What is (are) the condition(s) for performing a colonoscopy under general anesthesia?

Colonoscopy can be done in outpatient care

All antiplatelet therapy must be stopped before the examination

Anesthesia can be performed by the gastroenterologist

Colic preparation requires a purge over three days

A residue-free diet is prescribed for a few days before the exam


Which of the following treatments has (have) a Marketing Authorization (MA) to help maintain abstinence?


What characteristic(s) is suggestive of cirrhotic ascites?


Regarding the serum total PSA (Prostate Specific Antigen):

Its increase involves performing endorectal prostate ultrasound as a diagnosis

Its dosage is not of interest for subjects whose life expectancy is less than 10 years

Its dosage must be carried out annually from the age of 50 as part of a mass screening

Its increase implies the systematic realization of the determination of its free fraction

Its increase should lead to discuss the realization of prostate biopsies


The initial assessment of urinary incontinence systematically includes:

A measurement of the post-void residue by ultrasound


Irritative clinical signs of benign prostatic hyperplasia include:


About the pathophysiology of renal colic, what are the true propositions?

The pain is induced by irritation of the superior ureteral nerve

Intracavitary hyperpressure stimulates intrarenal synthesis of prostaglandin E2

Nausea and vomiting trigger the secretion of anti-diuretic hormone (ADH)

The dilation underlying the obstacle is related to the relaxation of ureteral smooth muscle fibers

The tensioning of the pyel-calycal cavities is responsible for a rapid decrease


This is an abdominal CT scan injected into coronal sections

This is an injected abdominal CT scan, at a late time


Normal sexuality includes the following phases:


In acute urethritis in men, clinical examination includes:

Research to interrogation of a contaminating report


The presence of isolated leukocyturia without germs should suggest:


The electrocardiographic signs of hyperkalemia are:


Which of these terms designates the suspension of all motor and language activity that can be observed following psychological shock?


What is (are) the positive symptom(s) of schizophrenia?


In generalized anxiety disorder, anxiety is associated with:


Lack of awareness of the morbid nature of the disorders


School phobia in children and adolescents:

Is associated with poor academic performance

Leads to a major risk of dropping out of school

Evolves into a social phobia in 65% of cases


What therapeutic strategy(s) to recommend as a first line in the face of post-traumatic stress disorder in adults?


Among the possible proposals, which is (are) the possible cause(s) of pulmonary arterial hypertension?


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?

Stress test with oxygen consumption measurement


Regarding heart failure, which is (are) the exact proposal(s)?

Prevalence of heart failure increases with age

Heart failure with preserved ejection fraction is more common in young subjects

About one in 5 patients die 5 years after diagnosis

Hospitalization for acute heart failure is a factor of severity


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?


Which of the following proposals is (are) characteristic of the venous origin of a leg ulcer?

Presence of a phlebecatic crown of the plantar arch


What therapeutic is (are) indicated for chronic venous insufficiency at the malleolar ulcer stage and secondary to varicose disease?

Varicose vein surgery (stripping +/- crossectomy)


Regarding the interpretation of this electrocardiogram and among the following propositions, which one (are) accurate?

2:1 conductive atrial flutter to the ventricles


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?


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?


Which of the following ametropia can (may) lead to monocular diplopia?


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?

Decrease in visual acuity predominant by far


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?

Identical, limiting ocular history under local corticosteroid treatment


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?

Ocular hypertonia by recoil of the iridocorneal angle


Polyclonal hypergammaglobulinemia is (one or more exact answers):

Common during systemic lupus erythematosus


The biological marker(s) observed during macrophage activation syndrome is:


An increase in the blood level of eosinophils may be observed in the following situation(s):


Of the following infections, indicate the one (s) due to Staphylococcus aureus.


What is (are) the symptom(s) encountered during pertussis?


Which of the following viruses can induce congenital viral infections? D.


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))?

A rubella IgM assay on the same serum of the patient is necessary before any interpretation

Rubella serology on a second serum of the patient is necessary before any interpretation

The patient is protected against rubella infection

The patient has biological signs of primary rubella infection

Further testing is useful following current exposure


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?

Consultation with a referring physician to discuss the implementation of treatment


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


What is (are) the mechanism(s) involved in mononucleosis syndrome?

Activation of the lymphocyte immune response in response to an infectious agent in general viral

Monoclonal proliferation of a lymphocyte line

Proliferation of macrophage antigen-presenting cells


Which of the following proposal(s) on smoking is (are) erroneous?

Fagerström's test evaluates pharmacological dependence on nicotine

Tobacco is estimated to kill 70,000 to 80,000 people a year in France

Second-hand smoke is a causal factor in sudden infant death syndrome

Smoking during pregnancy increases the risk of low birth weight


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)?


What are the right answers regarding this pulmonary function test?

VEMS/FVC post-bronchodilation ratio of 63

FEV1/FVC ratio pre-bronchodilation at 73

Completely reversible obstructive ventilatory disorder

Significantly reversible obstructive ventilatory disorder


During sarcoidosis, histological analysis of hilar lymphadenopathy conventionally shows epithelioid and gigantocellular granulomas. Which of the following conditions can (may) show a similar appearance?


Regarding the scanner cut below, what is (are) the exact statement(s)?

You first request a transparietal needle puncture to obtain a diagnosis of certainty

You mention the diagnosis of germ cell tumour

You mention the diagnosis of neurogenic tumor


Which of the following can be a direct addressee(s) of a patient's cause of death?

His beneficiaries, unless refused by the patient before his death

The lawyer appointed by the patient's beneficiaries

The doctor mandated by the death insurance company


What is (are) the circumstance(s) that should lead the physician to check the medical-legal obstacle box on a death certificate:


Regarding the exchange of medical information, what is (are) the exact answer(s)?

Physicians must ensure that professional secrecy is respected by their non-physician collaborators: secretaries and nurses

The sharing of medical information between healthcare professionals is limited to diagnostic information

Treating physicians may exchange information concerning a patient whom they treat together unless the latter objects to it.

The transmission of medical information between doctors can lead to prosecution for non-compliance with medical confidentiality

A doctor can only provide medical information about a patient to another healthcare professional


Which of the following proposals falls within the remit of the High Authority for Health (HAS)?

Development of clinical practice guidelines

Collect and track adverse drug and health product events

Give authorization for the establishment of a phase III randomized therapeutic trial

Management of indicators for the improvement of the quality and safety of care (IPAQSS)


Which of the following people can be an investigator in a clinical research study?


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?

It is managed by the High Authority of Health (HAS)

It is based on indicators that are reported by the institutions

One of the indicators collected relates to the maintenance of the patient's record

It includes the nosocomial infections dashboard

Indicators collected by institutions under this program are confidential


Which of the following measures constitutes a secondary prevention measure in oncology?

