Which of the following are true about Kawasaki disease?

It mainly affects children from 1 to 15 years old

It is a febrile adenocutaneous-mucosal syndrome

A palmo-plantar desquamation, often late (the only Kawasaki I saw had no peeling at all but you have to remember what is in the college!)


Which of the following propositions are true regarding the anatomical pathology expression of giant cell arteritis (Horton's disease)?

Essentially mononuclear inflammatory infiltrate

It is the INTERNAL elastic limiting that is destroyed (much less solid than the external elastic limiting)

Destruction of the external elastic limiter

They are found in Goodpasture's disease (vasculitis of microvessels)


Which of the following proposals are common features of the 3 ANCA small vessel vasculitis?

Not microscopic polyangiitis (the term "granulomatous" is not found in the name of this vasculitis)

Glomerulonephritis is rapidly progressive (GNRP)


Which of the following proposals are vasculitis concerning the large vessels (aorta and main collaterals)?

Field: subject willingly elderly, >50 years old

Anti-MBG antibody vasculitis concerning capillaries


Which of the following are true regarding the diagnosis of Granumolatosis with Polyangiitis (Wegener)?

It is the only vasculitis that has ANCA type c (anti-proteinase 3)

ANCA are directed against the PR3 protein

Biopsy finds granulomatous pauci-immune necrotizing vasculitis

Direct immunofluorescence on the biopsy piece is negative


Which of the following propositions are true about Behçet's disease?

It occurs mainly in men from the Mediterranean Basin (Turkey++), the Middle East (Turkey) or the Far East.

Behçet's disease begins around the age of 30

Diagnosis cannot be made before the age of 50

It combines oral and genital aphthosis, posterior uveitis, and sometimes joint, digestive, cardiac and / or cerebral damage

Bipolar aphthosis with oral and genital involvement


Which of the following are true about microscopic polyangiitis?

It is the only vasculitis of ANCA small vessels that is non-granulomatous. The other two (Granulomatosis with Polyangiitis, and Eosinophilic granulomatous with Polyangiitis) are granulomatous, as their name suggests. Remember: often, EVERYTHING is in the name 😅

The only vasculitis where c-ANCA is found is granulomatous with polyangiitis (Wegener)

Glomerulonephritis and pulmonary capillaritis are common


Which of the following propositions are true about chronic atrophic polychondritis?

Like Behçet's disease and Cogan syndrome, it affects vessels of all sizes.

It is a vasculitis that affects only small vessels

It is an "exceptional" disease from an epidemiological point of view

It is an inflammation of the cartilages of the ears and nose, aortic valves, aorta and trachea

This is the description of Cogan syndrome, a vasculitis affecting vessels of all caliber (very rare)

It is a non-syphilitic interstitial keratitis and audio-vestibular involvement


Which of the following are true about Takayasu's disease?

It affects large arteries: aorta and its main branches. She has a predilection for the carotid territory and subkeyboard

It affects the vessels of the microcirculation

It mainly affects men under 50 years of age

We can find vascular murmurs and an abolition of the pulse

We can find a tensional asymmetry and limp of the limbs


Which of the following propositions are true for a 42-year-old woman with a pathogenic BRAC1 mutation in remission from breast cancer?

True. Bilateral appendectomy to be offered from age 40 for BRCA1 and age 45 for BRCA2

True, the relevance of ultrasound is left to the discretion of the radiologist

Breast monitoring is done by annual mammography for life, associated or not with an ultrasound (excluding mammectomy)

True, no genetic testing in miners (unless there is immediate medical necessity, which is not the case for BRCA mutations)

Genetic tests in offspring will be offered after they reach the age of majority

The risk of digestive cancer is higher than in the general population

He should have been offered a bilateral mastectomy from the age of majority.


Which of the following are breast cancer risk factors?

False. There is no longer an over-risk of breast cancer when the pill was stopped more than 10 years ago

The use of the estrogen-progestin pill 15 years ago

False. It is protective (decrease in the duration of hormonal impregnation)

Late age at first pregnancy (> 30 years)


Regarding the epidemiology of breast cancer, which of the following propositions are true?

False. About 58,000 cases per year (we must retain about 54,000 - 58,000 as an order of magnitude, this figure changes depending on the sources). It is the most common cancer AND the deadliest in women.

There are 78,000 new cases of breast cancer in France per year

It is the 2nd most common cancer in France, all sexes combined

True. It is the deadliest cancer in women.

Breast cancer causes 12,000 deaths per year in France

False. The 5-year survival rate is 87% and 76% at 10 years. It is a cancer with a high survival rate thanks to mass screening that allows early detection of cancers (at stage N0)

1 in 5 women will develop breast cancer in her lifetime


Regarding the BI-RADS classification of the ACR, which ones are true?

False. ACR 0 means that further investigation is required. ACR 1 means that the mammogram is normal.

ACR 3 means that the anomaly is probably benign but requires short-term monitoring (3 or 6 months)

False. ACR 6 means that there is histological evidence of certainty of the malignancy of the lesion.

ACR 6 means that there is an abnormality suggestive of cancer

ACR 4 means that there is an undetermined or suspicious anomaly

ACR 5 means that there is an abnormality very suggestive of cancer


Lymphatic drainage of the breast is done to which site(s)?

True. Lymphatic drainage occurs to 3 main sites: axillary caval nodes, upper and subclavicular lymph nodes, and internal mammary chain nodes.

