Regarding Congenital Hip Dysplasia, which of the following are true?

It concerns 3-20/100,000 children in France.

Congenital torticollis is a risk factor.

False: This is a common field but does not count in the list of risk factors.

Abduction Nle > 60° Imaging, but > 4 months: Basin Radio

A hip ultrasound should be performed on a 5-month-old child if an Abduction is measured at 50°


Which of the following refer to muscles innervated by the ulnar nerve?

Deep leader of the short flexor of the thumb


What is the name of the classification of hemorrhoidal prolapse?


What is the type of endobrachyoesophageal epithelium?

Normal epithelium of the esophagus (the same as the vagina)

Non-keratinized stratified squamous epithelium

Keratinized stratified squamous epithelium


Cytolysis in favor of acute alcoholic hepatitis predominates on:


Which of the following are signs of a strangulated hernia?

True, nausea, vomiting, stopping materials and gases, bloating


It can be accompanied by a localized defense


What proportion of adults are affected by pyrosis?


Which of the following are non-epithelial tumors of the salivary glands?

True, benign nerve tumor (at the expense of Schwann cells)


Which of the following propositions are true about otosclerosis?

Otosclerosis causes conductive hearing loss with normal eardrums

The sex ratio is 2:1 with male predominance 👨

There is about 15% familial form 👨 👩 👧 👦


Which of the following are true about pneumocystosis?

Frosted glass opacities, lung nodules, cystic images, pneumothorax. Radio sometimes misleading

Chest X-ray highlights systematized alveolar condensation

Opportunistic infection of patients with cellular immunosuppression (HIV, hematology, immunosuppressants...)

False, diagnosis mainly provided by PCR on sputum or LBA fluid

Diagnosis of pneumocystis based on serology


Regarding pathological bereavement, what are the exact proposal(s)?

True, these three steps are essential to identify during successive interviews in patients

Classic grief is characterized by 3 phases: stupefaction, painful emotional phase, reorganization phase

False, we talk about pathological grief from 12 months of symptomatology, 6 months is for children

We talk about pathological bereavement from 6 months of symptomatology

We do not talk about pathological grief in the child, because he does not understand the notion of death

False. If supportive therapy and empathetic listening are the very basis of care, antidepressants are not prescribed and anxiolytics are abhorred

A pathological bereavement benefits from a management by supportive psychotherapy, empathic listening, antidepressant and / or anxiolytics


You receive Mr. Bond, James, 45 years old in your general practice, he lost his wife Teresa 9 months ago and he talks very often about her and the circumstances of her disappearance. Rightly you suspect pathological bereavement, which of the following elements would direct you towards this pathology?

False, this is normal grief. Pathological grief would be characterized by persistent depressed mood.

A feeling of emptiness and loss related to the state of lack of the deceased

Self-critical, fatalistic, guilt-inducing or pessimistic ruminations

False, this is normal grief. Pathological grief is characterized by a real depressive episode characterized with an intense and major suicidal crisis.

Thoughts of suicide centered on "joining the deceased"

False, this is normal grief. Pathological bereavement will be characterized by ruminations cf. B

Concerns and remembrance about the deceased


Regarding infectious endocarditis, what are the exact proposal(s)?

False, it is the cocci gram + that are more than predominant in endocarditis since they cover more than 85% of endocarditis germs (staph, CGP in clusters + strepto, diplococcus)

The germs that will be predominant in infectious endocarditis are gram-positive cocci and gram-negative bacilli.

True, these are the two main causes that will involve prevention by antibiotic therapy during dental care for example 🦷 (+ history of IE)

High-risk heart disease in infective endocarditis is prosthetic heart valves and congenital heart disease

False, for two reasons: An ETT sees vegetation very badly, that's why we will prefer an ETO and to explore finely the mitral valve which is quite small, the ETT is not effective enough

In case of endocarditis with suspicion of mitral vegetation, ETT alone will often be used

The choice of antibiotic therapy depends on the germ in question, the nosocomial or community character and the notion of valve prosthesis or not

True, this is one of the few causes where we will carry out this daily monitoring.