Offer hepatitis B vaccination to all children

Offer a blood test in the stool regularly, from the age of 50

Have a mammogram regularly, from the age of 50

Regularly perform a cervico-vaginal smear


Which of the following areas of responsibility is covered by the Regional Health Agencies (RHAs)?

Authorization to practice for liberal practitioners

The organization of the provision of care according to the needs of the population


Verapamil (Isoptine®) and diltiazem (Bitildiem®):

Are brakers at the atrioventricular node


Have a brutal and rapid effect on diuresis


The Mini Nutritionna/Assessment (or MNA) nutritional test:

Is a test with a total score out of 30 points

Is a test that defines malnutrition if the score is less than 23 5 points

Is a test that defines malnutrition if the score is less than 17 points

Is a test that requires the calculation of body mass index

Is a test that takes into account the presence of neuropsychological problems


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)?

Phenylketonuria is the only disease of amino acid and organic acid metabolism currently being screened for newborn in France

General screening test can detect hypothyroidism of pituitary origin

This couple can refuse the screening after information

Completion before 48 h of life decreases the sensitivity and/or specificity of the screening test

Targeted screening for sickle cell disease is not indicated in this child


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?


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?


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?

A catch of 2 feedings in the last 24 hours

Audible hissing sounds outside of auscultation


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?

This treatment prevents any recurrence of pre-eclampsia

This treatment should be started preferentially before 15 weeks of amenorrhea

This treatment is administered according to the Doppler of the uterine arteries

This treatment includes 500 mg of aspirin

This treatment must be maintained until the end


What are (are) the possible antihypertensive treatment(s) during pregnancy?


What is (are) the factor(s) of poor prognosis of breast cancer?

The absence of estrogen hormone receptors

The association of an important intraductal component with the infiltrating component


In the most common form of trisomy 21 in the fetus, which is (are) the exact proposition(s)?

The measurement of nuchal translucency is usually increased

The free fraction of beta HCG is conventionally increased in the 1st trimester

PAPP-A (pregnancy associated placenta protein A) is classically decreased in the 2nd trimester

Alphafetoprotein in the 1st trimester is increased


In newborns the risk of nuclear jaundice:

Increases if jaundice begins before the 24th hour of life

Is linked to the neurotoxicity of conjugated bilirubin

Rarely engages long-term neurological prognosis


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?

Thoraco-abdominopelvic CT scan with iodinated contrast medium injection

Lymph node biopsy with histological examination


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:


Increased resistance of the glomerular efferent arteriole

A decrease in glomerular filtration pressure


What lesion(s) can be observed on the renal biopsy during rapidly progressive glomerulonephritis?

Linear deposition of IgG in immunofluorescence

Granular deposits of IgG in immunofluorescence

Congo red birefringent fibrillar deposits

Microvascular lesions with fibrinoid necrosis


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?

If he worked for 30 years in the industry developing the molecule until he retired 2 years ago

If he has been paid by the pharmaceutical industry to teach general practitioners

If it has already published results questioning the interest of this new molecule, as part of a research program funded by public funds

If he has been paid by the manufacturer to include patients in phase III trials that evaluated this new molecule

If the son of this doctor is a medical delegate for the industry marketing the molecule


Areas of interest to indicators for improving the quality and safety of care (IPAQSS) include:

The rate of methicillin-resistant staphylococci

Operating compliance of PCRs in oncology


Which of the following proposals on the roles played by Regional Health Agencies (RHAs) at the regional level is correct?

They are responsible for health monitoring and security at the regional level

They are responsible for prevention and health promotion

They are responsible for university preventive medicine

They are responsible for providing care in each health territory of the region.

They are responsible for the accreditation of medical internship sites in the region.


Which of the following study designs would allow us to study the relationship between coffee consumption and the risk of developing Alzheimer's disease?

The follow-up of a cohort of several thousand patients with Alzheimer's disease

A study in which subjects with Alzheimer's disease and an equivalent number of subjects without dementia would be included

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

A comprehensive study based on data on notifiable diseases

A study of the prevalence of coffee consumption in a representative sample of the general population


May have skin, subcutaneous or combination (cutaneous and subcutaneous) development

At risk of ulceration and superficial necrosis


Among the following examinations, which is the most efficient for the analysis of the morphology of a tooth root?

Blondeau incidence (nose-chin-plate incidence)


Which of the following imaging tests shows the temporomandibular joints?

Dental panoramic picture (orthopantomogram)

Nuclear magnetic resonance imaging (MRI)


For skin tumours of the face, please indicate the exact proposal(s):

Tobacco is the main risk factor for developing basal cell carcinoma

Squamous cell carcinomas are more lymphophilic than basal cell carcinomas

Melanoma is a tumor exclusively with a cutaneous starting point

Melanomas are more common than basal cell carcinomas

The treatment of skin cancers is mainly based on surgery


A professional hockey player fell on the ice with a mandibular impact. The orthopantomogram performed is as follows:

There is a bifocal fracture of the mandible

One of the fracture features passes through the left mandibular neck

A fracture line passes through tooth No. 37

A fracture line passes behind tooth No. 33


The elevator muscle of the upper eyelid is inserted on the tarsus

Both eyelids delimit the palpebral cleft

The orbicular muscle of the eye is innervated by the facial nerve

The upper eyelid lift muscle is innervated by the facial nerve


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?

Chemoprophylaxis with chloroquine and proguanil


Which of the following occupations is associated with an increased risk of bladder cancer?


In the context of a work stoppage relating to an occupational disease, indicate the exact proposal(s):

The occupational physician receives the obligatory employee during his return to work during his return to work.

The pre-recovery visit makes it possible to determine the date of consolidation of the disease

The pre-resumption visit makes it possible to plan a possible shift adjustment when work resumes

A systematic visit at the initiative of the occupational physician is planned one month after the resumption

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.


Which of the following can be seen in a woman with polycystic ovary syndrome? Indicate the correct answer(s):


Decreased visual acuity is early by macular edema

Retinal microaneurysms are mostly peripheral

In the absence of diabetic retinopathy, ophthalmological monitoring should be annual

The management of a diabetic involves glycemic and arterial blood pressure control

Laser photocoagulation treatment is indicated only for complicated stages of retinal detachment


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?

Central visual acuity is affected only late.

The main element of follow-up is the examination of the visual field.

Monitoring of the retinal periphery is a major component of monitoring.

The patient should warn any new doctor of his glaucoma because some local treatments have systemic effects.

Monitoring of intraocular pressure is useful but not sufficient to judge the effectiveness of treatment.