The lymph nodes of the external breast chain

The lymph nodes of the internal breast chain

False. It is a left supraclavicular lymph node, but it mainly drains the digestive system and is suggestive of digestive cancer (e.g. pancreas, colon).


Which of the following are genetic mutation(s) that can cause breast cancer?

True. It is also a syndrome that causes childhood cancer.

True. The mutation causes breast and ovarian cancer.

False. It causes, among other things, colon, endometrial and ovarian cancers.


An ultrasound found an 18mm lesion in the right breast. On clinical examination, you do not find any skin involvement and the lymph node areas are perfectly free. No clinical signs elsewhere. What is the TNM classification of this lesion?

Mx because we did not make an extension assessment

True. T1c more precisely (between 1 and 2 cm)


Which of the following is the most common histological form of breast cancer?


Which of the following are true for giant cell arteritis (Horton's disease)?

It occurs in subjects over 65 years of age

It predilection affects the carotid and vertebral territory (including the temporal artery)

This is a NOIIA in giant cell arteritis. NORB is found in Multiple Sclerosis

Pseudo-rhizomelic arthritis is often associated


Regarding epilepsy-Absence of the child. Which of the following are true?

Treatment is usually stopped after puberty

Attentional disorders are a common comorbidity to always look for in children with this syndrome.


Concerning centrotemporal peak epilepsy (CTEP) in children. Which of the following are true?

True: Oral area, with hypersalivation, speech stoppage, hemifacial clonia, paresthesias of the tongue and gums.

The beginning is focal: central opercular

No: before 15 years, and beginning of the syndrome usually around 10 years

The prognosis is pretty good, with a cure before 10 years


Are multi-daily absences >10/d, favored by hypopnea

EEG is characterized by bursts of synchronous generalized polyspike-wave discharges at 3cycles / minute

It is an epileptic syndrome with a good prognosis, very pharmacosensitive (80%)


Which of the following are criteria for lumbar puncture during a febrile seizure in children?

no, but it is a criterion for complex febrile seizure <6MONTHS

Bulging of the fontanel and anomaly of the tone


Which of the following are true about febrile seizures?

No, a febrile seizure is by definition <5 years.

A febrile seizure > 15min in a 6-year-old child is complex

True: psychomotor delay = complex crisis

A generalized febrile seizure of 5 minutes, without post-critical deficit, with normal neurological examination in a 2-year-old child who has just acquired standing with supports is a complex febrile crisis and justifies hospitalization.

A generalized febrile attack of 12 minutes with a fever at 41 ° C, in a child of 3 years without post-critical deficit, without particular history, with a normal neurological examination requires a lumbar puncture.

No because > 1 year, <15min, generalized

A generalized febrile seizure of 14 minutes with a fever at 42 ° C, in a 4-year-old child without post-critical deficit, without any particular history, with a normal neurological examination is a complex febrile seizure.


Regarding occupational health, what are the exact proposal(s)?

True, it makes sense. We will determine if a disease is of occupational cause if the disease occurs after exposure (chronological criterion) and if the lesions are semiologically compatible with exposure (semiological criterion)

The imputability between disease and exposure is justified by chronological and semiological criteria

False, it is by far the musculoskeletal disorders (carpal tunnel, meniscal involvement)

The most common occupational diseases are occupational cancers

True, completely! Some workers such as health professionals can contract these pathologies as a result of their work, so it is very clearly occupational ⚒ diseases!

Tuberculosis or viral hepatitis can be considered occupational diseases

For job retention, the occupational physician may set up job changes, job adjustments or professional reclassifications.

True, if he is dismissed, it will be during the resumption visit that takes place after the resumption of work

An employee cannot be dismissed during a work stoppage


Regarding the follow-up visit in occupational medicine, which of these proposals is/are true?

Wrong, it's the pre-resumption visit that!

The follow-up visit is requested by the general practitioner, the patient or the medical officer of the health insurance

True, it is done from a work stoppage for more than 1 month, so this is the case

The follow-up visit is carried out at the end of a pregnancy/maternity leave

True, this is the purpose of the takeover visit

The follow-up visit decides whether or not the employee is fit

The resumption visit is done within 8 days of the resumption of work by the employee

When transferring to another position in the company, in case of job adaptation, the salary remains the same for a period of 3 months


Regarding orthopedic treatment, which proposals are true?

Consolidation of fractures is faster in small children

The average duration of consolidation is shorter for epiphyseal detachments

This is the case for diaphyseal fractures

The consolidation of metaphyseal fractures is equivalent to that of adults

Duration valid for a diaphyseal fracture in a child over 5 years of age (equivalent to adults)

Fractures of the 2 bones of the forearm must be immobilized 90 days

Analgesic immobilization, non-systematic, between 0 and 21 days

A lump of butter fracture must be immobilized on average 45 days


Which of the following are systematic additional reviews for INM? (based on HAS, 2009)


Which of the following propositions are true regarding unexpected infant death?

This is, according to the HAs, any "death occurring suddenly in an infant under 2 years of age when nothing in his known history could have predicted"

Deaths that remain unexplained are grouped under the term unexplained IMN.

In France, approximately 500 infants under 2 years of age die unexpectedly annually

It is most often an infant aged between 2 and 4 months

This is most often an infant between 20 and 24 months of age.