Monitoring for infective endocarditis requires daily blood cultures until negativation


Intern in the emergency room, you receive Mr. Beam, Gregory, 67 years old for a febrile joint effusion. Instinctively you turn to septic arthritis and you decide to perform a joint puncture. Which of the following are true?

True, this is the semiology of a joint effusion of the knee.

You affirmed the effusion by highlighting a sign of the flow and a patellar shock

False, we bite in the external upper quadrant between the patella and the femur, in the subquadricipital bursa.

You place your needle for puncture at the level of the lower outer quadrant of the knee

If your sample contains blood, it will necessarily be hemarthrosis

Purulent fluid is an indication for probabilistic antibiotic therapy

A neutrophil polynucleosis (>2000/mm3) in the joint fluid will support your diagnosis


You receive Mr Silva, Raoul, 55 years old, farmer, who injured his leg while installing the barbed wire of his cow field. The wound may be superficial, but there is debris of earth and the patient tells you that the fence was a little rusty. When you ask him if he is up to date in his tetanus vaccination he looks at you with big round eyes and answers with a dazed look that he has no idea... What do you do after wound treatment?

True, tetanus is a more than minor item of the Pilly, but this situation is the only one that is really required of the item. The fact that it is not up to date (or at least we have a doubt), requires vaccination or serovaccination. Here, the wound is dirty (earth) so we do a serovaccination rather than a vaccination alone.

Determination of tetanus antibodies before any serovaccination


What is the first-line treatment for Neisseria gonorrhoeae?


You receive in consultation Mr Sansei, Rupan, 35 years old, who comes to see you because he and his family present since this afternoon an intense digestive symptomatology (diarrhea, nausea, vomiting, abdominal pain) without fever. During your interrogation, he told you that he was at a wedding meal that very noon and that he gorged himself on petit fours, and pastries... With this, what germ do you suspect in front of this table of Collective Food Infection Toxi (TIAC)?

False, it takes at least 12 hours of incubation and it gives acute febrile diarrhea

True, very short period of action and S. aureus is often implicated in front of milk derivatives, catering dishes etc ...

False, the picture is often that of isolated diarrhea.

False, the time of action is 24 to 48 hours


Which of the following are signs or symptoms of giant cell arteritis (Horton's disease)?

"Sign of the comb" characterized by pain during hairdressing in particular

Ophthalmological signs are important because they involve the functional prognosis: transient amaurosis, diplopia or even irreversible blindness by NOIAA


Regarding the assessment of the extension of breast cancer. Which of the following are true?

False. Only if the cancer is classified as T3, T4 or N1. An extension assessment is not done if the cancer is classified as T1 or T2.

The extension assessment is systematic for all breast cancers.

True. According to the recommendations, there are 3 ways to make the extension assessment: 1. Chest X-ray + abdominal ultrasound + bone scintigraphy (no longer done in real life, it's a little archaic); 2. Injected CT-TAP + bone scan; 3. FDG CT-PET. The goal is to look for the most common metastases in breast cancer: liver, lung and bone.

Chest X-ray, abdominal ultrasound and bone scintigraphy

False. Brain MRI is not part of the extension workup unless there is a clinical call point. The only tumor where brain MRI is systematic is lung cancer

False. If you do the CT-PET scan, you will not do the bone scan because it is useless.

AP-CT, chest X-ray and bone scintigraphy


Which of the following propositions are true regarding pulmonary vasculitis involvement?

It is only seen during small-caliber vasculitis

This is the case in granulomatosis with polyangiitis (Wegener)

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) is accompanied by pulmonary nodules sometimes excavated

Pulmonary infiltrates can be found in all ANCA vasculitis

Pulmonary infiltrates can be found in IgA vasculitis

Vasculitis with anti-MBG antibodies may be accompanied by pneumorenal syndrome

ENT involvement = granulomatous ANCA vasculitis. HIA involvement (intraalveolar hemorrhage) = microscopic polyangiitis +++

Microscopic polyangiitis may be accompanied by sinusitis


What is the sex ratio of duodenal ulcer?


