year-old patient saw a tremor in the last three fingers of his right hand that his entourage also noticed when walking. It swings the upper right limb less to walking. On examination, you notice that the tremor disappears with outstretched arms. You perceive that passive mobilization of the right elbow is more difficult and mobilization of the right shoulder is painful. Osteotendinous reflexes are normal. This type of tremor is probably aggravated by what? ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Emotion","justification":"Stress increases it"},{"idx":1,"correct":true,"proposition":"Mental arithmetic","justification":""},{"idx":2,"correct":false,"proposition":"Writing","justification":""},{"idx":3,"correct":false,"proposition":"The movement","justification":""},{"idx":4,"correct":false,"proposition":"Sleep","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-42","enonce":"Which of the following applies(s) to a central neurological bladder?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Spinal cord injury above the sacral centers","justification":""},{"idx":1,"correct":false,"proposition":"Detrusor hypoactivity","justification":"Acute urine retention is observed in peripheral disorders"},{"idx":2,"correct":true,"proposition":"Incontinence","justification":"No vesicosphincter dyssinergeria"},{"idx":3,"correct":true,"proposition":"Risk of ureterobesical reflux","justification":""},{"idx":4,"correct":false,"proposition":"Low intravesical pressures","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-44","enonce":"Which of the following biological signs points you to iatrogenic adrenal insufficiency in a 38-year-old patient with a history of Crohn's disease treated for 5 years with 10 mg\/Day prednisone?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Natrimia at 128 mmol\/L","justification":""},{"idx":1,"correct":false,"proposition":"Kaliemia at 5.8 mmol\/L","justification":""},{"idx":2,"correct":true,"proposition":"Fasting blood glucose at 3 mmol\/L","justification":""},{"idx":3,"correct":false,"proposition":"Plasma ACTH at 8 hours at 585 pg\/ml (N: 10 - 20)","justification":""},{"idx":4,"correct":false,"proposition":"Urinary free cortisol at 25 μg\/24 hours (N: < 90)","justification":"It is used for hypercortiscime, and not for hypo (because there is no lower threshold) ☺️"}],"type":"qi"}
{"_id":"annales-2018-qi-45","enonce":"You see a 15-day-old newborn who has an isolated fever at 38.2 ° C and a general condition preserved: ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"You reassure parents about the benign nature of this fever during viral epidemics","justification":"Its age makes it possible to consider the hypothesis of a late bacterial neonatal infection."},{"idx":1,"correct":false,"proposition":"The flu test is not informative at this age","justification":"It is quite informative"},{"idx":2,"correct":true,"proposition":"The urine strip is not informative at this age","justification":""},{"idx":3,"correct":true,"proposition":"Cytobacteriological examination of urine is systematic","justification":""},{"idx":4,"correct":true,"proposition":"The realization of a lumbar puncture is systematic","justification":"He has 15 days he 👉 has the right to a complete check-up and hospital supervision"}],"type":"qi"}
{"_id":"annales-2018-qi-46","enonce":"The lesions in the photo below should evoke (only one expected response) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Polygenic hypercholesterolemia","justification":""},{"idx":1,"correct":false,"proposition":"Familial combined hyperlipidemia","justification":""},{"idx":2,"correct":true,"proposition":"Homozygous familial hypercholesterolemia","justification":"Tendon xanthomas -> problem of significant LDL -> homozygous familial hypercholesterolemia"},{"idx":3,"correct":false,"proposition":"Dysbetalipoproteinemia","justification":""},{"idx":4,"correct":false,"proposition":"A syndrome of familial hyperchylomicronemia","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-47","enonce":"A 4-year-old efant presents to the emergency room for painful lameness without fever. What is the exact proposal(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Presence of a lump of butter fracture","justification":""},{"idx":1,"correct":false,"proposition":"Presence of a green wood fracture","justification":"No break in continuity"},{"idx":2,"correct":false,"proposition":"Presence of a hair fracture","justification":""},{"idx":3,"correct":true,"proposition":"Presence of traumatic curve","justification":"Fibula"},{"idx":4,"correct":false,"proposition":"Presence of a Salter II","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-48","enonce":"In front of a lesion of the tongue, which is (are) the clinical sign(s) that will orient (steer) towards a malignant origin?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Indurated injury","justification":""},{"idx":1,"correct":false,"proposition":"Painful lesion","justification":"Pain does not point to one cause over another"},{"idx":2,"correct":true,"proposition":"Bleeding on contact when palpating the lesion","justification":""},{"idx":3,"correct":true,"proposition":"Submucosal induration","justification":""},{"idx":4,"correct":true,"proposition":"Presence of associated leukoplakia","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-49","enonce":"You intervene at the home of an infant found dead by his parents a few minutes ago: ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"You ask to be accompanied by the police","justification":""},{"idx":1,"correct":false,"proposition":"You do not have to sign the death certificate before admission to the hospital","justification":""},{"idx":2,"correct":false,"proposition":"You write a report to the Public Prosecutor","justification":""},{"idx":3,"correct":true,"proposition":"You propose to the parents to perform an autopsy in search of the causes of death","justification":""},{"idx":4,"correct":false,"proposition":"The transfer of the body must be done to a forensic institute","justification":"Emergency College: 'It is recommended that the medical first responders or the regulation of Centre 15 contact an MIN reference centre as soon as possible in order to organise the immediate transfer of the child to this structure' (and not a forensic institute)"}],"type":"qi"}
{"_id":"annales-2018-qi-50","enonce":"You explain to young parents whose child has a first febrile episode the measure(s) to take during this episode: ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Drug treatment is required for temperatures above 39°C","justification":"No drug is introduced on a temperature value"},{"idx":1,"correct":false,"proposition":"Drinking is necessary every hour as long as the fever persists","justification":"It is necessary for the goodwill of the child"},{"idx":2,"correct":false,"proposition":"Cool wraps should be used if the child is uncomfortable","justification":""},{"idx":3,"correct":true,"proposition":"The use of ibuprofen is possible only after 3 months","justification":""},{"idx":4,"correct":false,"proposition":"Keep the child out of the community for the duration of the fever","justification":"There is no such recommendation"}],"type":"qi"}
{"_id":"annales-2018-qi-51","enonce":"Regarding cervical swelling, which proposal(s) is (are)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"A cyst of the thyroglossal tract is mobile to swallowing","justification":""},{"idx":1,"correct":false,"proposition":"Right supraclavicular lymphadenopathy may be indicative of genitourinary cancer","justification":"Left (third ganglion)"},{"idx":2,"correct":true,"proposition":"Superficial renitent swelling localized to the anterior edge of the sternocleidomastoid muscle is suggestive of an amygdaloid cyst","justification":""},{"idx":3,"correct":false,"proposition":"Brachial plexus schwannoma is a differential diagnosis of submandibular lymphadenopathy","justification":"The mandible and arm are relatively far from each other ☺️"},{"idx":4,"correct":true,"proposition":"Accessory nerve schwannoma is a differential diagnosis of spinal lymphadenopathy","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-52","enonce":"Regarding the peritonsillar phlegmon, which is (are) the exact item(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"The abscess is localized at the level of the lateropharyngeal space","justification":""},{"idx":1,"correct":true,"proposition":"There may exist trismus","justification":"The retrostylian gives a torticollis:)"},{"idx":2,"correct":true,"proposition":"The anterior pillar of the palace veil is enlarged","justification":""},{"idx":3,"correct":false,"proposition":"In adults, hospitalization is systematic","justification":""},{"idx":4,"correct":false,"proposition":"The drainage of the abscess is done either by puncture or by no incision under general anesthesia","justification":"Not under GA;) It is done in two seconds in the emergency room, under AL"}],"type":"qi"}
{"_id":"annales-2018-qi-53","enonce":"Regarding benign paroxysmal positional vertigo, what is(are) the exact item(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":" It lasts less than one minute","justification":""},{"idx":1,"correct":false,"proposition":"It follows vestibular ischemia","justification":"lithiasis of one of the ciruclair ducts"},{"idx":2,"correct":true,"proposition":"It is treated with vestibular physiotherapy","justification":""},{"idx":3,"correct":false,"proposition":"It is associated with tinnitus","justification":"no appendix signs (no hearing loss, no nausea, ...)"},{"idx":4,"correct":true,"proposition":"There is a triggering positional factor","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-55","enonce":"A 62-year-old patient has hyponatremia of progressive onset. It appears clinically euvolemic. His blood test is as follows: Na 125 mmol\/L - K 4 mmol\/L - chlorine 110 mmol\/L - HCO3- 25 mmol\/L - blood glucose 5 mmol\/L - protein 67 g\/L - urea 4 mmol\/L and serum creatinine 78 μmol\/L. Urine balance: Na 100 mmol\/L - K 25 mmol\/L - urea 350 mmol\/L and creatinine 8 mmol\/L. What is(are) the possible cause(s) of this biological table? (one or more correct answers)","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"SIADH","justification":"Plasma hyposmolarity, euvolemic patient and urinary hyperosmolarity make the diagnosis"},{"idx":1,"correct":false,"proposition":"Tea and toast syndrome","justification":""},{"idx":2,"correct":false,"proposition":"Furosemide","justification":""},{"idx":3,"correct":false,"proposition":"Amlodipine","justification":""},{"idx":4,"correct":false,"proposition":"Lithium","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-56","enonce":"An 86-year-old patient is hospitalized for hematemesis. It is known to have viral hepatitis B, not followed. His family describes a bloody vomiting equivalent in volume to that of a basin. On examination, he presents ascites and asterixis. Systolic blood pressure is 55 mmHg. Which of the following is associated with a poor prognosis? ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Age","justification":""},{"idx":1,"correct":false,"proposition":"Hematemesis volume","justification":"This is not a factor of poor prognosis because the estimate is not reliable"},{"idx":2,"correct":true,"proposition":"Blood pressure","justification":""},{"idx":3,"correct":true,"proposition":"Hepatic encephalopathy","justification":""},{"idx":4,"correct":true,"proposition":"Ascites","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-57","enonce":"A 62-year-old patient has the following laboratory work: Na 142 mmol\/L - K 5.7 mmol\/L - chlorine 110 mmol\/L - HCO3- 18 mmol\/L - protein 88 g\/L - urea 20 mmol\/L - serum creatinine 170 μmol\/L. Which drug(s) can (can) give this biological table? (one or more correct answers)","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Ibuprofen ","justification":""},{"idx":1,"correct":true,"proposition":"Candesartan","justification":""},{"idx":2,"correct":true,"proposition":"Amiloride","justification":""},{"idx":3,"correct":false,"proposition":"Amlodipine","justification":"It does not act on the kidney"},{"idx":4,"correct":false,"proposition":"Prednisone","justification":"We would then find hypokalemia (by aldosterone-like effect on mineralocorticoid receptors)."}],"type":"qi"}
{"_id":"annales-2018-qi-58","enonce":"You take care of a 67-year-old patient in the emergency room whose reason for entry is right calf pain. The interrogation and clinical examination find a progressive cancer during treatment and a localized tenderness along the right deep venous network. The rest of the exam is unremarkable. You use a simplified clinical prediction model of deep vein thrombosis (DVT) that indicates a DVT probability of 17%. You ask for a venous Doppler ultrasound of the lower limbs to confirm this suspicion of DVT. Which of the following is correct:","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Post-test likelihood of DVT depends on the sensitivity of venous Doppler ultrasound","justification":""},{"idx":1,"correct":false,"proposition":"The pre-test probability of DVT depends on the specificity of venous Doppler ultrasound","justification":""},{"idx":2,"correct":true,"proposition":"Post-DVT probability depends on venous Doppler ultrasound likelihood ratio","justification":""},{"idx":3,"correct":true,"proposition":"Post-test probability of DVT depends on the intrinsic performance of venous Doppler ultrasound","justification":""},{"idx":4,"correct":true,"proposition":"The post-test probability of DVT can be determined graphically using the Fagan nomogram","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-59","enonce":"A 43-year-old patient consults for moderate hyperferritinemia at 2 times the normal discovered on a systematic assessment carried out by occupational medicine. It is asymptomatic. Which element(s) will orient towards metabolic hepatosiderosis?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"High transferrin saturation coefficient","justification":"would lead to hemoichromatosis"},{"idx":1,"correct":true,"proposition":"Overweight","justification":""},{"idx":2,"correct":true,"proposition":"Hypertriglyceridemia","justification":""},{"idx":3,"correct":false,"proposition":"Graves' disease","justification":""},{"idx":4,"correct":false,"proposition":"History of colon cancer","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-60","enonce":"In front of sigmoid diverticulitis, an injected abdominal tomography CT scan is performed. Can it show (one or more exact answers)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Addition images containing air at the anti-mesenteric edge of the colon","justification":""},{"idx":1,"correct":false,"proposition":"Thinning of the colonic wall","justification":""},{"idx":2,"correct":true,"proposition":"An infiltration of fat around a diverticulum","justification":""},{"idx":3,"correct":true,"proposition":"A thickening of the colonic wall","justification":""},{"idx":4,"correct":true,"proposition":"Pylephlebitis","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-61","enonce":"In which situation(s) does a patient benefit from an exemption from co-payment (based on Social Security tariffs)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Care of any minor children","justification":""},{"idx":1,"correct":true,"proposition":"Care, whatever it may be, to subjects benefiting from State Medical Aid (AME)","justification":""},{"idx":2,"correct":false,"proposition":"Care, whatever it is, for pregnant women from the 4th month of pregnancy","justification":"From the sixth month for pregnancy care"},{"idx":3,"correct":true,"proposition":"Performing a mammogram as part of the national screening program","justification":""},{"idx":4,"correct":false,"proposition":"Additional tests performed as part of participation in a clinical trial","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-62","enonce":"A 48-year-old patient has been presenting for a few weeks headaches that lead to the diagnosis of high blood pressure. The average outpatient blood pressure is 177\/92 mmHg. Its biological balance is as follows: Na 142 mmol \/ L, K 3.4 mmol \/ L, Creatinine 70 μmol \/ I, Calcemia 2.5 mmol \/ L. Diuresis of 24 h: 1 400 ml. urinary lonogram: Na 180 mmol\/L, K 50 mmol\/L, proteinuria< 0.01 g\/1. In view of this assessment, what is (are) the cause (s) that you must mention for this high blood pressure?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Renal arterial stenosis","justification":""},{"idx":1,"correct":false,"proposition":"Syndrome de Gitelman","justification":""},{"idx":2,"correct":true,"proposition":"Primary hyperaldosteronism","justification":""},{"idx":3,"correct":true,"proposition":"Chronic licorice consumption","justification":""},{"idx":4,"correct":false,"proposition":"Pheochromocytoma","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-63","enonce":"Which tumor marker is of interest in screening, diagnosis, prognosis and monitoring of the cancer of which it is specific? (1 response expected)","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"ACE","justification":""},{"idx":1,"correct":false,"proposition":"Alpha FP","justification":""},{"idx":2,"correct":false,"proposition":"hCG","justification":""},{"idx":3,"correct":false,"proposition":"CA125","justification":""},{"idx":4,"correct":true,"proposition":"PSA","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-64","enonce":"Under the law of 2 February 2022 known as the Claeys-Leonetti << law>> when a patient can no longer express himself, a treatment that appears useless, disproportionate or when it has no other effect than the sole artificial maintenance of life, may be suspended at the end of a collegial procedure defined by regulation. Which element(s) are (s) provided for in this procedure?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Consultation of advance directives if they exist","justification":""},{"idx":1,"correct":true,"proposition":"The opinion of at least one consultant","justification":""},{"idx":2,"correct":true,"proposition":"A discussion with the healthcare team present","justification":""},{"idx":3,"correct":false,"proposition":"Information from the on-call director if this procedure takes place on weekends","justification":"He is not part of the medical team"},{"idx":4,"correct":true,"proposition":"The decision must be recorded in the medical record","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-65","enonce":"On what means(s) is the assessment of the qualitative dimension of pain based?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Questionnaire DN4","justification":"Only qualitative questionnaire in the list of proposals"},{"idx":1,"correct":false,"proposition":"doloplus questionnaire","justification":""},{"idx":2,"correct":false,"proposition":"Algoplus scale","justification":""},{"idx":3,"correct":false,"proposition":"Analogue visual scale","justification":""},{"idx":4,"correct":false,"proposition":"Digital scale","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-66","enonce":"By what therapeutic means(s) can neuropathic pain be managed as a first line?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"A tricyclic antidepressant"},{"idx":1,"correct":true,"proposition":"An antiepileptic drug of the class Gabapentinoids","justification":""},{"idx":2,"correct":false,"proposition":"Morphine"},{"idx":3,"correct":true,"proposition":"Transcutaneous electrical stimulation","justification":""},{"idx":4,"correct":false,"proposition":"Spinal cord stimulation"}],"type":"qi"}
{"_id":"annales-2018-qi-67","enonce":"A 55-year-old patient is being treated in a palliative care unit for a terminal course of respiratory failure complicating major emphysema. Her main complaint is an increase in her dyspnea. How to manage this dyspnea? (one or more correct answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Assessment of the symptom by a visual analogue scale","justification":""},{"idx":1,"correct":false,"proposition":"Adaptation of oxygen therapy flow rate so that arterial oxygen saturation is greater than 95%","justification":""},{"idx":2,"correct":true,"proposition":"Introduction or increase of opioid therapy","justification":"It is a treatment for dyspnea in palliative care"},{"idx":3,"correct":true,"proposition":"Comfortable patient installation","justification":""},{"idx":4,"correct":false,"proposition":"Deep and continuous sedation from the outset until death","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-68","enonce":"Can obesity surgery such as a longitudinal gastrectomy be proposed (one or more exact answers)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"In adolescents from 15 years of age if their BMI is greater than 40","justification":""},{"idx":1,"correct":true,"proposition":"In a 55-year-old adult, OSA device, with a BMI > 35","justification":""},{"idx":2,"correct":false,"proposition":"in case of severe eating disorder","justification":"This is a contraindication"},{"idx":3,"correct":true,"proposition":"If the subject has understood and accepts post-operative medical and surgical follow-up for life","justification":""},{"idx":4,"correct":true,"proposition":"If the patient has received clear and complete information about the operative risks","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-69","enonce":"A 52-year-old patient with no particular history has high blood pressure, proteinuria of 2g \/ 24 h, hematuria at 105 red blood cells \/ ml with serum creatinine at 130 μmol \/ L. His vesicorenal ultrasound is normal. Here is the report of his renal biopsy: cortical fragment comprising 15 glomeruli including 4 sclerotic glomeruli. The permeable glomeruli exhibit mesangial and endocapillary proliferation. Moderate arteriolosclerosis lesions. Lesions of tubular atrophy and interstitial fibrosis on approximately 20% of the parenchyma. Immunofluorescence finds deposits of IgA to +++ in the mesangium and C3 to 1+ in the vessels and glomeruli. What is (are) the possible diagnosis(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Tubulointerstitial nephropathy","justification":"No leukocyturia, proteinuria > 1g\/24h"},{"idx":1,"correct":false,"proposition":"Lupus nephropathy class IV","justification":""},{"idx":2,"correct":false,"proposition":"Pauciimmune glomerulonephritis","justification":""},{"idx":3,"correct":true,"proposition":"IgA nephropathy","justification":"This is the typical picture"},{"idx":4,"correct":false,"proposition":"Nephroangiosclerosis","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-71","enonce":"As a young general practitioner, you are seeing for the first time a 52-year-old patient who complains of insomnia, anxious ruminations, loss of vital momentum and family and professional disinvestment. He indicates that his symptoms appeared 6 months ago, following the arrival of a new team leader who constantly remarks, about his slow work and lack of intellectual abilities. He even reports insults hurled at him several times, when he was alone with his boss. This patient has no notable medical history, apart from depression reactive to a divorce, 10 years ago. The patient asks you to make a declaration of occupational disease. What do you need to indicate on the initial medical certificate?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"The existence of a depressive syndrome","justification":"'Insomnia, anxious ruminations, loss of vital momentum and family and professional disinvestment'"},{"idx":1,"correct":true,"proposition":"The date you first noticed the pathology","justification":""},{"idx":2,"correct":false,"proposition":"History of depressive syndrome","justification":"Only the medical information that is needed is shared"},{"idx":3,"correct":false,"proposition":"The existence of harassment by a colleague","justification":""},{"idx":4,"correct":false,"proposition":"The name of the head of department","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-72","enonce":"A 12-year-old patient is admitted to the pediatric emergency department with meningeal syndrome. He is installed in an examination room by a nursing assistant and the nurse comes to take his temperature and blood pressure. The intern then comes to examine the child and suspects an invasive meningococcal infection, which will be confirmed by CSF (meningococcal C) analysis. The nurse, aged 30, comes to see the intern saying she is worried because she is pregnant and she wonders what she should do because she took care of the child without a mask and is not vaccinated against meningococcus. What measure(s) should be proposed to it","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Vaccination with meningococcal C conjugate vaccine","justification":""},{"idx":1,"correct":false,"proposition":"Prophylaxis with oral rifampicin for 5 days","justification":""},{"idx":2,"correct":false,"proposition":"Rifampicin prophylaxis per for 2 days","justification":""},{"idx":3,"correct":true,"proposition":"Reassure them that there is no risk of contamination","justification":"It is not contact case because the contact with the child lasted only a few minutes (less than 30-60 minutes)"},{"idx":4,"correct":false,"proposition":"Prophylaxis with ceftriaxone injection","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-74","enonce":"What vaccinations are mandatory for a nurse working in a hospital in a care unit (one or more possible answers)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Pneumococcal vaccination","justification":""},{"idx":1,"correct":true,"proposition":"Vaccination against diphtheria, tetanus and poliomyelitis","justification":""},{"idx":2,"correct":false,"proposition":"Vaccination against hepatitis A","justification":""},{"idx":3,"correct":false,"proposition":"Pertussis vaccination","justification":""},{"idx":4,"correct":true,"proposition":"Vaccination against hepatitis B","justification":"These are the only two mandatory vaccines for caregivers"}],"type":"qi"}
{"_id":"annales-2018-qi-75","enonce":"Regarding acute peritonitis, which proposal(s) do you retain?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"The abdominal CT scan is the reference morphological examination for diagnosis","justification":""},{"idx":1,"correct":true,"proposition":"Surgical treatment should include washing of the peritoneal cavity","justification":""},{"idx":2,"correct":true,"proposition":"The 3 most common causes are appendicitis, peptic ulcer, diverticulum colic","justification":""},{"idx":3,"correct":true,"proposition":"The evolving risk of peritonitis is septic shock","justification":""},{"idx":4,"correct":false,"proposition":"Peritonitis is always linked to digestive perforation","justification":"Not primary peritonitis"}],"type":"qi"}
{"_id":"annales-2018-qi-76","enonce":"Regarding acute bowel obstruction, what is the exact information(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"A functional occlusion may be caused by a hydroelectrolyte disorder","justification":""},{"idx":1,"correct":true,"proposition":"A peritoneal flange can lead to occlusion by strangulation","justification":""},{"idx":2,"correct":true,"proposition":"Strangulation occlusion threatens gut vitality within hours","justification":""},{"idx":3,"correct":true,"proposition":"The abdominal CT scan with contrast injection is the reference exam","justification":""},{"idx":4,"correct":true,"proposition":"Colon cancer is the leading cause of obstruction colonic occlusion","justification":"Fecal impaction is the leading cause of rectal 💩 obstruction"}],"type":"qi"}
{"_id":"annales-2018-qi-77","enonce":"Regarding occlusive syndrome: (one or more exact answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Stopping materials is a physical sign absent in 30% of cases","justification":""},{"idx":1,"correct":false,"proposition":"Abdominal pain is still the initial symptom","justification":""},{"idx":2,"correct":false,"proposition":"The seat of abdominal pain signs the seat of the obstacle","justification":""},{"idx":3,"correct":true,"proposition":"Repeated and frequent vomiting temporarily relieves abdominal pain in small intestine occlusions","justification":""},{"idx":4,"correct":true,"proposition":"The shutdown of the gas is the essential functional sign for diagnosis","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-78","enonce":"Mr. M., 58 years old, is referred to you for anomalies in the martial record. In his history, there is only diabetes diagnosed 3 months ago. On clinical examination, the temperature is 37.3 °C.  You notice hepatomegaly evaluated at 5 cm under the right costal awning. His martial assessment is presented below: Transferrin saturation coefficient (TSC) at 62%, ferritin at 1,200 ng\/ml (normal 30 to 300 mg\/ml). Which of the following proposals could explain the abnormalities of the martial assessment presented in this clinical context?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Inflammatory syndrome","justification":""},{"idx":1,"correct":false,"proposition":"Dysmetabolic hepatosiderosis","justification":""},{"idx":2,"correct":true,"proposition":"Genetic hemochromatosis","justification":"High CSE makes the diagnosis."},{"idx":3,"correct":false,"proposition":"Myelodysplasia","justification":""},{"idx":4,"correct":false,"proposition":"Macrophage activation syndrome","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-79","enonce":"When admitting a polytrauma patient in severe hemorrhagic shock (one or more exact answers):","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"A bodyscan is essential and must be carried out urgently","justification":""},{"idx":1,"correct":true,"proposition":"A fast-echo performed at the patient's bed is enough to affirm hemoperitoneum","justification":""},{"idx":2,"correct":false,"proposition":"An emergency laparotomy is indicated to affirm the abdominal origin of hemorrhagic shock","justification":""},{"idx":3,"correct":true,"proposition":"In case of massive hemoperitoneum, the << damage control technique >> is the reference technique","justification":""},{"idx":4,"correct":false,"proposition":"The <<damage control>> technique aims to control bleeding and at the same time treat digestive lesions","justification":"Only control bleeding to save the patient's life. We will take care of the rest in a second time."}],"type":"qi"}
{"_id":"annales-2018-qi-80","enonce":"Mr. M., 22 years old, consults urgently because of asthenia associated with a fever at 39 ° C evolving for 72 hours. He complains of odynophagia and diffuse myalgia. On clinical examination, you find cervical lymphadenopathy and splenomegaly through the finger. A blood test was performed in the city and shows the following results: Haemoglobin 13.2 g\/dl, MCV 89 fl, platelets 120 G\/L, leukocytes 10.6 G\/L, neutrophils 1.6 G\/L, basophils 0, 1 G\/L, eosinophils 0.4 G\/L, lymphocytes 8 G\/L, monocytes 0.5 G\/L. Blood smear: presence of many large lymphocytes with hyperbasophilic cytoplasm. Which of the following complementary examinations do you think should be carried out as a first-line treatment in this clinical context?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Myelogram"},{"idx":1,"correct":false,"proposition":"Lymphocyte immunophenotyping","justification":""},{"idx":2,"correct":true,"proposition":"Antigenemia p24"},{"idx":3,"correct":true,"proposition":"MNI test"},{"idx":4,"correct":false,"proposition":"Cytomegalovirus (CMV) serology","justification":"Does not give lymphadenopathy or angina (p. 178 of the R2C College of Hematology)"}],"type":"qi"}
{"_id":"annales-2018-qi-82","enonce":"Ms. M., aged 58, is referred to internal medicine for a fever at 38.5 ° C associated with the following rash, present for 3 weeks. She also has paresthesias of the 2 feet. You mention: (one or more exact answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Cryoglobulinemic vasculitis","justification":""},{"idx":1,"correct":false,"proposition":"Immunological thrombocytopenic purpura (ITP)","justification":"Purpura is rather vascular here"},{"idx":2,"correct":true,"proposition":"Microscopic polyangiitis","justification":""},{"idx":3,"correct":false,"proposition":"Giant cell arteritis","justification":"Vasculitis of the large vessels do not give purpura"},{"idx":4,"correct":false,"proposition":"Behçet's disease","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-83","enonce":"About breath in mitral insufficiency, which is (are) the exact proposition(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"It is ejective mesosystolic","justification":""},{"idx":1,"correct":true,"proposition":"It is most often in steam jet","justification":""},{"idx":2,"correct":true,"proposition":"It may be associated with mesodiastolic rolling","justification":""},{"idx":3,"correct":true,"proposition":"It is most often of apexoaxillary site","justification":""},{"idx":4,"correct":false,"proposition":"It radiates to the carotids","justification":"This is the case of the RA"}],"type":"qi"}
{"_id":"annales-2018-qi-84","enonce":"A 42-year-old patient is admitted for chest pain. After interpreting this electrocardiogram, indicate the exact proposal(s): ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"This is acute pericarditis","justification":""},{"idx":1,"correct":true,"proposition":"This is an acute coronary syndrome","justification":""},{"idx":2,"correct":true,"proposition":"There are mirror images","justification":""},{"idx":3,"correct":false,"proposition":"There is a complete left branch block","justification":""},{"idx":4,"correct":false,"proposition":"This is a Wolff-Parkinson-White syndrome","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-85","enonce":"A 62-year-old patient is admitted for lipothymia. After interpreting this electrocardiogram, indicate the exact proposal(s). ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"There is sinus dysfunction","justification":""},{"idx":1,"correct":false,"proposition":"There is an atrioventricular block of the first degree","justification":""},{"idx":2,"correct":true,"proposition":"There is a right branch block","justification":""},{"idx":3,"correct":true,"proposition":"There is a BAV 2 for 1","justification":""},{"idx":4,"correct":false,"proposition":"There is a complete atrioventricular block","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-86","enonce":"In a clinical trial, randomization of the evaluated treatment is intended to be first and foremost:","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Establish comparable groups based on potential confounders","justification":""},{"idx":1,"correct":false,"proposition":"Conclude a difference with a statistical significance level of 5%","justification":""},{"idx":2,"correct":false,"proposition":"Mitigate sampling fluctuations","justification":"Fluctuations are mitigated by increasing the sample size (to approximate the size of the source population)"},{"idx":3,"correct":false,"proposition":"Keep subjects in ignorance of the treatment allocated for the duration of the study","justification":"This is the role of the blind"},{"idx":4,"correct":false,"proposition":"Reduce the number of subjects needed","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-88","enonce":"In the following list of bacterial infections, which bacterial infection(s) is (are) not usually associated with hyperleukocytosis?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Gram-negative liver abscess","justification":""},{"idx":1,"correct":false,"proposition":"Acute pyelonephritis","justification":""},{"idx":2,"correct":true,"proposition":"Typhoid fever","justification":"The third to know is brucellosis 🦠"},{"idx":3,"correct":false,"proposition":"Pneumococcal lung infection","justification":""},{"idx":4,"correct":true,"proposition":"Tuberculosis","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-91","enonce":"In the absence of a statistically significant difference in the primary outcome between the two groups of a prospective randomised placebo-controlled trial, mention should be made of: ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"The risk of statistical error of the second kind (beta)","justification":""},{"idx":1,"correct":true,"proposition":"The lack of effect of the treatment","justification":"Oupsi doupsi"},{"idx":2,"correct":true,"proposition":"A lack of statistical power","justification":"Due to lack of subjects in the study"},{"idx":3,"correct":false,"proposition":"Non-inferiority of the treatment assessed","justification":""},{"idx":4,"correct":false,"proposition":"The risk of statistical error of the first kind (alpha)","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-92","enonce":"The association, at autopsy, of a recent, bilateral and multi-focal subdurai hematoma and bilateral retinal hemorrhages in a 6-month-old baby with no particular history suggests the diagnosis of: (one or more exact answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Sudden infant death syndrome","justification":""},{"idx":1,"correct":true,"proposition":"Shaken baby syndrome","justification":""},{"idx":2,"correct":false,"proposition":"Syndrome de Silverman","justification":""},{"idx":3,"correct":false,"proposition":"Rupture of cerebral arteriovenous malformation","justification":""},{"idx":4,"correct":false,"proposition":"Accidental head injury","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-93","enonce":"The administrative part of the death certificate, electronically or on paper, is transmitted: (one or more correct answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"At the town hall of the place of death","justification":"who issues the burial permit"},{"idx":1,"correct":false,"proposition":"At the National Institute of Health and Medical Research (INSERM)","justification":""},{"idx":2,"correct":true,"proposition":"To the funeral home manager mandated by the family","justification":"to proceed with burial"},{"idx":3,"correct":false,"proposition":"To the public prosecutor","justification":""},{"idx":4,"correct":false,"proposition":"To the family of the deceased","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-94","enonce":"Congenital long QT syndrome is an inherited rhythm disorder of autosomal dominant inheritance that predisposes to sudden death in childhood and can be managed preventively. This pathology is very heterogeneous at the genetic level. What is the exact proposal(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"The genes involved code for ion channels","justification":""},{"idx":1,"correct":false,"proposition":"Long QT syndrome is most often associated with a congenital heart defect","justification":""},{"idx":2,"correct":false,"proposition":"The genetic evaluation of this pathology is done by the study of the karyotype","justification":""},{"idx":3,"correct":true,"proposition":"The diagnosis in an index case must lead to information to the relatives","justification":"through the patient (the doctor cannot contact the relatives himself because of medical confidentiality)"},{"idx":4,"correct":false,"proposition":"Molecular predictive diagnosis is not allowed in minor children in this situation","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-95","enonce":"The drafting of a descriptive medical certificate requires the evaluation of the ITT in the criminal sense of the term. What is the meaning of this acronym?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Total incapacity for work","justification":""},{"idx":1,"correct":false,"proposition":"Temporary total incapacity","justification":""},{"idx":2,"correct":false,"proposition":"Total temporary incapacity","justification":""},{"idx":3,"correct":false,"proposition":"Inability to work fully","justification":""},{"idx":4,"correct":false,"proposition":"Total temporary incapacity","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-97","enonce":"In this family with no particular history, 3 boys were diagnosed with fragile X syndrome (III-3, III-7 and III-11). What is the exact proposal(s)?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Boys III-3, III-7 and III-11 carry a complete mutation in the FMR1 gene","justification":""},{"idx":1,"correct":false,"proposition":"Girl III-2 with mild intellectual disability is likely a heterozygous carrier of a premutation","justification":""},{"idx":2,"correct":true,"proposition":"The III-6 girl has a one in 2 risk of being a heterozygous carrier of a premutation or a complete mutation","justification":""},{"idx":3,"correct":true,"proposition":"Women II-1, II-4, and II-7 have an increased risk of premature ovarian failure","justification":""},{"idx":4,"correct":true,"proposition":"Subject I-2 is a hemizygous carrier of a premutation","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-98","enonce":"The objectives of the forensic care of a victim of sexual violence are: (one or more exact answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Describe traumatic bodily injury","justification":""},{"idx":1,"correct":false,"proposition":"Determine if the person consented at the time of the facts","justification":"😨😨"},{"idx":2,"correct":false,"proposition":"Determine if victim impact statements are credible","justification":""},{"idx":3,"correct":true,"proposition":"Set up multidisciplinary care","justification":""},{"idx":4,"correct":true,"proposition":"Take DNA samples","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-99","enonce":"What are the possible therapeutic strategies for asthma and chronic obstructive pulmonary disease (COPD)? (one or more correct answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Long-term inhaled corticosteroid therapy monotherapy in COPD","justification":""},{"idx":1,"correct":true,"proposition":"Continuous inhaled corticosteroid monotherapy for asthma","justification":""},{"idx":2,"correct":false,"proposition":"Long-acting long-acting beta-2 agonist as monotherapy for asthma","justification":"Every asthmatic should have his inhaled corticosteroid close to him."},{"idx":3,"correct":true,"proposition":"Combination of inhaled corticosteroid and long-acting beta-2 agonist inhaled as background therapy for asthma","justification":""},{"idx":4,"correct":true,"proposition":"Long-acting beta-2 agonist monotherapy in COPD","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-101","enonce":"You receive the result of a blood ionogram showing a serum potassium level of 6 mmol \/ L. What iatrogenic cause(s) can you mention?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Long-term oral corticosteroid therapy","justification":""},{"idx":1,"correct":true,"proposition":"Angiotensin II antagonist","justification":""},{"idx":2,"correct":true,"proposition":"Mineralocorticoid receptor blocker","justification":""},{"idx":3,"correct":true,"proposition":"ACE inhibitor","justification":""},{"idx":4,"correct":false,"proposition":"Loop diuretic","justification":"Hypokalaemic agents"}],"type":"qi"}