The supine sleeping position is a risk factor for MIN

The supine sleeping position is a protective factor of MIN


Which of the following are/are risk factors for unexpected infant death?

It is absolutely necessary to avoid the supine position

Soft mattresses and duvets/blankets should be avoided


Which of the following are true about pancreatic pain?

It sits mainly in epigastrium (possibly hypochondrium)

It sits in the umbilical region most often

It is transfixing (radiates to the back)

This is the case of the pain of the uclera. Pancreatic pain is aggravated by the meal, which can cause a fear of eating and therefore malnutrition


What is the threshold of days below which abdominal pain is considered acute?


Which of the following are endocrinological (and therefore non-digestive) etiologies of abdominal pain?

It is indeed a cause of abdominal pain (always do an ECG) but it is cardiac (not endocrinological, see statement). trap, I grant 💩 you


True. To see it in pictures: https://upload.wikimedia.org/wikipedia/commons/thumb/5/57/Stomach-fr.svg/1200px-Stomach-fr.svg.png

That was a tough question, sorry! In addition, it is clearly not mandatory to know, so do not worry if you can not retain 😉 it


Which of the following are germs that can cause acute gastritis?

True, then progresses to chronic gastritis

Not per se, but induced immunosuppression promotes infection/reactivation by/of HSV and CMV


What is the sex ratio for gastric ulcer?


In the case of a gastric ulcer, treatment with curative PPI lasts for:

True. 6 weeks of curative PPIs in addition to Helicobacter Pylori treatment


Among the following proposals, which are techniques that could be used for the detection of H. Pylori?

True, reference technique to control post-treatment disappearance

Cytobacteriological examination of sputum (ECBC)


Which of the following are true about gastritis?

Lymphocytic gastritis is often asymptomatic

True, as well as gastritis under PPI and gastritis due to H. Pylori. These are the three causes of atrophiing gastritis.

Autoimmune gastritis can progress to atrophy

Autoimmune gastritis mainly affects children

All gastritis is at risk of degeneration

Granulomatous gastritis has no risk of malignant transformation


Which of the following propositions are true about labialveolar clefts?

They are due to a defect of fusion of the buds of the face in the 1st trimester of pregnancy

They are due to a defect of fusion of the buds of the face in the 2nd trimester of pregnancy

Failure to merge the buds of the face in the 1st trimester

They are due to a defect of fusion of the neural crest in the 3rd trimester of pregnancy

True, no involvement of the bony palate and veil in the lip and alveolar cleft


Which of the following propositions are true regarding the total cleft lip-alveolo-palate?


You receive in your general practice Mr. Emiliano Largo, 75 years old, who has just returned from a consultation with an ophthalmologist. He admits, a little embarrassed, that he did not understand what the ophthalmologist told him and that he had understood, however, that he will have cataract surgery on his right eye. You decide to do some therapeutic education. Which of the following proposition(s) are true?

False, cataract may be very common, it is a pathology of the lens. The aging of the lens will result more in presbyopia (lack of accommodation that will disrupt near vision)

Cataract is a physiological aging of the lens, linked to a clouding of the latter

True, these are quite characteristic and frequent signs of cataracts (hemeralopia = twilight vision disorder)

Apart from decreased visual acuity, cataracts can be characterized by hemeralopia and yellowing of colors.

False, the examination with the slit lamp allows the diagnosis of cataract and specifies its topography, so it makes it possible to distinguish nuclear cataract, posterior subcapsular, cortical or total

The slit lamp examination distinguishes a primary or secondary cataract

False, this seemingly vicious trap between ultrasound in mode A and B makes it possible to return to an important point and misunderstood by students. Mode A ultrasound is a "profile" ultrasound that measures the axile length of the eye while mode B ultrasound is a frontal ultrasound that will explore "the fundus" of the eye and look for foreign bodies or retinal detachment.

Before surgery by phacoemulsification of the lens, certain additional examinations are performed: ultrasound mode B and keratometry

False, if the most common complication is this one, the most formidable is endophthalmitis!

If secondary clouding of the lens is the most common complication, the most formidable complication is retinal detachment


In your acute geriatric department, you have been hospitalized for a few hours Mr Traveylan, Alec, 88 years old, for acute pneumonia, of viral origin, related to CoVID 19, which led to a decompensation of his chronic heart disease. You ask your outpatient to summarize the overall care of the patient according to the Bouchon model or 1+2+3. Link the right number to the right pathology(s):

True, the 1 in the Bouchon model corresponds to physiological aging

True, the n°2 corresponds to chronic pathologies

True, the n°3 corresponds to the decompensating factor


Regarding the two types of possible health follow-ups in occupational health, which of the following proposals are accurate?

False, hiring and periodic visits must be made by the occupational physician. The nurse can make intermediate visits

The follow-up of an employee in a position at risk may include periodic follow-up visits by an occupational nurse

Periodic follow-up visits shall be carried out at least every two years

False, for non-at-risk employees, there is no certificate of aptitude

For employees in non-high-risk positions, the recruitment examination issues a certificate of suitability for employment

The prevention information visit is done periodically at least every 5 years

True, if he is not at risk, all mandatory visits can be made by an intern or a nurse

An employee will not necessarily see the occupational physician in his professional life


True, this is part of the non-exhaustive list of roles of the occupational health service.