Which of the following are differential ulcer diagnoses?

Well it's not too much the same place what 🤷 ♂


You see in your Geriatric SSR department, Mr. Gérard Bouchard, 99 years old, who shouts to anyone who will listen "THAT HE IS NOT DEAF", despite the fact that he repeats everything. What signs and symptoms make you suspect classic presbycusis?

True, typically presbycusis is bilateral

True, sign name that could fall in DP at the ECN, the cocktail party sign is a deafness that is aggravated by noisy situations. Presbycusis being a sensorineural hearing loss, the large number of extraneous noises will worsen the understanding

A very noisy sound environment (TV, radio/music)

False, patients have a feeling of blocked ear. Semiological subtlety, the sensation of ears full of water are rather found in seromucosal otitis (or tympanic ventilation defect)

True, the caricature example of the statement is true! 😅


Adenocarcinoma is the most common pancreatic tumour

TIPMP can be treated to prevent degeneration

Diagnosis of pancreatic tumors is based on ultrasound

R0 (complete resection) than in 10% of cases

Surgical resection is R0 only in 60% of cases


Which of the following are emetogenic treatments?


Regarding sexual violence, which of the following proposition(s) is true?

False, The majority of rapes occur in minors

True, sexual violence can cause traumatic shock, depression or suicide.

It is essential to assess the initial psychological consequences for a victim of sexual violence

False, The care of a victim of sexual violence is preferentially done by a requisition (especially for paramedical samples to genetically identify the aggressor) but this procedure is in no way mandatory

The care of a victim of sexual violence is mandatory via a requisition

True, for example, the assault may be old (several years), and in general, the victim's word is not initially questioned.

A normal clinical examination does not call into question sexual assault or violence

False, these local samples look for the presence of Gonococcus and Chlamydia. HIV/HBV/HCV are tested by blood test.

Local samples (cervix, vagina, urethra, anus, throat) can detect via PCR the presence of DNA or viral RNA of HIV/HBV/HCV viruses


The sex ratio of child fractures is ten boys to one girl

A traumatic mechanism discordant with the observed fracture must in particular search for a tumor

The classification of Salter and Harris is independent of the displacement of the fracture

A Salter 2 fracture will be managed by surgical treatment

Epiphysiodesis is a complication of Salter 5 fractures. It can also be iatrogenic in case of inappropriate treatment.

A Salter 5 fracture will be treated with epiphysiodesis


Which of the following are differential diagnoses of UC?


43-year-old patient, with a history of chronic alcoholism, presents to the emergency room for sudden onset epigastric pain

What will be the exams to be carried out in a first 1 time?

True. Lower myocardial infarction is a differential diagnosis to evoke in this situation

False. Not right away. It can be done in a 2nd time if we find a cardiac ischemic cause to evaluate hemodynamics

True. The positive diagnosis of acute pancreatitis is based on the combination of PAIN + LIPASE > 3N. In addition, an associated significant cytolysis is in favor of a biliary origin of this pancreatitis

False. It has not been recommended for more than 5 years

False. Not right away. In case of confirmed acute pancreatitis, the AP CT scan should be performed at 48h-72h. On the other hand, abdominal ultrasound will be done as soon as the diagnosis is confirmed in order to eliminate a lithiatic cause


How many years should a medical record be kept after a consultation (with a living adult)?


Which of the following are true about enzalutamide?

It is an androgen receptor inhibitor that prevents their translocation into the nucleus and their attachment to DNA.

It lowers it (thus increasing the risk of comitial crisis)

Its main adverse effect is to increase the epileptogenic threshold

It improves overall survival and symptom-free survival


Which of the following propositions concerning essential hypertension are true?

Cardiovascular risk doubles for SBP elevation of 20 mmHg

It is more common in women and black subjects.

