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?


What advantage(s) does permanent implant brachytherapy offer in prostate cancer compared to conventional irradiation?

Lower risk of sequelae erectile dysfunction


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?

Increased right calf circumference by 1 cm

Increased visibility of superficial veins


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?

Spontaneous hyper signal in T2 sequence on MRI


What element(s) contraindicate(s) the organization of palliative care care at home?

Lack of consent and consent of the patient

The fact that the patient lives in a building without an elevator

The fact that the patient has more than 2 electric syringes

The fact that the patient lives alone at home


On what argument(s) do you assess the seriousness of an epistaxis?


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.

It has no other effect than the only artificial maintenance of life


A 44-year-old man's bank check revealed hypokalemia at 3.2 mmol / L. What is the exact proposal(s)?

The patient must be hospitalized in an emergency

A urine ionogram on a sample should be requested

Hypokalaemia poses a risk of complete arrhythmia by atrial fibrillation

In case of associated high blood pressure, it is necessary to look for a chronic intake of licorice

In case of associated high blood pressure, it is necessary to seek a cocaine intake


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?

To suspend your salt-free diet during the heat wave

Quantify your diuresis during the heat wave

Bring urine strips to measure daily urine density


What is(are) the characteristic(s) of therapeutic part-time?

It can be prescribed by the general practitioner

It may be prescribed by the occupational physician

It can correspond to a recovery of 80 percent of a full-time equivalent.


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?


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?


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?

Burnout is not, today, a recognized pathology

Reactive anxio-depressive syndrome following sexual insistence

The precise date of the advances of its executive


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)?

Look for latex irritation dermatitis due to a history of atopy

Performs an anti-Hbs antibody test to check for immunization against hepatitis B virus

Require you to be vaccinated with the dTP vaccine

Flu vaccine is highly recommended but not mandatory


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?

Pathology is lateralized on the dominant limb

You noticed the pathology while it was active

The gestures performed are at risk for the rotator cuff


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?


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?


Which of the following pathologies can (may) promote the appearance of cataracts?


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)?


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?


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)


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?


A 62-year-old patient is referred by her general practitioner to the emergency department for pallor. The blood count is below.
 Reticulocytes are at 40 G/L. You mention: (one or more expected answers)


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?


About the decision on medical termination of pregnancy (IMG), which is (are) the exact proposal(s)?

The couple can make the IMG decision on their own if the disease is particularly severe

Serious and incurable diseases are listed in a list giving entitlement to an IMG

IMG is only allowed if it is certain that the unborn child has the disease

The IMG is authorized by law with no term limit

The particular severity of a disease meets certain objective criteria such as the risk of premature death or cognitive impairment.


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)


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)?

There is a fracture of the right femoral neck

There is a fracture of the left trochanterian massif

There is a dislocation of the left coxofemoral joint

There is a fracture of the pubic symphysis

There is a fracture of the right shutter frame


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)?

High risk of ovarian cancer may warrant oophorectomy

Breast monitoring relies on simple breast ultrasound

The risk of early breast cancer justifies genetic analysis in her underage daughters

The breast risk of recurrence may justify mastectomy


It is necessary to offer an oncogenetic consultation in the following situation(s):

In a patient with a breast tumor at age 35

Faced with the existence of a bilateral breast tumor

In front of the existence of polyfocal colonic malignancies

Faced with the existence of an ovarian tumor in a 74-year-old woman

In a subject with a hundred polyps on the entire colonic frame


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?

In the absence of an investigation announced by the gendarme, the doctor does not have to check << medical-legal obstacle >> on the death certificate

Checking this box is a medical decision based on medical arguments

The doctor must examine the body for an exit hole for the projectile

The appearance of cadaveric lividities on the body will allow the doctor to support the hypothesis of a suicide

Cadaveric lividities not corresponding to pressure points may indicate secondary displacement of the body

The presence of recent bruises on the wrists and forearms goes against the hypothesis of suicide

We can think that these are traces of fights

An immediate putting in beer in a simple coffin must be requested in this context


The genital lesion that typically occurs at the time of a girl's first sexual intercourse is (only one response):

A contuse laceration of the osterious fork

A complete tear of the posterior part of the hymen

A bilateral contagious wound of the vaginal walls behind the hymen


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?