{"_id":"annales-2018-qi-102","enonce":"About drug antidotes:","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Protamine sulfate neutralizes the anticoagulant activity of heparin","justification":""},{"idx":1,"correct":true,"proposition":"Naloxone is a specific antagonist of morphinomimetics","justification":""},{"idx":2,"correct":false,"proposition":"Prothrombin factors are the antidote for clopidogrel","justification":"For anticoagulants"},{"idx":3,"correct":false,"proposition":"N-acetyl-cysteine is the antidote to acetylsalicylic acid","justification":"Paracetamol"},{"idx":4,"correct":true,"proposition":"Flumazenil is an antagonist of benzodiazepines and related molecules","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-103","enonce":"A 23-year-old woman is hospitalized in psychiatry for a state of psychomotor arousal evolving for a week, with disinhibition having led to reckless spending and risky sexual behavior. She has not slept for 72 hours but shows no fatigue and undertakes to present herself to each of the patients of the department. If you were to opt for monotherapy, which of these options would seem appropriate to you?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Lithium"},{"idx":1,"correct":false,"proposition":"Valproic acid","justification":"She is a woman of childbearing age"},{"idx":2,"correct":true,"proposition":"Risperidone"},{"idx":3,"correct":false,"proposition":"Carbamazepine"},{"idx":4,"correct":true,"proposition":"Quetiapine"}],"type":"qi"}
{"_id":"annales-2018-qi-104","enonce":"About the decision on medical termination of pregnancy (IMG) (one or more exact answers): ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Any request for IMG must be the subject of an opinion from the Multidisciplinary Center for Prenatal Diagnosis (CPDPN)","justification":""},{"idx":1,"correct":false,"proposition":"There is a list of pathologies for which there is a medical indication for IMG","justification":"No clear list"},{"idx":2,"correct":true,"proposition":"The admissibility of the claim is based on the demonstration of a << high probability of a particularly serious and incurable condition at the time of diagnosis>>","justification":""},{"idx":3,"correct":true,"proposition":"A reflection period should be offered to the pregnant woman between the diagnosis of the condition and the possible realization of the IMG","justification":""},{"idx":4,"correct":true,"proposition":"An IMG can be carried out after consultation with the FNDCP until the end","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-105","enonce":"A 31-year-old woman describes the sudden onset of intense fatigue a month ago accompanied by deep sadness. She addresses a lot of blame, especially not being able to take care of her 2-month-old daughter, is very slow down and often wakes up in the middle of the night. Li then sometimes has suicidal thoughts. Which of the following characteristics can (can) be indicative of bipolar mood disorder?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Female sex","justification":""},{"idx":1,"correct":true,"proposition":"Postpartum context","justification":""},{"idx":2,"correct":true,"proposition":"Melancholic features","justification":""},{"idx":3,"correct":true,"proposition":"Brutal start","justification":""},{"idx":4,"correct":false,"proposition":"Suicidal ideation","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-106","enonce":"Which of the following signs and symptoms is more common in the elderly compared to young adults?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":" Somatic complaints","justification":""},{"idx":1,"correct":false,"proposition":"Feelings of guilt","justification":""},{"idx":2,"correct":false,"proposition":"Self-depreciation","justification":""},{"idx":3,"correct":false,"proposition":"Suicidal ideation","justification":""},{"idx":4,"correct":false,"proposition":"Sexual disorders","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-107","enonce":"Which of the following signs can be a symptom(s) due to withdrawal from an opiate substance?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Constipation","justification":"Opiates make constipation"},{"idx":1,"correct":true,"proposition":"Bilateral mydriasis","justification":""},{"idx":2,"correct":false,"proposition":"Hallucinations","justification":""},{"idx":3,"correct":true,"proposition":"Vomiting","justification":""},{"idx":4,"correct":true,"proposition":"High blood pressure","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-108","enonce":"In front of a patient with a disorder related to alcohol use and opposed to the idea of addictological care, what attitude(s) characterize motivational interviewing?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":" Giving the patient a case for change","justification":""},{"idx":1,"correct":true,"proposition":"Let the patient explain what alcohol brings","justification":""},{"idx":2,"correct":false,"proposition":"Exposing the patient to situations at risk of excessive consumption","justification":""},{"idx":3,"correct":true,"proposition":"Identify the patient's personal reasons for change","justification":""},{"idx":4,"correct":false,"proposition":"Emphasize to the patient the risks associated with alcohol consumption","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-109","enonce":"A 69-year-old patient comes in for an annual visit to his new GP. Clinical examination reveals a pulse rate of 45 beats per minute. Name the drug(s) likely to be involved in this context: ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Selective beta-blocker","justification":""},{"idx":1,"correct":true,"proposition":"Class III antiarrhythmic","justification":""},{"idx":2,"correct":false,"proposition":"Dihydropyridine group calcium channel blocker","justification":"They are not bradycardic, to the contaire of verapamil\/diltiazem"},{"idx":3,"correct":true,"proposition":"Anticholinesterase","justification":""},{"idx":4,"correct":false,"proposition":"Inhaled rapid-acting, short-acting beta-2 mimetic bronchodilator","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-110","enonce":"About trisomy 21 syndrome (one or more exact answers): ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"It most often results from a maternal meiotic accident","justification":""},{"idx":1,"correct":false,"proposition":"When combined with a chromosomal formula 46,XX,der(14,21),+21, it does not require a family survey","justification":""},{"idx":2,"correct":false,"proposition":"Its post-natal diagnosis can be confirmed rapidly by molecular biology","justification":""},{"idx":3,"correct":true,"proposition":"Its risk of recurrence is close to 1\/100 to 1\/200 for a couple who had a first child affected","justification":""},{"idx":4,"correct":false,"proposition":"Its risk is decreased by advanced maternal age at the time of conception","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-111","enonce":"About histological lesions of glomerulopathies (one or more exact answers) ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Diagnosis of minimal glomerular lesions requires electron microscopy examination","justification":"There is no need to go all the way to the MO. We can be satisfied with the normality of the PBR in MO and MF and the clinical context."},{"idx":1,"correct":true,"proposition":"Segmental and focal hyalinosis may be primary in adults","justification":""},{"idx":2,"correct":true,"proposition":"Membranoproliferative glomerulopathy is characterized by double contours of the glomerular basement membrane","justification":""},{"idx":3,"correct":true,"proposition":"Deposits << humps >> are present in acute post-infectious glomerulonephritis","justification":""},{"idx":4,"correct":true,"proposition":"Diabetes can lead to glomerulopathy","justification":"Proteinuria without hematuria with fundus involvement"}],"type":"qi"}
{"_id":"annales-2018-qi-112","enonce":"Histological diagnosis of prostate adenocarcinoma on biopsy mapping (one or more exact responses): ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"Typically requires six biopsy samples","justification":"12"},{"idx":1,"correct":true,"proposition":"May affirm extra-prostatic involvement","justification":""},{"idx":2,"correct":false,"proposition":"Requires biopsy of seminal vesicles","justification":""},{"idx":3,"correct":true,"proposition":"Is specified in his prognosis by Gleason's architectural score","justification":"It's ISUP now:)"},{"idx":4,"correct":false,"proposition":"Is specified in its prognosis by the proliferation index","justification":"Prognosis = ISPU"}],"type":"qi"}
{"_id":"annales-2018-qi-113","enonce":"During surgery, an extemporaneous examination on a tissue sample is requested. The sample must be sent to the pathology laboratory (one or more exact answers)","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"at +4°C","justification":"at room temperature"},{"idx":1,"correct":false,"proposition":"At -20°C"},{"idx":2,"correct":false,"proposition":"Immersed in formalin"},{"idx":3,"correct":true,"proposition":"Without fixing liquid"},{"idx":4,"correct":false,"proposition":"Accompanied by a consent sheet"}],"type":"qi"}
{"_id":"annales-2018-qi-114","enonce":"On a liver biopsy puncture, the diagnosis of acute alcoholic hepatitis (one or more exact answers) is retained ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Neutrophil inflammation","justification":""},{"idx":1,"correct":true,"proposition":"Bloated hepatocytes","justification":""},{"idx":2,"correct":false,"proposition":"Councilman bodies","justification":"Mallory's bodies"},{"idx":3,"correct":false,"proposition":"Cirrhosis","justification":"We are in Acute"},{"idx":4,"correct":false,"proposition":"Cholestasis","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-116","enonce":"Regarding Alzheimer's disease, what statement(s) is(are) correct?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"Diagnosis is often late","justification":""},{"idx":1,"correct":false,"proposition":"This is a secondary dementia","justification":""},{"idx":2,"correct":false,"proposition":"Behavioural disorders often occur early in the illness","justification":""},{"idx":3,"correct":false,"proposition":"Dubois' 5-word test makes it possible to make the diagnosis","justification":""},{"idx":4,"correct":false,"proposition":"It evolves by flare-up leading to iterative hospitalizations","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-117","enonce":"Regarding organ ageing, which is the right proposal(s)? ","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"It is marked by a decrease in maximum capacities","justification":""},{"idx":1,"correct":false,"proposition":"It is mainly due to oxidative stress","justification":"telomere shortening"},{"idx":2,"correct":false,"proposition":"This is a concept without scientific evidence","justification":""},{"idx":3,"correct":true,"proposition":"It is characterized by a reduction in functional reserve capacities","justification":""},{"idx":4,"correct":false,"proposition":"It makes it possible to judge the autonomy of the individual","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-118","enonce":"Regarding fragility syndrome, which proposal(s) is(are) right?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":false,"proposition":"It is a concept without a precise definition","justification":"Criteria of Fried coughed cough"},{"idx":1,"correct":false,"proposition":"It makes it possible to evaluate the functional reserves of the organs","justification":""},{"idx":2,"correct":true,"proposition":"It is associated with a risk of addiction","justification":""},{"idx":3,"correct":false,"proposition":"It is associated with the risk of pressure ulcers during hospitalization","justification":"There is no definite association in the college between these two elements."},{"idx":4,"correct":false,"proposition":"It is associated with an increased risk of myocardial infarction","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-119","enonce":"You take care of an 85-year-old patient for head trauma on vitamin K antagonization (VKA) prescribed for atrial fibrillation. The INR is at 2.9. There is petechia on the brain scan. Which of the following proposals do you retain for your therapeutic care?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":" Immediate administration of prothrombin complex concentrate","justification":""},{"idx":1,"correct":false,"proposition":"Administration of vitamin K in 4 hours","justification":""},{"idx":2,"correct":false,"proposition":"Systematic control brain scan in 6 hours","justification":"Only if clinical worsening."},{"idx":3,"correct":false,"proposition":"Discontinuation of vitamin K antagonist with heparin relay at curative dose","justification":""},{"idx":4,"correct":true,"proposition":"Discontinuation of vitamin K antagonist","justification":""}],"type":"qi"}
{"_id":"annales-2018-qi-120","enonce":"Which of the following criteria(s) testify to severe malnutrition in the elderly?","item":"annales-2018-qi","matiere":"annales-2018","propositions":[{"idx":0,"correct":true,"proposition":"10% weight loss in 1 month","justification":""},{"idx":1,"correct":false,"proposition":"vitamin K administration in 4 hours","justification":""},{"idx":2,"correct":false,"proposition":"Scamer < systematic control in 6 hours","justification":""},{"idx":3,"correct":false,"proposition":"discontinuation of vitamin K antagonist with heparin relay at an effective dose","justification":""},{"idx":4,"correct":true,"proposition":"discontinuation of vitamin K antagonist","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-1","enonce":"Regarding cadaveric lividities, what is (are) the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"They correspond to a blow to the corpse","justification":""},{"idx":1,"correct":true,"proposition":"They correspond to a blood sweat through the vessels after death","justification":""},{"idx":2,"correct":true,"proposition":"They are one of the indicators of the movement of the body after death","justification":"They do not correspond to the parts that are detached in the new position of the body."},{"idx":3,"correct":false,"proposition":"They allow an accurate estimation of the post-mortem time","justification":"The estimate is not very precise (several hours of differential)."},{"idx":4,"correct":false,"proposition":"They are greenish in colour in case of fatal carbon monoxide poisoning","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-2","enonce":"Regarding functional dependence in the elderly, which proposal(s) is(are) right?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"It is measured by the AGGIR grid in clinical practice","justification":""},{"idx":1,"correct":true,"proposition":"It is present if an individual can no longer take public transport","justification":""},{"idx":2,"correct":true,"proposition":"It is present in case of urinary incontinence","justification":""},{"idx":3,"correct":false,"proposition":"It is present in case of decrease in walking speed","justification":"It is a criterion of fragility"},{"idx":4,"correct":true,"proposition":"It can get worse suddenly","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-3","enonce":"Acquired epithelial dysplasia is (one or more exact answers):","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"A particular form of hyperplasia","justification":""},{"idx":1,"correct":false,"proposition":"A particular form of metaplasia","justification":""},{"idx":2,"correct":true,"proposition":"Synonym of intraepithelial neoplasia","justification":"According to Anapath's college: \"dysplasia (acquired epithelial): morphological alterations testifying to the existence of a neoplastic process at an early, non-invasive stage.\" No crossing of the basement membrane."},{"idx":3,"correct":true,"proposition":"A pre-cancerous lesion","justification":"Anapath College: \"Acquired dysplasia results from genetic abnormalities that alter proliferation control and cell maturation.\" "},{"idx":4,"correct":true,"proposition":"A potentially reversible lesion","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-4","enonce":"About antenatal screening for trisomy 21 syndrome, which proposal(s) is (are) accurate?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Amniocentesis for fetal karyotyping is recommended for any pregnant woman over 38 years of age","justification":""},{"idx":1,"correct":true,"proposition":"Combined first trimester screening includes nuchal translucency measurement around 12 weeks of amenorrhea"},{"idx":2,"correct":true,"proposition":"Screening should be offered to all pregnant women","justification":"But it is not obligatory"},{"idx":3,"correct":false,"proposition":"Non-invasive prenatal screening (NIPT) is recommended for ultrasound diagnosis at 24 weeks of pregnancy of an atrioventricular canal","justification":""},{"idx":4,"correct":true,"proposition":"Medical termination of pregnancy for trisomy 21 syndrome is authorized in France until term","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-5","enonce":"About Fragile X Syndrome: (one or more correct answers)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":" There is never a father-son transmission","justification":""},{"idx":1,"correct":true,"proposition":"There is a correlation between the size of maternal premutation and the risk of having a child with fragile X syndrome","justification":""},{"idx":2,"correct":true,"proposition":"A father carrying the premutation oblIgAtoire transmits his premutation to all his daughters","justification":""},{"idx":3,"correct":true,"proposition":"A woman carrying the premutation in the heterozygous state can develop FXTAS (Fragile X Tremor Ataxia Syndrome) in adulthood.","justification":""},{"idx":4,"correct":true,"proposition":"A man carrying the premutation can develop FXTAS (Fragile X Tremor Ataxia Syndrome) in adulthood.","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-6","enonce":"Cat scratch disease: (one or more exact answers)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"can be confirmed by serology","justification":""},{"idx":1,"correct":true,"proposition":"can be confirmed by PCR on lymph node biopsy product","justification":""},{"idx":2,"correct":false,"proposition":"is usually secondary to a cat flea bite","justification":""},{"idx":3,"correct":true,"proposition":"is usually characterized by large lymphadenopathy with a tendency to fistulization","justification":""},{"idx":4,"correct":false,"proposition":"is due to Bartonella bacilliformis","justification":"Bartonella henselae is a Gram-negative bacillus (BGN)."}],"type":"qi"}
{"_id":"annales-2020-qi-7","enonce":"Regarding pelvic endometriosis, what is the exact answer(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"It is an autosomal recessive disease","justification":"The relative risk for family history is 5. However, it is not a monogenic disease."},{"idx":1,"correct":true,"proposition":"Normal pelvic ultrasound does not eliminate the diagnosis","justification":""},{"idx":2,"correct":true,"proposition":"It can lead to tubal infertility","justification":""},{"idx":3,"correct":true,"proposition":"It leads to early menopause","justification":"The college (2021 version) does not report early menopause in the chapter on endometriosis."},{"idx":4,"correct":true,"proposition":"It can lead to deep dyspareunia","justification":"And no intromission dyspaneuria."}],"type":"qi"}
{"_id":"annales-2020-qi-8","enonce":"A 65-year-old patient is monitored annually for bicuspid aortic insufficiency. He recently developed exertional dyspnea in stage II of the NYHA (New York Heart Association) classification. An echocardiogram is performed, what is (are) the exact proposal(s) concerning this examination in this indication?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Echocardiography helps quantify the extent of leakage","justification":""},{"idx":1,"correct":true,"proposition":"Echocardiography may show dilation of the left ventricle","justification":""},{"idx":2,"correct":true,"proposition":"Echocardiography should look for dilation of the ascending aorta","justification":""},{"idx":3,"correct":false,"proposition":"Echocardiography should evaluate aortic valve cord injuries","justification":"The aortic valve has no cords (mitral and tricuspid valve contreatment)."},{"idx":4,"correct":true,"proposition":"Echocardiography is an essential element to pose the surgical indication","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-9","enonce":"A 69-year-old patient underwent surgery for an aortic bicuspid with valve leakage. A bioprosthesis has been placed. Regarding bioprosthetic valves, which is (are) the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Bioprostheses are most often made of titanium or carbon","justification":""},{"idx":1,"correct":false,"proposition":"Bioprostheses require definitive anticoagulant treatment","justification":""},{"idx":2,"correct":true,"proposition":"The durability of bioprostheses is limited","justification":""},{"idx":3,"correct":false,"proposition":"Wearing a bioprosthetic valve prevents the occurrence of endocarditis","justification":""},{"idx":4,"correct":true,"proposition":"Bioprostheses are most often mounted on a metal frame","justification":"This allows the surgeon to make sutures easier."}],"type":"qi"}
{"_id":"annales-2020-qi-10","enonce":"Regarding focal nodular hyperplasia of the liver, which is (are) the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"It is a tumor with malignant potential requiring a curative resection","justification":""},{"idx":1,"correct":true,"proposition":"Three to five minutes after the CT scan of contrast medium, the lesion loses its enhancement","justification":"UFH receives only arterial blood (and nothing from the portal vein), so there is an early arterial enhancement and then a very progressive peripheral lavage that then leaves a central scar appearance."},{"idx":2,"correct":false,"proposition":"In a woman, it contraindicates any estrogen-progestin treatment","justification":"This proposition would be true if it concerned hepatic adenoma."},{"idx":3,"correct":true,"proposition":"From a histological point of view, it corresponds to a nodular reorganization of an area of hepatic parenchyma","justification":""},{"idx":4,"correct":false,"proposition":"In case of diagnostic certainty, it requires annual monitoring by liver MRI","justification":"No monitoring required."}],"type":"qi"}
{"_id":"annales-2020-qi-12","enonce":"A 45-year-old man consults for an uncomplicated right inguinal hernia. Generated by the regular externalization of this hernia, he wishes to have surgery. You are his general practitioner, you inform him that: (one or more exact answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Surgical treatment is indicated only if the volume of the hernia no longer allows its reintegration","justification":""},{"idx":1,"correct":true,"proposition":"The presence of pain signs symptomatic hernia and indicates surgical treatment","justification":""},{"idx":2,"correct":true,"proposition":"In case of surgery by first inguinal route, the intervention can be performed under local anesthesia","justification":""},{"idx":3,"correct":true,"proposition":"In case of laparoscopic first, the repair is done with a prosthesis","justification":""},{"idx":4,"correct":false,"proposition":"The interposition of a non-absorbable material eliminates the risk of recurrence","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-13","enonce":"In lupus nephropathies: (one or more exact answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Mesangial deposits of C1q can be found","justification":""},{"idx":1,"correct":false,"proposition":"Extracapillary proliferation can be seen in class II","justification":"Class II = deposition + mesangial blooms."},{"idx":2,"correct":false,"proposition":"Mesangial hypercellularity in more than half of the glomeruli corresponds to a class IV","justification":"Endocapillary\/extracapillary proliferation."},{"idx":3,"correct":true,"proposition":"Immunoglobulin deposits can be mesangial or extramembranous","justification":"extramembranous = class V"},{"idx":4,"correct":true,"proposition":"Onset before age 15 is a criterion for poor renal prognosis","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-14","enonce":"You receive in the emergency room of your hospital a 32-year-old woman who has just attempted suicide by ingesting liquid Destop (soda pipe unblocker). She is conscious. You must: (one or more correct answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Place the patient in a supine position to facilitate intubation if necessary","justification":""},{"idx":1,"correct":false,"proposition":"Place a gastric tube to evacuate caustic fluid","justification":"Especially not because there is a risk of digestive perforation."},{"idx":2,"correct":true,"proposition":"Do an examination of the oral cavity and the ENT sphere","justification":""},{"idx":3,"correct":false,"proposition":"Schedule upper endoscopy within 3 hours of patient admission","justification":"CT injected at H+3 and H+6 from ingestion (not management)"},{"idx":4,"correct":false,"proposition":"Administering activated charcoal","justification":"No antidote"}],"type":"qi"}
{"_id":"annales-2020-qi-15","enonce":"A first-semester intern takes up his duties in a new CHU. He is seen in consultation by the occupational physician. What is (are) the objective(s) of this consultation?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":" Trace the previous occupational exposures of this intern","justification":""},{"idx":1,"correct":true,"proposition":"Find out if the intern is not suffering from a dangerous condition for his professional entourage","justification":""},{"idx":2,"correct":true,"proposition":"Check the status of the intern vis-à-vis mandatory vaccinations and recommended for caregivers","justification":""},{"idx":3,"correct":false,"proposition":"Check if the intern has sufficient knowledge to ensure its service","justification":""},{"idx":4,"correct":false,"proposition":"Inform the intern's manager of his\/her medical history","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-16","enonce":"A patient, aged 56, has been off work for 6 months after the discovery of non-insulin-dependent diabetes complicated by arterial disease of the lower limbs. This patient is a mason in the building. What are the measures that could help him stay in employment? (one or more possible answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"A therapeutic part-time resumption","justification":""},{"idx":1,"correct":false,"proposition":"A third-class disability application","justification":""},{"idx":2,"correct":true,"proposition":"An application for recognition as a disabled worker","justification":""},{"idx":3,"correct":true,"proposition":"A pre-resumption visit to the occupational physician","justification":""},{"idx":4,"correct":false,"proposition":"An extension of sick leave until retirement age","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-17","enonce":"Which cancer(s) is (are) staged by the FIGO classification?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Endometrium"},{"idx":1,"correct":false,"proposition":"Multiple myeloma"},{"idx":2,"correct":true,"proposition":"Cervix"},{"idx":3,"correct":true,"proposition":"Ovary"},{"idx":4,"correct":false,"proposition":"Breast"}],"type":"qi"}
{"_id":"annales-2020-qi-18","enonce":"A 32-year-old patient has had renal colic for 3 years. He weighs 75 kg and his blood pressure is 121\/76 mmHg. It presents bilateral calculations of 3 to 8 mm visible to the scanner, density 1000 UH. \n\nIts biological balance shows: Na 142 mmol \/ L, K 4 mmol \/ L, protein 67 g \/ L, serum creatinine 70 μmol \/ L, serum calcium 2.5 mmol \/ L. Diuresis of 24 hours: 1000 mL. \n\n24-hour urinary lonogram shows natriuresis at 200 mmol\/L, kaliuresis at 35 mmol\/L and hypercalciuria. \n\nWhat is (are) the risk factor(s) for lithiasis in this patient?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"High kaluuresis ","justification":""},{"idx":1,"correct":true,"proposition":"Insufficient diuresis","justification":"At least 2 liters per day is recommended."},{"idx":2,"correct":false,"proposition":"Hypercalcemia","justification":""},{"idx":4,"correct":true,"proposition":"Hypercalciuria","justification":""},{"idx":5,"correct":true,"proposition":"Excessive salt intake","justification":"17 mmol NaCl = 1 g NaCl ingested. 200\/17 gives about 200\/20 = 10 g of NaCl per day. This is much more than the 6g \/ D indicated in a patient for secondary prevention of lithiasis."}],"type":"qi"}
{"_id":"annales-2020-qi-19","enonce":"An 88-year-old patient is referred to the emergency room for confusion during a heat wave. He lives in a nursing home. Its usual treatment is amlodipine, metformin, candesartan, furosemide. Its constants are: blood pressure 100\/70 mmHg, heart rate 92\/min, temperature 37.2 °C.  Its biological balance shows: Na 152 mmol\/L, K 5.7 mmol\/L, Chlorine 95 mmol\/L, HCO3- 14 mmol\/L, protein 88 g\/L, urea 20 mmol\/L, serum creatinine 170 μmol\/L. What is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":" The plasma anion hole is 43 mmol\/L (potassium not taken into account)","justification":""},{"idx":1,"correct":false,"proposition":"There is pure intracellular dehydration","justification":""},{"idx":2,"correct":true,"proposition":"Lactic acidosis should be sought","justification":""},{"idx":3,"correct":true,"proposition":"Renal failure explains the decrease in bicarbonates","justification":"Renal failure leads to decreased clearance of potassium and protons. The latter are buffered into the plasma by the bicarbonates, whose concentration then decreases."},{"idx":4,"correct":true,"proposition":"Candesartan promoted hyperkalaemia and acute renal failure","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-20","enonce":"A 68-year-old patient is referred to the emergency room for acute kidney failure by his general practitioner. He is hypertensive and diabetic. He has asthenia and diffuse myalgia.\n\nIts constants are: blood pressure 150\/85 mmHg, heart rate 70\/min, temperature 37.7 °C.\n\nRenal ultrasound is normal.\n\nIts biological balance finds:\n• haemoglobin 10.5 g\/dL\n• leukocytes 8 G\/L\n• Na 141 mmol\/L, K 4.2 mmol\/L, Cl 100 mmol\/L, HCO3- 22 mmol\/L, protein 68 g\/L\n• urea 23 mmol \/ L, serum creatinine 350 μmol \/ L\n• urine strip: 2+ proteins, 3+ red blood cells, negative leukocytes, negative nitrites;\n• urine test: Na 100 mmol\/L, K 34 mmol\/L, urea 150 mmol\/L, creatinine 4 mmol\/L, proteinuria 1.5 g\/1.\nWhich proposal(s) is the exact proposal(s) at this stage?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"There is a functional part to his acute renal failure","justification":""},{"idx":1,"correct":false,"proposition":"It may be acute tubular necrosis","justification":"Acute tubular necrosis does not normally regain hematuria or proteinuria."},{"idx":2,"correct":true,"proposition":"It may be rapidly progressive glomerulonephritis","justification":""},{"idx":3,"correct":false,"proposition":"It is necessary to evoke a diabetic nephropathy","justification":""},{"idx":4,"correct":false,"proposition":"It is necessary to evoke a myeloma tubulopathy","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-21","enonce":" Which proposal(s) regarding classification bias in analytical (or etiological) epidemiological studies is\/are correct?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Ranking biases may be differential between cases and controls","justification":"That is, the bias is not as strong between cases and controls. That is a possible situation."},{"idx":1,"correct":false,"proposition":"Ranking bias can be controlled for by multivariate analysis","justification":""},{"idx":2,"correct":false,"proposition":"The random selection of controls within a general population avoids ranking bias","justification":""},{"idx":3,"correct":true,"proposition":"Memory bias is a special case of ranking bias","justification":""},{"idx":4,"correct":true,"proposition":"The use of standardized and validated questionnaires makes it possible to limit the risk of ranking bias","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-22","enonce":"A 62-year-old man is seeing positive hepatitis C (HCV) serology. Transaminases are raised to twice normal. Which exam(s) are you asking for as a first line?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Liver biopsy","justification":""},{"idx":1,"correct":true,"proposition":"Non-invasive liver fibrosis tests","justification":""},{"idx":2,"correct":true,"proposition":"Hepatic ultrasound","justification":""},{"idx":3,"correct":false,"proposition":"Upper GI endoscopy","justification":""},{"idx":4,"correct":true,"proposition":"HCV viral load","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-23","enonce":"Which proposal(s) regarding the informational performance of a test is(are) accurate?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"The sensitivity of a test is the conditional probability that the test will be positive if the subject is free of the disease","justification":"Se = T+ \/ M+"},{"idx":1,"correct":true,"proposition":"The specificity of a test is estimated by the proportion of true negatives among subjects free of the disease","justification":"Spe = T- \/ M-"},{"idx":2,"correct":true,"proposition":"The likelihood ratio of a positive test is equal to the ratio of the probability that the test will be positive in a sick subject to the probability that the test will be positive in a subject free of the disease under study","justification":"RV+ = Se \/ (1-Spe). Now, 1-Spe = 1- (T-\/M-). i.e. 1-Spe = T+\/M-. So RV+ = (T+\/M+) \/ (T+\/M-)"},{"idx":3,"correct":false,"proposition":"The likelihood ratio of a negative test is equal to the ratio of sensitivity to specificity","justification":"RV- = (1-Se)\/Spe"},{"idx":4,"correct":true,"proposition":"Negative predictive value is the conditional probability of being free of the disease if the test is negative","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-24","enonce":"A 62-year-old patient consults you for pain that has been evolving for 5 days. This pain is permanent, intense and upsets the sitting position. On clinical examination, you perceive a left perianal inflammatory swelling. Inspection of the margin shows nothing in particular. Digital rectal examination is impossible because of pain. What etiology(s) do you mention?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"An fissure","justification":""},{"idx":1,"correct":false,"proposition":"Hemorrhoid thrombosis","justification":"The margin is described as normal. The pain has been permanent for five days (it is gradually decreasing in hemorrhoidal thrombosis)."},{"idx":2,"correct":false,"proposition":"Herpes","justification":""},{"idx":3,"correct":true,"proposition":"A perianal abscess","justification":""},{"idx":4,"correct":false,"proposition":"Chlamydia","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-25","enonce":"An X-ray of the entire spine is requested as part of an abnormality of spinal statics. What is (are) the exact proposal(s) concerning this spinal deformity?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"She is left thoracic","justification":""},{"idx":1,"correct":true,"proposition":"There is a rotation of the vertebral bodies","justification":""},{"idx":2,"correct":false,"proposition":"It is, until proven otherwise, idiopathic scoliosis","justification":""},{"idx":3,"correct":false,"proposition":"It is associated with a rocker of the pelvis","justification":""},{"idx":4,"correct":true,"proposition":"Expert advice is needed","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-26","enonce":"You are following a 22-year-old patient with a complete block of 21-hydroxylase, with a severe mutation on both alleles. She asks you about the risk of having a child with the same condition with her partner who has no particular history. Knowing that the frequency of heterozygosity in the general population is 1 in 50, what is the exact proposition?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"1 of 2","justification":""},{"idx":1,"correct":false,"proposition":"1 of 4","justification":""},{"idx":2,"correct":false,"proposition":"1 of 25","justification":""},{"idx":3,"correct":false,"proposition":"1 in 50","justification":""},{"idx":4,"correct":true,"proposition":"1 in 100","justification":"The mother will necessarily transmit her relief. So everything depends on the probability of the father to transmit his. The risk of it being heterozygous is 1 in 50. The risk that it will transmit its allele, if it is heterozygous, is 1\/2. 1\/50 * 1\/2 = 1\/100."}],"type":"qi"}