Essential hypertension is more common in humans.

135/85mmHg are the thresholds allowing the diagnosis of hypertension by blood pressure self-measurement.
For MAPA, the thresholds are: ≥ 130/80 mmHg over 24 hours or ≥ 135/85 when awake or ≥ 120/70 at sleep.

The MAPA (ambulatory measurement of BP) allows the diagnosis of hypertension if the average over 24 hours is ≥ 135/85 mmHg.

130/80 mmHg are the thresholds allowing the diagnosis of hypertension over 24 hours by MAPA. For blood pressure self-measurement, the diagnosis of hypertension is made for a BP ≥ 135/85 on average.

Blood pressure self-measurement allows the diagnosis of hypertension if the mean is ≥ 130/80 mmHg.

Essential hypertension multiplies the risk of stroke by a factor of 7.


How common is cholelithiasis in Western countries?


Which of the following propositions are true regarding judicial reporting?

It is intended for the Inspector of Child Welfare

The latter is done in the absence of urgency and leads to an evaluation within three months


What is the pace of monitoring for the occurrence of pancreatic adenocarcinoma in chronic pancreatitis?


Which of the following are etiologies of painful splenomegaly?

True, first cause to evoke in front of its gravity

True, sickle cell disease can be very painful


Which of the following are examinations to be carried out systematically in case of severe discomfort of the infant?

Apart from chest X-ray, no imaging examination to be performed systematically


Which of the following proposals regarding the care of a burn victim are true?

Two-thirds of cases are domestic or leisure accidents

According to Wallace's rule of "9" the surface of a child's head corresponds to 17% of his body surface.

According to Wallace's rule of "9" the area of both legs of an adult corresponds to 18% of his body surface.

Mortality associated with burns is nearly 28% for burns corresponding to more than 30% of the total body surface area

Distinguishing a deep 2nd degree from a superficial 2nd degree is difficult before J1


Which of the following are risk factors for abuse?


In case of precocious puberty, imaging is essential: brain MRI if suspicion of central precocious puberty, imaging of the gonads if suspicion of peripheral precocious puberty.

An increase in uterine body length > 35mm is a sign of estrogenic impregnation.

Bone age is not systematic as part of an early puberty check-up

Isolated precocious pubic hair is not synonymous with precocious puberty. It does not correspond to the pubertal activation of the gonadotropic axis but most often to the physiological increase in androgen production by the adrenal around the age of 8 years. BUT, it is a diagnosis of elimination, retained after evoking a pathological production of androgens of adrenal or gonadal origin.

Isolated early pubic hair should not be explored

False. We must think of a Kallman syndrome (which gives a delayed puberty of central origin by hypogonadotropic hypogonadism).                             Klinefelter syndrome gives it a delayed puberty of peripheral origin (although in reality it is more an appearance of pubertal signs without an increase in testicular volume).

Faced with delayed puberty in boys, with a history of anosmia in the family, it is necessary to think of Klinefelter's syndrome.


Which of the following are true about laxatives?

Osmotic laxatives draw water into colonic lumen

They are contraindicated in case of stenosis

Ballast laxatives may be responsible for bloating


Unless otherwise agreed, what is the duration of a patent for an originator pharmaceutical molecule?

True. Pharmaceutical patents are granted, like all other patents, for a period of 20 years from filing and subject to payment of annuities.


Normal and physiological puberty Which of the following are true?

G5 corresponds to an adult testicular volume, i.e. between 20 and 25 ml.

False Sorry it sucks as a trap, it is losangic in men, triangular in women, but I have already been done during my clerkship.

P5 corresponds to the adult aspect of the hairiness, ie triangular in men, losangic in women, extending to the root of the thighs.

A mammary gland protruding beyond the surface of the areola classifies breast development as S3

As soon as there is a small breast bud with enlargement of the areola we can speak of breast development S2.

G2 corresponds to a testicular volume between 4 and 6ml.


Which of the following propositions regarding compartment syndrome is true?