In front of a non-traumatic acute neck pain in a 30-year-old woman, you can immediately realize in first intention?


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):

The daily dose of insulin is usually 0.5 to 0.7 units/kg weight/day

Basal insulin should be discontinued in case of fasting examination

Rapid insulin can be used occasionally to correct hyperglycemia

The dosage of prandial insulin depends on the amount of carbohydrates ingested during the meal


What is the correct answer(s) regarding the pathophysiology of asthma?

Activation of nerve fibers responsible for bronchodilation

Overexpression of interleukin 10 (IL-10) and TNFa


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?


What is the exact proposal(s) regarding thyroid physiology?

Thyroid hormones increase gluconeogenesis


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?

Determination of anti-thyroperoxidase antibodies

Determination of anti-TSH receptor antibodies


Damage to the right trigeminal nerve can manifest as:

An abolition of the right corneal reflex

A hypoaesthesia of the right masseterine notch

An agueusia of the anterior 2/3 of the right hemi-tongue


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?

Suspended motor deficit of the upper limbs

Abolition of tendon reflexes in the lower limbs


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).


Regarding narcolepsy, what statement(s) is(are) accurate?

Is characterized by excess irrepressible daytime sleepiness

Temporal signal abnormalities are frequently found on MRI


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?

Foreign body in the conjunctival cul-de-sac


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?


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?


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?

This bacterial species is part of the family of enterobacteriaceae

It can be responsible for hemolytic uremic syndrome -

It is sensitive to amoxicillin in less than 10% of cases


Which of the following proposals on mother-to-child transmission of HIV is the right one:

The risk of transmission is greater in the first trimester of pregnancy

Risk is related to maternal plasma HIV load during childbirth

Antiretroviral therapy should be started in the mother as soon as HIV infection is diagnosed

A caesarean section must be performed there to prevent transmission.

Antiretroviral therapy should be started at birth in the child to prevent transmission


In the context of community-acquired acute pneumonia, what is the true proposition(s)?

Hyponatremia is specific to legionellosis

Pneumococcal pneumonia and legionellosis are notifiable diseases


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?

Toxic epidermal necrolysis (Lyell's syndrome)


In the face of a hemorrhagic syndrome, which is (are) the element(s) that point to an abnormality of primary hemostasis


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?

An extension of the Cephalin Time + activateun


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)?

FEV1/FVC ratio pre-bronchodilation to III

Partially reversible restrictive ventilatory disorder

These EFRs are compatible with a GOLD II stage COPD


Which of the following proposals regarding risk factors for lung cancer is the right one?

Exposure to asbestos is considered a risk factor

It is the primary current, which is the main carcinogenic risk factor related to passive smoking

The spouse (non-smoker) of a smoker has a 20-30% increased risk of lung cancer

Carbon monoxide (CO), resulting from incomplete carbon combustion, is considered a risk factor

Alkaline persulfates used by hairdressers are considered a risk factor


Which of the following proposals regarding transudative pleural effusions is(are) accurate?

They can be consecutive to bacterial pneumonia

They can be consecutive to a pulmonary embolism

They can be consecutive to viral pneumonia

They may be consecutive to metastatic effusion

They may be consecutive to pulmonary atelectasis


About cholitis, what is the exact proposal(s)?

It results in the successive appearance of three signs: pain, pruritus, jaundice

There is most often an increase in predominantly conjugated bilirubinemia

At first, there may be cytolysis greater than 5 times the upper limit of normal

Endoscopic retrograde biliary disobstruction with sphincterotomy should be discussed urgently


Secondary hypertension with low renin, hypokalaemia and kaliuresis > 20 mmol/L may be linked to 11

Excessive consumption of licorice A deficiency of b-hydroxy-dehydrogenase


In front of renal colic, what are the factors of gravity requiring a urological opinion (one or more possible correct answers)? Rossess,


What biological abnormality(ies) is present in systemic lupus erythematosus?

Presence of circulating immune complexes


About gastrointestinal stromal tumours (GIST), which is (are) the exact proposal(s)?

They most often develop in the muscular layer

The stomach is the most common primitive location of GIST

GISTs are frequently diagnosed incidentally during a digestive endoscopy

They are characterized in immunohistochemistry by the expression of c-kit (CD117)


Which vessel(s) are directly related to the pancreas?


The absence of a decrease in GH during OGGH is characteristic

GIgAntism testifies to an onset of the disease before puberty


Which of the following pathologies is (are) the cause(s) of high blood pressure? Indicate the correct answer(s):


Which of the following factors is(are) a scannographic criterion(s) for severity of acute pancreatitis?

The presence of intrapancreatic necrosis

The presence of extrapancreatic necrosis


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?

Obtain a PCH (Disability Compensation Benefit)

Obtaining recognition as a disabled worker (ROTH)


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?

Granular deposits of lgG and C3 at the dermal-epidermal junction

Linear IgA deposits along the dermo-e p idermal junction

Linear deposits of lgG and C3 along the dermal-epidermal junction

Intraepidermal deposits of lgG and C3 mesh


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)


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)

Treatment with amoxicillin-clavulanic acid


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?


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?

Signs of pulmonary arterial hypertension


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

Determination of vitamin B12 (cobalamin)


Hypersexuality is frequently observed during certain disorders. Which one(s)?

Parkinson's disease treated with dopamine agonists


Regarding denial of pregnancy, what is (are) the exact proposal(s)?

It is defined by the lack of awareness of pregnancy beyond 22 weeks of amenorrhea

It most often appears in women with a history of psychiatric disorders

Clinically, the usually observable manifestations of pregnancy are not apparent or absent

A differential diagnosis is pregnancy deliberately concealed from the entourage

Progression to puerperal psychosis is common


What is(are) the typical characteristic(s) of hepatocellular carcinoma in sectional imaging?

Spontaneously hyperdense appearance on computed tomography


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?

An X-ray of the lumbar spine from the front and profile


Which of the following proposals for fluorescein eye drops is accurate? Fluorescein is a fluorescent eye drop, which essentially allows us to explore the

Can be used to check the integrity of the corneal endothelium

Can be used to highlight a transfixing corneal wound

Can be used to highlight herpetic keratitis

Can be used as an anesthetic before removal of a corneal foreign body


Regarding the following iconography, which is (are) the exact proposal(s)?

Arrow 1 denotes the ascending horacic aorta e

Arrow 2 designates the superior vena cava

Arrow 3 designates the left inferior pulmonary vein

There is a dissection of the ascending thoracic aorta


Regarding the use of adrenaline during cardiac arrest, which is the exact proposal(s)?