The physician may refuse to respond to the requisition if he has no training in forensic medicine

Only a judicial police officer may request a doctor to examine a victim

The refusal to respond to the requisition is likely to engage the administrative liability of the doctor

The requested physician is released from the obligation of professional secrecy in the specific context of the mission entrusted to him

A copy of the report issued is given to the victim in person to assert what is right.


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)

The criminal liability of the surgeon may be engaged

It is not a medical fault because the prosthesis has been positioned according to the rules of the art

This situation may lead to an amicable settlement

The administrative responsibility of the establishment may be engaged for failure to organize the service


The shared medical record can be created by: (one or more exact answers)

The holder of parental authority for a minor patient


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)?

Increased plasma concentrations of inhaled corticosteroid

Risk of developing a cushingoid syndrome

Increased plasma concentrations of oral corticosteroid

Risk of developing adrenal insufficiency

Low risk of drug interaction with itraconazole


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?


About substances used for doping purposes in sport:

Early baldness may be a sign of chronic anabolic androgenic steroid administration

Beta-2 agonists exert an anabolic effect in high doses resulting in an increase in muscle mass

Beta-blockers are prohibited in competition in some sports

The occurrence of a pulmonary embolism in a professional cyclist should be investigated for taking erythropoietin receptor agonist


About the mechanisms of action of antibiotics:

Penicillin inhibits penicillin-binding proteins (PLPs), enzymes of the peptidoglycan biosynthesis pathway

Macrolides inhibit bacterial protein synthesis by binding to the ribosome

Fluoroquinolones inhibit the replication, transcription, repair and recombination of bacterial DNA

Glycopeptides inhibit cell wall synthesis of bacteria

Trimetroprim-sulfamethoxazole is a folic acid inhibitor


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?


Regarding testicular germ cell tumors, it is true that: (one or more answers)

They represent the first solid cancer in 20-year-old men

They may be associated with a serum increase in total HCG.

They are often associated with inguinal lymphadenopathy

They are often associated with lumbo-aortic lymphadenopathy.


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?


Regarding the diagnosis of lymph node Hodgkin lymphoma, it is true that (one or more answers):

It usually requires a biopsy removed from a lymph node

The levy must be fixed in full immediately

It is based on the identification of Reed-Sternberg cells

A national pathological network for proofreading has been set up by INCa

it requires immunohistochemical labeling


Among the bone tumors for which a biopsy is necessary for diagnosis there are (one or more responses):


Among the following, which criterion(s) is (are) part of the criteria of fragility of the elderly subject according to Fried?

The other 2 are: decreased muscle strength and decreased physical activity


Regarding the first-line management of urinary incontinence in the elderly, which of the following proposal(s) is (are) correct?

Placement of an indwelling urinary catheter

Transcutaneous electrical stimulation of the pudendal nerve


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)?

Ms. B. will receive an Internet link inviting her to connect at the scheduled time of the appointment to a secure site or application

The cardiologist must request and obtain Ms. B.'s consent before conducting the teleconsultation

As part of this teleconsultation, the cardiologist will not be able to write a prescription for treatment or additional examination

Mrs. B. will be reimbursed by the Health Insurance

The price of the teleconsultation is freely set by this cardiologist


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)?

The pre-test probability of DVT is implicitly estimated from your subjective impression.

The post-test probability of DVT depends on the pre-test probability and the informational characteristics intrinsic to the prescribed imaging test.

The pre-test probability of DVT is estimated from the positive and negative predictive values of the prescribed imaging examination.

The post-test probability of DVT depends on the likelihood ratios of the imaging test.