False. It is an immediate/early complication that occurs within 24 hours. The development of unbearable pain at the site of the fracture is the diagnostic key to this complication.

A. It is a late complication that can occur after fracture of a limb

False false false !! The pulse is preserved. If they disappear, we should rather suspect acute ischemia of the limb ... or the very late stage of the compartment syndrome... that is, when the patient has lost his leg and is no longer in pain at all. So remember that "PALOR" and "PULSELESSNESS" are signs too late in the syndrome of the compartments

False. The figure is correct: it is pathological if > 20 mmHg BUT the diagnosis is CLINICAL +++. So no need to make a pressure measurement to everyone

The measurement of a pressure in the compartments > 20 mmHg is essential for diagnosis

A discharge aponeurotomy is indicated within 6 hours

True! It is related to a syndrome of the compartments of the forearm responsible for muscle retraction! Syndrome well to know that can be found in pediatrics when one performs poorly plasters (among others).

All this information can be found on page 343 of the last college of anesthesia resuscitation (not essential to read but it is free and online so it is the only one I have on hand

Volkmann syndrome is responsible for a claw deformity of the hand


Which of the following are true about nephroblastoma?

Nephroblastoma metastasizes mainly to the pancreas

Asymptomatic for a very long time (such as kidney tumours in adults)

Nephroblastoma is immediately symptomatic

Nephroblastoma mainly affects adolescents


What are the first laboratory tests to order if variable common immunodeficiency is suspected?

True, notion of course to know because falls very often in MCQ

Determination of immunoglobulin G subclasses


Which of the following are clinical signs of pyloric stenosis?

Never bilieux (stenosis upstream of the duodenum)


Which of the following are contraindications to direct oral anticoagulants (DOACs)?

True, or even clearance< 30 mL/min/1m73^2 for some molecules

Severe renal impairment (clearance < 15 mL/min/1m73^2)


Sperm donation is non-anonymous and remunerated in Great Britain

Sperm donation is non-anonymous and remunerated in the US

Sperm donation is non-anonymous and remunerated in France

Sperm donation is anonymous and remunerated in Great Britain

Sperm donation is non-anonymous and unpaid in France


What is the threshold of length of the hepatic arrow at which we can speak of hepatomegaly?


Which of the following proposals are validating for CPD (Continuing Professional Development)?

Continuous Teamwork Improvement Program set up by the HAS in 2015 whose objective is to reduce EIAS

List of items essential to the smooth running of a procedure that allows a cross-checking of information


Which of the following proposals should be combated to avoid ACOS?

On the contrary, it must be respected and hypotension avoided.


Regarding facial paralysis among the following propositions, which one or which are true?

False, we are not in the situation of a stroke or the attack is located upstream of the decussation, here we are downstream so we will have a contralateral involvement.

Central facial paralysis is often associated with contralateral hemiparesis/hemiplegia

False, the VII innervates the muscles of the face it is the IX and the X that innervate the muscles of the pharynx / larynx.

In case of bilateral facial paralysis, the risk is suffocation by collapse of the muscles of the pharynx and the soft palate

False, the treatment of facial paralysis is based on corticosteroid therapy and artificial drops

Treatment of peripheral facial paralysis in frigore includes therapeutic abstention

True. Clinically rare pathologies, but this notion falls all the time in MCQ.

The causes of bilateral facial paralysis are: sarcoidosis, HIV, Melkerson Rosenthal syndrome, Guillain Barré and Lyme disease

In front of febrile facial paralysis it is essential to eliminate meningoradiculitis.


Which of the following propositions are true regarding pancreatic insufficiency, a consequence of chronic pancreatitis?

True, clear stools, putty, very foul-smelling, floating, staining toilet paper like a greasy


Which of these proposals are complications of obesity?

Two types of kidney damage secondary to obesity: FSH and proteinuria


What are the exact proposals regarding the hepatitis B virus and its natural history?

It is an enveloped double-stranded RNA virus.