In case of asystole, the first dose is 1 mg intravenously

If no venous line is available, injection through the intubation tube is possible

Control of heart rate effectiveness 5 min after first injection

In case of asystole, the injection of adrenaline most often leads to ventricular fibrillation

In case of ventricular fibrillation, adrenaline administration should be started after the fifth external electric shock


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?

It must be treated with vitamin K antagonist for life

The effective target INR of vitamin K therapy is between 2 and 3

In case of labile INRs, it is possible to replace the antivitamin K with a direct oral anticoagulant

Antibiotic prophylaxis is essential before a dental avulsion

Vitamin K treatment should be suspended before dental scaling


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?

The tone of the breath is often in steam jet

The irradiation of the breath is done towards the armpit

The breath is accompanied by the abolition of the 82

The breath is accompanied by a fixed doubling of the 82 in children


Which of the following proposals concerning pharmacovigilance is true?

It is based on spontaneous patient notification

It is based on spontaneous notification from health professionals

Spontaneous notifications cannot lead to the withdrawal of a medicinal product from the market

Accountability uses chronological and semiological criteria

Accountability estimates the causal link between a drug and an adverse reaction


Indicate the true answer(s) regarding temporary use authorizations for a medicinal product

Allow for early availability after marketing authorisation

Avoid the application for marketing authorisation


Indicate the true answer(s) for pharmacological therapeutic monitoring based on pharmacokinetic parameters. Pharmacological therapeutic monitoring can be useful:

To prevent auditory toxicity of aminoglycosides

In order to prevent ineffectiveness of Tramadol

In order to understand the therapeutic success of morphine [>

To prevent ineffectiveness of tacrolimus


Which of the following drug classes is(s) nephrotoxic at usual doses


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

You reassure her, the FCETUS running little risk since outside the irradiation field

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

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

You request a dosimetric expertise and wait for the result before pronouncing an opinion

You explain the risks associated with the examination and discuss with her a possible medical termination of pregnancy


The maximum passive joint amplitudes of this patient's right knee are represented by the photos below. Which of the following is (are) accurate?

The patient has a recurvatum of 30 degrees

The patient has a joint stroke of 70 degrees


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:


In front of a clinical picture of agitation, which is (are} the exact proposal(s) on the use of antipsychotics for sedative purposes?

Are useful for all degrees of stirring severity

Are to be associated with benzodiazepines

Should not be prescribed for angle-closure glaucoma


What medication(s) can cause agitation in the elderly?


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?

Determination of anti-cytoplasmic antibodies of neutrophils (ANCA)


Which element(s) should evoke the secondary character of a bilateral Raynaud's phenomenon

Revelation by an attack of the indexes and majors

Presence of retractile scars on the pulp of the index fingers


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)?

Is intended for any employee close to the patient

Guarantees to return to work under the same conditions

Allows the daughter of the p atiente to say p dare to p lus of tem p s with her mother


According to the law concerning the person of trust, which is (are) the correct statement(s)?

It must be obligatorily designated in writing

It is consulted when the patient is no longer able to express his will

It can be the private nurse or the patient's attending physician


Concerning the characteristic(s) of breakthrough pain:

They are characterized by quick installation

They are characterized by a short duration

They impose an increase in the background treatment of pain


Which of the following proposals is(s) the risk factor(s) of complicated bereavement?


During the assessment of the extension of clinically localized cancers of the larynx and hypopharynx, which is (are) the recommended examination(s)?


In front of this table of palmar keratoderma evolving for 3 months, what diagnosis (s) is (are) to consider?


Which of the following dual antihypertensive therapies is (are) most often discouraged?


Which diagnosis(s) is (are) classified as somatoform disorders?

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


For polycystic ovary syndrome, indicate the correct answer(s)

This is the most common cause of dysovulation

It is often associated with resistance to the action of insulin

The presence of more than 12 follicles is a diagnostic criterion


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?


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:


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

The result is obtained after a duration of about 5 min

Its positivity is in favor of group A hemolytic B streptococcus

A shipment to the bacteriology laboratory is necessary to have the result


HPV is a risk factor for tonsillar cancer

Tobacco is a risk factor for ethmoid sinus cancer

Wood dust is a risk factor for maxillary sinus cancer

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 .


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?

It is a T1 sequence without gadolinium injection

The 1 corresponds to the right sphenoidal sinus

The 2 corresponds to the right parotid gland

There is a tumor of the left submandibular gland


Regarding the 1+2+3 Bouchon rule in the elderly:

It is not usable in very old individuals (> 90 years)

It allows the calculation of comorbidities

The<< 3 >> corresponds to an acute pathogen

It helps explain atypical clinical presentations in the elderly

It helps explain the accumulation of diseases during aging


Immobilization syndrome is a common complication in subjects over 75 years of age. Which of the following is true?

Associated with a risk of excess mortality

Occurs from the first hour of immobilization

Increases the risk of venous insufficiency


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?

Brain computed tomography scheduled within 48 hours

Administration of vitamin K and concentrates of prothrombin complexes


Is linked to abnormalities of the retinal pigment epithelium


The Mini Nutritionna/Assessment (or MNA) nutritional test:

Is a test with a total score out of 30 points

Is a test that defines malnutrition if the score is less than 23 5 points

Is a test that defines malnutrition if the score is less than 17 points

Is a test that requires the calculation of body mass index

Is a test that takes into account the presence of neuropsychological problems


About cervical swelling, what is (are) the exact item(s)?

A cyst of the thyroglossal tract is mobile to swallowing

Right supraclavicular lymphadenopathy may be indicative of kidney cancer

Superficial renitent swelling localized to the anterior edge of the sternocleidomastoid muscle is suggestive of an amygdaloid cyst

Brachial plexus schwannoma is a differential diagnosis of submandibular lymphadenopathy

Accessory nerve schwannoma is a differential diagnosis of spinal lymphadenopathy


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)?

Mrs. V. did not take her martial treatment

Mrs. V. has probable sickle cell disease

Mrs. V. has probable heterozygous thalassemia

Mrs. V. has not yet replenished her iron reserves

Mrs. V. has an added inflammatory pathology


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.

This is an acute care approach, delaying entry into palliative care

This is an unreasonable obstinacy, given the incurability of the disease and the poor prognosis.

This is an acute care approach, to be conducted within a palliative care approach

This is an acute care approach, the objectives of which must be discussed and validated with the patient.

This is comfort care, the objective of which is to avoid unnecessary suffering


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


Regarding imaging of pancreatic tumors, what is(are) the exact answer(s)?

In front of jaundice, the first intention examination is the MRI to visualize the bile ducts

In case of suspicion of pancreatic cancer, it is the CT scan with injection of contrast medium that is the first-line examination

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.

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)

Most pancreatic cancers are diagnosed incidentally on imaging

abdominal performed for another indication


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.