The occupational health service has as its action the prevention of the consumption of toxic substances at work

The occupational health service has as its action the prevention of sexual and moral harassment

False, naughty trap, there are no psychomotor and occupational therapists ...

The occupational health service may consist of nurses, psychologists, psychomotor therapists and occupational therapists.

True, double secret characteristic of the profession

The occupational physician is bound by medical and professional secrecy

True, 2021 College of Occupational Medicine Update

The role of the occupational physician is only preventive


Regarding accidents at work and occupational diseases, what are the possible benefits received by the employee?

False, cash benefit = compensation (think of cash as "pay in cash")

False, nothing to see it is the great war invalids / great war maimed


Which of the following are possible causes of ptosis?

Levator muscle of the eyelid = oculomotor nerve III


Which of the following suggests a rapid test in consultation that can support the diagnosis of myasthenia gravis in case of ptosis?

Test indicated when a patient suffers from ocular paralysis (and not ptosis). It consists of a graphic recording of ocular motor skills in different positions of the gaze.

True, ptosis decreases after several seconds

Useless for myasthenia gravis, not in consultation

Unnecessary and unchanged/normal in myasthenia gravis


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

False, the definition here corresponds to peripheral facial paralysis. We must not forget that we can have central facial paralysis, which corresponds to an attack of the central nervous system.

Facial paralysis corresponds to distal involvement of nerve VII

True, unlike a central facial paralysis where we will have a predominant lower facial involvement.

Peripheral facial paralysis is characterized by upper and lower involvement of the face

True, to have seen him in internship it is all the more bluffing. The eyes open we will have an asymmetry sometimes minimal, and the sign of Charles Bell can be revealed entirely at the closing of the eyes.

The sign of Charles Bell is revealed or increased when a patient is asked to close his eyes

False, it is done on the healthy side. To help you remember tell you that it is the VII (motor nerve) that is abolished, so you have "no muscle" to stretch the mouth on the healthy side. But do not panic, I still confuse today the affected side ...

Deviation of the mouth in unilateral peripheral facial paralysis occurs on the paralyzed side

True, it is the main cause of facial paralysis, but you have to think about all the other causes too.

Facial paralysis "a frigore" is the most common cause of facial paralysis and is characterized by restoration without sequelae in about 90-95% of cases


Regarding tamoxifen, which statement(s) are correct?

False. In premenopausal women. In postmenopausal women, anti-aromatases are indicated (Anastrozole, Letrozole)

Tamoxifen is indicated in postmenopausal women with hormone receptor positive

True. Tamoxifen increases the risk of endometrial cancer.

In case of bleeding during tamoxifen treatment, endometrial cancer should always be ruled out and diagnostic hysteroscopy with biopsy curettage performed.

Tamoxifen is prescribed for a period of 5 years

True. Effective contraception is indicated.

Tamoxifen is linked to an over-risk of thromboembolic complications


Which of the following are true about Lyme disease?

True, and more specifically borreliosis (infectious diseases caused by bacteria carried and transmitted to humans by ticks or lice)

True, the best way to remember it is to pronounce it (no I'm kidding)


Which of the following propositions, is (are) true regarding fat embolism?

True. CLINICAL diagnosis above all and not paraclinical that will guide. If you ever miss the clinic, the fundus will allow a retrospective diagnosis

The diagnosis is primarily clinical and is based on the discovery of hyperthermia, sinus tachycardia and polypnea a few hours after a limb fracture

False. In addition there is only hypoxemia that is almost constant

The diagnosis is primarily paraclinical and based on the discovery of thrombocytopenia, hemolytic anemia and arterial hypoxemia.

True. It can be used to make a retrospective diagnosis when clinical manifestations have been missed.

The fundus can find retinal hemorrhages, cottony nodules and retinal edema

True! These manifestations are fickle, however.

The Gurd triad is based on the association of lesional pulmonary edema + neuro-psychic manifestations + petechiae of the trunk and mucous membranes

True! HEMODYNAMICS to be monitored extremely rigorously in the context of (poly)trauma. Fat embolism was the subject of an entire question at ECNI 2021. All this information can be found in the latest college of anesthesia resuscitation p344: https://www.cnear.fr/dfasm

Preventive treatment is based on immobilization of fracture foci, maintenance of good hemodynamics and the fight against pain


You receive in your acute geriatric department Mr. Dominique Greene, 89 years old, who comes for a classic fall care. You wonder what systematic assessment you are going to make and you note possible examinations / supports. What reviews will you NOT incorporate into your systematic review?

True, the fall assessment is as follows: Reassessment of the prescription, Evaluation of autonomy and functional independence by ADL and IADL/////NFS, CRP, Ionogram, Vitamin D, Blood glucose, Renal work, Liver test, CPK, Troponin, +/- TSH, Albumin, ////ECG, IPS, Orthostatic hypotension test, +/- ETT, Holter ECG, Brain imaging if call point


Among the following proposals, which examination(s) of unscrambling for etiological purposes must / must imperatively be carried out in front of any acute renal failure?

useful only if parenchymal cause (eliminate pre-renal and post-renal cause before)


Which of the following proposals concerning the therapeutic management of a polytrauma patient are true?