It may be responsible for the development of HCC on healthy liver.

Chronic hepatitis B is a reportable disease and requires routine antiviral treatment

False. Acute hepatitis is an MDO but not the chronic form. In addition, treatment is indicated according to certain situations and is therefore not systematic.

The risk of fulminant hepatitis is rare and occurs especially in pregnant women.

False. Risk of HBV-related fulminant hepatitis = 1%. It is HEV that is at risk of fulminant hepatitis in pregnant women.

90-95% of acute hepatitis progress to cure, which is characterized biologically by: Ag Hbs -; ac anti Hbc - and ac anti Hbs +

False. It is true that 90% of acute HBV are of favorable evolution but the serological profile corresponds to Ag Hbs -, ac anti Hbc + (the patient has been in contact with the virus!!) and ac anti Hbs +.   The serological profile given in the question corresponds to a vaccination.


Which germs are gram-positive cocci in clusters?

Diplococcus is a streptococcus, so chains!


Which joints are usually affected in rheumatoid arthritis?

False, IPDs are joints usually respected by rheumatoid arthritis


You receive Mr IZUKU, Midoriya, 76 years old, whom you follow for a suspicion of multiple myeloma of the bones. You want to make the diagnosis, via a myelogram. But your patient, worried, asks you many questions about this examination. What are your answers?

A myelogram is a biopsy of the bone marrow

False, this is a bone marrow smear, not a biopsy

The myelogram is most often very painful and requires locoregional anesthesia before its realization

False, the myelogram is most often unpleasant, but it only requires local anesthesia by xylocaine or EMLA patch

A myelogram with a threshold greater than 20% plasma cells is defined as pathological and affirms the diagnosis of multiple myeloma

False, the 20% threshold is for acute leukemia, it's 10% for plasma cells in multiple myeloma

Sternal myelogram is most often contraindicated in patients who have previously had a sternal myelogram

False, in theory several myelograms can be performed in sternal

If the myelogram is not contributive, an osteomedullary biopsy will be done

True, this is the case when the marrow is very poor


What ultrasound arguments of nodules would be in favor of malignancy?


What are the differential diagnoses of appendicitis?

ileoccolic Crohn's disease or ulcerative colitis


Enterobacteras are:
- E. coli
-Klebsiella
- Proteus mirabilis
-Salmonella
-Shigella
- Yersinia


What medications can you prescribe for malaria chemoprophylaxis?


What vaccinations can be used post-exposure?


What vaccine is administered intradermally?


What vaccinations are mandatory for healthcare staff?


What are the indications for the BCG vaccine?

Child residing in Île-de-France, French Guiana or Mayotte


What are the radiographic cardinal signs of osteoarthritis?

True. The radiological cardinal signs of osteoarthritis are POGO: Localized joint pinching, Osteophytosis, Subchondral geodes, Condensing osteosclerosis

False, no bone erosions in osteoarthritis! They are found in RP for example


Which meningitis should benefit from corticosteroid therapy?

These are pneumococcal meningitis in all cases, and:
- H. influenzae meningitis in children
- N. meningitidis (meningococcus) meningitis in adults

Haemophilus influenzae meningitis in children

Meningococcal meningitis in children and adults


You are an intern in the emergency department of a peripheral CH. While you were quietly watching the latest episode of Squid Game on your brand new phone (now that you have a real salary, you can indeed treat yourself to small pleasures), you are called by the nurse to do a lumbar puncture to Theo, 2 years old, who has a fever of 40.5 ° C, a very flexible neck. The fluid is cloudy and the anathomopathology intern (who happens to be one of your best friends in the day school) calls you to announce the presence of live Gram-negative diplococci. Which propositions are true?

It is not a germ classically responsible for meningitis at its age

True, it is rather pneumococcus and H. influenzae. Neisseria meningitidis predominates between 18 and 25 years.