This examination makes it possible to analyze the infratentorial compartment better than the supratentorial compartment

This examination is impossible, the fontanelles are closed at his age

This test can detect an intracranial tumor

This examination has operator-dependent sensitivity and specificity


What is the diagnostic criterion(s) to make the diagnosis of celiac disease without performing an intestinal biopsy?

Anti-transglutaminase IgA greater than 10 times normal

anti-transglutaminase lgG greater than 10 times normal

Presence of anti-endom IgA at a significant level

Presence of anti-gliadin IgA at a significant level

Presence of a HLA DO2 or DO8 group This is an interesting MCQ, the appropriate answer is to be found in pediatrics. We distinguish

2 steps to the diagnosis of celiac disease


What symptoms make you suspect rhegmatogenous retinal detachment?

Amputation of the visual field in the sector


In front of a febrile roseoliform exanthema of the child, the main etiologies are (one or more exact answers):


About heart failure, which proposal(s) is true?

Cardiac auscultation may show a burst of B2 at the aortic focus in pulmonary arterial hypertension

Cardiac auscultation may reveal a murmur of mitral insufficiency related to the dilation of the mitral ring

Jugular turgor is a peripheral sign of left heart failure

Peripheral edema is soft, blue and painful

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)

Crackling or subcrackling rails are often bilateral


A 70-year-old patient presents to the emergency room for chest pain and dyspnea. Give the exact proposal(s):

4 corresponds to a pulmonary embolism in the left pulmonary artery

4 corresponds to a dissection of the pulmonary artery


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:

Anti-inflammatory treatment with fluoroquinolone


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):

Given these RFEs, the patient must be hospitalized

A methacholine bronchial hyperreactivity test should be performed

This is done when the suspiscion of asthma is very high despite a significantly non-reversible TVO.

Clinical history and EFRs are consistent with asthma

Significant but not complete reversible TVO

Clinical history and EFRs are consistent with COPD

A treatment can only be put in place once smoking has been definitively stopped

We must indeed stop smoking but we start treating as soon as possible


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):

It is neither tachycardium nor hypotensive. So no filling at this stage.

You prescribe an intravenous vasoconstrictor agent such as telipressin

His coronary artery disease contraindicates this treatment

You prescribe an injected chest CT scan with arterial time acquisition after checking for contraindications

The master examination in case of hemoptysis

You reassure the patient and explain that it is normal to bleed on antiaggregants


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?

The picture is typical. It is a differential diagnosis of autoimmune bullous dermatoses.


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?

Cross-linking at the bases is very suggestive of this diagnosis.


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?

This is the typical photo of erythema nodosum


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?

Lesions of crustose, meliceric and perioral appearance (or sitting on the face).


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)


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)


Which of the following statements about weakening osteopathy is?

Primary hyperparathyroidism preferentially affects the cortical bone

Treatment of hypothyroidism increases the risk of osteoporotic fracture

Cortisonic osteoporosis mainly affects the cortical bone

Estrogen deficiency is responsible for osteoclastic hyperactivity

Treatment with bisphosphonate increases osteoblast activity

Only teriparatide (FORSTEO) has this effect. It is indicated in case of two vertebral fractures.


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)


Which of the following infectious diseases is(are) reportable in France?


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)

The presence of a lupus-type anticoagulant

The addition of plasma did not correct it

The presence of an anti-factor VIII antibody


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?


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)

Smoking cessation aid by nicotine replacement therapy

Cervico-uterine smear if it is more than one year old

Prescription of folate at a dose of 5 mg/day

Discontinuation of perindopril treatment and switching to another antihypertensive drug


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?

The breasts are too dense before the age of 30, so an ultrasound is done.


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?

Transdermal patch releasing norelgestromin and ethinyl estradiol

Subcutaneous device releasing etonogestrel


Faced with a suspicion of metallic intraocular foreign body, which examination(s) do you propose urgently?

This is contraindicated: by pressing, we increase the IOP, which is dangerous.


What is the exact proposal(s) concerning voluntary termination of pregnancy (IVG) in France?

A woman under guardianship can request an abortion

A woman can request complete anonymity for the performance of an abortion

IUD placement is contraindicated in the immediate aftermath of a surgical abortion

Prostaglandins cannot be used in cases of hereditary porphyria

A psychosocial interview must be systematically carried out before the abortion is carried out


Is an infection of a pilosebaceous follicle of the eyelids

Is a resorption granuloma of a meibomian gland of the eyelids


What are the possible etiologies of decreased visual acuity associated with eye redness (several exact responses)?

Acute glaucoma crisis due to angle closure


In case of myopia (one or more exact answers):

The optical system formed by the eye is too convergent

Distance vision is better than near vision without correction

A divergent lens can be used for correction

Lowers the refractive power that is too strong in myopia (and glass convergent for hyperopia)

The risk of retinal detachment may be increased


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)?

A secondary localization of prostate origin typically has an osteolytic appearance on the X-ray and CT scan.

Osteocondensant in three out of four cases.

The appearance of the cortical is suggestive of a malignant lesion

They are observed on the first scanner, infero-lateral:)

On the bone level, this lesion remains confined to the metaphysis


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)?

The electrotherapy techniques practiced by the physiotherapist will aim to reduce edema

We are sceptical about this proposal. There is nothing on the new colleges, so we can forget 🙃 about it

The prescription of English cane could be made by the liberal physiotherapist after discharge from the hospital

Your physiotherapy prescription must mention the physiotherapy techniques to be used.

The adaptation of the home must be done after writing a file with the MDPH

The application will have to be made to the General Council to obtain an APA


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):

Tracheal stenosis is a complication of prolonged orotracheal intubation

You prefer for the treatment of this pressure ulcer a combination of local antiseptics and dry dressings.

The presence of this pressure ulcer contraindicates wheelchair placement

Not at all, it is necessary to mobilize the patient to avoid the development of a new pressure ulcer.

The lesion being of spinal cord level C6 you expect anesthesia from the lateral edge of the forearm in anatomical position

The request for long-term illness can be made by the attending physician

It is even he who does it most of the time


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)?

The lateral collateral ligament is probably ruptured

The mechanism is in eversion so it is the medial that breaks

The distal tibio-fibular ligament is probably intact

There is a suprasyndesmotic fracture of the malleola. Side

There is a risk of major skin pain on the medial side of the ankle


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.

It is prescribed on a simple prescription

It is prescribed on a large apparatus form

It is refunded at 100% of its purchase price


Regarding carpal tunnel syndrome, which is (are) the true proposition(s)?