True, A=Airway, B=Breathing, C=Circulation, D=Disability, E=Environment and ensures no source of potential instability is forgotten

Treatment of vital distress follows sequence A, B, C, D, E

Stage E (Environment) mainly involves the fight against hypothermia

Stage D (Disability) focuses on neurological examination

The volume of blood lost during the first 6 hours post-traumatic of a femur fracture can reach 2000 mL

False, hypocalcemia that results from the dilution and presence of citrate in PSL (calcium chelator)

A massive transfusion exposes to the risk of hypercalcemia


Which of the following are causes of dysphonia with normal and mobile vocal cords?

It is not dysphonia (differential diagnosis), hypophonia is observed


Which of the following are recommendations for pregnant women who are not immune to toxoplasmosis?

There is no vaccine against toxoplasmosis


Which of the following can cause lesional esophageal dysphagia?

Non-lesional dysphagia: perprandial retrosternal pain


Which of the following proposals designate types of orthotics?

True: reduced pain and deformities at rest


Which of the following proposals correspond to a situation where a doctor can prescribe off-label? 😱

I kindly remind you that general medicine is a specialty. 😇😇

At the request of the specialist when you are a generalist


Which of the following are confusogenic molecules due to their anticholinergic activity?

No anticholinergic action. However, it can participate in dehydrating the patient (cause of confusion)


Regarding preeclampsia, which of the following are true?

True. Cf. 2020 CNGOF Recommendations. It is routinely put on to prevent complications of eclampsia.

IV magnesium sulfate is indicated in all pregnant women with severe pre-eclampsia with at least 1 severity endpoint

HELLP syndrome is frequently associated with DIC.

The anti-hypertensive recommended in first line in front of severe hypertension in pre-eclampsia is labetolol

True. First-line treatment: labetolol. Second-line therapy: calcium channel blocker (nicardipian) or uradipil, as monotherapy or in combination.

In case of contraindication or failure of first-line antihypertensive therapy, the second-line antihypertensive drug for severe hypertension in pre-eclampsia is a calcium channel blocker (nicardipine) or uradipil

False. This is a difference with hypertension in adults and hypertension in pregnant women. In adults, it is ≥ 180 mmHg PAS and/or ≥ 110 mmHg PAD. In pregnant women, it is ≥ 160 mmHg PAS and / or ≥ 110 mmHg PAD.

Severe hypertension during pregnancy is defined as SBP ≥ 180 and/or PAD ≥ 110 mmHg


The direct toxicity of a drug is dose-dependent 💊

Digestive absorption of drugs is age-dependent 👴

The hepatic first-pass effect is decreased in the elderly 🧓

Most are not ➡ always checked on the CRAT website

Albuminemia increases during pregnancy 🤰


True. Between 5 and 60 minutes for each symptom

Symptoms of migraine aura last less than an hour

Tension ⚡ headaches have nothing to do with high blood pressure.

Headaches due to drug abuse may be due to paracetamol

This is the case of cluster headache. For tension headaches, it is amitriptyline

The background treatment for tension headaches is verapamil

Oxygen therapy is part of the treatment of cluster headache crisis


Which of the following proposals for pre-eclampsia are criteria for severity?

True. Defined by mechanical hemolysis (schizocytes, LDH ≤ 600 IU/L, total bilirubin ≥ 12mg/L), hepatic cytolysis (AST≥70 IU/L) and thrombocytopenia (≤100 G/L)

False, nephrotic syndrome with proteinuria ≥5g/24h


Mr. Idaho, Duncan, 35 years old, comes to see you in your office because he would like to be recognized for his chronic lumbosciatica related to his profession, in occupational disease. Which of the following means qualify for recognition as an occupational disease?

False, the presumption of imputability applies to accidents at work and not to occupational diseases. Attention, classic trap in MCQ.

True, if the disease corresponds to the picture (physical injuries, delay etc ...) there is no need for additional evidence

False, the occupational physician cannot certify the occupational disease, just with a certificate

Certificate from the occupational physician certifying the occupational origin of the disease

True, the CRRMP allows to debate cases that do not fit completely in the tables or being outside the tables, overall, they will study in detail the links between illness and work and grant or not the disease as occupational or not.

Recognition of the file before the Regional Committee for the Recognition of Occupational Diseases (CRRMP)

Pathology that started during labour and persisted for more than 5 years


Which of the following are contraindications to transparietal PBH?

True, these are the 4 contraindications mentioned in the college 😉


Which of the following are true for macrophage activation syndrome (SAM)?


Which of the following propositions are true about ALD?

Each ALD has a fixed term, at the end of which renewal can be requested

It is usually requested by the attending physician

Only for care related to the pathology in question

It offers the right to 100% coverage for all care

It makes it possible to free oneself from mutual insurance companies


How many loose/watery stools per day are we talking about diarrhea?

True, diarhea if > 3 watery/soft stools per day


Which of the following are causes of extrahepatic jaundice?


Which of the following are signs and/or symptoms of UC?

The diagnosis is made on a bundle of arguments


A "green wood" fracture is a fracture where part of the cortical of the bone is ruptured, and the other side of the cortical is continuous.

A fracture in "lump of butter" results from a torsional mechanism

Traumatology is the second leading cause of death between 1 year and 19 years

The occurrence of a fracture in an infant who does not move must give rise to suspicion of abuse.

True. The water density of the child's bone gives it greater plasticity.

Fractures made of green wood and lump of butter are specific to the child


What is the main property of dobutamine?

True, increased strength of
contraction. Continuous infusion with the self-pushing syringe

No effect on the conduction velocity of nerve impulses of myocardial muscle fibers


Which of the following are signs of hepatocellular insufficiency?