He does not have meningitis because his neck is flexible

False, ultra false, and probably zero! In children, neck stiffness is often missing (have you ever seen a 2-year-old? It's super flexible, isn't it?). Don't worry if you ticked it, that's how we all 😊 learn

Treatment with antibiotic + corticosteroid therapy is initiated

False, in children it is only in pneumococcal and H. influenzae meningitis that corticosteroids are put

He has meningitis caused by Neisseiria meningitdis

True, at NEC the only gram-negative diplococci are meningococci

He has Haemophilus influenzae meningitis


What are the complications of post-PL syndrome?

True, these are the two complications to know about.

False, it is the semiology of post-PL syndrome (blurred vision, sound distortion with tinnitus and decreased hearing acuity, nausea, vomiting, dizziness, orthostatic headache) and not its complication


What is the treatment of primary Toxoplasma gondii infection in the immunocompetent, in the general case (without chorioretinitis)?

Cerebral toxoplasmosis, disseminated in the immunocompromised

pyrimethamine + folinic acid + sulfadiazine + prednisone

pyrimethamine-sulfadoxine + folinic acid


What etiologies should be suspected in hypoglycorachic lymphocytic meningitis

True, it will also be necessary to evoke carcinomatous meningitis if the terrain lends itself to it


What are the 3 cardinal signs in symptomatic aortic stricture?

True: the core can no longer push hard enough to adapt to peripheral O2 needs because of RAC, so lack of O2, so syncope

False, hypertrophy of the VG who fights against the RAC, but suddenly the tension does not increase ...


Regarding chronic urticaria, what are the exact proposal(s)?

There are multiple causes of chronic urticaria, including stress

False, stress does not induce hives but can maintain it!

A hives that occurs after high heat is probably bradykinic urticaria

In the context of cold urticaria, the ice cube test must be done in a hospital setting to be able to react in case of anaphylactic shock

True! As surprising as it may seem, it is a provocation test, so it can lead to anaphylactic shock.

Chronic urticaria may reveal hypothyroidism

True, this is why we will look for anti-thyroperoxidase antibodies in case of resistance to symptomatic treatment

The reference treatment of urticaria is based on local corticosteroid therapy

False! On antihistamines, urticaria being mediated by histamine


The 1st dose is carried out at 2 months then 4 and 11 months and at 6 years.

People in regular close and lasting contact with an infant in the first 6 months do not respond to the strategy of cocooning

False, verification and, if necessary, vaccination catch-up.

Vaccination confers longer immunity than natural immunity acquired after pertussis.

False, vaccine: 5-10 years VS natural immunity: 10-15 years.

True, hence the many reminders made throughout life.

Pertussis vaccine is an acellular vaccine.


What are the treatments for allergic rhinitis?

Strongly discouraged, because there is always a systemic passage so risk of angina


What biological tests can you perform to look for hypersecretion of GH?

The reference test for the detection of corticotropic deficiency is insulin hypoglycemia (rank C)

Oral Induced Hyperglycemia Test (also called OPGH)

True, a sharp decrease in GH is expected

Very difficult to do and interpret (nocturnal and pulsatile secretion)

We never see this dosage (neither at the ECN, nor in practice)


In a randomized clinical trial, patients' consent is collected by:


In a randomized investigator clinical trial:

It is the guarantor of the protection of persons

It is the guarantor of the quality of care

It must above all respect the ethical rules and give priority to care over research


What is the definition of a clonic crisis?

Repetitive and rhythmic segmental muscle twitches

Contraction of agonist and antagonist muscles, alone or in bursts


Which antibiotics have poor diffusion in the CSF?

C3G diffuses very poorly in the CSF, like all other treatments, because the blood-brain barrier is formidable. However, unlike most other antibiotics, this poor diffusion can be compensated for by increasing the doses, all without being toxic. Hence the notion of meningeal dosage:) p277 of the Pilly of 2021


Mr. Tunik, 65, is hospitalized for the first time in psychiatry for a megalomaniac delirium that has lasted for a few months and worsens. In front of this first episode, you obviously asked for brain imaging that finds multiple cerebral infarctions. On clinical examination, you will find a decrease in visual and auditory acuity, an abolition of the photomotor reflex but a preservation of pupillary motility during convergent accommodation, and elements that seem compatible with frontal dementia.
The patient reports intense shooting pains of the limbs. You find abolished ROTs and frank ataxia.
What is the most unifying diagnosis?