The electromyogram is essential for diagnosis

It can cause a deficit of the long flexor of the thumb

It may lead to an abolition of the pen-radial reflex


You examine an ankle. Which characteristic(s) related to the anatomical structure pointed out is (are) correct?

This is the tendon of the extensor muscle of the toes

This is the tendon of the fibular muscle

This is the tendon of the anterior tibial muscle

The corresponding muscle is innervated by the deep fibular nerve

Like all muscles of the anterior compartment of the leg

The corresponding muscle is innervated by the roots L4 and L5


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?

This classification is for disk degeneration


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?

We visualize a fracture of the base of the thumb

Traumatic injury is the tearing of a long flexor tendon


In case of paralysis of the oculomotor nerve (III), you may encounter on examination:

Internal rectus muscle is innervated by the III

The ptosis will give a false enophtalmos rather


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?

Meningeal syndrome related to subarachnoid hemorrhage (SAH)


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?


Which of the following applies(s) to a central neurological bladder?

Spinal cord injury above the sacral centers

Acute urine retention is observed in peripheral disorders


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?

Plasma ACTH at 8 hours at 585 pg/ml (N: 10 - 20)

Urinary free cortisol at 25 μg/24 hours (N: < 90)

It is used for hypercortiscime, and not for hypo (because there is no lower threshold) ☺


You see a 15-day-old newborn who has an isolated fever at 38.2 ° C and a general condition preserved:

You reassure parents about the benign nature of this fever during viral epidemics

Its age makes it possible to consider the hypothesis of a late bacterial neonatal infection.

The flu test is not informative at this age

The urine strip is not informative at this age

Cytobacteriological examination of urine is systematic

The realization of a lumbar puncture is systematic

He has 15 days he 👉 has the right to a complete check-up and hospital supervision


The lesions in the photo below should evoke (only one expected response)

Tendon xanthomas -> problem of significant LDL -> homozygous familial hypercholesterolemia

A syndrome of familial hyperchylomicronemia


A 4-year-old efant presents to the emergency room for painful lameness without fever. What is the exact proposal(s)?


In front of a lesion of the tongue, which is (are) the clinical sign(s) that will orient (steer) towards a malignant origin?

Pain does not point to one cause over another

Bleeding on contact when palpating the lesion


You intervene at the home of an infant found dead by his parents a few minutes ago:

You do not have to sign the death certificate before admission to the hospital

You write a report to the Public Prosecutor

You propose to the parents to perform an autopsy in search of the causes of death

The transfer of the body must be done to a forensic institute

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)


You explain to young parents whose child has a first febrile episode the measure(s) to take during this episode:

Drug treatment is required for temperatures above 39°C

No drug is introduced on a temperature value

Drinking is necessary every hour as long as the fever persists

It is necessary for the goodwill of the child

Cool wraps should be used if the child is uncomfortable

The use of ibuprofen is possible only after 3 months

Keep the child out of the community for the duration of the fever


Regarding cervical swelling, which proposal(s) is (are)?

A cyst of the thyroglossal tract is mobile to swallowing

Right supraclavicular lymphadenopathy may be indicative of genitourinary cancer

Superficial renitent swelling localized to the anterior edge of the sternocleidomastoid muscle is suggestive of an amygdaloid cyst

Brachial plexus schwannoma is a differential diagnosis of submandibular lymphadenopathy

The mandible and arm are relatively far from each other ☺

Accessory nerve schwannoma is a differential diagnosis of spinal lymphadenopathy


Regarding the peritonsillar phlegmon, which is (are) the exact item(s)?

The abscess is localized at the level of the lateropharyngeal space

The anterior pillar of the palace veil is enlarged

In adults, hospitalization is systematic

The drainage of the abscess is done either by puncture or by no incision under general anesthesia

Not under GA;) It is done in two seconds in the emergency room, under AL


Regarding benign paroxysmal positional vertigo, what is(are) the exact item(s)?

It is treated with vestibular physiotherapy

no appendix signs (no hearing loss, no nausea, ...)


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)

Plasma hyposmolarity, euvolemic patient and urinary hyperosmolarity make the diagnosis


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?

This is not a factor of poor prognosis because the estimate is not reliable


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)

We would then find hypokalemia (by aldosterone-like effect on mineralocorticoid receptors).


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:

Post-test likelihood of DVT depends on the sensitivity of venous Doppler ultrasound

The pre-test probability of DVT depends on the specificity of venous Doppler ultrasound

Post-DVT probability depends on venous Doppler ultrasound likelihood ratio

Post-test probability of DVT depends on the intrinsic performance of venous Doppler ultrasound

The post-test probability of DVT can be determined graphically using the Fagan nomogram


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?


In front of sigmoid diverticulitis, an injected abdominal tomography CT scan is performed. Can it show (one or more exact answers)?

Addition images containing air at the anti-mesenteric edge of the colon

An infiltration of fat around a diverticulum


In which situation(s) does a patient benefit from an exemption from co-payment (based on Social Security tariffs)?

Care, whatever it may be, to subjects benefiting from State Medical Aid (AME)

Care, whatever it is, for pregnant women from the 4th month of pregnancy

Performing a mammogram as part of the national screening program

Additional tests performed as part of participation in a clinical trial


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?


Which tumor marker is of interest in screening, diagnosis, prognosis and monitoring of the cancer of which it is specific? (1 response expected)


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?

Consultation of advance directives if they exist

A discussion with the healthcare team present

Information from the on-call director if this procedure takes place on weekends

The decision must be recorded in the medical record


On what means(s) is the assessment of the qualitative dimension of pain based?

Only qualitative questionnaire in the list of proposals


By what therapeutic means(s) can neuropathic pain be managed as a first line?

An antiepileptic drug of the class Gabapentinoids


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)

Assessment of the symptom by a visual analogue scale

Adaptation of oxygen therapy flow rate so that arterial oxygen saturation is greater than 95%

Introduction or increase of opioid therapy

It is a treatment for dyspnea in palliative care

Deep and continuous sedation from the outset until death


Can obesity surgery such as a longitudinal gastrectomy be proposed (one or more exact answers)?

In adolescents from 15 years of age if their BMI is greater than 40

In a 55-year-old adult, OSA device, with a BMI > 35

If the subject has understood and accepts post-operative medical and surgical follow-up for life

If the patient has received clear and complete information about the operative risks


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)?


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?

'Insomnia, anxious ruminations, loss of vital momentum and family and professional disinvestment'

The date you first noticed the pathology

Only the medical information that is needed is shared

The existence of harassment by a colleague


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

Vaccination with meningococcal C conjugate vaccine

Prophylaxis with oral rifampicin for 5 days

Reassure them that there is no risk of contamination

It is not contact case because the contact with the child lasted only a few minutes (less than 30-60 minutes)


What vaccinations are mandatory for a nurse working in a hospital in a care unit (one or more possible answers)?