Which of the following are true about migraines?

Migraine with aura is an independent risk factor for cerebral infarction, especially in women under 45 years of age.

Migraine with typical aura involves visual, sensory or language disorders of gradual and successive installation

Sensory disorders are most common in migraines with aura

auras can change over the course of life

Auras are always the same throughout life

Episodic migraine lasts less than 25 days a month


Which of the following are true for pellagreal encephalopathy?


The dynamic muscle replacement orthosis is a corrective orthosis

Canes and wheelchairs are external technical aids

The stabilization orthosis allows the maintenance of activity despite an unstable limb


One of your patients is being treated with VKA for her PE. VKAs prevent hepatic synthesis of several coagulation factors. Which?


Which of the following propositions are found in junctional tachycardia?

Purposes unless pre-existing branch blog

True, until you reach maximum heart rate (220 - age)


A 57-year-old patient comes to see you for a left epistaxis of low abundance

ATCD: Repeated MTEV
TTT: Fluindione

What is the 1st measure to be carried out?

True. In front of an epistaxis:
1. We decoiled by blowing the patient's nose

2. Bidigital compression is done to try to stop the bleeding

Prescription of Group O+ phenotyped RGCs


What does the FIGO 0 classification of a uterine fibroid mean?

Fully intracavitary pedunculated submucosal fibroid

Interstitial fibroid in contact with the endometrium


Which of the following propositions are true regarding extemporaneous examination?

It is always complemented by an analysis

The result must be fast (in less than 30 minutes)


Regarding the epidemiology of Crohn's disease:

The threshold for rare diseases is 1/2000


Which of the following are etiologies of jaundice with normal urine?

Rotor syndrome is a benign inherited liver disease characterized by predominantly conjugated chronic hyperbilirubinemia without hemolysis or histological hepatic abnormalities.


Which of the following are the causes of hematocrit elevation?

True. Cause of false polycythemia (ht/hb increased but normal total mass). It often corresponds to young, sedentary, overweight men and other associated vascular risk factors. The measurement of the globular mass is normal.


You are an intern in cardiology and your outpatient, asks you during the visit what are the main differences between mechanical prostheses and biological prostheses?

True, unlike bioprostheses that often have a lifespan of 20 years.

Mechanical prostheses have a theoretically unlimited lifespan

False, because of their limited lifespan, we will rather implement these prostheses in elderly subjects.

Biological prostheses are preferred in young subjects because they avoid taking an anticoagulant

False, there is the same risk regardless of the type of prosthesis

The risk of infective endocarditis is greater in front of a mechanical prosthesis than in front of a bioprosthesis

True, finesse of the college of cardiology that I did not know but that an expert cardiologist could drop in IQ

The risk of thromboembolic complications is higher for mitral prostheses than for aortic prostheses

True, so make sure your patients take their blood thinning treatment!

The main risk factor for thromboembolic event on prosthetic valve is insufficient anticoagulant therapy


Which of the following are true about corneal transplantation?

There is a risk of immune rejection of the graft

There is a risk of cell rejection of the graft


Regarding the classification of Salter and Harris

The trait respects the germinative layer of the growth cartilage: the risk of epiphysiodesis is therefore low

A Salter 1 fracture is characterized by a trait passing exclusively through the growth zone, which induces a high risk of epiphysiodesis

A Salter 2 fracture is characterized by a trait passing through the growth zone and the epiphysis

The trait passes through the growth zone and the epiphysis (the germinative zone of cartilage is located towards the epiphysis)

In a Salter 3 fracture, the germinative layer is always crossed by the fracture line

The line goes from the metaphysis to the epiphysis: it crosses transversely the growth cartilage

In a Salter 4 fracture, the fracture line is transverse to the growth cartilage

It is generally associated with other fractures, in case of compression mechanism (axial trauma)

A Salter 5 fracture does not exist in isolation


Which of the following are risk factors for lithiasis?


Which of the following is the optimal management of asymptomatic cholelithiasis?

True, therapeutic abstention in front of asympatomatic cholelithiasis (80% are asympto)

It is the management of hepatic colic calmed by analgesic / NSAIDs / antispasmodics

Cold cholecystectomy (less than one month)

This is the management of acute cholecystitis

This is the management of cholitis (with cholecystectomy)


Screening is done the anti-tranglutamase IgA assay

Screening is done the anti-endomysium IgA assay


Which of the following proposals are part of the initial assessment recommended urgently in the face of confusion?


Concerning Headaches in children. Which of the following are situations for a Brain Scan indication?

Statural inflection in a 2-year-old child

An abnormality on neurological examination in a 3-month-old child

Positional headaches of decubitus, morning with vomiting in jets in a 7-year-old child

A progressive appearance of horizontal diplopia of the right eye that converges to the left associated with a headache in a 4-year-old child

Statural delay in a 5-year-old child associated with progressive onset headaches


You are a nuclear medicine intern and you receive, Mr. Banner, Bruce, 76 years old, to have him perform a PET-CT, as part of a pulmonary cancer extension assessment. During this examination, you do everything to minimize the body's exposure to ionizing radiation. What factors influence this exposure?

True, notion of highly fallable course at the ECN

False, it's a stupid distractor because it needed one

The dose previously received during a previous exposure

Thickness and composition of any screens


Which of the following are true about abiraterone acetate?