{"_id":"annales-2020-qi-27","enonce":"In a 68-year-old patient, with which etiology(ies) can this skin lesion be associated?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Polygenic hypercholesterolemia","justification":""},{"idx":1,"correct":true,"proposition":"Familial combined hyperlipidemia","justification":""},{"idx":2,"correct":true,"proposition":"Heterozygous familial hypercholesterolemia","justification":""},{"idx":3,"correct":false,"proposition":"A syndrome of familial hyperchylomicronemia","justification":"Clinical signs of hypertrygliceridemia: eruptive xanthomatosis, hepatosplenomegaly, acute pancreatitis (if > 10g\/L), retinal lipemia, abdominal pain."},{"idx":4,"correct":true,"proposition":"An etiology unrelated to dyslipidemia","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-28","enonce":"A 6-year-old boy consults for the sudden appearance of diffuse edema within 10 days of a viral episode. His blood pressure is 100\/60 mmHg. The urine strip finds a three-choice proteinuria (+++) without hematuria. Blood urea and creatinine are normal. What is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Diagnosis of pure nephrotic syndrome is most likely","justification":""},{"idx":1,"correct":false,"proposition":"You have to look for schizocytes","justification":""},{"idx":2,"correct":true,"proposition":"An albuminemia assay is essential","justification":""},{"idx":3,"correct":false,"proposition":"A renal biopsy is indicated before treatment","justification":""},{"idx":4,"correct":false,"proposition":"A hemostasis assessment must be done","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-29","enonce":"In a patient with recent parkinsonism syndrome, what element(s) will make you remember a diagnosis other than Parkinson's disease?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"A good response to dopatherapy","justification":""},{"idx":1,"correct":true,"proposition":"Falls","justification":""},{"idx":2,"correct":true,"proposition":"Dysautonomia","justification":""},{"idx":3,"correct":true,"proposition":"Cognitive impairment","justification":""},{"idx":4,"correct":false,"proposition":"A slow tremor of 4 - 6 Hz","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-30","enonce":"A 25-year-old patient arrives at the emergency room because he has just violently twisted his ankle during a basketball game. His ankle is edematous. What is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"The presence of a sub-lateral malleolar bruise makes the radiographic assessment essential","justification":"It is not the bruise but the pain that falls within Ottawa's criteria"},{"idx":1,"correct":true,"proposition":"The impossibility of taking three steps makes the radiographic assessment essential","justification":""},{"idx":2,"correct":true,"proposition":"Pain of the base of the 5th metatarsal should suggest a tearing of the insertion of the short fibular tendon","justification":""},{"idx":3,"correct":true,"proposition":"An x-ray of the ankle showing a medial malleolar fracture without fracture of the lateral malleolus should be supplemented by an x-ray of the entire leg","justification":"The famous Maisonneuve 😋 fractures"},{"idx":4,"correct":true,"proposition":"A talo-crural effusion is at best visible on the front X-ray","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-31","enonce":"On this X-ray of the pelvis from the front, to which anatomical structures do the numbers correspond? (one or more correct answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"The number 1 corresponds to the acetabulum","justification":""},{"idx":1,"correct":false,"proposition":"The number 2 corresponds to the major tubercle","justification":"Grand trochanter"},{"idx":2,"correct":false,"proposition":"The number 3 corresponds to the third left obturator foramen","justification":"It's the second (or the first, it depends how you count) 😬"},{"idx":3,"correct":true,"proposition":"The number 4 corresponds to the first left sacred fora men","justification":""},{"idx":4,"correct":true,"proposition":"The number 5 corresponds to the right iliopubic branch","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-32","enonce":"A quadriplegic patient complains of feeling the two angles of his jaw differently. Do you consider that it is an attack of the following neurological structure(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Facial nerve","justification":""},{"idx":1,"correct":true,"proposition":"C3 metamer","justification":""},{"idx":2,"correct":false,"proposition":"From the maxillary nerve","justification":""},{"idx":3,"correct":true,"proposition":"C2 metamer","justification":""},{"idx":4,"correct":false,"proposition":"Hypoglossal nerve","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-33","enonce":"A patient has ankle pain with swelling following a mild sprain that occurred 3 weeks ago and for which she had not consulted. You suspect complex regional pain syndrome (CRPS) type 1. Which of these proposals concerning the CRPS is the true proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"The edema of the SDRC does not take the bucket","justification":""},{"idx":1,"correct":true,"proposition":"CRPS is associated with joint effusion","justification":""},{"idx":2,"correct":false,"proposition":"CRPS is associated with biological inflammatory syndrome","justification":""},{"idx":3,"correct":false,"proposition":"Scintigraphy is essential for diagnosis","justification":""},{"idx":4,"correct":true,"proposition":"X-ray may be normal","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-34","enonce":"What are the possible etiologies of eye redness (one or more exact answers)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Acute glaucoma crisis due to angle closure","justification":""},{"idx":1,"correct":false,"proposition":"Obliteration of the central artery of the retina","justification":""},{"idx":2,"correct":true,"proposition":"Infectious keratitis","justification":""},{"idx":3,"correct":false,"proposition":"Posterior uveitis","justification":""},{"idx":4,"correct":true,"proposition":"Corneal ulcer","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-35","enonce":"Which of the following are suggestive of an allergic etiology in conjunctivitis? (one or more correct answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Ocular pruritus","justification":"Pruritus strongly evokes an allergy. Pollen-allergic externals (like me) have a distinct advantage here 😅."},{"idx":1,"correct":false,"proposition":"Unilateral infringement","justification":""},{"idx":2,"correct":false,"proposition":"Abundant eye secretions","justification":"Secretions are often abundant in conjunctivitis, whatever their origins."},{"idx":3,"correct":true,"proposition":"Seasonal recurrence","justification":""},{"idx":4,"correct":true,"proposition":"Atopic terrain","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-36","enonce":"In case of myopia: (one or more exact answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"The optical system formed by the eye is too convergent","justification":""},{"idx":1,"correct":false,"proposition":"Distance vision is better than near vision without correction","justification":""},{"idx":2,"correct":true,"proposition":"Light rays focus in front of the retina","justification":""},{"idx":3,"correct":true,"proposition":"A divergent lens can be used for correction","justification":""},{"idx":4,"correct":true,"proposition":"The risk of retinal detachment may be increased","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-37","enonce":"What is the exact proposal(s) regarding vaginal infection with Trichomonas vaginalis?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Upper genital infection is frequently associated","justification":""},{"idx":1,"correct":true,"proposition":"Leucorrhoea has a foul smell","justification":""},{"idx":2,"correct":true,"proposition":"Leucorrhoea are greenish in color","justification":""},{"idx":3,"correct":false,"proposition":"\"Clue-cells\" are visible under a microscope","justification":"This is true with Gardenerella vaginalis infections"},{"idx":4,"correct":false,"proposition":"Treatment includes fluconazole","justification":"👉 Metronidazole "}],"type":"qi"}
{"_id":"annales-2020-qi-38","enonce":"Which of the following infections is (are) the one that can (can) classically be associated with eosinophilia?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Loase","justification":""},{"idx":1,"correct":true,"proposition":"Strongyloidiasis","justification":""},{"idx":2,"correct":false,"proposition":"Pneumocystosis","justification":""},{"idx":3,"correct":false,"proposition":"Malaria","justification":""},{"idx":4,"correct":true,"proposition":"Schistosomosis","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-39","enonce":"Which of the following proposals on antibiotic treatment for strep throat is, which is (are) accurate: ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"The main goal of treatment is to reduce the risk of post-strep throat glomerulonephritis","justification":"The risk of glomerulonephritis is not diminished by drug treatment (but other complications, such as rheumatic fever, are)."},{"idx":1,"correct":false,"proposition":"One of the goals is to reduce the duration of symptoms by 3 to 4 days","justification":"The duration of symptoms is reduced by a maximum of 48 hours according to studies."},{"idx":2,"correct":true,"proposition":"The first-line treatment is amoxicillin","justification":""},{"idx":3,"correct":false,"proposition":"In case of allergy to first-line treatment, one possibility is levofloxacin","justification":""},{"idx":4,"correct":false,"proposition":"It is necessary to detect the contamination of the close entourage by a Rapid Diagnostic Test (RDT)","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-40","enonce":"A young West Indian woman is referred to you by occupational medicine for abnormalities of the blood count. The CBC shows: red blood cells 5.17 T\/L, hematocrit 38.9%, Hb 124 g\/L, MCV 75 fL, MCDC 32 g\/dL, leukocytes 4.0 G\/L, platelets 232 G\/L. What do you do? (only one answer expected)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Determination of ferritinemia","justification":""},{"idx":1,"correct":false,"proposition":"Hemoglobin electrophoresis","justification":"Main lure here 👉 but it is first necessary to dose the ferritinemia before thinking of thalassemia 🤭."},{"idx":2,"correct":false,"proposition":"Determination of reticulocytes","justification":""},{"idx":3,"correct":false,"proposition":"No balance sheet","justification":""},{"idx":4,"correct":false,"proposition":"Oral iron prescription","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-41","enonce":"A 70-year-old man consults for a diffuse itchy rash that appeared 48 hours ago, initially on the trunk. He has been widowed for 2 years and has an estimated active smoking of 45 packs years. His history includes plaque psoriasis since the age of 40 localized to the elbows, treated with topical corticosteroids and chronic obstructive pulmonary disease since the age of 55. He has been receiving amoxicillin-clavulanic acid treatment for bronchial superinfection for 10 days. The temperature is at 37.8 degrees Celsius, without alteration of the general condition. Examination of the mucous membranes is normal. There is no sign of Nikolsky. There is no peripheral lymphadenopathy or hepatosplenomegaly. The blood count, liver test and renal function are unremarkable. What diagnosis do you mention? (one or more correct answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Maculopapular exanthema of drug origin","justification":""},{"idx":1,"correct":false,"proposition":"Secondary syphilis","justification":""},{"idx":2,"correct":false,"proposition":"Measles","justification":""},{"idx":3,"correct":false,"proposition":"Acute generalized exanthematous pustulosis","justification":""},{"idx":4,"correct":false,"proposition":"Erythrodermic psoriasis","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-42","enonce":"A 35-year-old man, with no particular history, has been complaining for 3 months of redness, heat and intense pain such as burns of both feet. Symptoms appear abruptly, often after exposure to heat, and usually disappear about 1 hour later. What diagnosis do you mention?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Raynaud's syndrome","justification":""},{"idx":1,"correct":true,"proposition":"Erythermalgia","justification":""},{"idx":2,"correct":false,"proposition":"Acrocyanosis","justification":""},{"idx":3,"correct":false,"proposition":"Acrocholosis","justification":"Acrocholosis is mainly observed during certain neurological pathologies such as peripheral neuropathies. Heat sensitization is observed, without any dermatological expression."},{"idx":4,"correct":false,"proposition":"Chilblains","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-43","enonce":"Which pleural effusion(s) should be punctured urgently?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Fluid pleural effusion in a context of suspected pulmonary embolism","justification":""},{"idx":1,"correct":false,"proposition":"Fluid pleural effusion in acute heart failure","justification":""},{"idx":2,"correct":true,"proposition":"Fluid pleural effusion in an infectious context","justification":""},{"idx":3,"correct":true,"proposition":"Fluid pleural effusion suspected of hemothorax","justification":""},{"idx":4,"correct":false,"proposition":"Fluid pleural effusion suspected of neoplasia","justification":"This is not an emergency."}],"type":"qi"}
{"_id":"annales-2020-qi-44","enonce":"What main etiology(ies) may be responsible for chronic cough?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Active smoking","justification":""},{"idx":1,"correct":false,"proposition":"Treatment with calcium channel blocker","justification":"By IEC\/ARA2."},{"idx":2,"correct":true,"proposition":"Uncontrolled gastroesophageal reflux disease asthma","justification":""},{"idx":3,"correct":true,"proposition":"GERD","justification":""},{"idx":4,"correct":true,"proposition":"Chronic sinusitis","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-45","enonce":"About heart failure, what is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Its prevalence increases with the age of the population","justification":""},{"idx":1,"correct":true,"proposition":"Ejection fraction is the parameter used to characterize the systolic function of heart failure","justification":""},{"idx":2,"correct":true,"proposition":"Heart failure with preserved systolic function is mainly linked to left ventricular filling disorder","justification":""},{"idx":3,"correct":true,"proposition":"Heart failure with preserved systolic function is very often associated with hypertension","justification":"HTA 👉 Hypertrophic cardiomyopathy 👉 Heart failure with LVEF preserved."},{"idx":4,"correct":false,"proposition":"Heart failure with preserved systolic function is usually associated with","justification":""},{"idx":5,"correct":false,"proposition":"dilation of the left ventricle","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-46","enonce":" What are the functional or clinical sign(s) of faecal incontinence?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Liquid oozing","justification":"Fecal incontinence = loss of uncontrolled stool."},{"idx":1,"correct":false,"proposition":"The impossibility of distinguishing the passage of gases and stool","justification":"Not related to faecal incontinence (which is the loss of uncontrolled stool). This proposal refers instead to incontinence, which corresponds to a completely different semiological framework."},{"idx":2,"correct":false,"proposition":"The emission of more than three bowel movements per day","justification":"This corresponds to the definition of diarrhea, of which fecal incontinence is a differential diagnosis to be aware of."},{"idx":3,"correct":true,"proposition":"Loss of the sensation of exonerating need","justification":""},{"idx":4,"correct":false,"proposition":"Urge to defecate","justification":"Tenesmus \/ Epreinte 👉 they are part of the rectal 💩 syndrome"}],"type":"qi"}
{"_id":"annales-2020-qi-47","enonce":"Regarding protein-energy malnutrition, which proposal(s) is(are) accurate?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"It reduces the speed of healing of chronic wounds","justification":""},{"idx":1,"correct":true,"proposition":"It is measured by the evolution of the weight over the last 6 months","justification":""},{"idx":2,"correct":false,"proposition":"It is diagnosed by a MNA score less than 21\/30","justification":""},{"idx":3,"correct":true,"proposition":"It reduces the speed of healing of chronic wounds","justification":""},{"idx":4,"correct":false,"proposition":"It is a consequence of physiological aging","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-48","enonce":"Regarding successful ageing, which proposal(s) is\/are right ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Psychosocial determinants are major factors","justification":""},{"idx":1,"correct":false,"proposition":"It occurs only in individuals with a long life expectancy","justification":""},{"idx":2,"correct":false,"proposition":"It cannot exist in individuals with addiction","justification":""},{"idx":3,"correct":true,"proposition":"It partly has a genetic basis","justification":""},{"idx":4,"correct":false,"proposition":"It is superimposed on healthy aging","justification":"It's not just health in life 😉"}],"type":"qi"}
{"_id":"annales-2020-qi-49","enonce":"A bronchioloalveolar lavage with hyperlymphocytosis is seen when: (one or more responses) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Langheransian histiocytosis","justification":"Increase in NNCs"},{"idx":1,"correct":false,"proposition":"Active smoking","justification":"Increase in NNCs"},{"idx":2,"correct":true,"proposition":"Sarcoidosis","justification":"Increase in CD4+"},{"idx":3,"correct":true,"proposition":"Tuberculosis","justification":"Presence of lymphocytes"},{"idx":4,"correct":false,"proposition":"Alveolar hemorrhage","justification":"Presence of sideraphagous"}],"type":"qi"}
{"_id":"annales-2020-qi-51","enonce":"Investors want to estimate the prevalence of diabetes in a French city among subjects aged 18 or older. They draw lots from a representative sample of the subjects registered on the electoral list of that city. Random participants are invited to participate in this study. Which proposal(s) is (are) accurate?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"This is a descriptive epidemiology study","justification":""},{"idx":1,"correct":false,"proposition":"The subjects on the voters list of this city constitute the target population","justification":"Target population = subjects aged 18 or over living in the French city in question"},{"idx":2,"correct":false,"proposition":"Subjects refusing to participate may cause ranking bias","justification":""},{"idx":3,"correct":false,"proposition":"This is a randomized study","justification":""},{"idx":4,"correct":true,"proposition":"This is a cross-sectional study","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-54","enonce":"Regarding the medical information transmitted to the patient, which is (are) the right proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"The transmission of medical information must be mentioned in the medical record","justification":""},{"idx":1,"correct":true,"proposition":"Information must be clear, fair and appropriate","justification":""},{"idx":2,"correct":false,"proposition":"Proof that the medical information has been issued must be provided by the patient","justification":""},{"idx":3,"correct":true,"proposition":"The patient has the right to refuse to be informed","justification":""},{"idx":4,"correct":false,"proposition":"The physician has the right to refuse to inform a patient","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-55","enonce":"A 33-year-old man, driving school instructor, consults for low back pain that has appeared for four months and wakes him up in the morning. You want to eliminate spondyloarthritis. What visible sign(s) on the standard lumbar spine X-ray might be in favor of this diagnosis?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Erosions of the vertebral plateaus","justification":""},{"idx":1,"correct":true,"proposition":"Thin, vertical bone bridges at the periphery of intervertebral discs","justification":""},{"idx":2,"correct":false,"proposition":"Disc pinches","justification":"Sign of osteoarthritis"},{"idx":3,"correct":true,"proposition":"Fusions of zygapophyseal line spacing","justification":""},{"idx":4,"correct":true,"proposition":"A square appearance of the vertebral bodies on profile X-rays","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-56","enonce":"A 55-year-old patient comes to consult for pain of the anterior surface of the right thigh radiating to the knee appeared for 5 months. Its body mass index is measured at 32 kg\/m^2. An X-ray of the front pelvis is performed. What diagnosis do you mention on imaging? (only one answer expected)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Coxarthrosis","justification":""},{"idx":1,"correct":false,"proposition":"Fracture due to bone failure","justification":""},{"idx":2,"correct":false,"proposition":"Rheumatoid Coxite","justification":""},{"idx":3,"correct":false,"proposition":"Lysis of the acetabulum","justification":""},{"idx":4,"correct":false,"proposition":"The x-ray is normal, so you evoke cruralgia","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-57","enonce":"A 57-year-old patient suffered trauma to her right ankle following a fall. She was unable to regain support on her lower limb when she stood up. She complains of elective pain in the posterior part of the fibula. You have had x-rays of your right ankle. What is the real proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"There is a trans-syndesmotic fibular fracture line","justification":""},{"idx":1,"correct":false,"proposition":"There is a fracture of the distal 1\/3 of the tibial diaphysis","justification":""},{"idx":2,"correct":false,"proposition":"There is a fracture of the neck of the talus","justification":""},{"idx":3,"correct":true,"proposition":"There is a tibio-fibular diastasis","justification":""},{"idx":4,"correct":false,"proposition":"There is a tibiotalar dislocation","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-59","enonce":"A 45-year-old woman consults you following a skiing accident 3 days after the trauma. She complains of pain in the inner side of the left knee during flexion\/extension. You do not find patellar shock. You cause this pain on palpation visualized in this photo, as well as in valgus. There is no previous laxity. What is your diagnosis(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"A complex regional pain syndrome","justification":""},{"idx":1,"correct":false,"proposition":"A fracture of the medial tibial plateau","justification":""},{"idx":2,"correct":false,"proposition":"A sprain of the anteroexternal cruciate ligament","justification":""},{"idx":3,"correct":true,"proposition":"A sprained medial collateral ligament","justification":"This is the right place and this is the right clinic 😉 Elective pain on flexion\/extension eliminates the fracture. The lack of laxity makes a sprain of the cruciate ligaments unlikely. As for CRPS, we are only 3 days away from trauma and there are no clinical arguments in favor."},{"idx":4,"correct":false,"proposition":"A fracture of the medial edge of the patella","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-60","enonce":"A 35-year-old man consults you for a foot falling to the right. He explains that he was crouched for a long time for work. Achilles and quadricipital reflexes are preserved. The manual test finds a right hip abduction at 5\/5, a right leg extension at 5\/5, right foot lifters at 3\/5. The sensitivity of the back of the foot is impaired, while the cutaneous areas of the sole of the foot are respected. The lumbosacral and right hip mobilities are free. What is your most likely diagnosis?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"A tendon rupture of a levator muscle in the right foot","justification":"This would not explain the sensory impairment."},{"idx":1,"correct":true,"proposition":"Damage to the right fibular nerve","justification":"This is the right territory 😉: affecting the lifters of the foot (at the motor level) and the back of the foot (at the sensory level)."},{"idx":2,"correct":false,"proposition":"Damage to the right tibial nerve","justification":"The numerous branches of the tibial nerve mainly innervate the muscles and skin of the calf (thus the posterior part of the leg), as well as the sole of the foot. This is not the right semiology!"},{"idx":3,"correct":false,"proposition":"Damage to the right obturator nerve","justification":"The right obturator nerve essentially innervates the thigh, at the motor and sensory level."},{"idx":4,"correct":false,"proposition":"An attack of the right L5 root","justification":"Root involvement is made very unlikely by the highly targeted involvement of a single nervous territory (that of the right fibular)."}],"type":"qi"}
{"_id":"annales-2020-qi-62","enonce":"You see a 63-year-old patient in consultation. A former English teacher, he is being treated for hypertension by an ACE inhibitor. He complains of stage 1 dyspnea of MRD. It has no other functional signs. He weighs 82 kg and is 171 cm tall. In terms of chest examination, palpation and percussion are normal. Auscultation finds bilateral but predominant crackles in the right base. The clinical examination is also strictly normal. He benefited from EFR. You do not yet have imaging tests that will of course be important. \nIn the light of these initial results, which diagnosis do you think is most likely? (only one answer expected)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Heart failure","justification":"This is the main distractor here, but is made less likely by the absence of signs of right heart failure, the lack of correlation between stage 1 dyspnea and the presence of crackling at rest (i.e. crackling is therefore not related to OAP, since the patient is dyspneic only with sustained effort),  the absence of a clear etiology to heart failure (no ACS, no alcohol consumption, etc.). All these arguments make REIT more likely."},{"idx":1,"correct":true,"proposition":"Idiopathic pulmonary fibrosis","justification":""},{"idx":2,"correct":false,"proposition":"Chronic obstructive pulmonary disease","justification":""},{"idx":3,"correct":false,"proposition":"Pleural effusion"},{"idx":4,"correct":false,"proposition":"Asthma"}],"type":"qi"}
{"_id":"annales-2020-qi-64","enonce":"What are the indications for the implementation of oral corticosteroid therapy when a diagnosis of sarcoidosis is highlighted? (one or more correct answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"The presence of erythema nodosum","justification":""},{"idx":1,"correct":false,"proposition":"The presence of mediastinal lymphadenopathy exceeding 2 cm in diameter","justification":"The lymphadenopathy of sarcoidosis is not compressive. So OSEF frankly 😂."},{"idx":2,"correct":false,"proposition":"The presence of non-disabling arthralgia","justification":""},{"idx":3,"correct":true,"proposition":"The occurrence of central facial paralysis","justification":""},{"idx":4,"correct":true,"proposition":"The occurrence of hepatic cholestasis with gammaGT and alkaline phosphatases > 2N","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-65","enonce":"AL amyloidosis can be revealed as: (one or more possible responses)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Spontaneous hematomas of the eyelids","justification":""},{"idx":1,"correct":true,"proposition":"From macroglossia"},{"idx":2,"correct":true,"proposition":"Polyadenopathy"},{"idx":3,"correct":true,"proposition":"Heart failure"},{"idx":4,"correct":true,"proposition":"Edema of the lower limbs","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-66","enonce":"In a 40-year-old patient who has had deep vein thrombosis, what risk factors for venous thrombosis are you looking for? (one or more possible answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Smoking","justification":"It is a risk factor for arterial damage (venous thrombosis is an attack of the veins)."},{"idx":1,"correct":false,"proposition":"High blood pressure","justification":"It is a risk factor for arterial damage (venous thrombosis is an attack of the veins)."},{"idx":2,"correct":true,"proposition":"Air travel of more than 6 hours","justification":""},{"idx":3,"correct":false,"proposition":"Dyslipidemia","justification":"It is a risk factor for arterial damage (venous thrombosis is an attack of the veins)."},{"idx":4,"correct":true,"proposition":"Estrogen-progestin therapy","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-67","enonce":"You see in consultation a patient of 34 years, without particular history for the discovery of a splenomegaly exceeding the costal rim of 3 cm. What abnormalities of the blood count could point you to a particular etiology? (one or more possible answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"A haemoglobin of 11.5 g\/dl","justification":"Splenic sequestration of red blood cells and platelets is a consequence of splenomegaly (i.e. any splenomegaly, whatever its cause, is accompanied by anemia and thrombocytopenia distribution) and does not point us towards etiology."},{"idx":1,"correct":true,"proposition":"Reticulocytes at 200 G\/L","justification":""},{"idx":2,"correct":false,"proposition":"130 G\/L blisters","justification":""},{"idx":3,"correct":true,"proposition":"Lymphocytes at 13 G\/L","justification":""},{"idx":4,"correct":true,"proposition":"The presence of 2% myelocytes and 3% metamyelocytes","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-68","enonce":"In case of exophthalmos, what are the clinical elements that would direct you to a Basedowian origin? (one or more correct answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Retraction of the upper eyelid","justification":""},{"idx":1,"correct":true,"proposition":"Diplopia by involvement of the inferior rectus muscle","justification":""},{"idx":2,"correct":false,"proposition":"Male","justification":""},{"idx":3,"correct":false,"proposition":"Unilateral infringement","justification":""},{"idx":4,"correct":true,"proposition":"Painless nature of exophthalmos","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-69","enonce":"What pathology can result in myodesopsia? (only one exact answer) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Macular edema","justification":"Macular edema can give metamorphopsis (for example, in diabetic retinopathy or in AMD) but not myodesopsia."},{"idx":0,"correct":false,"proposition":"Anterior uveitis","justification":""},{"idx":0,"correct":false,"proposition":"Dry syndrome","justification":""},{"idx":0,"correct":false,"proposition":"Nuclear cataract","justification":""},{"idx":0,"correct":true,"proposition":"Retinal detachment","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-70","enonce":"Your 66-year-old patient recently received BCG therapy and surgery for a vegetative tumour of the bladder underground, whose histology had concluded that there was high-grade urothelial carcinoma that deeply infiltrated the chorion (T1bG3). You have not yet applied to the health insurance fund for a long-term illness. He was a worker in a dye factory his entire career, until his retirement at age 60. Several of his former colleagues have been recognized as having an occupational disease for the same pathology. He wondered what recognition as an occupational disease would currently bring him, to know whether it was worthwhile to apply for it. What do you say to him? (one or more possible answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Increased daily allowances","justification":"A priori, he is not on sick leave 🤷 ♂️ If he were in AT, he would have an increase in daily allowances."},{"idx":1,"correct":true,"proposition":"A pension, depending on the degree of disability","justification":""},{"idx":2,"correct":false,"proposition":"A conviction of the employer for inexcusable fault","justification":""},{"idx":3,"correct":false,"proposition":"Compensation from the Asbestos Victims Compensation Fund (FIVA)","justification":""},{"idx":4,"correct":true,"proposition":"An exemption from user fees","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-71","enonce":"Mrs. D., aged 27, gave birth vaginally 6 weeks ago to a girl weighing 3120 g who is doing well. She describes difficulties in caring for her child. Which of the following symptoms suggest postpartum depression?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Irritability","justification":""},{"idx":1,"correct":false,"proposition":"Temporo-spatial disorientation","justification":""},{"idx":2,"correct":true,"proposition":"Anxiety","justification":""},{"idx":3,"correct":true,"proposition":"Feeling of incapacity","justification":""},{"idx":4,"correct":false,"proposition":"Delirium of negation of the child","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-72","enonce":"A 67-year-old woman with autosomal dominant polycystic kidney disease has reached the stage of end-stage renal disease and wants to be transplanted from a cadaveric donor. What is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"She is past the age limit for kidney transplantation","justification":""},{"idx":1,"correct":false,"proposition":"There is a low risk of recurrence of polycystic disease on the transplant","justification":""},{"idx":2,"correct":false,"proposition":"The donor will necessarily be of the same sex","justification":""},{"idx":3,"correct":true,"proposition":"His risk of cancer will increase after transplantation","justification":""},{"idx":4,"correct":false,"proposition":"Its cardiovascular risk will decrease after transplantation","justification":"The cardiovascular risk is increased after transplantation, especially because of immunosuppressants. It is one of the leading causes of mortality in chronic transplant patients."}],"type":"qi"}
{"_id":"annales-2020-qi-73","enonce":"As part of the law of 2 February 2022 known as the Leonetti-Claeys law<<>>, the legislator has given the right to a patient with a serious and incurable condition to benefit from deep and continuous sedation until death if he decides to stop treatment with the consequence of a short-term commitment of his vital prognosis and unbearable suffering. What deadline has been adopted by the High Authority for Health to define this << short term >>?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Less than 48 hours","justification":""},{"idx":1,"correct":false,"proposition":"Less than 7 days","justification":""},{"idx":2,"correct":true,"proposition":"A few hours to a few days","justification":""},{"idx":3,"correct":false,"proposition":"A few days to a few weeks","justification":""},{"idx":4,"correct":false,"proposition":"1 to 6 months","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-74","enonce":"Regarding the physiology of the larynx, what are the exact proposals? (one or more expected answers)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"The vibration of the vocal folds is carried out thanks to the pressure under glottigue","justification":""},{"idx":1,"correct":true,"proposition":"The intrinsic muscles are innervated by the inferior laryngeal nerve","justification":""},{"idx":2,"correct":false,"proposition":"Laryngeal dystonia is a common cause of unilateral laryngeal immobility","justification":""},{"idx":3,"correct":true,"proposition":"Unilateral laryngeal immobility may be related to cricoarytenoid dislocation","justification":""},{"idx":4,"correct":true,"proposition":"Multiple sclerosis can lead to unilateral laryngeal immobility","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-75","enonce":"Regarding the functional assessment of hearing, what are the exact proposals? (one or more correct answers)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"In the presence of sensorineural hearing loss, the Weber is lateralized on the deaf side","justification":""},{"idx":1,"correct":true,"proposition":"The Rinne test compares the transmission of sounds in air and bone conduction","justification":""},{"idx":2,"correct":false,"proposition":"Tonal audiometry is sufficient to analyze hearing acuity","justification":""},{"idx":3,"correct":true,"proposition":"In the presence of sensorineural hearing loss, the air and bone curves are superimposed","justification":""},{"idx":4,"correct":true,"proposition":"Impedancemetry is used to analyze the function of the tympano-ossicular system","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-76","enonce":"A 59-year-old man has dysuria with an indurated nodule, painless occupying less than half of the right prostate lobe on digital rectal examination. The PSA value is 7 ng\/ml What is the evolutionary risk of this disease entity according to the D'Amico classification? (only one answer expected) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Low-risk prostate cancer","justification":""},{"idx":1,"correct":false,"proposition":"Intermediate-risk prostate cancer","justification":""},{"idx":2,"correct":false,"proposition":"High-risk prostate cancer","justification":""},{"idx":3,"correct":false,"proposition":"It is probably not a cancer and the d'Amico classification does not apply","justification":""},{"idx":4,"correct":true,"proposition":"This question cannot be answered with the elements of the statement alone.","justification":"We are missing the Gleason. If it is 3+3 👉 the risk is low. Note that the Gleason has recently been replaced by the ISUP score. This IQ therefore loses some of its interest 😬."}],"type":"qi"}
{"_id":"annales-2020-qi-77","enonce":"A young woman aged 35, practicing the profession of hairdresser consults you for increased lower limb pain at the end of the day and in the pre-menstrual period. These pains are type of heaviness of both legs. On clinical examination, there are no varicose veins but simple telangectasias and vesper edema. You remember the diagnosis of functional venous insufficiency.\n\nWhat measure(s) do you propose for this patient?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Wearing elastic compression","justification":""},{"idx":1,"correct":false,"proposition":"Stripping by bilateral stripping","justification":""},{"idx":2,"correct":false,"proposition":"Echosclerorosis of the great saphenous veins","justification":""},{"idx":3,"correct":true,"proposition":"Regular walking","justification":""},{"idx":4,"correct":true,"proposition":"Elevation of the legs of the bed","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-78","enonce":"A 56-year-old patient consults with the results of an abdominopelvic CT scan with injection performed to explore left abdominal pain. The CT scan finds a left renal cyst of 2.9 cm, hyperdense not raising after injection of contrast medium, with thin partitions and fine parietal calcifications. What is your treatment option?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Renal lumpectomy","justification":""},{"idx":1,"correct":true,"proposition":"No treatment or monitoring","justification":"It is an incidentaloma that requires no treatment or supervision."},{"idx":2,"correct":false,"proposition":"Simple left nephrectomy","justification":""},{"idx":3,"correct":false,"proposition":"Left enlarged nephrectomy","justification":""},{"idx":4,"correct":false,"proposition":"Scannographic monitoring every year","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-79","enonce":"What is(are) the correct statement(s) regarding permanent tubal sterilization?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"It can be performed in a single woman","justification":""},{"idx":1,"correct":false,"proposition":"It can be performed on a minor woman if both parents (or legal guardians) sign the authorization to operate","justification":""},{"idx":2,"correct":true,"proposition":"It can be performed in a woman who has never had an intrauterine device","justification":""},{"idx":3,"correct":false,"proposition":"It must be carried out after a reflection period of 3 months","justification":"The cooling-off period is... 🌟 4 months ⭐ (do not rage, life is too short)."},{"idx":4,"correct":true,"proposition":"It can be performed in a woman who has never had a child","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-80","enonce":"A 65-year-old man consults you for a congenital thoracic nevus that has recently changed, with the appearance of pigment strengthening on two distinct areas. This hyperpigmentation would have started 2 years ago on the lateral edge and, since this summer, the patient has noticed the appearance of a central strengthening of the pigmentation that has become nodular. You suspect a degeneration of this pigment lesion which measures 4 x 3 cm. What is your attitude in the first intention towards this lesion? (only one answer expected) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Prescribing a PET scan","justification":""},{"idx":1,"correct":false,"proposition":"Prescription of a right axillary ultrasound","justification":""},{"idx":2,"correct":false,"proposition":"Pigmented nodule biopsy","justification":"This attitude is possible in the face 😊."},{"idx":3,"correct":true,"proposition":"Excision of the entire lesion with a margin of 1 cm","justification":"Suspicion of melanoma 👉 excision then histopathological study. The narrowest margins are chosen. A rework may be carried out depending on the histopathological 🔬 study."},{"idx":4,"correct":false,"proposition":"Excision of the entire lesion with a margin of 2 cm","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-81","enonce":"You see in consultation M. P., 35 years old, 3 months from a head trauma. He was hit on a bicycle by a car. He suffered a brief loss of consciousness. The brain CT imaging assessment was without abnormalities. Since then, he complains of concentration difficulties that hinder him in his daily professional life, in particular, and his wife evokes a very marked irritability. What is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"These symptoms correspond to a subjective syndrome of head trauma","justification":""},{"idx":1,"correct":true,"proposition":"Irritability can be part of dysexecutive semiology","justification":""},{"idx":2,"correct":false,"proposition":"These symptoms require a brain MRI","justification":"No brain MRI in the absence of clinical signs of calling."},{"idx":3,"correct":false,"proposition":"Professional prosecution is compromised","justification":"This proposition is too definitive to be true."},{"idx":4,"correct":true,"proposition":"A thorough neuropsychological evaluation is recommended","justification":"This assessment will be able to objectify the disorders as well as quantify them. It will make it possible to offer appropriate care."}],"type":"qi"}