The more the plausibility ratio of the exam tends towards O, the more the post-test probability of DVT will tend towards 0


A 65-year-old man has nodular basal cell carcinoma (BCC) of the forehead 1 cm in diameter. What is the exact proposal(s)?

CBC develops on pre-existing actinic keratosis

The evolutionary risk is the appearance of visceral metastases


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)


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?


A depressive episode characterized postpartum:

Occurs mainly between 3 and 6 weeks after delivery

Affects nearly 25% of women who have given birth

Is most often associated with psychotic features

Is at high risk of progression to bipolar disorder


Dyspnea with prolonged expiratory time can evoke

An exacerbation of chronic obstructive pulmonary disease


Which clinical and paraclinical sign(s) suggestive of severity in a patient with pneumothorax?

Reduction or abolition of vesicular murmur

Hypotension with systolic blood pressure less than or equal to 90 mmHg


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)?

Uncontrolled high blood pressure is a common cause of chronic cough

Looking for the prescription of an ACE inhibitor on its prescription

Looking for gastroesophageal reflux symptoms

Looking for sibilants pulmonary auscultation

Looking for a calcium channel blocker prescription on your prescription


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?


Which of the following proposals regarding the complications of prolonged use of estrogen-progestin contraception is (are) accurate?


Which of the following viruses is sexually transmittable?


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?


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?

This is the only test that can CONFIRM Horton's hypothesis


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)


A young woman has reducible bilateral exophthalmos. In the following list, which examination(s) are necessary for the diagnosis of Graves' disease?

Orbital CT scan without injection of iodinated contrast medium

Graves' disease = Hyperthyroidism by activation of TRAK receptors


What are the possible etiologies of decreased visual acuity associated with eye redness? (one or more correct answers)

Acute glaucoma crisis due to angle closure


Which of the following clinical elements points to adhesive capsulitis of the shoulder?


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)?


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?

There is an old fracture of the scaphoid


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)?

A knee effusion on a profile X-ray may suggest an acute rupture of the anterior cruciate ligament

X-rays of a spontaneously reduced patellofemoral dislocation may be normal

A fracture of the tibial plateau visible on the X-ray requires further exploration by an MRI

Arthroscan exploration of a chondral knee injury requires the injection of intra-articular gadolinium salt

Ultrasound is a good examination to study the knee extensor apparatus


During amyotrophic lateral sclerosis, you may observe the following clinical sign(s)


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)?

There is a risk of neurological complication by nuclear jaundice

Phototherapy should be done as soon as possible

Breastfeeding should be interrupted so as not to aggravate jaundice

Mother-child ABO compatibility must be checked


Which of the following applies(s) to NPH insulin?

Its duration of action is about 12 hours

It should not be combined with rapid insulin

It should not be prescribed to pregnant women


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?

Tabulation of thyroidectomy if the nodule is papillary cancer


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?

Upper gastrointestinal endoscopy revealing stenosis of the lower esophagus

Presence of propagated peristaltic waves with significant hyperpressure of the sphincter on an esophageal manometry


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?


In front of a table of acute maxillary sinusitis, which is (are) the element (s) that orient (s) towards a bacterial origin?

Increased infraorbital sinus pain despite symptomatic treatment prescribed for at least 48 hours


A 76-year-old patient is referred for dysphagia. Which element(s) would orient (s) towards the diagnosis of Zenker's diverticulum?

Presence of regurgitation of undigested food

Sign of the << tide >> to nasofibroscopy


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)?


On this CT scan of the abdomen: (one or more exact answers)

The structure designated by the number 1 is a hepatic vein

The structure designated by the number 2 is the portal vein

The structure designated by the number 3 is the aorta

The structure designated by the number 4 is the spleen

The structure designated by the number 5 is the stomach


In hepatic computed tomography, in typical forms, after intravenous injection of iodinated contrast medium, which proposal(s) is(are) exact?

A hemangioma becomes opaque through the periphery

Hepatocellular carcinoma increases with arterial time

Hepatocellular carcinoma is the site of late-time wash-out

A metastasis rises intensely at the portal time


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?