It is a selective inhibitor of androgen synthesis

Daily oral form in combination with prednisone (10 mg/day)

It is in the form of subcutaneous injection


Which of the following designates an essential isotopic examination in the assessment of neuroblastoma?

Possible in the prostate cancer extension assessment


One of your patients is being treated with VKA for her PE. VKAs prevent hepatic synthesis of several coagulation factors. Which?


It is transmitted in an autosomal dominant manner

Phenylalanine (Phe) is an essential amino acid

Clinical signs are due to accumulation of neurotoxic products


True. It includes the eardrum, the posterior wall of the external auditory canal, part of the pinna of the ear (the conch) (according to Wikipedia, mentioned on page 84 of the 4th edition of the college of CMF)


Which of the following are the false causes of increased sedimentation rate?

True, I know it sucks, but there are many PH who do this kind of MCQ because they are simple MCQs... Refer to the table on page 110 of the College of Internal Medicine. To remember this I told myself that it was decreased when there were too many "normal" cells (polycythemia, leukocytosis, thrombocytosis) or not enough proteins (hypofibrinogemia, hypogammaglobulinemia).


Which of the following are causes of idiopathic ICT?

No hypervitaminosis in water-soluble vitamins (the too full we piss!) --> Here cause of idiopathic HTIC = Hypervitaminosis A

Not idiopathic because anomaly visible on imaging


Which of the following propositions are true about diverticular hemorrhages?

They are the cause of a third of lower bleeding

The positive diagnosis can only be made by colonoscopy


Which of the following are possible pathophysiological explanations for confusional state?


Regarding the monitoring of prosthetic heart valves, what are the exact proposal(s)?

False, AOD are never indicated in case of prosthetic valves, only VKAs are used

Treatment with VKA requires regular INR monitoring, but not treatment with DOAC, which promotes the use of the latter

False, even if it can indeed be benign, it must know how to look for a prosthesis dysfunction

The appearance of a new breath after valve surgery is common and benign

False, the ECG is totally normal because the prosthesis has no connection with the electrical current of the heart unlike a pacemaker

The ECG is classically slightly altered by the functioning of the valve prosthesis

False, bioprostheses are organic tissue, unlike mechanical prostheses

Bioprostheses are highly radiopaque on chest X-ray

True, the ETT is the monitoring examination but does not allow the fine analysis of the valve or prosthesis

ETO is performed in case of suspected thrombosis or prosthesis dysfunction


Trastuzumab is always combined with chemotherapy

False. If the HER is 2+ in immunohistochemistry, the FISH analysis should be completed. If it is not amplified in FISH, anti-HER2 treatment is not indicated.

Trastuzumab is still indicated if immunohistochemistry regains HER2 2+

The two most commonly used classes of chemotherapy for breast cancer are anthracylins and taxanes

Adjuvant radiotherapy is always indicated in a woman who has received conservative breast surgery (lumpectomy) for carcinoma in situ.

Anti-aromatases may aggravate pre-existing osteoporosis requiring bone densitometry monitoring


Which of the following are risk factors for post-febrile seizure epilepsy?

True because Complex Febrile Crisis is a fdr


Which of the following can cause lesional esophageal dysphagia?

True. All these proposals are causes of non-lesional esophageal dysphagia


Which of the following are risk factors for recurrence of febrile seizures?

And no: it's <38.5 ° C, which is logical since the child had a feverish attack on a fever that was not that hot. So it can recur on low fever.

1st degree family history of febrile seizure


Which of the following are nerves involved in the corneal reflex?

True. Also called ophthalmic nerve. It is a mixed nerve involved in the afferent pathway of the corneal reflex.

Motor nerve innervating the lateral right (abduction of the eye)

Motor nerve innervating medial right, inferior oblique, lower right, and superior right

True. Mixed nerve involved in the efferent pathway of the corneal reflex

Mixed nerve involved in many reflexes such as the reflex of the palé veil


Which of the following are pro-inflammatory cytokines or proteins increased during inflammation?

True, I know it may seem like detail to you, but remember that these are targets of certain biotherapies in chronic inflammatory diseases, so the MCQ can fall...

True, see A. even more frequent MCQ on TNF alpha

True, remember in general that ALL proteins of inflammation are positive except 3: albumin, transthyretin, transferrin.


Which of the following are factors in the severity of pre-eclampsia?

False. According to the new 2020 recommendations, it is > 90 μmol/L.

Severe headache that does not respond to treatment


Which of the following propositions are true about House Brackmann's classification?

Grade 2 = discrete deficit, visible during movement

Grade 3 = complete palpebral occlusion possible with effort

complete palpebral occlusion impossible, very asymmetrical movements, severe syncinesis and hypertonia


Which of the following are parasites that can occur as liver nodules?


What are the risk factors for recurrence of a complex febrile seizure in children?

True. To retain these criteria more simply, it is enough to remember that children at risk are those with "a small brain sensitive to heat".

Short time between onset of fever and seizure

True. A low fever at the time of the febrile attack testifies to this sensitivity to heat

Low fever at the time of the febrile attack (< 38.5°C)

False. It's a trap. It is a low fever at the time of the seizure that is a recurrence FDR.

High fever at the time of the febrile attack (> 40°C)


About high blood pressure in children
Which of the following are true?

True
In pediatrics we think a lot in percentile and standard deviation.

In children, normal BP is below the 90th percentile.