{"_id":"annales-2020-qi-83","enonce":"A patient describes very severe pain in the right hemiface accompanied by rubefaction of the face and tearing. You mention cluster headache. Which proposal(s) concerning this diagnosis is (are) accurate?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"It mainly affects women","justification":""},{"idx":1,"correct":false,"proposition":"It is treated with carbamazepine","justification":"A mnemonic means: \"AVF is rare, you will not see a thousand (verapamil).\" 😍"},{"idx":2,"correct":false,"proposition":"It affects alternately the right and left hemiface","justification":""},{"idx":3,"correct":true,"proposition":"It is treated by inhalation of oxygen","justification":""},{"idx":4,"correct":false,"proposition":"It is treated by thermocoagulation of the Gasser lymph node","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-84","enonce":"Which of the following parasitosis is transmitted through skin contact (walking barefoot, swimming)? ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Ascariasis","justification":""},{"idx":1,"correct":true,"proposition":"Strongyloidiasis (anguillulosis)","justification":"barefoot walking"},{"idx":2,"correct":true,"proposition":"Schistosomosis (schistosomiasis)","justification":"bathing"},{"idx":3,"correct":false,"proposition":"Hydatidosis (echinococcosis)","justification":""},{"idx":4,"correct":false,"proposition":"Teniosis","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-85","enonce":"In the following list of bacterial infections, which one or are the ones that do not usually cause hyperleucytosis?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Typhoid fever","justification":""},{"idx":1,"correct":false,"proposition":"Necrotizing dermohypodermatitis","justification":""},{"idx":2,"correct":false,"proposition":"Gram-negative liver abscess","justification":""},{"idx":3,"correct":false,"proposition":"Acute pyelonephritis","justification":""},{"idx":4,"correct":true,"proposition":"Pulmonary tuberculosis","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-87","enonce":"What element(s) is (are) part of the diagnosis of conversion disorder?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Neurological symptoms","justification":""},{"idx":1,"correct":true,"proposition":"Psychological factor found","justification":""},{"idx":2,"correct":false,"proposition":"Histerionic personality","justification":""},{"idx":3,"correct":false,"proposition":"Simulation","justification":"Patients do not simulate. Their symptoms are sincere."},{"idx":4,"correct":false,"proposition":"Erotomania","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-90","enonce":"You receive in the emergency room a 22-year-old patient brought by paramedics, who intervened at home at 9:30 p.m. on a call from her boyfriend. He found his girlfriend in a stuporous and confused state, two hours after an argument that took him out of the house. He doesn't know what happened during those two hours. You find a patient agitated. She aggressively answers your questions and yells that she wants to leave the hospital, struggling violently. You objectify reactive intermediate pupils and phlebotomies on both anterior surfaces of the wrists, the depth of which you cannot determine because of agitation. Which of the following proposals for the management of this patient is: ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"The clinical picture makes you reject the hypothesis of benzodiazepine poisoning","justification":"This hypothesis cannot be eliminated."},{"idx":1,"correct":false,"proposition":"You must respect the patient's wishes and let her out","justification":""},{"idx":2,"correct":false,"proposition":"You must physically restrain the patient without chemical restraint","justification":""},{"idx":3,"correct":true,"proposition":"You mention possible alcohol consumption","justification":""},{"idx":4,"correct":false,"proposition":"The patient must be seen immediately by psychiatrists","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-91","enonce":"A 25-year-old patient is hospitalized in hematology in the context of induction chemotherapy for acute lymphoblastic leukemia. On call, you are called at 8 p.m. because she \"does not breathe well\". You find a patient lying in bed, restless, polypneic with a supraclavicular pull and a thoraco-abdominal, cyanotic and marbled swing. Vital parameters are: heart rate at 125\/min, blood pressure at 95\/60 mmHg, respiratory rate at 38\/min, SpO2 at 87% under 2 L\/min of oxygen to the nasal glasses. What are you doing while waiting for the mobile resuscitation team? (one or more correct answers)","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"You increase the O2 to 5 L\/min with glasses","justification":""},{"idx":1,"correct":false,"proposition":"You increase the O2 to 10 L\/min with glasses","justification":""},{"idx":2,"correct":true,"proposition":"You change the nasal glasses for a high-concentration face mask","justification":""},{"idx":3,"correct":false,"proposition":"You place the patient in the Trendelenburg position","justification":""},{"idx":4,"correct":true,"proposition":"You place the patient in a semi-seated position","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-93","enonce":"Regarding immunohistochemistry during an histopathological examination, it is true that: (one or more exact answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"It can be done extemporaneously","justification":""},{"idx":1,"correct":true,"proposition":"It is most often done on frozen samples","justification":""},{"idx":2,"correct":true,"proposition":"It highlights proteins","justification":""},{"idx":3,"correct":true,"proposition":"It can be quantitative","justification":"Either directly under the microscope (manual counting) or via flow cytometry techniques."},{"idx":4,"correct":true,"proposition":"It may be for prognostic purposes","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-94","enonce":"A 22-year-old patient is referred for consultation by her general practitioner because of an abnormal blood count, which is presented to you below. The patient is asymptomatic, has no fever or other symptoms suggestive of an infectious episode, significant cutaneous or joint signs. The physical examination is normal, and finds no palpable lymphadenopathy or organomegaly.\nWhich of the following explorations do you carry out in 1st intention in this patient?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Hemostasis assessment"},{"idx":1,"correct":true,"proposition":"Hepatic test"},{"idx":2,"correct":false,"proposition":"Myelogram"},{"idx":3,"correct":false,"proposition":"Anti-native DNA antibodies"},{"idx":4,"correct":false,"proposition":"Thoraco-abdomino-pelvic CT scan","justification":"The systematic first-line assessment in front of isolated thrombocytopenia reminiscent of ITP is: CBC on citrated tube (if suspected of false thrombocytopenia with EDTA), a blood smear, a PPE, HIV HBV HCV serologies, a liver test, NAAs, a renal assessment (creatinine, hematuria), a hemostasis assessment (TP, TCA, fibrinogen), grouping and RAI (in severe forms). According to the PNDS of the HAS: https:\/\/www.has-sante.fr\/upload\/docs\/application\/pdf\/2017-06\/dir36\/pnds-_purpura_thrombopenique_immunologique.pdf"}],"type":"qi"}
{"_id":"annales-2020-qi-95","enonce":"Which of the following proposals can (may) constitute a criminal offence that can be charged against a doctor?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Writing a false certificate","justification":""},{"idx":1,"correct":false,"proposition":"Lack of information provided to the patient","justification":"Ordinal and civil offense, but not criminal."},{"idx":2,"correct":true,"proposition":"Non-assistance to a person in danger","justification":""},{"idx":3,"correct":true,"proposition":"The technical fault","justification":""},{"idx":4,"correct":true,"proposition":"Intentional homicide","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-96","enonce":"A 15-year-old woman consults for heavy menstruation for 10 to 15 days a month since menarche. Which additional exam(s) do you prescribe as a first-line treatment?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Bleeding time","justification":"Really no longer done at the ECN (especially in the first line) 😅"},{"idx":1,"correct":false,"proposition":"Antithrombin III assay","justification":""},{"idx":2,"correct":false,"proposition":"Plasma Factor V assay","justification":""},{"idx":3,"correct":true,"proposition":"Complete blood and platelet count","justification":""},{"idx":4,"correct":true,"proposition":"Plasma determination of Willebrand factor ","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-97","enonce":"You welcome to the emergency room Mrs. X. aged 75, referred by her doctor because of a picture of acute anuric renal failure in a context of diarrhea. Blood sugar levels measured in the city 3 hours earlier were 6.9 mmol\/L. At the time of the transfer to her bed in a cubicle, she suddenly loses consciousness. His pulse is no longer perceived. The scope is not yet plugged in. Which of the following proposals regarding its management is (are) accurate?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"You start by ventilating it with a balloon","justification":""},{"idx":1,"correct":true,"proposition":"You massage it right away","justification":""},{"idx":2,"correct":false,"proposition":"You immediately inject 1 mg of adrenaline","justification":""},{"idx":3,"correct":true,"proposition":"You have the external defibrillator brought in immediately","justification":""},{"idx":4,"correct":true,"proposition":"You prescribe intravenous calcium","justification":"Calcium gluconate has a cardioprotective function in hyperkalemia. In case of taking digitalis, magnesium chloride should rather be prescribed."}],"type":"qi"}
{"_id":"annales-2020-qi-98","enonce":"A 73-year-old man presents for dermatology for itchy skin lesions evolving for 2 years having started in the groin and pubis, with recent extension to the upper limbs, face and neck, despite treatment with antihistamines and very strong local dermocorticosteroids (clobetasol). The history includes untreated hypertension, prostatectomy for adenoma he was 3 years old and left total nephrectomy for kidney cancer he was 5 years old. Which test will be most cost-effective to confirm the diagnosis you suspect?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Cutaneous histology","justification":"Bullous dermatosis is not suspected in front of this table."},{"idx":1,"correct":false,"proposition":"Direct cutaneous immunofluorescence","justification":"Bullous dermatosis is not suspected in front of this table."},{"idx":2,"correct":false,"proposition":"Complete blood count","justification":""},{"idx":3,"correct":false,"proposition":"Search for clonality in the skin by PCR","justification":""},{"idx":4,"correct":true,"proposition":"Mycological skin sampling","justification":"Dermatophytosis is suspected here. The most cost-effective examination is therefore a mycological sample to find out what we are ⚔ fighting against."}],"type":"qi"}
{"_id":"annales-2020-qi-99","enonce":"A 45-year-old man consults you for dyspnea of effort. On cardiac auscultation, you find a proto-meso-diastolic murmur better perceived when sitting. Blood pressure is 120\/40 mmHg in both arms. Neck inspection finds synchronous pulse beats. What is your diagnosis?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Benign acute pericarditis","justification":""},{"idx":1,"correct":true,"proposition":"Aortic insufficiency","justification":""},{"idx":2,"correct":false,"proposition":"Mitral prolapse or Barlow's disease","justification":""},{"idx":3,"correct":false,"proposition":"!right heart failure","justification":""},{"idx":4,"correct":false,"proposition":"Aortic coarctation","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-100","enonce":"As a general practitioner, you detect an HIV infection in a 27-year-old butcher. Several butchers work in his butcher shop and they share knives. Which prevention measure should you propose first (only one expected response)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Prescription of sick leave until an undetectable viral load is obtained","justification":""},{"idx":1,"correct":false,"proposition":"Tell the patient to inform other butchers of their HIV status","justification":""},{"idx":2,"correct":true,"proposition":"Recommend the use of strictly personal knives","justification":"Primary prevention measures are more urgent to put in place than secondary prevention measures (telling colleagues that they should be tested)."},{"idx":3,"correct":false,"proposition":"Inform other butchers yourself of this HIV status","justification":""},{"idx":4,"correct":false,"proposition":"Request the patient's invalidity from the medical officer","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-101","enonce":"A 4-year-old boy is brought to the emergency room for a hematemesis that occurred in a context of rheumatoid purpura started 3 days earlier. Upon diagnosis, he complained of abdominal pain that was treated symptomatically. His heart rate is 120 beats per minute, his systolic blood pressure is 110 mmHg, his temperature is 37.1°C.  Abdominal palpation is painful, defenseless. What is the most likely diagnosis?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Acute intussusception","justification":"No hematemesis in IIA."},{"idx":1,"correct":false,"proposition":"Duodenal ulcer","justification":"This potit patient has no reason to have a duodenal 🤷 ♂️ ulcer"},{"idx":2,"correct":false,"proposition":"Swallowed epistaxis","justification":"The college reminds us several times: a swallowed epistaxis is not a cause of hematemesis but a differential diagnosis!"},{"idx":3,"correct":false,"proposition":"Esophagitis","justification":"This potit patient has no reason to have esophagitis 🤷 ♂️"},{"idx":4,"correct":true,"proposition":"Hematoma of the gastric wall","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-102","enonce":"A 68-year-old man consults his GP for a recent onset resting tremor. The clinical examination shows a slowdown at the initiation of movements and a phenomenon of << cogwheel >> at the wrists. What medication(s) should you look for before making a definitive diagnosis?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Selective 5-hydroxytryptamine-1D receptor agonists (triptans)","justification":"Triptans are not a classic cause of iatrogenic parkinsonism syndrome."},{"idx":1,"correct":true,"proposition":"Certain intestinal motor stimulants, such as metoclopramide","justification":""},{"idx":2,"correct":true,"proposition":"Neuroleptics of the phenothiazine class","justification":""},{"idx":3,"correct":true,"proposition":"Some antihistamines for systemic use, such as alimemazine","justification":""},{"idx":4,"correct":true,"proposition":"Neuroleptics of the butyrophenone class","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-103","enonce":"A young man consults the emergency room following an assault. His attacker stabbed him in the face. It has a transfixing jugal wound of 5 cm, above the lateral canthus (see diagram). What anatomical elements can be damaged by this wound? (one or more expected answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"The frontal branch of the facial nerve","justification":""},{"idx":1,"correct":true,"proposition":"The parotid salivary duct","justification":""},{"idx":2,"correct":true,"proposition":"The oral branch of the facial nerve","justification":""},{"idx":3,"correct":true,"proposition":"The facial artery"},{"idx":4,"correct":false,"proposition":"The infraorbital nerve"}],"type":"qi"}
{"_id":"annales-2020-qi-104","enonce":"A 79-year-old man with Parkinson's disease has intense and continuous suprapubic pain. He has not been able to urinate for several hours. Palpation shows a rounded suprapubic mass, matte to percussion. It is treated with dopaminergics (levodopa-benserazide), sympathomimetic (midodrine) for orthostatic hypotension and alpha-blocker (tamsulosin). After bladder probing, what modification(s) of the drug treatment do you propose?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Decrease in the dosage of levodopa-benserazide","justification":""},{"idx":1,"correct":false,"proposition":"Discontinuation of tamsulosin"},{"idx":2,"correct":true,"proposition":"Discontinuation of midodrine"},{"idx":3,"correct":false,"proposition":"Introduction of furosemide"},{"idx":4,"correct":false,"proposition":"Introduction of a beta-blocker","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-106","enonce":"A 34-year-old woman was diagnosed with pulmonary tuberculosis. A triple antibiotic therapy (rifampicin, isoniazid, pyrazinamide) is implemented. Its only usual treatment is oral contraception (levonorgestrel, ethinyl estradiol). What advice(s) do you have?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Use a mechanical contraceptive method for the duration of rifampicin treatment","justification":""},{"idx":1,"correct":false,"proposition":"Replace current contraception with a progestin","justification":"Rifampicin is an enzyme inducer that reduces the effectiveness of oral contraception."},{"idx":2,"correct":true,"proposition":"Inform about the risk of reducing the contraceptive effectiveness of an estrogen-progestin","justification":""},{"idx":3,"correct":false,"proposition":"Increase the dose of ethinyl estradiol","justification":""},{"idx":4,"correct":false,"proposition":"Regularly dose plasma rifampicin","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-107","enonce":"A vestibular schwannoma can be diagnosed before: (one or more expected responses) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":" Sudden deafness","justification":""},{"idx":1,"correct":false,"proposition":"Unilateral conductive hearing loss of slowly progressive evolution","justification":"Deafness is conductive."},{"idx":2,"correct":true,"proposition":"Facial paralysis","justification":""},{"idx":3,"correct":true,"proposition":"Ataxia with frustrated walking","justification":"Vestibular 👉 involvement Ataxia with light walking (= frustrated)."},{"idx":4,"correct":false,"proposition":"Minimal otolicorrhea","justification":"It's a bit far from the external 😉 ear canal"}],"type":"qi"}
{"_id":"annales-2020-qi-108","enonce":"A 75-year-old patient complains of a cough, with colored sputum, in a context of fever evolving for 72 hours. Her doctor did not notice any signs of seriousness and prescribed probabilistic clarithromycin antibiotics. Its usual treatment is limited to ezetimibe-simvastatin and low-dose acetylsalicylic acid. What advice(s) could you make?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"No therapeutic modification","justification":""},{"idx":1,"correct":true,"proposition":"Discontinuation of simvastatin for the duration of clarithromycin treatment","justification":"Macrolides are enzyme inhibitors. There is no risk in stopping statins for a few days."},{"idx":2,"correct":false,"proposition":"Discontinuation of acetylsalicylic acid for the duration of treatment with clarithromycin","justification":""},{"idx":3,"correct":false,"proposition":"Decrease in ezetimibe dosage during treatment with clarithromycin","justification":""},{"idx":4,"correct":false,"proposition":"Replacement of clarithromycin with erythromycin","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-109","enonce":"Speech therapy sessions may be prescribed in case of: (one or more expected responses) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Severe bilateral deafness of the child","justification":""},{"idx":1,"correct":true,"proposition":"Stuttering in an adult","justification":""},{"idx":2,"correct":true,"proposition":"Decreased post-traumatic oral opening","justification":""},{"idx":3,"correct":true,"proposition":"Meniere's disease after an acute phase","justification":""},{"idx":3,"correct":true,"proposition":"acquisition of an esophageal voice","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-11","enonce":"Jules, 7, is scheduled to have surgery for phimosis. The preoperative hemostasis assessment shows: Quick time (TQ) = 12.5 s; control= 11.5 s; ratio: 1.08; cephalin time with activator (TCA) = 59 s; control= 32 s; ratio: 1.84; fibrinogen 2.8 g\/L (standards: 2-4 g\/L); blisters 290 G\/L. \n\nWhat are the diagnostic hypotheses to be formulated in Jules in front of this hemostasis assessment? (one or more correct answers) ","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Willebrand disease","justification":""},{"idx":1,"correct":true,"proposition":"Factor XI deficiency","justification":"TCA: factor VIII (hemophilia A, Willebrand disease because this factor is protected by Willebrand factor), factor IX (hemophilia B), factor XI and factor XII."},{"idx":2,"correct":false,"proposition":"Protein C deficiency","justification":""},{"idx":3,"correct":true,"proposition":"Hemophilia A","justification":""},{"idx":4,"correct":true,"proposition":"Hemophilia B","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-111","enonce":"A woman of Martinican origin has just given birth. The child's father is also of Martinican origin. The child has a cleft lip and palate. With regard to regulatory newborn screening of this child, what is the exact proposal(s)?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Phenylketonuria is the only disease of amino acid and organic acid metabolism currently being screened for newborn in France","justification":"Now there is the MCAD deficiency"},{"idx":1,"correct":false,"proposition":"General screening test can detect hypothyroidism of pituitary origin","justification":""},{"idx":2,"correct":true,"proposition":"This couple can refuse the screening after information","justification":""},{"idx":3,"correct":true,"proposition":"Completion before 48 h of life decreases the sensitivity and\/or specificity of the screening test","justification":""},{"idx":4,"correct":false,"proposition":"Targeted screening for sickle cell disease is not indicated in this child","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-112","enonce":"You receive a 3-month-old infant for a systematic visit. He was born at term after a normal pregnancy. You saw him at the age of 2 months for his vaccinations, his examination was normal. He is very awake but moves spontaneously very little. What proposal(s) is (are) in favor of peripheral neurological involvement?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Essentially axial hypotonia","justification":""},{"idx":1,"correct":true,"proposition":"Normal head circumference","justification":""},{"idx":2,"correct":false,"proposition":"Presence of oculomotor disorders","justification":""},{"idx":3,"correct":true,"proposition":"Presence of smile response","justification":""},{"idx":4,"correct":false,"proposition":"Presence of dysmorphic signs","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-114","enonce":"You organize the care pathway of a 90-year-old patient, previously autonomous and living at home, admitted following a fracture of the upper end of the femur operated the day before with the placement of an intermediate prosthesis without surgical complications. Which proposal(s) are (are) part of your care?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Immediate resumption of walking","justification":""},{"idx":1,"correct":true,"proposition":"Preventive anticoagulation for a period of 45 days","justification":""},{"idx":2,"correct":false,"proposition":"Routine prescription of oral nutritional supplements","justification":""},{"idx":3,"correct":false,"proposition":"Prescribing benzodiazepines to ensure restful sleep","justification":""},{"idx":4,"correct":true,"proposition":"Prescription of bisphosphonates in case of femoral T-score ≤ -1","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-115","enonce":" Which symptom(s) is part of the clinical picture of a hypomanic episode?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Disorganization of thought","justification":"Disorganization of thought is classically not found in bipolarity (rather a symptom of schizophrenia)."},{"idx":1,"correct":true,"proposition":"Distractibility","justification":""},{"idx":2,"correct":false,"proposition":"Suicidal ideation","justification":"The presence of suicidal ideation classifies the clinical picture in the manic phase."},{"idx":3,"correct":true,"proposition":"Megalomaniac ideas","justification":""},{"idx":4,"correct":true,"proposition":"Irritability","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-116","enonce":"In front of a twelve-month-old child, what proposal(s) do you remember as a warning sign of a neurodevelopmental disorder?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":" A lack of joint attention","justification":""},{"idx":1,"correct":false,"proposition":"Separation anxiety","justification":"This is quite normal at this age."},{"idx":2,"correct":false,"proposition":"A lack of daytime cleanliness","justification":""},{"idx":3,"correct":true,"proposition":"A lack of smile-response","justification":""},{"idx":4,"correct":true,"proposition":"An absence of nycthemeral periodicity of sleep","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-117","enonce":"A 34-year-old patient complains of excessive anxiety. Which of the following symptoms specifically points to a diagnosis of generalized anxiety disorder?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":" Irritability","justification":""},{"idx":1,"correct":true,"proposition":"A delay in falling asleep of more than 1 hour"},{"idx":2,"correct":false,"proposition":"Significant anxiety when speaking in public","justification":"This proposal refers to social phobia."},{"idx":3,"correct":true,"proposition":"A fatIgAbility","justification":""},{"idx":4,"correct":false,"proposition":"A sad mood for two weeks following an emotional breakdown","justification":"This proposal refers to the characterized depressive episode."}],"type":"qi"}
{"_id":"annales-2020-qi-118","enonce":"The mother of a 17-year-old patient smoking cannabis asks you about the risks associated with this use, acute or chronic. What information(s) is(are) accurate about this?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":true,"proposition":"Possible occurrence of delirium","justification":""},{"idx":1,"correct":true,"proposition":"Possible occurrence of a withdrawal syndrome","justification":""},{"idx":2,"correct":false,"proposition":"Increased risk of status seizure","justification":""},{"idx":3,"correct":true,"proposition":"Increased risk of bronchopulmonary disease","justification":""},{"idx":4,"correct":true,"proposition":"Risk of precipitating entry into schizo p hrenia in vulnerable individuals","justification":""}],"type":"qi"}
{"_id":"annales-2020-qi-120","enonce":"You are the general practitioner of Mr. M., 75 years old, who has been suffering for 3 years from small cell lung cancer. He is also followed by a mobile palliative care team for the management of very disabling pain related to bone metastases. The patient lives at home with his wife. With your agreement, the mobile team doctor came to see the patient at home because of an increase in the pain picture. He decided to modify the analgesic treatment by introducing corticosteroids and increasing the opioid treatment. 48 hours later, during her visit to her home, the liberal nurse calls you because she suspects an overdose with opioids. What is the most important question to ask?","item":"annales-2020-qi","matiere":"annales-2020","propositions":[{"idx":0,"correct":false,"proposition":"Does the patient have a miosis?","justification":""},{"idx":1,"correct":false,"proposition":"Did the patient vomit that night?","justification":""},{"idx":2,"correct":true,"proposition":"What is the patient's respiratory rate?","justification":""},{"idx":3,"correct":false,"proposition":"Is the patient drowsy?","justification":""},{"idx":4,"correct":false,"proposition":"Is the patient painful?","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-2","enonce":" In consultation with his parents, you will see a 16-year-old teenager who has been suffering from generalized tonic-clonic seizures since the age of 12. Her epilepsy is poorly balanced by treatment (valproate). They ask you about his academic orientation, because he must choose a professionalizing path. They considered several possibilities. Among those they mention to you, which one (which) do you advise against (one or more expected proposals)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"tiler","justification":""},{"idx":1,"correct":false,"proposition":"Delivery driver","justification":""},{"idx":2,"correct":false,"proposition":"carpenter","justification":""},{"idx":3,"correct":false,"proposition":"car mechanic","justification":""},{"idx":4,"correct":false,"proposition":"roofer","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-3","enonce":" Regarding AA amyloidosis, what is (are) the exact proposal(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"the kidney is frequently affected","justification":""},{"idx":1,"correct":false,"proposition":"the heart is frequently affected","justification":""},{"idx":2,"correct":false,"proposition":"the peripheral nerve is frequently affected","justification":""},{"idx":3,"correct":false,"proposition":"it is linked to an accumulation of IgA","justification":""},{"idx":4,"correct":false,"proposition":"Diagnosis can be made on a salivary gland biopsy","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-4","enonce":" Regarding mutations in the APC gene in familial adenomatous polyposis syndrome, which proposals are correct? (one or more proposals expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Pathogenic mutations in this gene are expressed in the heterozygous state","justification":""},{"idx":1,"correct":false,"proposition":"A colonoscopy may be offered to minors","justification":""},{"idx":2,"correct":false,"proposition":"Genetic exploration must be offered to relatives","justification":""},{"idx":3,"correct":false,"proposition":"Upper gastrointestinal involvement is possible and warrants gastroscopy","justification":""},{"idx":4,"correct":false,"proposition":"Mutations in this gene predispose to breast cancer","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-5","enonce":" Regarding cadaveric lividities, which is (are) the exact proposal(s):","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"They are dependent on the type of insects present on the corpse","justification":""},{"idx":1,"correct":false,"proposition":"They are less marked in case of internal bleeding at the time of death","justification":""},{"idx":2,"correct":false,"proposition":"They are non-existent in melanoderma individuals","justification":""},{"idx":3,"correct":false,"proposition":"They are one of the indicators of the post-mortem time","justification":""},{"idx":4,"correct":false,"proposition":"They are due to a passive phenomenon of blood sweating after death","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-6","enonce":" A 42-year-old patient has cervical angioedema. The blood laboratory test shows a deficiency of C1 esterase inhibitor. Which drug(s) is (are) likely to be involved?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"proton pump inhibitors","justification":""},{"idx":1,"correct":false,"proposition":"calcium channel blockers","justification":""},{"idx":2,"correct":false,"proposition":"Selective competitive bradykinin receptor antagonist type 2","justification":""},{"idx":3,"correct":false,"proposition":"sartans","justification":""},{"idx":4,"correct":false,"proposition":"ACE inhibitors","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-7","enonce":" Mr. C., 60 years old, is followed by his general practitioner whom he declared as a general practitioner. The latter has just diagnosed him with chronic obstructive pulmonary disease. The patient presents an active smoking quantified at 45 pack-years. He has just been admitted to long-term illness. He has no other pathology and is totally autonomous. Which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It is exempt from the flat-rate contribution of € 1 per consultation","justification":""},{"idx":1,"correct":false,"proposition":"He is exempt from the co-payment for all medical examinations that he will have to carry out","justification":""},{"idx":2,"correct":false,"proposition":"It benefits from a management of nicotine substitutes","justification":""},{"idx":3,"correct":false,"proposition":"He benefits from 100% coverage of his ambulance transport for all his consultations","justification":""},{"idx":4,"correct":false,"proposition":"In case of hospitalization, the hospital package may be reimbursed, in part or in full, by its complementary health","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-8","enonce":" You receive a 70-year-old patient with a history of myocardial infarction, who has uncontrolled epistaxis. What will be the elements of your care? (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"you ask him not to blow his nose","justification":""},{"idx":1,"correct":false,"proposition":"you set up a venous line","justification":""},{"idx":2,"correct":false,"proposition":"you perform an ECG","justification":""},{"idx":3,"correct":false,"proposition":"You request a CT scan of the facial mass","justification":""},{"idx":4,"correct":false,"proposition":"embolization will be the first-line treatment","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-9","enonce":" Here is an X-ray of the elbow in profile made in the context of a trauma. What is (are) the exact element(s) of radioanatomy?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"1 corresponds to the radius neck","justification":""},{"idx":1,"correct":false,"proposition":"2 corresponds to the olecranium","justification":""},{"idx":2,"correct":false,"proposition":"3 corresponds to the capitulum","justification":""},{"idx":3,"correct":false,"proposition":"4 corresponds to the ulna","justification":""},{"idx":4,"correct":false,"proposition":"5 corresponds to the coracoid process","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-10","enonce":" A 45-year-old patient has weakness of the left hemibody predominant in the arm. His entourage tells you that he hit his left side several times when crossing the doors of his home. The bilateral and simultaneous tactile stimulation of the 2 upper limbs is not perceived on the left while the right and left stimulations are perfectly identified when the stimulation is done only on one side. By asking the patient to stare at your nose and alternately mobilizing your hands, he cannot discern the movements of your right hand while your left hand is perfectly perceived. The osteotendinous reflexes are more vivid on the left than on the right. The plantar skin reflex is extended to the left. Which clinical sign(s) should be mentioned?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"left hemicorporeal hypoaesthesia","justification":""},{"idx":1,"correct":false,"proposition":"Left sensory extinction","justification":""},{"idx":2,"correct":false,"proposition":"Left homonymous lateral hemianopsia","justification":""},{"idx":3,"correct":false,"proposition":"left pyramidal syndrome","justification":""},{"idx":4,"correct":false,"proposition":"extrapyramidal syndrome","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-11","enonce":" One patient is being followed for minimal corticosteroid-dependent glomerular lesions syndrome. He suddenly relapses to the decline of corticosteroids. He gained 10 kg in 1 week. Its biology is as follows: albuminemia 12g \/ l, urea 25 mmol \/ l, serum creatinine 160 micromol \/ l, natriuresis 12 mmol \/ l, kaliuresis 35 mmol \/ l. ECBU: red blood cells <1000 \/ ml, leukocytes <1000 \/ ml, sterile in 24h. What is the most likely cause of acute renal failure in this patient?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"functional renal impairment by relative (or effective) hypovolemia","justification":""},{"idx":1,"correct":false,"proposition":"Functional renal impairment by true hypovolemia","justification":""},{"idx":2,"correct":false,"proposition":"thrombosis of renal veins","justification":""},{"idx":3,"correct":false,"proposition":"glomerular extracapillary proliferation","justification":""},{"idx":4,"correct":false,"proposition":"Extramembranous deposits","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-12","enonce":" Which of the following symptoms is (are) part of the diagnosis of obsessive-compulsive disorder?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Ideative obsessions","justification":""},{"idx":1,"correct":false,"proposition":"fear of committing a reprehensible act in spite of oneself","justification":""},{"idx":2,"correct":false,"proposition":"Reference ideas","justification":""},{"idx":3,"correct":false,"proposition":"suicidal ruminations","justification":""},{"idx":4,"correct":false,"proposition":"verification rituals","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-13","enonce":" You suspect multiple myeloma in a 58-year-old patient who comes to see you for impaired general condition and bone pain. It has a peak of monoclonal appearance at electrophoresis. Which exams do you think are relevant to perform? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Bone densitometry","justification":""},{"idx":1,"correct":false,"proposition":"A myelogram","justification":""},{"idx":2,"correct":false,"proposition":"Determination of serum calcium","justification":""},{"idx":3,"correct":false,"proposition":"Serum albumin determination","justification":""},{"idx":4,"correct":false,"proposition":"Determination of beta2 microglobulinemia","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-14","enonce":" Regarding small cell lung cancers, what is (are) the exact answer(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"They represent 35% of all bronchial cancers","justification":""},{"idx":1,"correct":false,"proposition":"These are willingly cancers with proximal localization on the airways","justification":""},{"idx":2,"correct":false,"proposition":"They are readily accompanied by superior cava syndrome","justification":""},{"idx":3,"correct":false,"proposition":"Paraneoplastic syndromes are exceptional in this histological form","justification":""},{"idx":4,"correct":false,"proposition":"Treatment is more often surgical in locally advanced forms","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-15","enonce":" Mrs. F, 22, has a microcytic iron deficiency anemia of gynecological origin. You prescribe a martial treatment per os. What do you say to him? (one or more possible answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"An oral treatment of 1 month is usually sufficient to correct the iron deficiency","justification":""},{"idx":1,"correct":false,"proposition":"Martial supplementation will be continued until serum iron normalizes","justification":""},{"idx":2,"correct":false,"proposition":"Treatment can lead to digestive disorders","justification":""},{"idx":3,"correct":false,"proposition":"vitamin C increases oral iron absorption","justification":""},{"idx":4,"correct":false,"proposition":"oral iron causes stool discoloration","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-16","enonce":" With regard to thyroid goiters, which proposition(s) is(are) true?