Exactly! We find the sign of Argyll-Robertson (abolition of the photomotor reflex but preservation of pupillary motility during convergent accomodation), tabès (posterior cordal degeneration giving ataxia, areflexia, and shooting pain of the limbs), multiple infarctions related to angiitis, and frontal dementia with megalomania

It does give psychiatric pictures, but finally, this patient is not very psychiatric.


This is the case with disharmonious IUGR

True, most newborns and adults will have a short stature.

It is a IUGR that is, most often, constitutional.

True, genetic cause ++ (Trisomy 13 or 18)


What are the different clinical signs of bankruptcy to look for in favor of DRA?

Recruitment of accessory respiratory muscles


The only 2 indications that remain in the CEP 2021 are: Recurrence of persistent PNO or PNO after 3-5 days of drainage

Persistent PNO after 3-5 days of drainage


The lethal triad of severe traumatized includes:

It is therefore necessary to detect and fight against these three elements from the beginning of the management of a severely traumatized patient


What arguments are in favor of a glomerular origin of chronic renal failure?

True, a late hypertension would rather be in favor of an interstitial origin

False, rather in favor of an interstitial origin

Context of recurrent upper urinary tract infections


Which test differentiates between central diabetes insipidus and nephrogenic diabetes insipidus? (one or more exact propositions)

Difference between potomania and diabetes insipidus

True. If diabetes insipidus is central: polyuria will stop.


What are the etiologies of a harmonious IUGR?


They should not be prescribed with other blood thinners

They are often introduced at the same time as VKAs to relay 😉

They work by inhibiting procoagulant factors: factors II and X

Renal failure is a contraindication to their use

No, unlike LMWH (which is contraindicated in GFR < 60 = moderate CKD).

They can be antagonized by protamine sulfate

They have an antidote and that's great! 🙌🙌 (unlike AOD for example)


A murmur on an arterial path translates a stenosis of more than:


Which of the following are correct about syphilis? (one or more answers are correct)

The standard of care is based on penicillin M

Syphilitic posterior uveitis is treated as neurosyphilis

That is to say with 2 weeks of peniage G IV

syphilis is said to be early when it is less than 6 months old

Syphilitic chancre is classically painful


Which of the following are symptoms or signs that can be found during syphilis? (one or more answers are correct)

This is rather found in case of viruses with glandular tropism, such as mumps


What is the most common germ in urinary tract infections? (only one answer expected)

3rd, in young women ++, no nitrites at BU, treatment with nitrofurantoin 5J (CI if IR)


What is the case, in humans, where antibiotic prophylaxis of urinary tract infection is indicated?


What is the probabilistic first-line treatment for acute cystitis at risk of complication in a renal failure patient with stage 4 CKD?

Second-line treatment if nitrofurantoin possible

Nitrofurantoin is contraindicated if GFR <30 (stage 4 CRM = GFR between 15 and 30)

We prefer to wait for the susceptibility test, but sometimes the symptoms are very disabling. In this case, we adapt secondarily.


About the pertussis clinic, indicate the true propositions:

There is a cough in paroxysmal fits with difficulty of inspiratory or chronic spasmodic recovery.

There are 3 phases of evolution in order: fifth, catarrh, convalescence.

False, catarrh then fifth, then convalescence.

The cough found in whooping cough can also be called "rooster crow".


In benign prostatic hyperplasia, what is the recommended management for minimal or moderate lower urinary tract symptoms without impaired quality of life? (only one answer expected)

Hygiene-dietary rules can be established: water restriction after 6pm, limitation of alcohol and coffee consumption, treatment of associated constipation, cessation of treatments promoting dysuria.