Vaccination against diphtheria, tetanus and poliomyelitis

These are the only two mandatory vaccines for caregivers


Regarding acute peritonitis, which proposal(s) do you retain?

The abdominal CT scan is the reference morphological examination for diagnosis

Surgical treatment should include washing of the peritoneal cavity

The 3 most common causes are appendicitis, peptic ulcer, diverticulum colic

The evolving risk of peritonitis is septic shock

Peritonitis is always linked to digestive perforation


Regarding acute bowel obstruction, what is the exact information(s)?

A functional occlusion may be caused by a hydroelectrolyte disorder

A peritoneal flange can lead to occlusion by strangulation

Strangulation occlusion threatens gut vitality within hours

The abdominal CT scan with contrast injection is the reference exam

Colon cancer is the leading cause of obstruction colonic occlusion

Fecal impaction is the leading cause of rectal 💩 obstruction


Regarding occlusive syndrome: (one or more exact answers)

Stopping materials is a physical sign absent in 30% of cases

Abdominal pain is still the initial symptom

The seat of abdominal pain signs the seat of the obstacle

Repeated and frequent vomiting temporarily relieves abdominal pain in small intestine occlusions

The shutdown of the gas is the essential functional sign for diagnosis


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?


When admitting a polytrauma patient in severe hemorrhagic shock (one or more exact answers):

A bodyscan is essential and must be carried out urgently

A fast-echo performed at the patient's bed is enough to affirm hemoperitoneum

An emergency laparotomy is indicated to affirm the abdominal origin of hemorrhagic shock

In case of massive hemoperitoneum, the << damage control technique >> is the reference technique

The <<damage control>> technique aims to control bleeding and at the same time treat digestive lesions

Only control bleeding to save the patient's life. We will take care of the rest in a second time.


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?

Does not give lymphadenopathy or angina (p. 178 of the R2C College of Hematology)


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)

Immunological thrombocytopenic purpura (ITP)

Vasculitis of the large vessels do not give purpura


About breath in mitral insufficiency, which is (are) the exact proposition(s)?

It may be associated with mesodiastolic rolling


A 42-year-old patient is admitted for chest pain. After interpreting this electrocardiogram, indicate the exact proposal(s):

This is a Wolff-Parkinson-White syndrome


A 62-year-old patient is admitted for lipothymia. After interpreting this electrocardiogram, indicate the exact proposal(s).

There is an atrioventricular block of the first degree

There is a complete atrioventricular block


In a clinical trial, randomization of the evaluated treatment is intended to be first and foremost:

Establish comparable groups based on potential confounders

Conclude a difference with a statistical significance level of 5%

Fluctuations are mitigated by increasing the sample size (to approximate the size of the source population)

Keep subjects in ignorance of the treatment allocated for the duration of the study


In the following list of bacterial infections, which bacterial infection(s) is (are) not usually associated with hyperleukocytosis?


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:

The risk of statistical error of the second kind (beta)

Non-inferiority of the treatment assessed

The risk of statistical error of the first kind (alpha)


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)

Rupture of cerebral arteriovenous malformation


The administrative part of the death certificate, electronically or on paper, is transmitted: (one or more correct answers)

At the National Institute of Health and Medical Research (INSERM)

To the funeral home manager mandated by the family


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)?

The genes involved code for ion channels

Long QT syndrome is most often associated with a congenital heart defect

The genetic evaluation of this pathology is done by the study of the karyotype

The diagnosis in an index case must lead to information to the relatives

through the patient (the doctor cannot contact the relatives himself because of medical confidentiality)

Molecular predictive diagnosis is not allowed in minor children in this situation


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?


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)?

Boys III-3, III-7 and III-11 carry a complete mutation in the FMR1 gene

Girl III-2 with mild intellectual disability is likely a heterozygous carrier of a premutation

The III-6 girl has a one in 2 risk of being a heterozygous carrier of a premutation or a complete mutation

Women II-1, II-4, and II-7 have an increased risk of premature ovarian failure

Subject I-2 is a hemizygous carrier of a premutation


The objectives of the forensic care of a victim of sexual violence are: (one or more exact answers)

Determine if the person consented at the time of the facts

Determine if victim impact statements are credible


What are the possible therapeutic strategies for asthma and chronic obstructive pulmonary disease (COPD)? (one or more correct answers)

Long-term inhaled corticosteroid therapy monotherapy in COPD

Continuous inhaled corticosteroid monotherapy for asthma

Long-acting long-acting beta-2 agonist as monotherapy for asthma

Every asthmatic should have his inhaled corticosteroid close to him.

Combination of inhaled corticosteroid and long-acting beta-2 agonist inhaled as background therapy for asthma

Long-acting beta-2 agonist monotherapy in COPD


You receive the result of a blood ionogram showing a serum potassium level of 6 mmol / L. What iatrogenic cause(s) can you mention?


Protamine sulfate neutralizes the anticoagulant activity of heparin

Naloxone is a specific antagonist of morphinomimetics

Prothrombin factors are the antidote for clopidogrel

N-acetyl-cysteine is the antidote to acetylsalicylic acid

Flumazenil is an antagonist of benzodiazepines and related molecules


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?


About the decision on medical termination of pregnancy (IMG) (one or more exact answers):

Any request for IMG must be the subject of an opinion from the Multidisciplinary Center for Prenatal Diagnosis (CPDPN)

There is a list of pathologies for which there is a medical indication for IMG

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>>

A reflection period should be offered to the pregnant woman between the diagnosis of the condition and the possible realization of the IMG

An IMG can be carried out after consultation with the FNDCP until the end


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?


Which of the following signs and symptoms is more common in the elderly compared to young adults?


Which of the following signs can be a symptom(s) due to withdrawal from an opiate substance?


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?

Let the patient explain what alcohol brings

Exposing the patient to situations at risk of excessive consumption

Identify the patient's personal reasons for change

Emphasize to the patient the risks associated with alcohol consumption


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:

Dihydropyridine group calcium channel blocker

They are not bradycardic, to the contaire of verapamil/diltiazem

Inhaled rapid-acting, short-acting beta-2 mimetic bronchodilator


About trisomy 21 syndrome (one or more exact answers):

It most often results from a maternal meiotic accident

When combined with a chromosomal formula 46,XX,der(14,21),+21, it does not require a family survey

Its post-natal diagnosis can be confirmed rapidly by molecular biology

Its risk of recurrence is close to 1/100 to 1/200 for a couple who had a first child affected

Its risk is decreased by advanced maternal age at the time of conception


About histological lesions of glomerulopathies (one or more exact answers)

Diagnosis of minimal glomerular lesions requires electron microscopy examination

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.