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Iodine deficiency is a risk factor for simple goiter","justification":""},{"idx":1,"correct":false,"proposition":"Tobacco promotes the occurrence of goiters","justification":""},{"idx":2,"correct":false,"proposition":"A scintigraphy is the first-line examination in front of a goiter","justification":""},{"idx":3,"correct":false,"proposition":"The cervico-thoracic CT scan is used to diagnose plunging goiters","justification":""},{"idx":4,"correct":false,"proposition":"the blood test of TSH is essential in the goiter assessment","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-17","enonce":" Which of the following proposals regarding indications for bariatric surgery is (are) true?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"BMI should be greater than 40 kg\/m2 or 35 kg\/m2 if there is associated co-morbidity","justification":""},{"idx":1,"correct":false,"proposition":"The indication for bariatric surgery should be taken in a multidisciplinary consultation meeting for all patients","justification":""},{"idx":2,"correct":false,"proposition":"Surgery can only be offered after failure of well-conducted medical care for at least 6 months","justification":""},{"idx":3,"correct":false,"proposition":"the patient must be over 21 years of age","justification":""},{"idx":4,"correct":false,"proposition":"the patient must agree to be followed for life","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-18","enonce":" With regard to liver tumours, which is (are) the true proposition(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Hepatic adenoma has a hypodense, heterogeneous appearance with fleeting arterial enhancement on injected CT","justification":""},{"idx":1,"correct":false,"proposition":"focal nodular hyperplasia is characterized by the presence of a hypo-intense central scar on T1 MRI","justification":""},{"idx":2,"correct":false,"proposition":"On CT scan, the hemangioma is characterized by a << >> clod enhancement after injection of contrast medium","justification":""},{"idx":3,"correct":false,"proposition":"In the context of chronic liver disease, the first diagnosis to evoke in front of an isolated nodule on CT scan is hepatocellular carcinoma","justification":""},{"idx":4,"correct":false,"proposition":"MRI is used to characterize liver tumours","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-19","enonce":" A patient, whom you have been following for a long time for her active non-progressive multiple sclerosis (MS) and who does not tolerate her treatment, consults you with a scientific article talking about a new treatment that has just been put on the market and that allows good control of flare-ups. She would like to hear from you. You see that this is a non-inferiority trial conducted in patients with non-progressive active MS compared to a reference treatment currently available to this patient. The authors of the study considered that a 10% increase in relapses compared to the standard of care was acceptable as long as there was also a decrease in adverse events. This is a sufficiently powered test with no obvious bias. The relative risk (RR) of relapse is 1.03 (95% confidence interval [1.01-1.06]), and the RR of adverse event is 0.95 (95% confidence interval [0.87-1.02]). The authors conclude that their treatment is interesting because it is non-inferior and without over-risk of adverse events. What can you tell your patient based on these results? (one or more proposals expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"New treatment controls flare-ups in an acceptable way","justification":""},{"idx":1,"correct":false,"proposition":"New treatment puts less risk of adverse events","justification":""},{"idx":2,"correct":false,"proposition":"The new treatment may be interesting for your patient","justification":""},{"idx":3,"correct":false,"proposition":"Only a superiority trial would make it possible to evaluate the interest of this new treatment","justification":""},{"idx":4,"correct":false,"proposition":"A statistical test of non-inferiority is missing to conclude that the treatment is worthwhile","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-20","enonce":" A colleague wants to set up a study on a new preventive treatment for flare-ups in Crohn's disease. It is a known molecule, already used in other inflammatory diseases and without known serious adverse effects. The study sponsor has sent them documents to fill out and your colleague is asking for your opinion on the regulatory procedures. What do you say to this colleague? (one or more proposals expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"This is a minimal-risk interventional study","justification":""},{"idx":1,"correct":false,"proposition":"The favourable opinion of a Committee for the Protection of Persons (CPP) is necessary","justification":""},{"idx":2,"correct":false,"proposition":"The authorization of the National Agency for the Safety of Medicines and Health Products (ANSM) is necessary","justification":""},{"idx":3,"correct":false,"proposition":"An information sheet for the patient on the risks involved is necessary","justification":""},{"idx":4,"correct":false,"proposition":"A phase 1 study is required beforehand","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-21","enonce":" A patient consults for the renewal of his glasses. Your clinical examination reveals acuity at 10\/10 th Parinaud 2 in both eyes with the following correction: - 8 (-1 to 150 °) in the right eye and -9 (-1.25 to 135 °) in the left eye. What are the risks associated with its ametropia? (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"chronic angle-closure glaucoma","justification":""},{"idx":1,"correct":false,"proposition":"retinal detachment","justification":""},{"idx":2,"correct":false,"proposition":"cataract","justification":""},{"idx":3,"correct":false,"proposition":"macular atrophy","justification":""},{"idx":4,"correct":false,"proposition":"accommodative strabismus","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-22","enonce":" You are called to the home of a 10-year-old child who has acute hives 4 days after a booster vaccine. The lesions are diffuse in the chest and limbs, and rapidly migratory, which impresses the mother of the child. Pulmonary auscultation is free. Blood pressure is at 105\/70 mm Hg. What do you offer? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Oral corticosteroid therapy oral solution","justification":""},{"idx":1,"correct":false,"proposition":"H1 antihistamine oral solution once daily","justification":""},{"idx":2,"correct":false,"proposition":"Transfer to emergency department for a few hours of monitoring","justification":""},{"idx":3,"correct":false,"proposition":"Dermocorticoid class 2 for the duration of symptoms","justification":""},{"idx":4,"correct":false,"proposition":"Remote allergological investigation of the current acute episode","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-24","enonce":" You take care of a patient in intensive care. He is married and has 3 children, one of whom is a minor. He designated his only brother as a trusted person. He did not write advance directives. Unfortunately, its clinical situation becomes extremely pejorative with an almost non-existent recovery capacity. You decide to initiate a reflection on a possibility of limitation of processing, in order to avoid unreasonable obstinacy. As part of this reflection, you initiate a collegial procedure as provided for by law. Which person should be consulted in the context of this collegial procedure to seek the wishes expressed by the patient?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"His only brother","justification":""},{"idx":1,"correct":false,"proposition":"The 2 adult children","justification":""},{"idx":2,"correct":false,"proposition":"His wife","justification":""},{"idx":3,"correct":false,"proposition":"His notary","justification":""},{"idx":4,"correct":false,"proposition":"The minor child","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-26","enonce":" A 25-year-old woman, hairdresser, has erythematous and pruritic dermatitis of the hands, located in particular between the fingers, reminiscent of allergic contact dermatitis. What element(s) reinforces the hypothesis of work-related allergic contact dermatitis?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"regular use of products containing allergens in the workplace","justification":""},{"idx":1,"correct":false,"proposition":"similar injuries in co-workers","justification":""},{"idx":2,"correct":false,"proposition":"the presence of positive skin prick tests","justification":""},{"idx":3,"correct":false,"proposition":"regression of injuries during leave","justification":""},{"idx":4,"correct":false,"proposition":"the appearance of lesions from the first days of her apprenticeship as a hairdresser","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-28","enonce":" In the context of palliative care, the High Authority for Health defines a concept of vital prognosis << in the short term >>. Which of the following best fits this definition?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"from seconds to minutes","justification":""},{"idx":1,"correct":false,"proposition":"from a few minutes to a few hours","justification":""},{"idx":2,"correct":false,"proposition":"from a few hours to a few days","justification":""},{"idx":3,"correct":false,"proposition":"from a few days to a few weeks","justification":""},{"idx":4,"correct":false,"proposition":"from a few weeks to a few months","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-29","enonce":" A young man of 23 years comes to your office in a painting of asthenia and myalgia; it has no history. On examination, you notice erythematous angina, cervical and axillary lymphadenopathy of one or two centimeters, soft, mobile and painless. What are the biological arguments in favor of infectious mononucleosis? (one or more possible answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":">10% hyperbasophilic polymorphic lymphocyte cells","justification":""},{"idx":1,"correct":false,"proposition":"> 50% lymphocytes in the leukocyte formula","justification":""},{"idx":2,"correct":false,"proposition":"Hepatic cytolysis","justification":""},{"idx":3,"correct":false,"proposition":"Hepatic cholestasis","justification":""},{"idx":4,"correct":false,"proposition":"Thrombocytosis","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-30","enonce":" During the clinical examination of a 62-year-old patient treated for high blood pressure and who consults you for the occurrence of pain in the lower right limb when walking, you have measured humeral pressure in both arms as well as distal pressures and established the value of systolic ankle pressure indexes:  humeral pressures at 162\/72 mmHg on the right and 158\/70 mmHg on the left arm; left ankle pressure at 148 mmHg (systolic left ankle pressure index at 0.93); right ankle pressures at 120 mmHg (systolic left ankle pressure index at 0.75). What can you say from these results? (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"the treatment of hypertension is not suitable","justification":""},{"idx":1,"correct":false,"proposition":"This patient is a carrier of arterial disease of the lower limbs","justification":""},{"idx":2,"correct":false,"proposition":"This limping patient is in the stage of exercise ischemia","justification":""},{"idx":3,"correct":false,"proposition":"This patient has significant anisotension","justification":""},{"idx":4,"correct":false,"proposition":"This patient is suspected of aortic dissection","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-31","enonce":" You have been following Mr. X in consultation for 2 years. This 62-year-old patient has a subrenal abdominal aortic aneurysm. The last ultrasound assessment carried out 6 months ago did not show any evolution of the aneurysm which had been measured at 41 mm anteroposterior diameter. He presents today in emergency for the occurrence for more than an hour of a dull and continuous abdomino-lumbar pain. Gentle abdominal palpation is difficult. You find all the peripheral pulses. Blood pressure is measured at 140\/70 mmHg in both arms and heart rate is steady at 76 beats per minute. What management strategy do you propose to this patient? (only one answer expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Emergency exploratory laparotomy","justification":""},{"idx":1,"correct":false,"proposition":"Emergency Aortic Doppler Ultrasound","justification":""},{"idx":2,"correct":false,"proposition":"emergency arteriogram of the aorta","justification":""},{"idx":3,"correct":false,"proposition":"emergency aortic angiography","justification":""},{"idx":4,"correct":false,"proposition":"Intensive Care Monitoring","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-33","enonce":" You see in the early afternoon at your office a young man of 17 years who has a fever at 39 ° C since this morning. He is brought by his mother who prefers to come to your house because she lives next door, while the hospital is 1 kilometer away. He tells you that he has had a headache for several hours despite taking paracetamol. He vomited recently when he didn't eat anything at noon. The temperature is 39.2°C.  He has trouble bringing his chin back to the sternum, can't help but bend his lower limbs and says he is bothered by street noise. There are no skin abnormalities. What do you do very quickly? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Blood culture collection","justification":""},{"idx":1,"correct":false,"proposition":"Performing a lumbar puncture","justification":""},{"idx":2,"correct":false,"proposition":"Administration of one gram of ceftriaxone intramuscularly","justification":""},{"idx":3,"correct":false,"proposition":"Administration of oral or intravenous dexamethasone","justification":""},{"idx":4,"correct":false,"proposition":"Call to Centre 15 (UAS)","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-34","enonce":" A 25-year-old woman consults with her 27-year-old husband for a desire for pregnancy. It reports regular cycles of 28 days and periods lasting 4 days. They have been in a relationship for five years and have been trying unsuccessfully to get pregnant for two years (stopping the pill and regular sex). This man has no history and he does not smoke. This woman has never smoked and was operated on for appendicular peritonitis at the age of 16, by laparoscopy. The clinical examination of this man shows normal hair and genitals (testicles and penis) of normal appearance and volume. He is 1m80 tall and weighs 74 kg. The clinical examination of this woman objectifies the scars of laparoscopy, normal breasts and normal external genitalia; She is 1m67 tall and weighs 59 kg. The examination of the cervix under speculum is normal, as is the vaginal examination which does not objectify any abnormality. Among all the examinations that you could prescribe for this interfility assessment, and taking into account your observation (interrogation and clinical examination of this couple), what are the two most important examinations to prescribe to determine the continuation of the care?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Antral follicle count by pelvic ultrasound","justification":""},{"idx":1,"correct":false,"proposition":"Spermogram and spermocytogram","justification":""},{"idx":2,"correct":false,"proposition":"Hormonal plasma assays of the woman (FSH, LH, E2, AMH) on the third day of the cycle","justification":""},{"idx":3,"correct":false,"proposition":"Hysterosalpingography","justification":""},{"idx":4,"correct":false,"proposition":"Bacteriological, mycological and parasitological vaginal samples","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-35","enonce":" A 40-year-old patient presents to the emergency room. He is known to be diabetic but adherence to treatment is poor. His left foot is deformed. The patient does not complain of pain. At the opening of the dressing, there is purulent discharge and a foul odor. On inspection, the patient is marbled. Blood pressure is at 80\/40mmHg. On palpation of the leg, you find a crackling and the local aspect is as follows. Which of the following proposals do you think is appropriate to the situation?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"The absence of pain is an element of good prognosis","justification":""},{"idx":1,"correct":false,"proposition":"Mottling and general signs indicate a therapeutic emergency","justification":""},{"idx":2,"correct":false,"proposition":"The functional prognosis of the leg is exceeded","justification":""},{"idx":3,"correct":false,"proposition":"The introduction of antibiotic therapy will be done after deep samples are taken in the operating room","justification":""},{"idx":4,"correct":false,"proposition":"The prognosis is life-threatening","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-36","enonce":" A 42-year-old woman consults for difficulty falling asleep that has lasted for years. She feels very tense and constantly worries \"about everything and nothing,\" she says. This makes her irritable and tiresome. What is the most likely diagnosis?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Depressive episode characterized with anxious characteristics","justification":""},{"idx":1,"correct":false,"proposition":"Adjustment insomnia","justification":""},{"idx":2,"correct":false,"proposition":"Generalized anxiety disorder","justification":""},{"idx":3,"correct":false,"proposition":"Panic disorder","justification":""},{"idx":4,"correct":false,"proposition":"Avoidant personality disorder","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-37","enonce":" You see a 25-year-old patient in the emergency room who has a traumatic wound on the lateral side of the knee. A photograph of the lesion is attached. On clinical examination, the patient has a motor deficit of dorsal flexion of the ankle and foot. There is also hypoaesthesia of the back of the foot. Given the location of the wound, which lesion do you suspect in the first place?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Trunk of the sciatic nerve","justification":""},{"idx":1,"correct":false,"proposition":"Common fibular nerve","justification":""},{"idx":2,"correct":false,"proposition":"Anterior tibial tendon","justification":""},{"idx":3,"correct":false,"proposition":"Proximal insertion of the long fibular muscle","justification":""},{"idx":4,"correct":false,"proposition":"Clean extensor muscle of hallux","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-38","enonce":" A 45-year-old woman consults for pelvic heaviness associated with moderate and intermittent left lower back pain. In her history, you note two vaginal deliveries, a cholecystectomy and a pollen allergy without associated asthma. His last cervical smear was two years ago and he was normal. She has contraception by copper intrauterine device. Clinical examination by abdominal palpation and objective vaginal examination a mobile pelvic mass of 10 cm, without ascites clinically identifiable with abdominal palpation. Vaginal secretions are normal in appearance. She weighs 62 kg for 1m59. The urine strip does not objectify leukocytes, red blood cells or nitrites and the search for beta-hCG is negative. What are the two most likely diagnoses?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Polymyomatous uterus","justification":""},{"idx":1,"correct":false,"proposition":"Endometrial adenocarcinoma","justification":""},{"idx":2,"correct":false,"proposition":"Pyosalpinx","justification":""},{"idx":3,"correct":false,"proposition":"Ovarian tumour","justification":""},{"idx":4,"correct":false,"proposition":"Uterine adenomyosis","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-39","enonce":" An 85-year-old woman with a history of breast neoplasia consults for right thigh pain. These pains are permanent. X-rays of the right femur were performed. Which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"There is weakening of the right proximal femur","justification":""},{"idx":1,"correct":false,"proposition":"There are osteocondensing ranges","justification":""},{"idx":2,"correct":false,"proposition":"There are osteolytic beaches","justification":""},{"idx":3,"correct":false,"proposition":"There are periosteal appositions","justification":""},{"idx":4,"correct":false,"proposition":"There are multiple areas of disappearance of cortical","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-40","enonce":" Regarding the osteology of the facial massif: (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"1 refers to the temporal bone","justification":""},{"idx":1,"correct":false,"proposition":"2 refers to the frontal bone","justification":""},{"idx":2,"correct":false,"proposition":"3 refers to the infraorbital foramen","justification":""},{"idx":3,"correct":false,"proposition":"4 refers to zygomatic bone","justification":""},{"idx":4,"correct":false,"proposition":"5 refers to the mandibular condyle","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-41","enonce":" You receive a young woman victim of a sports accident, she has a periorbital hematoma. What clinical elements point you to a fracture of the floor of the orbit? (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"inferior palpebral emphysema","justification":""},{"idx":1,"correct":false,"proposition":"conjunctival hemorrhage","justification":""},{"idx":2,"correct":false,"proposition":"diplopia","justification":""},{"idx":3,"correct":false,"proposition":"hypoaesthesia of the wing of the nose","justification":""},{"idx":4,"correct":false,"proposition":"epistaxis","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-42","enonce":" A 5-year-old child fell on his chin, he has a 1 cm wound, you want to eliminate a fracture of the mandibular condyle. What are you looking for at the clinical examination? (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"hypoaesthesia of the lower lip","justification":""},{"idx":1,"correct":false,"proposition":"an otorragia","justification":""},{"idx":2,"correct":false,"proposition":"stomatorragia","justification":""},{"idx":3,"correct":false,"proposition":"a limitation of the mouth opening","justification":""},{"idx":4,"correct":false,"proposition":"laterodeviation in the mouth opening","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-43","enonce":" An 18-year-old patient is transferred from orthopaedic surgery to follow-up care and orthopaedic rehabilitation. He was operated on 5 days before a major exostosis of the tibiotal joint as part of Bessel Hagen disease (multiple exostosis disease). He wears a resin immobilization for 6 weeks. The pain is localized throughout the leg but predominates at the ankle. The rating on the numerical scale is 6\/10. The pain is not relieved by level 1 analgesics at an effective dose. Which of the following proposals should you mention?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Compression under resin","justification":""},{"idx":1,"correct":false,"proposition":"Hey intra-articular morrhage","justification":""},{"idx":2,"correct":false,"proposition":"Complex regional pain syndrome type 1","justification":""},{"idx":3,"correct":false,"proposition":"Surgical site infection","justification":""},{"idx":4,"correct":false,"proposition":"Venous thrombosis of the leg","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-44","enonce":" A chronic low back pain patient enters a physical medicine and rehabilitation department for a multi-professional rehabilitation programme. He has been suffering from low back pain for 5 years. These continued after acute low back pain at his workplace. Which of the following applies(s) to the management of this patient?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"The physiotherapist can work on isometric strengthening of the abdominal strap muscles","justification":""},{"idx":1,"correct":false,"proposition":"Ergotherapy has a role in the management of","justification":""},{"idx":2,"correct":false,"proposition":"The realization of plantar orthotics by an orthopaedic technician is indicated","justification":""},{"idx":3,"correct":false,"proposition":"CBT (cognitive behavioural therapies) can be used to better manage pain","justification":""},{"idx":4,"correct":false,"proposition":"You can apply to the social security fund to apply for recognition of disabled workers.","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-45","enonce":" A 25-year-old patient presents for consultation for inflammatory arthralgia evolving for 6 months. She has Hashimoto's thyroiditis currently substituted with levothyroxine. She has no other symptoms to report and the clinical examination is poor, showing no synovitis. An immunological assessment was performed: - negative anti-CCP antibodies - rheumatoid factor positive >3N - anti-positive anti-nuclear antibodies - anti-SSA and anti-SSB positive >3N - negative native anti-DNA The search for antiphospholipids is positive anti-cardiolipin type (IgG and IgM positive >3N) without anti-b2GPI or circulating anticoagulant. The diagnosis of rheumatoid arthritis can be made","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"None of the propositions are true","justification":""},{"idx":1,"correct":false,"proposition":"The diagnosis of Sjögren's syndrome can be affirmed","justification":""},{"idx":2,"correct":false,"proposition":"Antiaggregant therapy should be introduced","justification":""},{"idx":3,"correct":false,"proposition":"It will be necessary to recontrol the anti-phospholipids at 3 months","justification":""},{"idx":4,"correct":false,"proposition":"The diagnosis of lupus may be suspected","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-47","enonce":" Which of the following proposals characterizes COPD?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"The constant association with chronic bronchitis","justification":""},{"idx":1,"correct":false,"proposition":"An incompletely reversible obstructive syndrome","justification":""},{"idx":2,"correct":false,"proposition":"Often accelerated decline in respiratory function","justification":""},{"idx":3,"correct":false,"proposition":"Smoking cessation cure","justification":""},{"idx":4,"correct":false,"proposition":"A beneficial effect of mumomotor drugs","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-48","enonce":" In a 40-year-old man complaining of a tendency to doze off during the day, what symptom(s) correspond to the diagnosis of narcolepsy?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"continuous and increasing sleepiness during the day","justification":""},{"idx":1,"correct":false,"proposition":"hypnopompic hallucinations","justification":""},{"idx":2,"correct":false,"proposition":"repeated bouts of abrupt abolition of muscle tone without altered consciousness","justification":""},{"idx":3,"correct":false,"proposition":"Hypnagogic hallucinations","justification":""},{"idx":4,"correct":false,"proposition":"transient complete paralysis occurring at the beginning of the night","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-49","enonce":" A ten-year-old has been repeating regularly for more than two years that he has << stomach ache >>. These abdominal complaints, without identified triggering factor, have been the subject of numerous assessments that have shown no cause of injury. Which of the following diagnostic proposals is the most likely?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"excessive fear of having a disease (hypochondria)","justification":""},{"idx":1,"correct":false,"proposition":"disorder with functional neurological symptomatology (conversion disorder)","justification":""},{"idx":2,"correct":false,"proposition":"somatic symptomatological disorder (somatoform pain disorder)","justification":""},{"idx":3,"correct":false,"proposition":"simulation","justification":""},{"idx":4,"correct":false,"proposition":"factitious disorder","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-50","enonce":" What type(s) of event(s) experienced can (can) lead to the development of post-traumatic stress disorder?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Receiving a letter of dismissal without having been prepared","justification":""},{"idx":1,"correct":false,"proposition":"verbal abuse and insults on the phone by an unhappy customer","justification":""},{"idx":2,"correct":false,"proposition":"Serious car accident without physical injury","justification":""},{"idx":3,"correct":false,"proposition":"Direct witness to the sudden death of a loved one by heart attack","justification":""},{"idx":4,"correct":false,"proposition":"Assault by a dog with severe bites","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-52","enonce":" You see a 23-year-old patient who complains of nocturnal dyspnea episodes 2 to 3 times a week. These episodes almost always occur around 5 a.m. She sometimes uses a salbutamol spray, which relieves her within minutes. She lives in a seemingly healthy apartment and has no pets at home. It is also sometimes hampered by a shortness of breath in its activities. She does not complain of any other symptoms. She has no other history and does not smoke. When you see her in consultation, her auscultation is normal. Which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"A nocturnal ventilatory polygraph recording should be performed","justification":""},{"idx":1,"correct":false,"proposition":"An allergy assessment including prick-tests to the main pneumallergens is necessary","justification":""},{"idx":2,"correct":false,"proposition":"A diagnosis of asthma seems likely","justification":""},{"idx":3,"correct":false,"proposition":"an oral corticosteroid test should be undertaken","justification":""},{"idx":4,"correct":false,"proposition":"Pulmonary function testing is indicated","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-53","enonce":" Regarding confusion in subjects over 75 years of age, which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It can be seen in case of meningoencephalitis","justification":""},{"idx":1,"correct":false,"proposition":"An organic etiology is rarely objectified","justification":""},{"idx":2,"correct":false,"proposition":"It is indicative of a decrease in cognitive reserves","justification":""},{"idx":3,"correct":false,"proposition":"It can be complicated by transient urinary incontinence","justification":""},{"idx":4,"correct":false,"proposition":"It can be complicated by bedsores","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-54","enonce":" You see a 9-month-old infant due to contact with his uncle who was hospitalized 15 days ago for tuberculosis with a cave. Her uncle spent 8 days at the child's home 2 months ago. The child was vaccinated with BCG at one month of age. The child's chest x-ray is normal. Regarding the care of the child, which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"performing a tuberculin RDI","justification":""},{"idx":1,"correct":false,"proposition":"Performing an in vitro interferon gamma release test","justification":""},{"idx":2,"correct":false,"proposition":"realization of gastric tubing in search of BAAR","justification":""},{"idx":3,"correct":false,"proposition":"Prescription for prophylactic treatment with isoniazid and rifampicin","justification":""},{"idx":4,"correct":false,"proposition":"performing a chest CT scan","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-55","enonce":" In anticipation of a caesarean section, a hemostasis assessment reveals a PT at 110%, a TCA ratio of 1.4 (42 seconds for a control at 30 seconds) and a fibrinogen at 3.5 g \/ l. Counts and platelets are normal. The patient has no history or clinical signs. What analysis would you ask for in the first line? (only one answer expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Determination of factor II","justification":""},{"idx":1,"correct":false,"proposition":"Determination of factor XIII","justification":""},{"idx":2,"correct":false,"proposition":"TCA correction test (sick TCA + control)","justification":""},{"idx":3,"correct":false,"proposition":"Platelet aggregation test","justification":""},{"idx":4,"correct":false,"proposition":"Determination of endogenous pathway factors","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-56","enonce":" A 5-year-old child has febrile exanthema and vomiting. There are large, uniform bright red congestive tablecloths with no healthy skin gaps that predominate at the bending folds. Examination of the mouth and throat shows a partially depapillated saburral tongue and swollen and inflammatory tonsils. The temperature is 39.5°C.  The rapid diagnostic test for streptococcus A is positive. Which proposal(s) is (are) accurate regarding care?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"amoxicillin antibiotic therapy for 6 days","justification":""},{"idx":1,"correct":false,"proposition":"School eviction for 6 days","justification":""},{"idx":2,"correct":false,"proposition":"search for group A streptococcus in the patient's siblings","justification":""},{"idx":3,"correct":false,"proposition":"search for proteinuria at a distance from infection","justification":""},{"idx":4,"correct":false,"proposition":"Oral antibiotic prophylaxis in the 80-year-old grandmother","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-57","enonce":" When monitoring a patient's pregnancy, intestinal hyperechogenicity was detected on the second morphological ultrasound of the fetus. The assessment of suspicion of cystic fibrosis led to demonstrate in the fetus the presence in the homozygous state of the p.Phe508del mutation at the CFTR locus. Which proposal(s) is (are) the exact proposal(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Full information about cystic fibrosis should be offered to this woman","justification":""},{"idx":1,"correct":false,"proposition":"Cystic fibrosis is a reportable disease","justification":""},{"idx":2,"correct":false,"proposition":"Recourse to medical termination of pregnancy is possible","justification":""},{"idx":3,"correct":false,"proposition":"A possible negative opinion of a CPDPN (Multidisciplinary Center for Prenatal Diagnosis) cannot be appealed","justification":""},{"idx":4,"correct":false,"proposition":"The patient can apply to the CPDPN (Multidisciplinary Center for Prenatal Diagnosis) through her gynecologist","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-58","enonce":" A 15-day-old newborn is brought in for discomfort. On examination, there is mucocutaneous jaundice and the stool has been discolored for several days according to the parents. He has not regained his birth weight and has difficulty sucking. His capillary blood glucose is 0.3 g \/ L. What is (are) the possible diagnosis (s) in front of this whole table?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"viral hepatitis B","justification":""},{"idx":1,"correct":false,"proposition":"Neonatal diabetes","justification":""},{"idx":2,"correct":false,"proposition":"hypothyroidism","justification":""},{"idx":3,"correct":false,"proposition":"congenital adrenal hyperplasia","justification":""},{"idx":4,"correct":false,"proposition":"Insufficient energy intake","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-59","enonce":" An 11-month-old infant is brought to the emergency room for functional impotence of the right lower limb without any notion of trauma. On examination the mobilization of the right lower limb is very painful and the joint amplitudes impossible to evaluate, there is a bruise on the right cheek The X-ray shows a fracture of the right femur. You suspect abuse. The child is kept at home by his paternal grandmother. What do you do? (one or more exact propositions)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Reporting to the public prosecutor","justification":""},{"idx":1,"correct":false,"proposition":"Taking pictures of the bruise","justification":""},{"idx":2,"correct":false,"proposition":"referral to the Brigade for the Protection of Minors","justification":""},{"idx":3,"correct":false,"proposition":"drafting an interim care order","justification":""},{"idx":4,"correct":false,"proposition":"Medical interrogation of grandmother","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-60","enonce":" An infant born prematurely at 36 SA is brought to the emergency room at 4 months of age for bronchiolitis. His respiratory rate is 55 per minute, his heart rate is 140 beats per minute, his temperature is 38.2°C.  On clinical examination, there is intercostal pulling, cyanosis and intense cough. Parents report that he drinks about 120 mL of milk out of the 180 mL he used to drink. What is the main criterion of severity in this child? (only one answer expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"prematurity","justification":""},{"idx":1,"correct":false,"proposition":"intense cough","justification":""},{"idx":2,"correct":false,"proposition":"Intercostal draw","justification":""},{"idx":3,"correct":false,"proposition":"cyanosis","justification":""},{"idx":4,"correct":false,"proposition":"reduced food intake","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-61","enonce":" Mrs. T. 57 years old, diabetic, consults you for her annual ophthalmological check-up. The diagnosis of diabetic retinopathy is based on the examination of the fundus, we can find: (one or more exact proposals)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Cottony nodules","justification":""},{"idx":1,"correct":false,"proposition":"Microaneurysms","justification":""},{"idx":2,"correct":false,"proposition":"Choroidal neovascularization","justification":""},{"idx":3,"correct":false,"proposition":"Intraretinal hemorrhages","justification":""},{"idx":4,"correct":false,"proposition":"Pre-retinal hemorrhages","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-62","enonce":" In ophthalmology, about macular edema: (one or more exact answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"There is an increase in macular thickness in optical coherence tomography","justification":""},{"idx":1,"correct":false,"proposition":"The decrease in visual acuity is usually brutal","justification":""},{"idx":2,"correct":false,"proposition":"It can occur during diabetic retinopathy","justification":""},{"idx":3,"correct":false,"proposition":"It is visible after occlusion of the central artery of the retina","justification":""},{"idx":4,"correct":false,"proposition":"It can occur after cataract surgery","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-63","enonce":" Ms. R., 42, is being treated for multiple sclerosis. It is sent to the ophthalmologist for assessment. Multiple sclerosis can cause: (one or more exact propositions)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Internuclear ophthalmoplegia","justification":""},{"idx":1,"correct":false,"proposition":"Nystagmus","justification":""},{"idx":2,"correct":false,"proposition":"An occlusion of the central artery of the retina","justification":""},{"idx":3,"correct":false,"proposition":"Retinal detachment","justification":""},{"idx":4,"correct":false,"proposition":"Increased retro-ocular pain during eye movements","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-64","enonce":" A 70-year-old woman presents to the emergency room for a rash (see photograph) that appeared a week ago. She has been complaining of pruritus for 3 months. She is a widow, mother of 5 children and lives alone at home. She has no medical follow-up or background treatment. Which of the following tests will be most useful in confirming the diagnosis you suspect?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":" Direct immunofluorescence on skin biopsy","justification":""},{"idx":1,"correct":false,"proposition":"Indirect immunofluorescence on blood sample","justification":""},{"idx":2,"correct":false,"proposition":"Parasitological skin sampling for sarcoptes","justification":""},{"idx":3,"correct":false,"proposition":"Ferritinemia","justification":""},{"idx":4,"correct":false,"proposition":"Complete blood count","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-65","enonce":" A patient is accompanied by her roommate to the emergency room at 2:00 a.m. Clinical examination suggests meningitis. The results of the lumbar puncture are: leukocytes 10,000 \/ ml; proteinorachy 2.8 g \/ l; glycorachia 0.8 mmol \/ l (blood glucose at 6 mmol \/ l); Gram-negative cocci in diplococci on direct examination. Which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"You will report this case as soon as confirmed by the microbiological culture","justification":""},{"idx":1,"correct":false,"proposition":"One of the objectives of mandatory disease reporting is epidemiological surveillance","justification":""},{"idx":2,"correct":false,"proposition":"One of the objectives of reporting is to initiate preventive measures","justification":""},{"idx":3,"correct":false,"proposition":"you prescribe precautions such as << Air>>","justification":""},{"idx":4,"correct":false,"proposition":"you initiate antibiotic prophylaxis for the patient's roommate","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-66","enonce":" A 28-year-old patient comes to the emergency room with a very painful erection that has been going on for 9 hours now. What are the main possible causes of such a state? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Sickle-cell anemia","justification":""},{"idx":1,"correct":false,"proposition":"Trauma on flaccid penis","justification":""},{"idx":2,"correct":false,"proposition":"Testicular cancer","justification":""},{"idx":3,"correct":false,"proposition":"Intracavernous injection of prostaglandins","justification":""},{"idx":4,"correct":false,"proposition":"Multiple myeloma","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-67","enonce":" What is (are) the true proposal(s) concerning the urodynamic balance?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It includes flowmetry","justification":""},{"idx":1,"correct":false,"proposition":"It gives information about bladder sensitivity","justification":""},{"idx":2,"correct":false,"proposition":"It includes a measurement of the post-voiding residue","justification":""},{"idx":3,"correct":false,"proposition":"It gives information on bladder compliance","justification":""},{"idx":4,"correct":false,"proposition":"It is performed under anesthesia","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-68","enonce":" An 80-year-old patient is admitted for a hip fracture. He is being treated for ischemic heart disease with aspirin (75 mg\/day) combined with beta-blocker therapy. He has no other antecedent. His consciousness is normal and he is not confused. Its vital parameters are normal. Regarding the intensity of his pain, what is or are the scale(s) usable in this clinical context?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"DN4 scale","justification":""},{"idx":1,"correct":false,"proposition":"The analogue visual scale","justification":""},{"idx":2,"correct":false,"proposition":"the numerical scale of 0-10","justification":""},{"idx":3,"correct":false,"proposition":"The simple verbal scale","justification":""},{"idx":4,"correct":false,"proposition":"Behavioral Pain Scale (BPS)","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-69","enonce":" You receive Mrs. V., 67 years old, for a table of alteration of the general condition associated with the following rash, which has been evolving for 4 weeks: Which of the following diagnoses seems compatible with the above clinical presentation?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"immunological thrombocytopenic purpura","justification":""},{"idx":1,"correct":false,"proposition":"IgA vasculitis","justification":""},{"idx":2,"correct":false,"proposition":"Purpura fulminans","justification":""},{"idx":3,"correct":false,"proposition":"Microscopic polyangiitis","justification":""},{"idx":4,"correct":false,"proposition":"vasculitis with anti-glomerular basement membrane antibodies","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-70","enonce":" On an anatomo-pathological account of bronchoalveolar lavage, it is specified that the Golde score is equal to 5. Regarding Golde's score, check the exact proposal(s):","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"This is a histoprognostic score","justification":""},{"idx":1,"correct":false,"proposition":"It evaluates the amount of lymphocytes","justification":""},{"idx":2,"correct":false,"proposition":"It evaluates hemosiderin overload","justification":""},{"idx":3,"correct":false,"proposition":"It is based on a count of red blood cells","justification":""},{"idx":4,"correct":false,"proposition":"The result indicates intraalveolar hemorrhage in this patient","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-71","enonce":" What is (are) the true proposal(s) concerning spinal anesthesia?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"This is perimedullary anesthesia","justification":""},{"idx":1,"correct":false,"proposition":"It is a loco-regional anesthesia","justification":""},{"idx":2,"correct":false,"proposition":"the anesthetic is given directly into the cerebrospinal fluid","justification":""},{"idx":3,"correct":false,"proposition":"It can be performed at the thoracic level","justification":""},{"idx":4,"correct":false,"proposition":"Respiratory complications are among the risks associated with this technique","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-73","enonce":" A 30-year-old patient underwent a scheduled cholecystectomy surgery. He goes to the emergency room 72 hours after the procedure because he is not feeling well. The HR is at 115\/min, the BP is at 85\/35 mmHg, the FR is at 30\/min, the SpO2 is at 94% in ambient air. The patient is stuporous and the diuresis of the last hours is zero. What type of shock seems most likely to you? (only one answer expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"it is probably hypovolemic shock","justification":""},{"idx":1,"correct":false,"proposition":"it is probably cardiogenic shock","justification":""},{"idx":2,"correct":false,"proposition":"it is probably hemorrhagic shock","justification":""},{"idx":3,"correct":false,"proposition":"it is probably septic shock","justification":""},{"idx":4,"correct":false,"proposition":"it is probably an obstructive shock","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-74","enonce":" What biological abnormality(s) usually accompanies moderate vitamin D deficiency in adults?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"hypocalcemia","justification":""},{"idx":1,"correct":false,"proposition":"hypercalciuria","justification":""},{"idx":2,"correct":false,"proposition":"hypercortisolemia","justification":""},{"idx":3,"correct":false,"proposition":"elevation of parathyroid hormone","justification":""},{"idx":4,"correct":false,"proposition":"hypomagnesemia","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-76","enonce":" What clinical element(s) does (make) refute the diagnosis of Parkinson's disease at the beginning of the disease?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"swallowing problems","justification":""},{"idx":1,"correct":false,"proposition":"cognitive impairment","justification":""},{"idx":2,"correct":false,"proposition":"Falls","justification":""},{"idx":3,"correct":false,"proposition":"Impaired sense of smell","justification":""},{"idx":4,"correct":false,"proposition":"bradykinesia","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-77","enonce":" Regarding meningiomas, what is (are) the exact answer(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"they develop from astrocytes","justification":""},{"idx":1,"correct":false,"proposition":"There is a female predominance","justification":""},{"idx":2,"correct":false,"proposition":"Their discovery is often fortuitous","justification":""},{"idx":3,"correct":false,"proposition":"they can develop as part of neurofibromatosis type 1","justification":""},{"idx":4,"correct":false,"proposition":"The peak incidence is around 40 years","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-78","enonce":" Which proposal(s) for cotrimoxazole is (are) correct?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Cotrimoxazole is a combination of 2 anti-infective agents","justification":""},{"idx":1,"correct":false,"proposition":"Its bioavailability is excellent","justification":""},{"idx":2,"correct":false,"proposition":"It is eliminated through urine","justification":""},{"idx":3,"correct":false,"proposition":"It is naturally active on staphylococci and Escherichia coli","justification":""},{"idx":4,"correct":false,"proposition":"Cotrimoxazole may have an anti-parasitic action","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-79","enonce":" An 85-year-old diabetic, hypertensive patient is hospitalized in front of the sudden appearance of a predominant rash with large folds of flexion and which gradually generalizes. The patient is dehydrated, her temperature is 38.5 ° C.  She has neutrophil hyperleukocytosis (8500\/mm3). The biological balance is also normal. The entourage tells you that she presented a picture of acute bronchitis 3 weeks ago. In the face of a persistent cough, treatment with amoxicillin combined with codeine and prednisolone was introduced 48 hours ago. His son tells you that his mother has already had many allergic reactions to antibiotics.","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"A maculopapular exanthema","justification":""},{"idx":1,"correct":false,"proposition":"acute generalized exanthematous pustulosis","justification":""},{"idx":2,"correct":false,"proposition":"drug hypersensitivity syndrome","justification":""},{"idx":3,"correct":false,"proposition":"Stevens Johnson syndrome","justification":""},{"idx":4,"correct":false,"proposition":"a flare-up of pustular psoriasis","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-80","enonce":" A 38-year-old patient underwent surgery for a non-functional pituitary macroadenoma, expressing beta-LH to immunohistochemistry, without markers of tumor aggressiveness. The postoperative period was marked by the occurrence of corticotropic insufficiency. Which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"treatment should include fludrocortisone","justification":""},{"idx":1,"correct":false,"proposition":"treatment should include hydrocortisone","justification":""},{"idx":2,"correct":false,"proposition":"The dosage of the treatment is adjusted according to the results of the cortisolemia at 8h","justification":""},{"idx":3,"correct":false,"proposition":"The return to normal of corticotropic function should be controlled by the 24-hour cortisolurie assay","justification":""},{"idx":4,"correct":false,"proposition":"Substitution of this deficiency renders annual influenza vaccination ineffective","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-81","enonce":" Regarding the characteristics of carcinoma in situ, which is (are) the exact proposition(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It can interest the entire height of the epithelium","justification":""},{"idx":1,"correct":false,"proposition":"It carries a risk of metastases","justification":""},{"idx":2,"correct":false,"proposition":"It crosses the basement membrane","justification":""},{"idx":3,"correct":false,"proposition":"It is destined to remain non-invasive","justification":""},{"idx":4,"correct":false,"proposition":"He has an excellent prognosis after treatment","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-82","enonce":" Regarding the prefixes\/suffixes used in TNM classifications, which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"c gives stage to clinical examination","justification":""},{"idx":1,"correct":false,"proposition":"p gives the postoperative stage","justification":""},{"idx":2,"correct":false,"proposition":"x means unrated or unknown","justification":""},{"idx":3,"correct":false,"proposition":"R gives stage after radiation therapy","justification":""},{"idx":4,"correct":false,"proposition":"gives it stage after neoadjuvant treatment","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-84","enonce":" Which of the following recommended treatment options for impaired ejection fraction heart failure, in addition to certain beta-blockers, has (have) demonstrated a decrease in mortality?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Henlé's loop diuretics","justification":""},{"idx":1,"correct":false,"proposition":"mineralocorticoid receptor antagonists","justification":""},{"idx":2,"correct":false,"proposition":"angiotensin-converting enzyme II inhibitors","justification":""},{"idx":3,"correct":false,"proposition":"digitalis","justification":""},{"idx":4,"correct":false,"proposition":"implantable defibrillators","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-85","enonce":" A 58-year-old patient, a former carpenter, is referred for unilateral nasal obstruction and you mention the diagnosis of adenocarcinoma of the ethmoid. Which proposals are correct? (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"there may be repeated epistaxis homolateral to obstruction","justification":""},{"idx":1,"correct":false,"proposition":"It is a disease entered in the schedule of occupational diseases","justification":""},{"idx":2,"correct":false,"proposition":"Cervical lymphadenopathy is common at the time of diagnosis","justification":""},{"idx":3,"correct":false,"proposition":"the tumour may be masked by a reactive polyp","justification":""},{"idx":4,"correct":false,"proposition":"the presence of exophthalmos would be a sign of an advanced tumor","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-86","enonce":" One patient had a brief loss of consciousness. You question him and the witnesses. What are the arguments in favor of syncope? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Brief, low-amplitude muscle twitching of the shoulders 20 seconds after loss of consciousness","justification":""},{"idx":1,"correct":false,"proposition":"inability to get up on one's own after returning to consciousness","justification":""},{"idx":2,"correct":false,"proposition":"prolonged drowsiness after return to consciousness","justification":""},{"idx":3,"correct":false,"proposition":"feeling strange before loss of consciousness","justification":""},{"idx":4,"correct":false,"proposition":"palpitations before loss of consciousness","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-87","enonce":" A couple consults you because of a pregnancy project. The woman is 32 years old and the man is on chronic hemodialysis due to X-linked Alport syndrome. What are the exact proposals? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Man cannot transmit the disease if they have a son","justification":""},{"idx":1,"correct":false,"proposition":"the child will necessarily carry a trait of the disease","justification":""},{"idx":2,"correct":false,"proposition":"It is better to resort to postnatal diagnosis if it is a son","justification":""},{"idx":3,"correct":false,"proposition":"It is better to resort to prenatal diagnosis if it is a girl","justification":""},{"idx":4,"correct":false,"proposition":"Hemodialysis of the husband contraindicates the plan of pregnancy","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-88","enonce":" What is the main reason for chronic kidney disease to shorten life expectancy? (only one answer expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Increased vascular risk","justification":""},{"idx":1,"correct":false,"proposition":"increased risk of cardiac conduction disorder","justification":""},{"idx":2,"correct":false,"proposition":"increased risk of heart rhythm disorder","justification":""},{"idx":3,"correct":false,"proposition":"Increased risk of cancer","justification":""},{"idx":4,"correct":false,"proposition":"Increased risk of infection","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-89","enonce":" A 42-year-old man was admitted to intensive care 48 hours ago for shock complicating acute pneumococcal pneumonia. Despite the correction of hemodynamic failure, it remains oliguric, and serum creatinine has increased from 78 μmol\/L at intake to 134 μmol\/L. What is (are) the exact proposal(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"there is acute renal failure","justification":""},{"idx":1,"correct":false,"proposition":"Acute tubular necrosis should be mentioned","justification":""},{"idx":2,"correct":false,"proposition":"It is necessary to evoke a cortical necrosis","justification":""},{"idx":3,"correct":false,"proposition":"It is necessary to evoke a secondary renal localization of the infection","justification":""},{"idx":4,"correct":false,"proposition":"a renal ultrasound should be performed","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-90","enonce":" In what situations is anemia of central origin? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Vitamin B12 deficiency","justification":""},{"idx":1,"correct":false,"proposition":"Iron deficiency","justification":""},{"idx":2,"correct":false,"proposition":"Autoimmune hemolytic anemia","justification":""},{"idx":3,"correct":false,"proposition":"Myelodysplastic syndrome","justification":""},{"idx":4,"correct":false,"proposition":"Multiple myeloma","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-91","enonce":" Your 55-year-old patient has been a cashier in a supermarket chain for 30 years. He has incomplete paraplegia following a road accident that occurred during his vacation 8 months ago. He is currently still on sick leave. What accompanying measures do you recommend? (one or more proposals expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Request an appointment at Pôle emploi","justification":""},{"idx":1,"correct":false,"proposition":"apply for recognition of the status of disabled worker","justification":""},{"idx":2,"correct":false,"proposition":"apply for disability","justification":""},{"idx":3,"correct":false,"proposition":"request a pre-resumption visit with your occupational physician","justification":""},{"idx":4,"correct":false,"proposition":"Request recognition in a commuting accident","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-92","enonce":" A 25-year-old patient, smoker (10 cigarettes a day since the age of 15), is referred for consultation for symmetrical polyarthritis affecting the wrists, proximal interphalangeal, and metacarpophalangeal, present for 2 months. She has a history of pericarditis 6 months before your consultation, which has improved on nonsteroidal anti-inflammatory drugs. However, she retains a persistent deep inspiration discomfort. She tells you that she has been sensitive to cold since the age of 15 (with fingers that turn white), and also sensitivity to the sun since she took the last summer of significant \"sunburn\" on the face and décolleté, while she had little exposure. She does not have a feeling of dry eye or dry mouth. The biological analyses are as follows:","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"The whole is in favor of inflammatory myopathy","justification":""},{"idx":1,"correct":false,"proposition":"the diagnosis of lupus can be affirmed even in the absence of native anti-DNA antibodies","justification":""},{"idx":2,"correct":false,"proposition":"The whole is in favor of rheumatoid arthritis","justification":""},{"idx":3,"correct":false,"proposition":"there is probably a secondary Sjögren's syndrome","justification":""},{"idx":4,"correct":false,"proposition":"there may be a congenital C4 deficiency","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-93","enonce":" What biological abnormality(s) may be related to an inflammatory syndrome?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Thrombocytopenia","justification":""},{"idx":1,"correct":false,"proposition":"increase in alpha-2 globulins","justification":""},{"idx":2,"correct":false,"proposition":"hypoalbuminemia","justification":""},{"idx":3,"correct":false,"proposition":"hyperferritinemia","justification":""},{"idx":4,"correct":false,"proposition":"decrease in transferrin","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-94","enonce":" A 48-year-old woman consults for paresthesias of the anterior surface of the thigh. You suspect cruralgia. What is (are) the true statement(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It can be caused by a foraminal disc herniation L5-S1","justification":""},{"idx":1,"correct":false,"proposition":"It can be caused by a paramedian disc herniation L4-L5","justification":""},{"idx":2,"correct":false,"proposition":"A motor deficit of the quadriceps can be observed","justification":""},{"idx":3,"correct":false,"proposition":"The pain may radiate to the anterior surface of the tibia","justification":""},{"idx":4,"correct":false,"proposition":"It can be caused by reducing the size of an osteoarthritic conjugation foramen","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-95","enonce":" Regarding the judicial report, which is (are) the exact proposal(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It can only be performed by a health professional","justification":""},{"idx":1,"correct":false,"proposition":"It is one of the authorized derogations from professional secrecy","justification":""},{"idx":2,"correct":false,"proposition":"It is done orally during a telephone communication to the public prosecutor","justification":""},{"idx":3,"correct":false,"proposition":"If written by a doctor, it increases the punishment of the perpetrator","justification":""},{"idx":4,"correct":false,"proposition":"It makes it possible to warn the judicial authorities of suspected violence in a minor","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-96","enonce":" Regarding the autopsy, which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"A medical autopsy may be requested by the doctor in order to investigate the causes of death","justification":""},{"idx":1,"correct":false,"proposition":"The family of the deceased may refuse to have a forensic autopsy of the body performed","justification":""},{"idx":2,"correct":false,"proposition":"The family of the deceased is the recipient of the conclusions of a medico-legal autopsy","justification":""},{"idx":3,"correct":false,"proposition":"Medical autopsy is governed by the same laws as organ harvesting","justification":""},{"idx":4,"correct":false,"proposition":"Family cannot see body before medical autopsy","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-97","enonce":" In case of metastatic pulmonary adenocarcinoma, the search for therapeutic molecular targets: (one or more exact answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"is systematic","justification":""},{"idx":1,"correct":false,"proposition":"can be made from formalin-fixed biopsy material and included in paraffin","justification":""},{"idx":2,"correct":false,"proposition":"can be done from frozen biopsy material","justification":""},{"idx":3,"correct":false,"proposition":"determines the therapeutic choice of first-line treatment","justification":""},{"idx":4,"correct":false,"proposition":"requires prior morphological pathological examination","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-98","enonce":" For osteosarcoma of the lower end of the femur, check the exact proposal(s):","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It consists of a proliferation of osteoblasts","justification":""},{"idx":1,"correct":false,"proposition":"The most frequent metastases are pulmonary","justification":""},{"idx":2,"correct":false,"proposition":"Its diagnosis requires a histo-radiological confrontation","justification":""},{"idx":3,"correct":false,"proposition":"Its diagnosis requires molecular confirmation","justification":""},{"idx":4,"correct":false,"proposition":"Surgical treatment from the outset is recommended","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-99","enonce":" An 89-year-old patient comes to consultation for a fall. He has had three falls in the past year. What factor(s) will you look for at the interrogation and clinical examination as a risk factor for osteoporosis in the elderly?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Obesity (body mass index > 30)","justification":""},{"idx":1,"correct":false,"proposition":"Smoking","justification":""},{"idx":2,"correct":false,"proposition":"Vitamin D deficiency","justification":""},{"idx":3,"correct":false,"proposition":"Chronic alcoholism","justification":""},{"idx":4,"correct":false,"proposition":"Sedentary lifestyle","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-100","enonce":" A patient has a fracture of the third thoracic vertebra and a fracture of the first lumbar vertebra. What are the elements in favor of vertebral fractures due to bone failure? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Disappearance of a thorny","justification":""},{"idx":1,"correct":false,"proposition":"Fracture of the third thoracic vertebra","justification":""},{"idx":2,"correct":false,"proposition":"Fracture of the first lumbar vertebra","justification":""},{"idx":3,"correct":false,"proposition":"Disappearance of the anterior cortical of the vertebral body","justification":""},{"idx":4,"correct":false,"proposition":"Respect for the pedicles of the fractured vertebra","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-101","enonce":" Which first-line examination(s) for etiological purposes should be requested in the face of hyperferritinemia? (one or more expected answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Transferrin saturation coefficient","justification":""},{"idx":1,"correct":false,"proposition":"Fasting blood glucose","justification":""},{"idx":2,"correct":false,"proposition":"Abdominal CT scan","justification":""},{"idx":3,"correct":false,"proposition":"Liver biopsy","justification":""},{"idx":4,"correct":false,"proposition":"Triglyceride levels","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-103","enonce":" Which semiological element(s) of imagery enter into the definition of a fluid pleural effusion?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"In radiography, it is a declivated opacity, basi-thoracic if the patient is standing","justification":""},{"idx":1,"correct":false,"proposition":"In radiography, in case of partitioned effusion, the internal limit of opacity can become convex","justification":""},{"idx":2,"correct":false,"proposition":"In radiography, there is an airy bronchogram within the abnormal opacity","justification":""},{"idx":3,"correct":false,"proposition":"There is an erasure of the diaphragm in radiography","justification":""},{"idx":4,"correct":false,"proposition":"Pleural ultrasound is the technique of choice for the diagnosis of fluid effusion in a lying patient","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-104","enonce":" Among the following proposals, what is the main clinical manifestation of an infection of the gastric mucosa by Helicobacter pylori? (only one answer expected)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"motor diarrhea","justification":""},{"idx":1,"correct":false,"proposition":"fever","justification":""},{"idx":2,"correct":false,"proposition":"dyspeptic syndrome","justification":""},{"idx":3,"correct":false,"proposition":"vomiting","justification":""},{"idx":4,"correct":false,"proposition":"pyrosis","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-105","enonce":" A 48-year-old non-diabetic patient experienced multiple episodes of hypoglycemia. What proposals are in favour of hypoglycaemia by hidden injections of rapid insulin? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"C-peptide increased during hypoglycemia","justification":""},{"idx":1,"correct":false,"proposition":"Weight gain","justification":""},{"idx":2,"correct":false,"proposition":"Pro-insulin increased during hypoglycemia","justification":""},{"idx":3,"correct":false,"proposition":"No sign of neuroglucopenia during episodes","justification":""},{"idx":4,"correct":false,"proposition":"Low cortisol during hypoglycemia","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-106","enonce":" A 6-year-old boy is brought to a dermatology consultation by his mother. He lives in rural areas and attends school. He has been presenting for 1 month alopecic plaques that continue to spread despite the prescription of topical corticosteroids. What diagnosis(s) do you mention?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Kerion","justification":""},{"idx":1,"correct":false,"proposition":"Scalp psoriasis","justification":""},{"idx":2,"correct":false,"proposition":"Alopecia","justification":""},{"idx":3,"correct":false,"proposition":"Seborrheic dermatitis","justification":""},{"idx":4,"correct":false,"proposition":"False asbestos moth","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-107","enonce":" Which bacterium(s) are the main responsible bacteria(s) for acute purulent otitis media?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Streptococcus pneumoniae","justification":""},{"idx":1,"correct":false,"proposition":"Haemophilus influenzae","justification":""},{"idx":2,"correct":false,"proposition":"Pseudomonas aeruginosa","justification":""},{"idx":3,"correct":false,"proposition":"Bordetella pertussis","justification":""},{"idx":4,"correct":false,"proposition":"Coxiella burnetii","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-108","enonce":" Which of the following infectious agents is usually associated with a biological mononucleosis syndrome?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"HIV","justification":""},{"idx":1,"correct":false,"proposition":"Toxoplasma gondii","justification":""},{"idx":2,"correct":false,"proposition":"Pneumocystis jirovecii","justification":""},{"idx":3,"correct":false,"proposition":"Gardnerella vaginalis","justification":""},{"idx":4,"correct":false,"proposition":"CMV","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-111","enonce":" You receive the result of the first toxoplasmosis screening serology of a patient who is 12 weeks pregnant with amenorrhea (AS). This is positive with the presence of IgM and IgG. Which proposals are correct? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"an IgG avidity test should be prescribed","justification":""},{"idx":1,"correct":false,"proposition":"It may be a primary infection in early pregnancy","justification":""},{"idx":2,"correct":false,"proposition":"it may be an old infection prior to the period of conception","justification":""},{"idx":3,"correct":false,"proposition":"amniocentesis with toxoplasma testing should be performed","justification":""},{"idx":4,"correct":false,"proposition":"the risk of mother-to-child transmission is high","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-112","enonce":" You are caring for a patient who opens their eyes to verbal stimulation, has an appropriate motor response to a painful stimulus, and responds confusedly. Regarding its Glasgow score, which proposal(s) is (are) accurate?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It takes into account brainstem reflexes","justification":""},{"idx":1,"correct":false,"proposition":"This is a comatose patient","justification":""},{"idx":2,"correct":false,"proposition":"the opening of the eyes is rated 3","justification":""},{"idx":3,"correct":false,"proposition":"motor skills are rated 4","justification":""},{"idx":4,"correct":false,"proposition":"The total score is 11","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-113","enonce":" When faced with this type of lesion in a child, what is the main diagnostic hyothesis? (only one exact answer)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"polygenic hypercholesterolemia","justification":""},{"idx":1,"correct":false,"proposition":"heterozygous familial hypercholesterolemia","justification":""},{"idx":2,"correct":false,"proposition":"homozygous familial hypercholesterolemia","justification":""},{"idx":3,"correct":false,"proposition":"dysbetaliboproteinemia","justification":""},{"idx":4,"correct":false,"proposition":"familial hyperchylomicronemia syndrome","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-114","enonce":" What are the possible side effects of strong opioids? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Constipation","justification":""},{"idx":1,"correct":false,"proposition":"Nausea","justification":""},{"idx":2,"correct":false,"proposition":"Drowsiness","justification":""},{"idx":3,"correct":false,"proposition":"Organic renal failure","justification":""},{"idx":4,"correct":false,"proposition":"Heart failure","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-115","enonce":" Regarding Takayasu's disease, what are the exact proposals? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It can be revealed by high blood pressure","justification":""},{"idx":1,"correct":false,"proposition":"it can give carotidodynias","justification":""},{"idx":2,"correct":false,"proposition":"It affects 9 women for 1 man","justification":""},{"idx":3,"correct":false,"proposition":"It can affect adults of any age","justification":""},{"idx":4,"correct":false,"proposition":"It belongs to the group of vasculitis of medium-sized vessels","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-116","enonce":" About bacterial endocarditis, which is (are) the exact proposal(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":" It occurs more frequently on an injured valve than on a healthy valve","justification":""},{"idx":1,"correct":false,"proposition":"It occurs more frequently in valvular heart disease of the right heart than of the left heart","justification":""},{"idx":2,"correct":false,"proposition":"The elemental lesion is composed of fibrinoplatelet debris","justification":""},{"idx":3,"correct":false,"proposition":"It occurs preferentially on an atrial septal defect","justification":""},{"idx":4,"correct":false,"proposition":"Patients with prosthetic valves are at higher risk of endocarditis","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-117","enonce":" The diagnosis of brain death requires: (one or more exact answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"Check the absence of spontaneous breathing by extubating the patient","justification":""},{"idx":1,"correct":false,"proposition":"Check for the absence of brain activity by a brain MRI with injection","justification":""},{"idx":2,"correct":false,"proposition":"Eliminate hypothermia","justification":""},{"idx":3,"correct":false,"proposition":"To be ascertained by a doctor practicing outside the establishment where the patient is hospitalized","justification":""},{"idx":4,"correct":false,"proposition":"To verify clinical or paraclinical criteria established by decree","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-118","enonce":" About sickle cell disease, which is (are) the exact proposal(s)?","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"It is a disease of membrane origin of the red blood cell","justification":""},{"idx":1,"correct":false,"proposition":"It is the most common genetic pathology of red blood cells in the world","justification":""},{"idx":2,"correct":false,"proposition":"Sick subjects are heterozygous for the causal mutation","justification":""},{"idx":3,"correct":false,"proposition":"Sickle cell screening is offered to all children born in France","justification":""},{"idx":4,"correct":false,"proposition":"A sick person who unites with a spouse from northern Europe has a high risk of having a sick child","justification":""}],"type":"qi"}