The Health Insurance will only reimburse 30% of the basic fee of the consultation

Ms C. will have a flat-rate contribution of one euro for this consultation

The Health Insurance will refuse to reimburse the drugs prescribed by this cardiologist

The cardiologist is authorized to practice an excess fee of up to 60 euros

The amount reimbursed by Social Security will be 11.51 euros


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?


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?

It may accelerate the occurrence of death

Its objective is to accelerate the occurrence of death

It can be implemented at the request of the family under certain conditions

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.

It is systematic as soon as a patient enters the agonic phase

Not at all systematic. It is the result of a multidisciplinary exchange between caregivers


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?

Exclusive external beam radiation therapy


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)

Combined hyperlipidemia entangled with type 2 diabetes

Dysbetalipoproteinemia entangled with type 2 diabetes

Heterozygous familial hypercholesterolemia + type 2 diabetes


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):

Make a urine strip to look for an infection

evoke appendicitis because in the 2nd trimester of pregnancy the coecal bottom is repressed in the right flank

initiate non-steroidal anti-inflammatory therapy in principle


Which of the following occupational exposures result in a proven excess risk of lung cancer (one or more possible responses)?


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:

A circulating anticoagulant of the lip type


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)


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)

A picture of the abdomen without preparation standing from the front to visualize the colonic frame and possible liquid levels

An abdominal CT scan without injection because sepsis increases the risk of kidney failure

A water-soluble enema, to eliminate another pathology with similar symptomatology, and avoid a barium in case of diverticular perforation

An abdominal CT scan with contrast medium injection, after checking for severe renal impairment or a history of severe allergy to contrast medium

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


Which of the following antimalarials for prophylaxis should only be continued one week after returning from an area at risk of malaria infection?


Which of the following bacteria has natural resistance to third-generation cephalosporins?

Mnemo: Princess LLEIA (Listeria, Legionella, Enterococcus, Intracellular, Anaerobic)


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

Beyond statistical significance, it is essential to assess the clinical relevance of the observed difference in effect

Randomization increases risk of bias when interpreting results

The double-blind technique is a method that aims to reduce bias in the realization and interpretation of the results of a clinical trial

The Transparency Commission of the HAS (Haute Autorité de Santé) can participate in the statistical analysis of this clinical trial on French territory

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


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)

The risk of cystic fibrosis transmission for couples 11-1 and 11-2 is about 1/60

The future risk for the II-3 free sister of having an affected child is about 1/120

I-4's spouse is pregnant. The a priori risk that the unborn child is affected is about 1/240

The woman II-3 can directly exercise a right of access to the medical file of her sister II-2

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


May manifest as delusions of persecution

Can manifest as fear of eating in public

Warrant treatment with antidepressants in severe forms


Regarding urothelial histological bladder carcinomas, which proposal(s) is(are) accurate?

They are detected with good sensitivity by urinary cytology

They are low-grade when they are carcinomas in situ

They are associated with bladder schistosomiasis in Africa

Grade has little interest for tumors infiltrating the muscular.

They can be classified T2 on endoscopic resection chips


Regarding the diagnosis of cirrhosis on a liver biopsy: (one or more exact answers)

This is a stage 4 of the METAVIR classification

Diagnostic performance depends on the size of the sample

Diagnostic performance is better in micronodular cirrhosis


Which of the following treatments may be responsible for delirium by its anticholinergic property?

Acetylcholine esterase inhibitor donepezil


For vesicular or follicular thyroid carcinomas: (one or more exact answers)

They account for less than 5% of thyroid cancers

They are frequently associated with multiple endocrine neoplasia type 2 (MEN-2)

The sensitivity of the diagnosis of malignancy by cyto-puncture is good


Regarding confusion, which proposal(s) is(are) right?

It is most often linked to an organic cause

It can manifest itself only in the form of drowsiness

It corresponds to the acute decompensation of brain function