Segmental and focal hyalinosis may be primary in adults

Membranoproliferative glomerulopathy is characterized by double contours of the glomerular basement membrane

Deposits << humps >> are present in acute post-infectious glomerulonephritis

Proteinuria without hematuria with fundus involvement


Histological diagnosis of prostate adenocarcinoma on biopsy mapping (one or more exact responses):

Is specified in his prognosis by Gleason's architectural score

Is specified in its prognosis by the proliferation index


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)


On a liver biopsy puncture, the diagnosis of acute alcoholic hepatitis (one or more exact answers) is retained


Regarding Alzheimer's disease, what statement(s) is(are) correct?

Behavioural disorders often occur early in the illness

Dubois' 5-word test makes it possible to make the diagnosis

It evolves by flare-up leading to iterative hospitalizations


Regarding organ ageing, which is the right proposal(s)?

It is marked by a decrease in maximum capacities

This is a concept without scientific evidence

It is characterized by a reduction in functional reserve capacities

It makes it possible to judge the autonomy of the individual


Regarding fragility syndrome, which proposal(s) is(are) right?

It is a concept without a precise definition

It makes it possible to evaluate the functional reserves of the organs

It is associated with a risk of addiction

It is associated with the risk of pressure ulcers during hospitalization

There is no definite association in the college between these two elements.

It is associated with an increased risk of myocardial infarction


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?

Immediate administration of prothrombin complex concentrate

Systematic control brain scan in 6 hours

Discontinuation of vitamin K antagonist with heparin relay at curative dose


Which of the following criteria(s) testify to severe malnutrition in the elderly?

discontinuation of vitamin K antagonist with heparin relay at an effective dose


Regarding cadaveric lividities, what is (are) the exact proposal(s)?

They correspond to a blood sweat through the vessels after death

They are one of the indicators of the movement of the body after death

They do not correspond to the parts that are detached in the new position of the body.

They allow an accurate estimation of the post-mortem time

The estimate is not very precise (several hours of differential).

They are greenish in colour in case of fatal carbon monoxide poisoning


Regarding functional dependence in the elderly, which proposal(s) is(are) right?

It is measured by the AGGIR grid in clinical practice

It is present if an individual can no longer take public transport

It is present in case of urinary incontinence

It is present in case of decrease in walking speed


Acquired epithelial dysplasia is (one or more exact answers):

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.

Anapath College: "Acquired dysplasia results from genetic abnormalities that alter proliferation control and cell maturation."


About antenatal screening for trisomy 21 syndrome, which proposal(s) is (are) accurate?

Amniocentesis for fetal karyotyping is recommended for any pregnant woman over 38 years of age

Combined first trimester screening includes nuchal translucency measurement around 12 weeks of amenorrhea

Screening should be offered to all pregnant women

Non-invasive prenatal screening (NIPT) is recommended for ultrasound diagnosis at 24 weeks of pregnancy of an atrioventricular canal

Medical termination of pregnancy for trisomy 21 syndrome is authorized in France until term


About Fragile X Syndrome: (one or more correct answers)

There is never a father-son transmission

There is a correlation between the size of maternal premutation and the risk of having a child with fragile X syndrome

A father carrying the premutation oblIgAtoire transmits his premutation to all his daughters

A woman carrying the premutation in the heterozygous state can develop FXTAS (Fragile X Tremor Ataxia Syndrome) in adulthood.

A man carrying the premutation can develop FXTAS (Fragile X Tremor Ataxia Syndrome) in adulthood.


Cat scratch disease: (one or more exact answers)

can be confirmed by PCR on lymph node biopsy product

is usually characterized by large lymphadenopathy with a tendency to fistulization

Bartonella henselae is a Gram-negative bacillus (BGN).


Regarding pelvic endometriosis, what is the exact answer(s)?

The relative risk for family history is 5. However, it is not a monogenic disease.

Normal pelvic ultrasound does not eliminate the diagnosis

The college (2021 version) does not report early menopause in the chapter on endometriosis.


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?

Echocardiography helps quantify the extent of leakage

Echocardiography may show dilation of the left ventricle

Echocardiography should look for dilation of the ascending aorta

Echocardiography should evaluate aortic valve cord injuries

The aortic valve has no cords (mitral and tricuspid valve contreatment).

Echocardiography is an essential element to pose the surgical indication


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)?

Bioprostheses are most often made of titanium or carbon

Bioprostheses require definitive anticoagulant treatment

The durability of bioprostheses is limited

Wearing a bioprosthetic valve prevents the occurrence of endocarditis

Bioprostheses are most often mounted on a metal frame

This allows the surgeon to make sutures easier.


Regarding focal nodular hyperplasia of the liver, which is (are) the exact proposal(s)?

It is a tumor with malignant potential requiring a curative resection

Three to five minutes after the CT scan of contrast medium, the lesion loses its enhancement

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.

In a woman, it contraindicates any estrogen-progestin treatment

This proposition would be true if it concerned hepatic adenoma.

From a histological point of view, it corresponds to a nodular reorganization of an area of hepatic parenchyma

In case of diagnostic certainty, it requires annual monitoring by liver MRI


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)

Surgical treatment is indicated only if the volume of the hernia no longer allows its reintegration

The presence of pain signs symptomatic hernia and indicates surgical treatment

In case of surgery by first inguinal route, the intervention can be performed under local anesthesia

In case of laparoscopic first, the repair is done with a prosthesis

The interposition of a non-absorbable material eliminates the risk of recurrence


In lupus nephropathies: (one or more exact answers)

Extracapillary proliferation can be seen in class II

Class II = deposition + mesangial blooms.

Mesangial hypercellularity in more than half of the glomeruli corresponds to a class IV

Immunoglobulin deposits can be mesangial or extramembranous

Onset before age 15 is a criterion for poor renal prognosis


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)

Place the patient in a supine position to facilitate intubation if necessary

Place a gastric tube to evacuate caustic fluid

Especially not because there is a risk of digestive perforation.

Do an examination of the oral cavity and the ENT sphere

Schedule upper endoscopy within 3 hours of patient admission

CT injected at H+3 and H+6 from ingestion (not management)


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?

Trace the previous occupational exposures of this intern

Find out if the intern is not suffering from a dangerous condition for his professional entourage

Check the status of the intern vis-à-vis mandatory vaccinations and recommended for caregivers

Check if the intern has sufficient knowledge to ensure its service

Inform the intern's manager of his/her medical history


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)

An application for recognition as a disabled worker

A pre-resumption visit to the occupational physician

An extension of sick leave until retirement age


Which cancer(s) is (are) staged by the FIGO classification?