{"_id":"annales-2022-qi-120","enonce":" In case of sarcoidosis, what are the exact answers regarding the granuloma? (one or more correct answers)","item":"annales-2022-qi","matiere":"annales-2022","propositions":[{"idx":0,"correct":false,"proposition":"it contains T cells","justification":""},{"idx":1,"correct":false,"proposition":"it contains epithelial cells","justification":""},{"idx":2,"correct":false,"proposition":"It is a tuberculoid granuloma","justification":""},{"idx":3,"correct":false,"proposition":"It can be seen on skin samples of erythema nodosum","justification":""},{"idx":4,"correct":false,"proposition":"It can be seen on accessory salivary gland samples","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-2","enonce":"A 30-year-old woman consults following an episode of spontaneous deep vein thrombosis. At the interrogation, you find a history of pulmonary embolism at age 50 in the mother. You suspect constitutional thrombophilia. Which analysis(s) do you think are relevant?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"The determination of protein Ce of protein S","justification":""},{"idx":1,"correct":false,"proposition":"Determination of factor V","justification":""},{"idx":2,"correct":true,"proposition":"The search for a mutation of the II factor","justification":""},{"idx":3,"correct":true,"proposition":"The dosage of antithrombin","justification":""},{"idx":4,"correct":false,"proposition":"The determination of D-dimer","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-3","enonce":"Mr. R., 54 years old, comes to consult for the discovery of a lump in the groin. On examination, you palpate a left inguinal lymphadenopathy 2.5 cm in diameter. What should your clinical examination include? (one or more possible answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Inspection of the skin of the entire left lower limb","justification":""},{"idx":1,"correct":true,"proposition":"An anal examination","justification":""},{"idx":2,"correct":true,"proposition":"Palpation of all lymph node areas","justification":""},{"idx":3,"correct":true,"proposition":"Inspection and palpation of the external genitalia","justification":""},{"idx":4,"correct":true,"proposition":"The search for splenomegaly","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-4","enonce":"A 45-year-old man consults the emergency room for severe pain in his right wrist that woke him up this morning. You find hyperthermia at 38.5 ° C.  The wrist is red, warm and very swollen. You suspect septic arthritis. Which of the following proposition(s) is (are) correct?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Standard radiography should be performed","justification":""},{"idx":1,"correct":true,"proposition":"Joint puncture is useful and easy to perform in emergency","justification":""},{"idx":2,"correct":false,"proposition":"Ultrasound is specific to the diagnosis","justification":""},{"idx":3,"correct":false,"proposition":"MRI is part of the systematic assessment","justification":""},{"idx":4,"correct":true,"proposition":"The scintigraphy may be indicated in a second step to look for osteitis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-5","enonce":"A young student wakes up the day after a party with toxic abuse and notices a deficit in her right arm. You mention paralysis of the right radial nerve by compression at the tricipital gutter. Which of the following proposals corresponds to this diagnosis?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Gooseneck deficiency","justification":""},{"idx":1,"correct":false,"proposition":"Triceps brachial muscle deficiency","justification":""},{"idx":2,"correct":false,"proposition":"A sensory deficit of the entire posterior surface of the forearm","justification":""},{"idx":3,"correct":true,"proposition":"Brachioradial muscle deficiency","justification":""},{"idx":4,"correct":false,"proposition":"An abolition of the cubito-pronator reflex","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-6","enonce":"The diagnosis of childhood autism spectrum disorder is based on:","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"A normal intellectual level","justification":""},{"idx":1,"correct":true,"proposition":"Fears unusual for age","justification":""},{"idx":2,"correct":false,"proposition":"A sadness of mood","justification":""},{"idx":3,"correct":true,"proposition":"Circumscribed and persevering interests","justification":""},{"idx":4,"correct":true,"proposition":"A deficit of social reciprocity","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-7","enonce":"An 8-year-old child comes to your consultation for swallowing pain, earache and fever. Examination of the objective throat of inflammatory tonsils. What is your attitude?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"You have a sample for streptococcus and rhinovirus PCR taken at the laboratory","justification":""},{"idx":1,"correct":false,"proposition":"You perform a strep rapid diagnostic test in the office","justification":""},{"idx":2,"correct":false,"proposition":"You prescribe symptomatic treatment with Ketoprofen","justification":""},{"idx":3,"correct":false,"proposition":"You prescribe amoxicillin + clavulanic acid as a first line","justification":""},{"idx":4,"correct":false,"proposition":"You prescribe in-the-ear antibiotic therapy","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-8","enonce":"Among the following proposals concerning the entourage of a patient with meningococcal meningitis, indicate which one(s) is\/are right.","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Ciprofloxacin is a second-line antibiotic prophylaxis","justification":""},{"idx":1,"correct":true,"proposition":"Antibiotic prophylaxis aims to eradicate pharyngeal carriage in contact subjects","justification":""},{"idx":2,"correct":false,"proposition":"Antibiotic prophylaxis is offered up to 1 month after last contact with the index case","justification":""},{"idx":3,"correct":true,"proposition":"Antibiotic prophylaxis is based primarily on rifampicin","justification":""},{"idx":4,"correct":true,"proposition":"Vaccination may be offered in combination with antibiotic prophylaxis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-10","enonce":"A 92-year-old patient has seen this tumor develop on the left nasal wing for a few months. The tumor is nodular, with bleeding ulceration on the surface. The patient is in good general condition, with no notable history. She worked as a farmer for 50 years. What is your diagnosis?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":" Nodular basal cell carcinoma","justification":""},{"idx":1,"correct":false,"proposition":"Merkel's carcinoma","justification":""},{"idx":2,"correct":false,"proposition":"Achromic nodular melanoma","justification":""},{"idx":3,"correct":false,"proposition":"Squamous cell carcinoma","justification":""},{"idx":4,"correct":false,"proposition":"Dubreuilh's melanoma","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-11","enonce":"A 64-year-old man has this chronic rash reaching 45% of the body surface area, evolving for about ten years. He has a history of hypertension treated with losartan, hydrochlorothiazide and atenolol, and smoking valued at 25 pack-years, as well as daily alcohol consumption. Which of the following measures do you think is appropriate for the management of this patient?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Smoking cessation","justification":"There are relatively few situations where this proposal is not checked off at EDN"},{"idx":1,"correct":true,"proposition":"Discontinuation of atenolol","justification":""},{"idx":2,"correct":false,"proposition":"Replacement of sartan with a calcium channel blocker","justification":""},{"idx":3,"correct":false,"proposition":"Very strong local dermocorticotherapy with clobetasol 30 grams per day","justification":""},{"idx":4,"correct":false,"proposition":"TL01 UVB Phototherapy (narrow spectrum)","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-13","enonce":"You receive a feverish 16-month-old infant in the emergency room, whose mother is worried because she finds him tired. Which of the following is(are) in favor of a serious infection?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Fever above 39.5°C","justification":""},{"idx":1,"correct":false,"proposition":"Lack of response to paracetamol","justification":""},{"idx":2,"correct":true,"proposition":"Anorexia","justification":""},{"idx":3,"correct":true,"proposition":"Hypotonia","justification":""},{"idx":4,"correct":false,"proposition":"Enanthemum","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-14","enonce":"An 80-year-old patient consults his general practitioner at the request of his wife for an annual check-up. What symptom(s) could you link to age-related androgen deficiency?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Sadness of mood","justification":""},{"idx":1,"correct":false,"proposition":"Haematuria","justification":""},{"idx":2,"correct":true,"proposition":"Gynecomastia","justification":""},{"idx":3,"correct":true,"proposition":"Abdominal obesity","justification":""},{"idx":4,"correct":false,"proposition":"Dysuria","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-15","enonce":"A 67-year-old patient consults a urologist because his father and brother have prostate cancer. What symptom(s) would be in favor of prostate cancer?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Erectile dysfunction","justification":""},{"idx":1,"correct":false,"proposition":"Stress urinary incontinence","justification":""},{"idx":2,"correct":false,"proposition":"Terminal hematuria","justification":""},{"idx":3,"correct":true,"proposition":"Dysuria","justification":""},{"idx":4,"correct":true,"proposition":"Initial hematuria","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-16","enonce":"What advantage(s) does permanent implant brachytherapy offer in prostate cancer compared to conventional irradiation?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Non-invasive treatment","justification":""},{"idx":1,"correct":false,"proposition":"Outpatient treatment","justification":""},{"idx":2,"correct":true,"proposition":"Higher dose delivered to the tumour","justification":""},{"idx":3,"correct":true,"proposition":"Better protection of healthy tissue","justification":""},{"idx":4,"correct":true,"proposition":"Lower risk of sequelae erectile dysfunction","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-17","enonce":"Ms. M., 35 years old, presents for a dull pain in her right calf that has existed since the previous evening. During the interrogation, you find the existence of arterial disease of the lower limbs in the father of this patient, which led to a leg amputation at the age of 78. Despite this hereditary history, Ms. M. reports smoking quantified at half a pack of cigarettes a day since the age of 18. You also find Raynaud's syndrome in the patient's mother. Ms. M. has no treatment and has just presented a spontaneous miscarriage for which she remained hospitalized 24 hours. Clinical examination reveals an increase in the circumference of the edema of the right calf by 1 cm compared to the contralateral calf. There is also an increase in skin heat in the right lower limb as well as an increase in the visibility of the superficial veins and pain on deep palpation of the calf. In this patient, what element(s) should be taken into account to establish the clinical probability score?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Family history of vascular pathology","justification":""},{"idx":1,"correct":false,"proposition":"Increased right calf circumference by 1 cm","justification":""},{"idx":2,"correct":true,"proposition":"Pain on deep palpation","justification":""},{"idx":3,"correct":true,"proposition":"Increased visibility of superficial veins","justification":""},{"idx":4,"correct":true,"proposition":"Recent hospitalization of 24 hours","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-19","enonce":"A 45-year-old woman consults for a right parotid mass. Which of the following criteria is (are) that directs you towards the diagnosis of pleomorphic adenoma?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Epidemiological criterion","justification":""},{"idx":1,"correct":true,"proposition":"Indurated lesion sometimes bumpy","justification":""},{"idx":2,"correct":true,"proposition":"Absence of facial paralysis","justification":""},{"idx":3,"correct":false,"proposition":"Algic character","justification":""},{"idx":4,"correct":true,"proposition":"Spontaneous hyper signal in T2 sequence on MRI","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-20","enonce":" What element(s) contraindicate(s) the organization of palliative care care at home?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"The fact that the patient is a child","justification":""},{"idx":1,"correct":true,"proposition":"Lack of consent and consent of the patient","justification":""},{"idx":2,"correct":false,"proposition":"The fact that the patient lives in a building without an elevator","justification":""},{"idx":3,"correct":false,"proposition":"The fact that the patient has more than 2 electric syringes","justification":""},{"idx":4,"correct":false,"proposition":"The fact that the patient lives alone at home","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-21","enonce":"On what argument(s) do you assess the seriousness of an epistaxis?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Abundance","justification":""},{"idx":1,"correct":true,"proposition":"Associated comorbidities","justification":""},{"idx":2,"correct":true,"proposition":"Tachycardia","justification":""},{"idx":3,"correct":true,"proposition":"Presence of sweat","justification":""},{"idx":4,"correct":true,"proposition":"Recurrent bleeding","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-22","enonce":"In order to avoid any << unreasonable obstinacy>> and in accordance with the terms of the law of 2 February 2022 known as the Leonetti-Claeys <<>> law, a treatment may be suspended or not undertaken, in accordance with the patient's will if the following condition(s) is (are) respected.","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"It is useless","justification":""},{"idx":1,"correct":true,"proposition":"It is disproportionate","justification":""},{"idx":2,"correct":true,"proposition":"It has no other effect than the only artificial maintenance of life","justification":""},{"idx":3,"correct":false,"proposition":"It can lead to a double effect","justification":""},{"idx":4,"correct":false,"proposition":"It is not scientifically proven","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-23","enonce":"A 44-year-old man's bank check revealed hypokalemia at 3.2 mmol \/ L. What is the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"The patient must be hospitalized in an emergency","justification":""},{"idx":1,"correct":false,"proposition":"A urine ionogram on a sample should be requested","justification":""},{"idx":2,"correct":true,"proposition":"Hypokalaemia poses a risk of complete arrhythmia by atrial fibrillation","justification":""},{"idx":3,"correct":true,"proposition":"In case of associated high blood pressure, it is necessary to look for a chronic intake of licorice","justification":""},{"idx":4,"correct":true,"proposition":"In case of associated high blood pressure, it is necessary to seek a cocaine intake","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-24","enonce":" What advice(s) can you give to a 78-year-old man with hypertension effectively treated with a low-salt diet and ACE inhibitor, and who is worried about the announcement in the media of an impending heat wave?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Drink enough","justification":""},{"idx":0,"correct":true,"proposition":"To suspend your salt-free diet during the heat wave","justification":""},{"idx":0,"correct":true,"proposition":"Watch your weight during the heat wave","justification":""},{"idx":0,"correct":true,"proposition":"Quantify your diuresis during the heat wave","justification":""},{"idx":0,"correct":false,"proposition":"Bring urine strips to measure daily urine density","justification":"Let's not go that far anyway 😂"}],"type":"qi"}
{"_id":"annales-2019-qi-25","enonce":" What is(are) the characteristic(s) of therapeutic part-time?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"It can be prescribed by the general practitioner","justification":""},{"idx":1,"correct":false,"proposition":"It may be prescribed by the occupational physician","justification":""},{"idx":2,"correct":true,"proposition":"It may be refused by the employer","justification":""},{"idx":3,"correct":false,"proposition":"It can last a maximum of 3 years","justification":""},{"idx":4,"correct":true,"proposition":"It can correspond to a recovery of 80 percent of a full-time equivalent.","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-26","enonce":"A 38-year-old woman is hospitalized after an emergency caesarean section at 36 weeks of amenorrhea for severe pre-eclampsia with HELLP syndrome. She is anuric upon admission. Which additional examination is a priority?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Abdominopelvic CT angiography","justification":""},{"idx":1,"correct":false,"proposition":"Angio-lRM of the renal arteries","justification":""},{"idx":2,"correct":true,"proposition":"Renal and urinary tract ultrasound","justification":""},{"idx":3,"correct":false,"proposition":"Pelvic ultrasound","justification":""},{"idx":4,"correct":false,"proposition":"Renal perfusion scintigraphy","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-27","enonce":"A 45-year-old woman has been consulting for persistent pelvic pain for a few weeks. She tells you that her last period was 3 weeks ago and she reports a few episodes of bleeding between periods, but very few. An endovaginal pelvic ultrasound was performed. This objective a moderate fluid effusion in the Douglas cul-de-sac and a heterogeneous right adnexal swelling measuring 3 cm of major axis, painful at the passage of the ultrasound probe. The objective clinical examination a flexible, slightly sensitive abdomen in the iliac fossa, defenseless. Blood pressure is 120\/60 mmHg. The temperature is 37.3°C.  The heart rate is 65 bpm. What plasma dosage(s) do you prescribe as a first-line treatment?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"CA 125","justification":""},{"idx":1,"correct":true,"proposition":"B-HCG","justification":"Any woman of childbearing age ..."},{"idx":2,"correct":false,"proposition":"HE4","justification":""},{"idx":3,"correct":false,"proposition":"Ca 19-9","justification":""},{"idx":4,"correct":false,"proposition":"CRP","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-28","enonce":"You receive a patient suffering for 2 weeks from a depressive syndrome. He tells you that he has been working more than 50 hours a week for months, regularly bringing home work and feeling << drained >>. In addition, he tells you that his executive reproaches him daily and unjustified since he refused his advances. He wishes to apply for recognition as an occupational disease. Which element(s) do you indicate on the initial medical certificate?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Burnout in a context of work overload","justification":"Burnout is not, today, a recognized pathology"},{"idx":1,"correct":false,"proposition":"Sexual and psychological harassment"},{"idx":2,"correct":true,"proposition":"Depressive syndrome"},{"idx":3,"correct":false,"proposition":"Reactive anxio-depressive syndrome following sexual insistence","justification":""},{"idx":4,"correct":false,"proposition":"The precise date of the advances of its executive","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-29","enonce":"At 25 years old, you have just passed your passage in the 38th cycle and you arrive in a new city as a first-semester intern, in the adult emergency room of the CHU. You had never been seen in school medicine or occupational medicine before, and you lost your health record a long time ago. You have no notable history, other than atopy in childhood, and two unreported blood-exposure accidents during your surgical rotations. You are summoned for an occupational medicine consultation. What should the occupational physician do (one or more exact proposals)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Look for latex irritation dermatitis due to a history of atopy","justification":""},{"idx":1,"correct":true,"proposition":"Performs an anti-Hbs antibody test to check for immunization against hepatitis B virus","justification":""},{"idx":2,"correct":true,"proposition":"Require you to be vaccinated with the dTP vaccine","justification":""},{"idx":3,"correct":false,"proposition":"Require you to get a flu shot","justification":"Flu vaccine is highly recommended but not mandatory"},{"idx":4,"correct":true,"proposition":"Perform an HIV serology"}],"type":"qi"}
{"_id":"annales-2019-qi-30","enonce":"You are seeing a 40-year-old patient with non-calcifying rotator cuff tendinopathy in the right shoulder. She is right-handed and works as an oyster worker. She explains that she has to handle bags of oysters weighing 20 kg to unload the barge, which leads her to have to abduct her shoulders. In her history, she is followed for well-balanced insulin-dependent diabetes. She quit smoking 3 months ago and started learning tennis. Which element(s) is (are) in favor of a potential occupational origin of his pathology?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Pathology is lateralized on the dominant limb","justification":""},{"idx":1,"correct":false,"proposition":"Diabetes is well balanced","justification":""},{"idx":2,"correct":false,"proposition":"You noticed the pathology while it was active","justification":""},{"idx":3,"correct":true,"proposition":"The patient is under 50 years of age","justification":""},{"idx":4,"correct":true,"proposition":"The gestures performed are at risk for the rotator cuff","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-31","enonce":"A 75-year-old woman has been consulting for bleeding externalized through the vagina for two months. She weighs 89 kg for 1 m 50. In her history, there are two vaginal deliveries and high blood pressure. She does not smoke and has no allergy. What is the most likely diagnosis?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Malignant tumor of the ovary","justification":""},{"idx":1,"correct":false,"proposition":"Malignant tumor of the cervix","justification":""},{"idx":2,"correct":false,"proposition":"Malignant tumor of the fallopian tube","justification":""},{"idx":3,"correct":false,"proposition":"Malignant tumor of the vagina","justification":""},{"idx":4,"correct":true,"proposition":"Malignant endometrial tumour","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-32","enonce":"A 27-year-old pregnant woman is seeking urination burns that have been ongoing for 24 hours. She is at 23 weeks of amenorrhea. This is her first pregnancy. She has no allergies and no history. The objective clinical examination a pain at the shaking of the right lumbar fossa. On vaginal touch, the cervix is long, posterior and closed. Blood pressure is 125\/65 mmHg. His heart rate is 78 bpm. Its temperature is 38.1 °C.  The urine strip objectifies the presence of proteins, leukocytes, blood and nitrites. A cytobacteriological examination of urine was prescribed. Direct examination shows 10,000\/mL leukocytes and gram-negative bacilli. Which antibiotic treatment is most relevant at this stage?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Ofloxacin","justification":""},{"idx":1,"correct":false,"proposition":"Amoxicillin-clavulanic acid","justification":""},{"idx":2,"correct":false,"proposition":"Fosfomycin","justification":""},{"idx":3,"correct":false,"proposition":"Amikacin","justification":""},{"idx":4,"correct":true,"proposition":"Cefotaxime","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-33","enonce":"Which of the following pathologies can (may) promote the appearance of cataracts?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Hyperthyroidism","justification":""},{"idx":1,"correct":true,"proposition":"Diabetes","justification":""},{"idx":2,"correct":true,"proposition":"Down syndrome","justification":""},{"idx":3,"correct":true,"proposition":"Horton's disease","justification":""},{"idx":4,"correct":false,"proposition":"Steinert's myopathy","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-34","enonce":"A 72-year-old patient has bilateral primary open-angle glaucoma treated with eye drops based on prostaglandin analogues and beta-blockers (fixed combination). Which of the following tests may have been used for the diagnosis of his glaucoma (one or more exact proposals)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Tonometry","justification":""},{"idx":1,"correct":true,"proposition":"Gonioscopy","justification":""},{"idx":2,"correct":false,"proposition":"Keratometry","justification":""},{"idx":3,"correct":true,"proposition":"Automated perimetry","justification":""},{"idx":4,"correct":true,"proposition":"Optical coherence tomography","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-35","enonce":"You are following Mrs. F., aged 32, for chronic thrombocytopenic purpura progressing by flare-ups. Her platelet count remains around 20 G\/L. What advice(s) do you give to this patient?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Do not take acetylsalicylic acid","justification":""},{"idx":1,"correct":false,"proposition":"Do not take paracetamol","justification":""},{"idx":2,"correct":false,"proposition":"Do not take antibiotics","justification":""},{"idx":3,"correct":true,"proposition":"Avoid intramuscular injections","justification":""},{"idx":4,"correct":false,"proposition":"Prohibit subcutaneous injections","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-36","enonce":"A 67-year-old patient arrives at the emergency department with fever at 39°C with chills of sudden onset. He is very asthenic. His wife who accompanied him found him pale and tired for several days. The first results on the hospital server show hemoglobin: 8.2 g \/ dL, leukocytes 2.8 G \/ L, polynuclear 0.41 G \/ L, platelets 36 G \/ L, reticulocytes 20 G \/ L. The automaton has not returned a formula and the smear has not yet been read. Which diagnosis(s) is compatible? (one or more exact propositions)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Bone marrow suppression","justification":""},{"idx":1,"correct":true,"proposition":"Acute leukemia","justification":""},{"idx":2,"correct":true,"proposition":"Myelodysplastic syndrome","justification":""},{"idx":3,"correct":false,"proposition":"Chronic lymphocytic leukemia","justification":""},{"idx":4,"correct":true,"proposition":"Hodgkin's disease","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-37","enonce":"A 19-year-old patient is referred to you for consultation because of repeated episodes of upper airway infection (ear infections, sinusitis) and bronchitis, with multiple antibiotic therapies (5 to 10 per year) in the last five years. A serum protein electrophoresis performed in the city shows the following results albumin 44 g \/ L - alpha1-globulins 2.61 g \/ L - alpha2-globulins 4.7 g \/ L - beta1-globulins 3.8 g \/ L - gamma globulins 3 g \/ L. blood lymphocyte immunophenotyping finds a decrease in switched memory B lymphocytes, without associated T-cell deficiency. To which of the following microorganism(s) does your patient have an increased susceptibility?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Streptococcus pneumoniae"},{"idx":1,"correct":false,"proposition":"Candida albicans","justification":""},{"idx":2,"correct":false,"proposition":"Mycobacterium tuberculosis"},{"idx":3,"correct":false,"proposition":"Pneumocystis jirovecii"},{"idx":4,"correct":false,"proposition":"Giardia lamblia"}],"type":"qi"}
{"_id":"annales-2019-qi-38","enonce":"A 62-year-old patient is referred by her general practitioner to the emergency department for pallor. The blood count is below. \n Reticulocytes are at 40 G\/L. You mention: (one or more expected answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Iron deficiency"},{"idx":1,"correct":false,"proposition":"Thrombotic microangiopathy","justification":""},{"idx":2,"correct":false,"proposition":"G6PD deficiency"},{"idx":3,"correct":false,"proposition":"Evans syndrome"},{"idx":4,"correct":true,"proposition":"Myelodysplasia"}],"type":"qi"}
{"_id":"annales-2019-qi-39","enonce":"A 37-year-old patient suffered a sprained right ankle 4 months ago. She complains of pain in the lower right limb when walking with allodynia of the upper surface of the right foot, equine varus of the right foot when walking, and edema of the foot. You mention a complex regional pain syndrome. What technique(s) can (s) be used by the physiotherapist?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Gain in range of motion","justification":""},{"idx":1,"correct":false,"proposition":"Work in charge","justification":""},{"idx":2,"correct":true,"proposition":"Skin desensitization","justification":""},{"idx":3,"correct":true,"proposition":"Triceps stretching","justification":""},{"idx":4,"correct":true,"proposition":"Balneotherapy","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-40","enonce":"About the decision on medical termination of pregnancy (IMG), which is (are) the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"The couple can make the IMG decision on their own if the disease is particularly severe","justification":""},{"idx":1,"correct":false,"proposition":"Serious and incurable diseases are listed in a list giving entitlement to an IMG","justification":""},{"idx":2,"correct":false,"proposition":"IMG is only allowed if it is certain that the unborn child has the disease","justification":""},{"idx":3,"correct":true,"proposition":"The IMG is authorized by law with no term limit","justification":""},{"idx":4,"correct":true,"proposition":"The particular severity of a disease meets certain objective criteria such as the risk of premature death or cognitive impairment.","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-41","enonce":"A young man of 25 years old consults you for acute low back pain occurred when getting up from his bed, radiating above 2 knees. He is addicted to the hard drugs he injects. All mobility of the spine is limited, pain in standing position is evaluated with an EN (numerical scale) of 7\/10. You find on the general examination a systolic heart murmur. He tells you that he has been coughing for several days. What do you suspect in this patient? (one or more possible answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Lumbago","justification":""},{"idx":1,"correct":true,"proposition":"Endocarditis","justification":""},{"idx":2,"correct":true,"proposition":"Cauda equina syndrome","justification":""},{"idx":3,"correct":true,"proposition":"Spondylodiscite","justification":""},{"idx":4,"correct":false,"proposition":"Ankylosing spondylitis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-42","enonce":"An 84-year-old man is referred to you after falling from bed. You have an x-ray of the pelvis. What is the real proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"There is a fracture of the right femoral neck","justification":""},{"idx":1,"correct":false,"proposition":"There is a fracture of the left trochanterian massif","justification":""},{"idx":2,"correct":false,"proposition":"There is a dislocation of the left coxofemoral joint","justification":""},{"idx":3,"correct":false,"proposition":"There is a fracture of the pubic symphysis","justification":""},{"idx":4,"correct":false,"proposition":"There is a fracture of the right shutter frame","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-43","enonce":"The assessment of a bilateral form of breast cancer in a 42-year-old woman revealed a pathogenic BRCA1 mutation. What is the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"High risk of ovarian cancer may warrant oophorectomy","justification":""},{"idx":1,"correct":false,"proposition":"Breast monitoring relies on simple breast ultrasound","justification":""},{"idx":2,"correct":false,"proposition":"The risk of early breast cancer justifies genetic analysis in her underage daughters","justification":""},{"idx":3,"correct":true,"proposition":"The breast risk of recurrence may justify mastectomy","justification":""},{"idx":4,"correct":false,"proposition":"She is at high risk for colon cancer","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-44","enonce":"It is necessary to offer an oncogenetic consultation in the following situation(s):","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"In a patient with a breast tumor at age 35","justification":""},{"idx":1,"correct":true,"proposition":"Faced with the existence of a bilateral breast tumor","justification":""},{"idx":2,"correct":true,"proposition":"In front of the existence of polyfocal colonic malignancies","justification":""},{"idx":3,"correct":false,"proposition":"Faced with the existence of an ovarian tumor in a 74-year-old woman","justification":""},{"idx":4,"correct":true,"proposition":"In a subject with a hundred polyps on the entire colonic frame","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-45","enonce":"A general practitioner is required by a gendarme, a judicial police officer, to note the death of a 62-year-old man, who was not his patient, discovered in the barn of his house, with a ballistic trauma of the cephalic end, with an entrance hole visibly under the chin. A firearm is located along the body. The gendarme found a suicidal writing in the house. The constable informs the doctor that there will be no investigation. Which proposal(s) is the right proposal?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"In the absence of an investigation announced by the gendarme, the doctor does not have to check << medical-legal obstacle >> on the death certificate","justification":"Checking this box is a medical decision based on medical arguments"},{"idx":1,"correct":true,"proposition":"The doctor must examine the body for an exit hole for the projectile","justification":""},{"idx":2,"correct":true,"proposition":"The appearance of cadaveric lividities on the body will allow the doctor to support the hypothesis of a suicide","justification":"Cadaveric lividities not corresponding to pressure points may indicate secondary displacement of the body"},{"idx":3,"correct":true,"proposition":"The presence of recent bruises on the wrists and forearms goes against the hypothesis of suicide","justification":"We can think that these are traces of fights"},{"idx":4,"correct":false,"proposition":"An immediate putting in beer in a simple coffin must be requested in this context","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-46","enonce":"The genital lesion that typically occurs at the time of a girl's first sexual intercourse is (only one response):","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"A contuse laceration of the osterious fork","justification":""},{"idx":1,"correct":true,"proposition":"A complete tear of the posterior part of the hymen","justification":""},{"idx":2,"correct":false,"proposition":"A superficial cut from the vestibule","justification":""},{"idx":3,"correct":false,"proposition":"Diffuse erythema of the labia minora","justification":""},{"idx":4,"correct":false,"proposition":"A bilateral contagious wound of the vaginal walls behind the hymen","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-47","enonce":"A judicial police officer takes a victim to a general medical office for the doctor to examine upon request. She says she has been subjected to domestic violence. Which proposal(s) is the right proposal?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"The physician may refuse to respond to the requisition if he has no training in forensic medicine","justification":""},{"idx":1,"correct":false,"proposition":"Only a judicial police officer may request a doctor to examine a victim","justification":""},{"idx":2,"correct":false,"proposition":"The refusal to respond to the requisition is likely to engage the administrative liability of the doctor","justification":""},{"idx":3,"correct":true,"proposition":"The requested physician is released from the obligation of professional secrecy in the specific context of the mission entrusted to him","justification":""},{"idx":4,"correct":false,"proposition":"A copy of the report issued is given to the victim in person to assert what is right.","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-48","enonce":"A patient with advanced left gonarthrosis for which a surgical indication has been decided in a CHU, understands upon waking that the knee prosthesis was placed by mistake on the right side. What are the right proposals? (One or more correct answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Side error is medical malpractice","justification":""},{"idx":1,"correct":true,"proposition":"The criminal liability of the surgeon may be engaged","justification":""},{"idx":2,"correct":false,"proposition":"It is not a medical fault because the prosthesis has been positioned according to the rules of the art","justification":""},{"idx":3,"correct":true,"proposition":"This situation may lead to an amicable settlement","justification":""},{"idx":4,"correct":false,"proposition":"The administrative responsibility of the establishment may be engaged for failure to organize the service","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-49","enonce":"The shared medical record can be created by: (one or more exact answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"The patient","justification":""},{"idx":1,"correct":false,"proposition":"The patient's designated support person","justification":""},{"idx":2,"correct":true,"proposition":"The holder of parental authority for a minor patient","justification":""},{"idx":3,"correct":true,"proposition":"The patient's attending physician","justification":""},{"idx":4,"correct":true,"proposition":"Social assistance for the patient","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-51","enonce":"A 52-year-old patient is being treated with inhaled corticosteroids (fluticasone) for asthma. Her doctor prescribes antimycotic treatment (itraconazole) and a short course of oral corticosteroids for an asthma exacerbation triggered by an infection. What is(are) the iatrogenic risk(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Increased plasma concentrations of inhaled corticosteroid","justification":""},{"idx":1,"correct":false,"proposition":"Risk of developing a cushingoid syndrome","justification":""},{"idx":2,"correct":true,"proposition":"Increased plasma concentrations of oral corticosteroid","justification":""},{"idx":3,"correct":false,"proposition":"Risk of developing adrenal insufficiency","justification":""},{"idx":4,"correct":false,"proposition":"Low risk of drug interaction with itraconazole","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-52","enonce":"A 75-year-old patient is treated with cholesterol-lowering (simvastatin) and vitamin K antagonist (warfarin). Her doctor prescribed macrolide antibiotics (clarithromycin) for acute bronchitis. What risk(s) can (s) be increased by a drug interaction?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Risk of tendinopathy","justification":""},{"idx":1,"correct":true,"proposition":"Risk of rhabdomyolysis","justification":""},{"idx":2,"correct":true,"proposition":"Increased risk of bleeding","justification":""},{"idx":3,"correct":true,"proposition":"Risk of potentially fatal arrhythmia","justification":""},{"idx":4,"correct":false,"proposition":"Decrease in lipid-lowering effect","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-53","enonce":"About substances used for doping purposes in sport:","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Early baldness may be a sign of chronic anabolic androgenic steroid administration","justification":""},{"idx":1,"correct":true,"proposition":"Beta-2 agonists exert an anabolic effect in high doses resulting in an increase in muscle mass","justification":""},{"idx":2,"correct":true,"proposition":"Beta-blockers are prohibited in competition in some sports","justification":""},{"idx":3,"correct":true,"proposition":"The occurrence of a pulmonary embolism in a professional cyclist should be investigated for taking erythropoietin receptor agonist","justification":""},{"idx":4,"correct":false,"proposition":"Caffeine is prohibited","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-54","enonce":"About the mechanisms of action of antibiotics:","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Penicillin inhibits penicillin-binding proteins (PLPs), enzymes of the peptidoglycan biosynthesis pathway","justification":""},{"idx":1,"correct":true,"proposition":"Macrolides inhibit bacterial protein synthesis by binding to the ribosome","justification":""},{"idx":2,"correct":true,"proposition":"Fluoroquinolones inhibit the replication, transcription, repair and recombination of bacterial DNA","justification":""},{"idx":3,"correct":true,"proposition":"Glycopeptides inhibit cell wall synthesis of bacteria","justification":""},{"idx":4,"correct":true,"proposition":"Trimetroprim-sulfamethoxazole is a folic acid inhibitor","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-55","enonce":"An 80-year-old patient is brought by his daughter for consultation for signs of nocturnal agitation attributed to repeated nightmares. He had been treated with bromazepam for several years but he reports that he stopped this medicine two weeks ago. What clinical sign(s) associated with a withdrawal syndrome are you looking for?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Headache","justification":""},{"idx":1,"correct":true,"proposition":"Motor incoordination","justification":""},{"idx":2,"correct":false,"proposition":"Hypothermia","justification":""},{"idx":3,"correct":false,"proposition":"Bradycardia","justification":""},{"idx":4,"correct":false,"proposition":"Tremors","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-56","enonce":"Regarding testicular germ cell tumors, it is true that: (one or more answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"They represent the first solid cancer in 20-year-old men","justification":""},{"idx":1,"correct":true,"proposition":"They may be associated with a serum increase in total HCG.","justification":""},{"idx":2,"correct":false,"proposition":"Biopsy is needed before orchiectomy","justification":""},{"idx":3,"correct":false,"proposition":"They are often associated with inguinal lymphadenopathy","justification":""},{"idx":4,"correct":true,"proposition":"They are often associated with lumbo-aortic lymphadenopathy.","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-57","enonce":"You receive a 25-year-old woman for the implementation of estrogen-progestin contraception combining ethinyl estradiol and levonorgestrel. What contraindication(s) are you looking for in questioning and clinical examination?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Family history of deep vein thrombosis","justification":""},{"idx":1,"correct":true,"proposition":"Severe high blood pressure","justification":""},{"idx":2,"correct":false,"proposition":"History of ectopic pregnancy","justification":""},{"idx":3,"correct":true,"proposition":"Migraine with focal neurological signs","justification":""},{"idx":4,"correct":true,"proposition":"Familial hypercholesterolemia","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-58","enonce":"Regarding the diagnosis of lymph node Hodgkin lymphoma, it is true that (one or more answers):","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" It usually requires a biopsy removed from a lymph node","justification":""},{"idx":1,"correct":false,"proposition":"The levy must be fixed in full immediately","justification":""},{"idx":2,"correct":true,"proposition":"It is based on the identification of Reed-Sternberg cells","justification":""},{"idx":3,"correct":true,"proposition":"A national pathological network for proofreading has been set up by INCa","justification":""},{"idx":4,"correct":true,"proposition":"it requires immunohistochemical labeling","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-59","enonce":"Among the bone tumors for which a biopsy is necessary for diagnosis there are (one or more responses):","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Chondrosarcoma","justification":""},{"idx":1,"correct":false,"proposition":"Non-ossifying fibroid","justification":""},{"idx":2,"correct":false,"proposition":"Osteoid osteoma","justification":""},{"idx":3,"correct":true,"proposition":"Osteosarcoma","justification":""},{"idx":4,"correct":true,"proposition":"Giant bone cell tumour","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-60","enonce":"Among the following, which criterion(s) is (are) part of the criteria of fragility of the elderly subject according to Fried?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Unintentional weight gain","justification":"Unintentional weight loss"},{"idx":1,"correct":true,"proposition":"Feeling tired","justification":""},{"idx":2,"correct":true,"proposition":"Decreased walking speed","justification":""},{"idx":3,"correct":false,"proposition":"Attentional disorders","justification":"The other 2 are: decreased muscle strength and decreased physical activity"},{"idx":4,"correct":false,"proposition":"Vesico-sphincter disorders","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-61","enonce":"Regarding the first-line management of urinary incontinence in the elderly, which of the following proposal(s) is (are) correct?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Wearing protective gear","justification":""},{"idx":1,"correct":true,"proposition":"Implementation of scheduled urination","justification":""},{"idx":2,"correct":true,"proposition":"Bladder anticholinergics for emergency","justification":""},{"idx":3,"correct":false,"proposition":"Placement of an indwelling urinary catheter","justification":""},{"idx":4,"correct":false,"proposition":"Transcutaneous electrical stimulation of the pudendal nerve","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-62","enonce":"Ms B., 57, is employed by a taps-making company. She has subscribed to a mutual health insurance. She lives in a rural area in metropolitan France, without the possibility of personal transport. As a general practitioner, you had already referred her to a cardiology consultation in the past. You now consider that a new cardiology consultation is necessary and you refer it to the cardiologist who follows Mrs. B. As the cardiologist's office is located 50 km from the patient's home, the cardiologist offers a teleconsultation. Ms. B. is not recognized as having a long-term illness. This cardiologist is conventionné, sector 1. Which of the following proposition(s) is the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Ms. B. will receive an Internet link inviting her to connect at the scheduled time of the appointment to a secure site or application","justification":""},{"idx":1,"correct":true,"proposition":"The cardiologist must request and obtain Ms. B.'s consent before conducting the teleconsultation","justification":""},{"idx":2,"correct":false,"proposition":"As part of this teleconsultation, the cardiologist will not be able to write a prescription for treatment or additional examination","justification":""},{"idx":3,"correct":true,"proposition":"Mrs. B. will be reimbursed by the Health Insurance","justification":""},{"idx":4,"correct":false,"proposition":"The price of the teleconsultation is freely set by this cardiologist","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-63","enonce":"You take care of a 52-year-old patient in the emergency room of the hospital for right calf pain. Your elements of interrogation and clinical examination lead you to hypothesize a deep vein thrombosis (DVT). As part of your diagnostic approach, you use a simplified clinical prediction model of DVT. The probability of DVT predicted by the model is high at 53 You decide to order an additional imaging test to confirm or refute your diagnostic hypothesis of DVT. Which of the following statements(are) the exact proposition(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"The pre-test probability of DVT is implicitly estimated from your subjective impression.","justification":""},{"idx":1,"correct":true,"proposition":"The post-test probability of DVT depends on the pre-test probability and the informational characteristics intrinsic to the prescribed imaging test.","justification":""},{"idx":2,"correct":false,"proposition":"The pre-test probability of DVT is estimated from the positive and negative predictive values of the prescribed imaging examination.","justification":""},{"idx":3,"correct":true,"proposition":"The post-test probability of DVT depends on the likelihood ratios of the imaging test.","justification":""},{"idx":4,"correct":true,"proposition":"The more the plausibility ratio of the exam tends towards O, the more the post-test probability of DVT will tend towards 0","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-64","enonce":"A 65-year-old man has nodular basal cell carcinoma (BCC) of the forehead 1 cm in diameter. What is the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"CBC develops on pre-existing actinic keratosis","justification":""},{"idx":1,"correct":true,"proposition":"CBC occurs in photo-exposed areas","justification":""},{"idx":2,"correct":true,"proposition":"Surgery is the first-line treatment","justification":""},{"idx":3,"correct":false,"proposition":"The evolutionary risk is the appearance of visceral metastases","justification":""},{"idx":4,"correct":false,"proposition":"Debulking chemotherapy may be offered","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-65","enonce":"What is your interpretation of this electrocardiogram recorded in a 50-year-old type II diabetic patient admitted to the emergency room for a sudden onset respiratory gene? (only one answer)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"CBC develops on pre-existing actinic keratosis","justification":""},{"idx":1,"correct":true,"proposition":"CBC occurs in photo-exposed areas","justification":""},{"idx":2,"correct":true,"proposition":"Surgery is the first-line treatment","justification":""},{"idx":3,"correct":false,"proposition":"The evolutionary risk is the appearance of visceral metastases","justification":""},{"idx":4,"correct":false,"proposition":"Debulking chemotherapy may be offered","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-66","enonce":"A 75-year-old patient presents to the emergency room for difficulty breathing. Here is his chest x-ray from the front standing. What element(s) are you visualizing?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Cardiomegaly","justification":""},{"idx":1,"correct":true,"proposition":"A fracture of the left collarbone","justification":""},{"idx":2,"correct":false,"proposition":"Left pleural effusion","justification":""},{"idx":3,"correct":true,"proposition":"Perihilar alveolar opacities","justification":""},{"idx":4,"correct":false,"proposition":"A pneumothorax","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-68","enonce":"A depressive episode characterized postpartum:","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Occurs mainly between 3 and 6 weeks after delivery","justification":""},{"idx":1,"correct":true,"proposition":"Affects nearly 25% of women who have given birth","justification":""},{"idx":2,"correct":true,"proposition":"Is unknown in 50% of cases"},{"idx":3,"correct":false,"proposition":"Is most often associated with psychotic features","justification":""},{"idx":4,"correct":true,"proposition":"Is at high risk of progression to bipolar disorder","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-69","enonce":"Dyspnea with prolonged expiratory time can evoke","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Acute edema of the lung","justification":""},{"idx":1,"correct":false,"proposition":"A pneumothorax","justification":""},{"idx":2,"correct":true,"proposition":"An asthma exacerbation","justification":""},{"idx":3,"correct":true,"proposition":"An exacerbation of chronic obstructive pulmonary disease","justification":""},{"idx":4,"correct":false,"proposition":"Laryngeal tumour","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-70","enonce":"Which clinical and paraclinical sign(s) suggestive of severity in a patient with pneumothorax?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Cyanosis","justification":""},{"idx":1,"correct":true,"proposition":"Polypnea > 30\/min","justification":""},{"idx":2,"correct":false,"proposition":"Reduction or abolition of vesicular murmur","justification":""},{"idx":3,"correct":false,"proposition":"Hypotension with systolic blood pressure less than or equal to 90 mmHg","justification":""},{"idx":4,"correct":false,"proposition":"Percussion tympanism","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-71","enonce":"A 65-year-old woman consults for a dry cough evolving for 2 months; This cough wakes her up at night. She has been being treated for high blood pressure for a few months. She never smoked. She has no other history. To specifically explore this cough, which propositions are accurate (one or more exact answers)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Uncontrolled high blood pressure is a common cause of chronic cough","justification":""},{"idx":1,"correct":true,"proposition":"Looking for the prescription of an ACE inhibitor on its prescription","justification":""},{"idx":2,"correct":true,"proposition":"Looking for gastroesophageal reflux symptoms","justification":""},{"idx":3,"correct":true,"proposition":"Looking for sibilants pulmonary auscultation","justification":""},{"idx":4,"correct":false,"proposition":"Looking for a calcium channel blocker prescription on your prescription","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-72","enonce":"A 16-year-old girl has these facial lesions that have been evolving for a few months (photo). Which of the following proposals, which diagnosis(s) do you retain?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Sarcoidosis","justification":""},{"idx":1,"correct":false,"proposition":"Papulopustular Rosacea","justification":""},{"idx":2,"correct":true,"proposition":"Polymorphic juvenile acne","justification":""},{"idx":3,"correct":false,"proposition":"Discoid lupus","justification":""},{"idx":4,"correct":false,"proposition":"Seborrheic dermatitis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-73","enonce":"Which of the following proposals regarding the complications of prolonged use of estrogen-progestin contraception is (are) accurate?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Subsequent decrease in fertility","justification":""},{"idx":1,"correct":false,"proposition":"Increased triglycerides","justification":""},{"idx":2,"correct":false,"proposition":"Increased risk of ovarian cancer","justification":""},{"idx":3,"correct":false,"proposition":"Increased risk of endometrial cancer","justification":""},{"idx":4,"correct":false,"proposition":"Increased risk of ectopic pregnancy","justification":""},{"idx":5,"correct":false,"proposition":"-miscarriage","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-74","enonce":"Which of the following viruses is sexually transmittable?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Adenovirus","justification":""},{"idx":1,"correct":false,"proposition":"Influenza virus","justification":""},{"idx":2,"correct":true,"proposition":"Hepatitis A virus","justification":""},{"idx":3,"correct":true,"proposition":"Hepatitis B virus","justification":""},{"idx":4,"correct":true,"proposition":"Hepatitis C virus","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-75","enonce":"A 26-year-old patient presents to the emergency department at 28 weeks of amenorrhea for headache and edema of the lower limbs. His blood pressure checked three times at rest is 160\/110 mmHg. You prescribe antihypertensive treatment. Which of the following medicinal products is authorised during pregnancy?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Urapidil","justification":""},{"idx":1,"correct":false,"proposition":"Enalapril","justification":""},{"idx":2,"correct":false,"proposition":"lndapamide","justification":""},{"idx":3,"correct":true,"proposition":"Nicardipine","justification":""},{"idx":4,"correct":true,"proposition":"Methyldopa","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-76","enonce":"A 75-year-old patient has right papillary edema with a significant decrease in visual acuity. He complains of fatigue and weight loss for 3 months and headaches. Which of the following tests allows you to confirm your main diagnostic hypothesis?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Optical coherence tomography","justification":""},{"idx":1,"correct":false,"proposition":"Sedimentation rate","justification":""},{"idx":2,"correct":false,"proposition":"CRP","justification":""},{"idx":3,"correct":true,"proposition":"Temporal artery biopsy","justification":"This is the only test that can CONFIRM Horton's hypothesis"},{"idx":4,"correct":false,"proposition":"Retinal angiography","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-77","enonce":"Three months after cataract surgery, a 72-year-old patient complains of myodesopsia. Which of the following signs could lead to fear of retinal detachment? (one or more answers are correct)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Dyschromatopsia","justification":""},{"idx":1,"correct":false,"proposition":"Phosphenes","justification":""},{"idx":2,"correct":false,"proposition":"Lagophthalmos","justification":""},{"idx":3,"correct":false,"proposition":"Visual field amputation","justification":""},{"idx":4,"correct":false,"proposition":"Ptosis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-78","enonce":"A young woman has reducible bilateral exophthalmos. In the following list, which examination(s) are necessary for the diagnosis of Graves' disease?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Thyroid scintigraphy","justification":""},{"idx":1,"correct":false,"proposition":"Kinetic perimetry","justification":""},{"idx":2,"correct":false,"proposition":"Orbital CT scan without injection of iodinated contrast medium","justification":""},{"idx":3,"correct":true,"proposition":"Anti-TSH receptor antibodies (TRAK)","justification":"Graves' disease = Hyperthyroidism by activation of TRAK receptors"},{"idx":4,"correct":false,"proposition":"Anti-thyroglobulin (TG) antibodies","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-79","enonce":"What are the possible etiologies of decreased visual acuity associated with eye redness? (one or more correct answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Acute glaucoma crisis due to angle closure","justification":""},{"idx":1,"correct":true,"proposition":"Anterior uveitis","justification":""},{"idx":2,"correct":false,"proposition":"Central retinal artery occlusion (OACR)","justification":""},{"idx":3,"correct":false,"proposition":"Neovascular glaucoma","justification":""},{"idx":4,"correct":false,"proposition":"Retinal vasculitis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-80","enonce":"Which of the following clinical elements points to adhesive capsulitis of the shoulder?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"A lateral rotation at 0°","justification":""},{"idx":1,"correct":true,"proposition":"A traumatic trigger","justification":""},{"idx":2,"correct":false,"proposition":"Shoulder swelling","justification":""},{"idx":3,"correct":false,"proposition":"Redness of the shoulder","justification":""},{"idx":4,"correct":false,"proposition":"History of diabetes","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-81","enonce":"You examine a 40-year-old patient after the harvest. He complains of a muscle control disorder to raise his right foot to walking. He has a sensory disorder of the first dorsal interosseous space. There is a step to walking, the Trendelenburg test is without abnormality, the fibular muscles are rated at 5\/5 in the motor test. What is your diagnosis(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Damage to the tibial nerve in the leg","justification":""},{"idx":1,"correct":false,"proposition":"Damage to the superficial fibular nerve","justification":""},{"idx":2,"correct":true,"proposition":"Deep fibular nerve damage","justification":""},{"idx":3,"correct":false,"proposition":"An attack of the root L4"},{"idx":4,"correct":false,"proposition":"Damage to the S1 root"}],"type":"qi"}
{"_id":"annales-2019-qi-82","enonce":"An 80-year-old patient comes to consult because she has left wrist pain for several years but is now very disabling. What is (are) the exact proposal(s) concerning the wrist X-ray that it brings you?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"There is rhizarthrosis","justification":""},{"idx":1,"correct":true,"proposition":"There is scaphotrapezian osteoarthritis","justification":""},{"idx":2,"correct":false,"proposition":"There is chondrocalcinosis","justification":""},{"idx":3,"correct":false,"proposition":"There is necrosis of lunatum","justification":""},{"idx":4,"correct":false,"proposition":"There is an old fracture of the scaphoid","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-83","enonce":"A 20-year-old patient arrives at the emergency room because she had a ski fall the previous weekend and has persistent severe knee pain that prevents support. What is the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"A knee effusion on a profile X-ray may suggest an acute rupture of the anterior cruciate ligament","justification":""},{"idx":1,"correct":true,"proposition":"X-rays of a spontaneously reduced patellofemoral dislocation may be normal","justification":""},{"idx":2,"correct":false,"proposition":"A fracture of the tibial plateau visible on the X-ray requires further exploration by an MRI","justification":""},{"idx":3,"correct":false,"proposition":"Arthroscan exploration of a chondral knee injury requires the injection of intra-articular gadolinium salt","justification":""},{"idx":4,"correct":false,"proposition":"Ultrasound is a good examination to study the knee extensor apparatus","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-85","enonce":"During amyotrophic lateral sclerosis, you may observe the following clinical sign(s)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Hypoaesthesia of the lower limbs","justification":""},{"idx":1,"correct":true,"proposition":"Cognitive impairment","justification":""},{"idx":2,"correct":true,"proposition":"Slurred speech","justification":""},{"idx":3,"correct":false,"proposition":"Vesico-sphincter disorders","justification":""},{"idx":4,"correct":true,"proposition":"Scattered fasciculations","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-86","enonce":"A 3-week-old newborn is brought by his parents to his pediatrician because his stool is discolored. The clinical examination finds jaundice. What is the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"This clinical situation is an emergency","justification":""},{"idx":1,"correct":false,"proposition":"There is a risk of neurological complication by nuclear jaundice","justification":""},{"idx":2,"correct":false,"proposition":"Phototherapy should be done as soon as possible","justification":""},{"idx":3,"correct":false,"proposition":"Breastfeeding should be interrupted so as not to aggravate jaundice","justification":""},{"idx":4,"correct":false,"proposition":"Mother-child ABO compatibility must be checked","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-87","enonce":"Which of the following applies(s) to NPH insulin?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Its duration of action is about 12 hours","justification":""},{"idx":1,"correct":true,"proposition":"It is an insulin suspension","justification":""},{"idx":2,"correct":false,"proposition":"It should not be injected into a venous","justification":""},{"idx":3,"correct":false,"proposition":"It should not be combined with rapid insulin","justification":""},{"idx":4,"correct":false,"proposition":"It should not be prescribed to pregnant women","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-89","enonce":"You refer a 47-year-old patient to the surgeon because of an isolated thyroid nodule, without satellite lymphadenopathy, which measures 38 x 25 x 23 mm in diameter. It is rated TIRADS 3 on ultrasound but interferes with swallowing. A surgical indication is made (right thyroid lobo-isthmectomy). What is (are) the possible event(s) in the postoperative period?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Hypoparathyroidism","justification":""},{"idx":1,"correct":false,"proposition":"Hypothyroidism","justification":""},{"idx":2,"correct":false,"proposition":"Left recurrent paralysis","justification":""},{"idx":3,"correct":true,"proposition":"Dysphonia","justification":""},{"idx":4,"correct":true,"proposition":"Tabulation of thyroidectomy if the nodule is papillary cancer","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-91","enonce":"A 42-year-old patient consults you for retrosternal chest pain and nocturnal regurgitation. The cardiovascular balance is negative. What is (are) the argument(s) in favor of a primitive achalasia?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Upper gastrointestinal endoscopy revealing stenosis of the lower esophagus","justification":""},{"idx":1,"correct":false,"proposition":"Presence of dysphagia only for solids","justification":""},{"idx":2,"correct":true,"proposition":"Regurgitation of food residues","justification":""},{"idx":3,"correct":false,"proposition":"Presence of iron deficiency anemia","justification":""},{"idx":4,"correct":false,"proposition":"Presence of propagated peristaltic waves with significant hyperpressure of the sphincter on an esophageal manometry","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-92","enonce":"What diagnosis(s) is (are) to evoke in a 2-year-old child who has functional impotence of the lower limb of sudden onset without notion of trauma in a non-febrile context?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"A fracture on tumor","justification":""},{"idx":1,"correct":false,"proposition":"Juvenile osteoarthritis","justification":""},{"idx":2,"correct":false,"proposition":"Epiphysiolysis of the femoral head","justification":""},{"idx":3,"correct":true,"proposition":"A fracture by trauma inflicted","justification":""},{"idx":4,"correct":false,"proposition":"Higher femoral osteonecrosis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-93","enonce":"In front of a table of acute maxillary sinusitis, which is (are) the element (s) that orient (s) towards a bacterial origin?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Increased infraorbital sinus pain despite symptomatic treatment prescribed for at least 48 hours","justification":""},{"idx":1,"correct":true,"proposition":"One-sided and throbbing pain","justification":""},{"idx":2,"correct":true,"proposition":"Increased pain during trunk anteflexion","justification":""},{"idx":3,"correct":false,"proposition":"Pain increasing during the morning","justification":""},{"idx":4,"correct":false,"proposition":"Increase in rhinorrhea over time","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-94","enonce":"A 76-year-old patient is referred for dysphagia. Which element(s) would orient (s) towards the diagnosis of Zenker's diverticulum?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Presence of regurgitation of undigested food","justification":""},{"idx":1,"correct":true,"proposition":"Fluctuating dysphagia","justification":""},{"idx":2,"correct":true,"proposition":"Sign of the << tide >> to nasofibroscopy","justification":""},{"idx":3,"correct":true,"proposition":"Presence of a nocturnal cough","justification":""},{"idx":4,"correct":false,"proposition":"Presence of dysphonia","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-96","enonce":"A 45-year-old patient consults for persistent low back pain for 3 months with macroscopic hematuria. The following imaging is performed. What is the exact proposal(s)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"This is an abdominal MRI","justification":""},{"idx":1,"correct":true,"proposition":"This is a coronal cup","justification":""},{"idx":2,"correct":true,"proposition":"This is imaging with contrast injection","justification":""},{"idx":3,"correct":true,"proposition":"There is a tumor of the right kidney","justification":""},{"idx":4,"correct":false,"proposition":"There is a left pyelocalicial dilation","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-97","enonce":"On this CT scan of the abdomen: (one or more exact answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"The structure designated by the number 1 is a hepatic vein","justification":""},{"idx":1,"correct":false,"proposition":"The structure designated by the number 2 is the portal vein","justification":""},{"idx":2,"correct":true,"proposition":"The structure designated by the number 3 is the aorta","justification":""},{"idx":3,"correct":true,"proposition":"The structure designated by the number 4 is the spleen","justification":""},{"idx":4,"correct":false,"proposition":"The structure designated by the number 5 is the stomach","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-98","enonce":"In hepatic computed tomography, in typical forms, after intravenous injection of iodinated contrast medium, which proposal(s) is(are) exact?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"A hemangioma becomes opaque through the periphery","justification":""},{"idx":1,"correct":true,"proposition":"Hepatocellular carcinoma increases with arterial time","justification":""},{"idx":2,"correct":true,"proposition":"Hepatocellular carcinoma is the site of late-time wash-out","justification":""},{"idx":3,"correct":false,"proposition":"A biliary cyst rises at portal time","justification":""},{"idx":4,"correct":false,"proposition":"A metastasis rises intensely at the portal time","justification":"hypodense all the time"}],"type":"qi"}
{"_id":"annales-2019-qi-99","enonce":"Ms. C., with no particular background, is a senior executive, an employee in a company and benefits from a mutual insurance company. Mrs. C. made an appointment directly with a cardiologist in sector 1, outside the framework of the coordinated care pathway. Which of the following is correct?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"The Health Insurance will only reimburse 30% of the basic fee of the consultation","justification":""},{"idx":1,"correct":true,"proposition":"Ms C. will have a flat-rate contribution of one euro for this consultation","justification":""},{"idx":2,"correct":false,"proposition":"The Health Insurance will refuse to reimburse the drugs prescribed by this cardiologist","justification":""},{"idx":3,"correct":true,"proposition":"The cardiologist is authorized to practice an excess fee of up to 60 euros","justification":""},{"idx":4,"correct":false,"proposition":"The amount reimbursed by Social Security will be 11.51 euros","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-100","enonce":"What adjuvant therapeutic management(s) will you offer to a 53-year-old patient with invasive adenocarcinoma of non-specific type of right breast, triple negative, pT2N+MO after conservative surgery and right axillary dissection?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Radiotherapy"},{"idx":1,"correct":true,"proposition":"Chemotherapy"},{"idx":2,"correct":false,"proposition":"Hormone therapy"},{"idx":3,"correct":false,"proposition":"Trastuzumab"},{"idx":4,"correct":false,"proposition":"Complementary clavicular dissection","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-101","enonce":"A patient is admitted to an identified palliative care bed for the management of amyotrophic lateral sclerosis. The patient is at a terminal stage of his disease. It benefits from nutrition, hydration by a gastrostomy device and non-invasive ventilation. After meeting the patient, the family asks to see you to discuss the principle of deep and continuous sedation until death as described in the law of February 2, 2022. What is the exact information(s) you can give the family about this sedation?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"It may accelerate the occurrence of death"},{"idx":1,"correct":false,"proposition":"Its objective is to accelerate the occurrence of death"},{"idx":2,"correct":false,"proposition":"It can be implemented at the request of the family under certain conditions"},{"idx":3,"correct":false,"proposition":"When a patient suffering from a serious and incurable condition decides to stop treatment and this cessation is life-threatening in the short term and is likely to cause unbearable suffering, he may request it."},{"idx":4,"correct":false,"proposition":"It is systematic as soon as a patient enters the agonic phase","justification":"Not at all systematic. It is the result of a multidisciplinary exchange between caregivers"}],"type":"qi"}
{"_id":"annales-2019-qi-102","enonce":" i You are caring for a 71-year-old patient in good general condition for Gleason 7 (3+4) prostate adenocarcinoma, initial PSA at 8 ng\/ml, clinical stage T2NOMO, recently discovered. Which therapeutic option(s) do you choose?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Cryotherapy","justification":""},{"idx":1,"correct":true,"proposition":"Radical prostatectomy","justification":""},{"idx":2,"correct":true,"proposition":"Long exclusive hormone therapy","justification":""},{"idx":3,"correct":true,"proposition":"Exclusive external beam radiation therapy","justification":""},{"idx":4,"correct":false,"proposition":"Transurethral prostate resection","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-103","enonce":"A 60-year-old type 2 diabetic patient has mixed dyslipidemia. Its balance is as follows: LDL cholesterol 2.9 g\/L (7.54 mmol\/L); HDL cholesterol 0.32 g\/L (0.78 mmol\/L); apo B 1.8 g\/L (normal< 1.2 g\/L); triglycerides 2.5 g\/L (2.75 mmol\/L). This lesion located on the major must evoke: (one or more exact answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Combined hyperlipidemia entangled with type 2 diabetes","justification":""},{"idx":1,"correct":false,"proposition":"Dysbetalipoproteinemia entangled with type 2 diabetes","justification":""},{"idx":2,"correct":true,"proposition":"Nephrotic syndrome","justification":""},{"idx":3,"correct":false,"proposition":"Lipoid necrobiosis","justification":""},{"idx":4,"correct":true,"proposition":"Heterozygous familial hypercholesterolemia + type 2 diabetes","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-104","enonce":"A 27-year-old woman is hospitalized urgently for pain in the right flank and nausea progressing for 24 hours. She is at 25 weeks of amenorrhea (AS). When it arrives, you notice a temperature of 38.5 ° C.  The pain radiates into the right lumbar fossa. You must (one or more correct answers):","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Make a urine strip to look for an infection","justification":""},{"idx":1,"correct":true,"proposition":"evoke appendicitis because in the 2nd trimester of pregnancy the coecal bottom is repressed in the right flank","justification":""},{"idx":2,"correct":false,"proposition":"initiate non-steroidal anti-inflammatory therapy in principle","justification":""},{"idx":3,"correct":true,"proposition":"request an abdominal ultrasound","justification":""},{"idx":4,"correct":false,"proposition":"Start antibiotic therapy in emergency","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-106","enonce":"Which of the following occupational exposures result in a proven excess risk of lung cancer (one or more possible responses)?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"Silica","justification":""},{"idx":1,"correct":true,"proposition":"Asbestos fibres","justification":""},{"idx":2,"correct":true,"proposition":"Polycyclic aromatic hydrocarbons","justification":""},{"idx":3,"correct":false,"proposition":"Aromatic amines","justification":""},{"idx":4,"correct":false,"proposition":"Formalin","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-107","enonce":"A 41-year-old patient, with no medical or surgical history, has epigastralgia and must undergo a digestive endoscopy. The anaesthetist ordered a blood count and hemostasis tests. Haemoglobin is 12.1 g\/dL, platelets 151 G\/L. Leukocytes are at 7.5 G\/L. The TCA is 1.7 times the control, the TP is 97%. She never had a bleeding episode. These results are consistent with:","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Vitamin K deficiency","justification":""},{"idx":1,"correct":false,"proposition":"A circulating anticoagulant of the lip type","justification":""},{"idx":2,"correct":true,"proposition":"Hereditary factor XII deficiency","justification":""},{"idx":3,"correct":true,"proposition":"Hereditary factor XI deficiency","justification":""},{"idx":4,"correct":false,"proposition":"An anti-factor VII antibody","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-108","enonce":"You are called to the neurovascular intensive care unit for a 37-year-old patient who has had a transient ischemic attack. By examining it, you notice lesions on the thighs. These are: (one exact answer)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Purpura","justification":""},{"idx":1,"correct":false,"proposition":"Confluent telangiectasias","justification":""},{"idx":2,"correct":false,"proposition":"Stretch marks","justification":""},{"idx":3,"correct":true,"proposition":"A livedo","justification":""},{"idx":4,"correct":false,"proposition":"Bruising","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-109","enonce":"A 57-year-old man is hospitalized urgently for left iliac fossa pain and hyperthermia. You see it in the emergency room and suspect acute diverticulitis of the sigmoid. You ask: (one or more correct answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"A picture of the abdomen without preparation standing from the front to visualize the colonic frame and possible liquid levels","justification":""},{"idx":1,"correct":false,"proposition":"An abdominal CT scan without injection because sepsis increases the risk of kidney failure","justification":""},{"idx":2,"correct":false,"proposition":"A water-soluble enema, to eliminate another pathology with similar symptomatology, and avoid a barium in case of diverticular perforation","justification":""},{"idx":3,"correct":true,"proposition":"An abdominal CT scan with contrast medium injection, after checking for severe renal impairment or a history of severe allergy to contrast medium","justification":""},{"idx":4,"correct":false,"proposition":"A rectosigmoidoscopy because the risk of perforation is less than with a long colonoscopy, and this examination makes it possible to formally eliminate the presence of colon cancer","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-110","enonce":"Which of the following antimalarials for prophylaxis should only be continued one week after returning from an area at risk of malaria infection?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Chloroquine","justification":""},{"idx":1,"correct":false,"proposition":"Chloroquine-proguanil","justification":""},{"idx":2,"correct":true,"proposition":"Atovaquone-proguanil","justification":""},{"idx":3,"correct":false,"proposition":"Cyclines","justification":""},{"idx":4,"correct":false,"proposition":"Mefloquine","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-111","enonce":"Which of the following bacteria has natural resistance to third-generation cephalosporins?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Golden staph","justification":""},{"idx":1,"correct":false,"proposition":"Klebsiella pneumoniae","justification":""},{"idx":2,"correct":false,"proposition":"Escerichia coli","justification":""},{"idx":3,"correct":false,"proposition":"Pneumococcus","justification":""},{"idx":4,"correct":true,"proposition":"Listeria monocytogenes","justification":"Mnemo: Princess LLEIA (Listeria, Legionella, Enterococcus, Intracellular, Anaerobic)"}],"type":"qi"}
{"_id":"annales-2019-qi-112","enonce":"You are reading an article reporting the results of a randomized, double-blind clinical trial, comparing two groups of patients, treated with either a new or a reference drug","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Beyond statistical significance, it is essential to assess the clinical relevance of the observed difference in effect","justification":""},{"idx":1,"correct":false,"proposition":"Randomization increases risk of bias when interpreting results","justification":""},{"idx":2,"correct":false,"proposition":"The double-blind technique is a method that aims to reduce bias in the realization and interpretation of the results of a clinical trial","justification":""},{"idx":3,"correct":false,"proposition":"The Transparency Commission of the HAS (Haute Autorité de Santé) can participate in the statistical analysis of this clinical trial on French territory","justification":""},{"idx":4,"correct":true,"proposition":"The statistical significance of the difference in effect of the two drugs is necessary to establish the superiority of therapeutic efficacy of the new drug","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-113","enonce":"In this family, the diagnosis of cystic fibrosis (frequency 1\/3000 in the population) was confirmed and 2 composite heterozygous mutations in the CFTR gene were identified in the young woman 11-2. What is the exact proposal(s)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"The risk of cystic fibrosis transmission for couples 11-1 and 11-2 is about 1\/60","justification":""},{"idx":1,"correct":true,"proposition":"The future risk for the II-3 free sister of having an affected child is about 1\/120","justification":""},{"idx":2,"correct":false,"proposition":"I-4's spouse is pregnant. The a priori risk that the unborn child is affected is about 1\/240","justification":""},{"idx":3,"correct":false,"proposition":"The woman II-3 can directly exercise a right of access to the medical file of her sister II-2","justification":""},{"idx":4,"correct":false,"proposition":"The I-1 woman refused the genetic test for heterozygosity for herself. The I-2 subject can directly transmit his own results to the children of I-1","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-114","enonce":"Social phobias:","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"Are specific forms of phobias","justification":""},{"idx":1,"correct":false,"proposition":"Mostly start from the age of 20","justification":""},{"idx":2,"correct":false,"proposition":"May manifest as delusions of persecution","justification":""},{"idx":3,"correct":true,"proposition":"Can manifest as fear of eating in public","justification":""},{"idx":4,"correct":true,"proposition":"Warrant treatment with antidepressants in severe forms","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-116","enonce":"Regarding urothelial histological bladder carcinomas, which proposal(s) is(are) accurate?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"They are detected with good sensitivity by urinary cytology","justification":""},{"idx":1,"correct":false,"proposition":"They are low-grade when they are carcinomas in situ","justification":""},{"idx":2,"correct":false,"proposition":"They are associated with bladder schistosomiasis in Africa","justification":""},{"idx":3,"correct":true,"proposition":"Grade has little interest for tumors infiltrating the muscular.","justification":""},{"idx":4,"correct":false,"proposition":"They can be classified T2 on endoscopic resection chips","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-117","enonce":"Regarding the diagnosis of cirrhosis on a liver biopsy: (one or more exact answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":"This is a stage 4 of the METAVIR classification","justification":""},{"idx":1,"correct":true,"proposition":"There are almost no false positives","justification":""},{"idx":2,"correct":false,"proposition":"There are almost no false negatives","justification":"Yes, we can tap next to it"},{"idx":3,"correct":true,"proposition":"Diagnostic performance depends on the size of the sample","justification":""},{"idx":4,"correct":false,"proposition":"Diagnostic performance is better in micronodular cirrhosis","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-118","enonce":"Which of the following treatments may be responsible for delirium by its anticholinergic property?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":true,"proposition":" Antiparkinsonian tropatepine","justification":""},{"idx":1,"correct":true,"proposition":"Antiemetic metoclopramide","justification":""},{"idx":2,"correct":true,"proposition":"Antihistamine H1 hydroxyzine","justification":""},{"idx":3,"correct":false,"proposition":"Acetylcholine esterase inhibitor donepezil","justification":""},{"idx":4,"correct":true,"proposition":"Antispasmodic oxybutynin","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-119","enonce":"For vesicular or follicular thyroid carcinomas: (one or more exact answers)","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"They account for less than 5% of thyroid cancers","justification":""},{"idx":1,"correct":false,"proposition":"They are frequently associated with multiple endocrine neoplasia type 2 (MEN-2)","justification":""},{"idx":2,"correct":true,"proposition":"They usually diffuse through the blood","justification":""},{"idx":3,"correct":true,"proposition":"The sensitivity of the diagnosis of malignancy by cyto-puncture is good","justification":""},{"idx":4,"correct":true,"proposition":"It is more common in men over 70","justification":""}],"type":"qi"}
{"_id":"annales-2019-qi-120","enonce":"Regarding confusion, which proposal(s) is(are) right?","item":"annales-2019-qi","matiere":"annales-2019","propositions":[{"idx":0,"correct":false,"proposition":"It is a rapidly evolving dementia","justification":""},{"idx":1,"correct":true,"proposition":"It is most often linked to an organic cause","justification":""},{"idx":2,"correct":false,"proposition":"It can manifest itself only in the form of drowsiness","justification":""},{"idx":3,"correct":true,"proposition":"It corresponds to the acute decompensation of brain function","justification":""},{"idx":4,"correct":true,"proposition":"It is more common in the elderly","justification":""}],"type":"qi"}