True
Hyper important in practice. It gives you a first idea. In practice, still think about taking the size into account because if the child is tall for age, we can find a HTA with this formula which is not necessarily present if we are based on the size.

To calculate the systolic blood pressure corresponding to the 95th percentile, one can use the formula: 100 + 2x Age (in years)

High blood pressure in children is defined as a BP measurement above the 95th percentile for the child's sex, age and height

False.
The prevention of hypertension in children is estimated at 3.5%

The prevalence of hypertension in children is estimated at 0.7%

FAAUUUX
Unlike the adult population, in pediatrics hypertension is always a priori secondary and must lead to the realization of an etiological assessment, which must be all the more exhaustive as the hypertension is of high level and the child is young.

For the record, we must not let a hypertension in children linger: last week at the CHU, HTA in a 5-year-old child, we did a Doppler ultrasound in search of stenosis of the renal arteries: highlighting a mass suggestive of neuroblastoma that compressed the renal artery ..

As in adults, hypertension is a priori primary and it is necessary to leave a few months before making an etiological assessment.


Which of the following proposals concerning the hospital management of a polytrauma patient is (are) true?

False, the first 15 minutes are devoted to the continuation of the acts of resuscitation initiated in pre-hospital, the conditioning of the patient and the realization of the clinical examination. The bodyCT will only be performed in a 3rd step if the patient has been stabilized.

The first 15 minutes are dedicated to the realization of a bodyCT

False, everything must be done to fight against hypothermia, which is a contributing factor to bleeding disorders, among other things.

The patient must be put in hypothermia to protect him from brain damage

False, the nasal route is contraindicated in a patient who has suffered facial or head trauma because of the risk of false route, especially intracerebral in case of ethmoid fracture.

The possible placement of a gastric tube must be done nasally in the context of facial trauma

Diphtheria vaccination status should be checked

The 2nd phase of care is dedicated to the realization of the biological and radiological assessment


A 57-year-old patient comes to see you for a left epistaxis of low abundance

ATCD: Repeated MTEV
TTT: Fluindione The patient also explains that he has lost weight and feels tired for 4 months. He also says he has the feeling of an obstruction of his left nasal cavity.

What is the exact answer(s)?

FALSE: In front of an epistaxis on bleeding disorder or angiomatosis: we use ABSORBABLE wicks

It is necessary to carry out a previous stamping with greasy strands

Previous buffering with absorbable wicks must be performed

FALSE. The INR is within its target (between 2-3 in this VTE situation). We are not dealing with serious bleeding. So no need to stop the VKA

If the patient's INR is 2.6, VKAs should be stopped for 24 hours in this patient

True. In front of unilateral epistaxis + progressive nasal obstruction + AEG => Suspicion cancer ETHMOID and CAVUM

CAVUM cancer is also to be evoked in front of reflex otalgia or seromucosal otitis


Which of these health security agencies/health vigilance missions pairs is accurate?

True, the ANSM's mission is pharmacovigilance, drug dependence, hemovigilance, materiovigilance, reactovigilance, cosmetovigilance, vigilance of tattoo products

National Agency for the Safety of Medicines (ANSM) and Drug Dependence

True, the missions of ANSES are nutrivigilance (including NOCs), toxicovigilance (toxic effects of substances on the body) and veterinary pharmacovigilance

National Agency for Food, Environmental and Occupational Health and Safety (ANSES) and Nutrivigilance

False, the missions of the biomedicine agency focus on biovigilance (organs, tissues, cells), ART

Agency for Biomedicine and Haemovigilance

Agency for Biomedicine and Vigilance with regard to medically assisted procreation

National Agency for Food, Environmental and Occupational Health and Safety (ANSES) and Réactovigilance


False, we distinguish precisely degenerative dementias from dementias with a vascular, inflammatory mechanism etc.

Degenerative dementia may be due to vascular or inflammatory disease

True, impaired autonomy is essential to talk about dementia

Dementia is defined by impaired cognitive and/or behavioural function associated with impaired autonomy

Alzheimer's disease is the leading cause of dementia


Which of the following are possible pathological signs in UC?


Which of the following are true about neuroblastoma?

It is a cancer affecting embryonic stem cells of the neural crest

It may be associated with Hirschsprung's disease

Less than 2 years old. It is mainly found between 1 and 2 years

It mainly concerns children under 6 months

It is the most common extracranial solid tumor in young children

There are genetic forms (ALK or PHOX2B gene)


Which of the following are d'Amico's treatment options for intermediate-risk prostate cancers?

Low risk or if probability of survival < 10 years

Active surveillance if probability of survival > 10 years

True. + Cleaning if probability of survival > 10 years

True. Or in combination with hormone therapy for 6 months

True. In gormes of best prognosis (PSA 10-15, GG2 or Gleason 3+4)


Which of the following propositions/are true for biamniotic bichorial pregnancies?

There is an antenatal risk of transfusion-transfusion syndrome (TTS)

False, a twin pregnancy is a multiple pregnancy

The term multiple pregnancy only applies when the uterus contains 3 or more fetuses.


Constipation is chronic if greater than:


Which of the following are signs or symptoms of Korsakoff syndrome?


Which of the following are risk factors for hernia?


Regarding major neurocognitive disorders, what are the exact proposal(s)?

A. Wrong, three times wrong! The MMS is a screening examination, the repetition of the latter allows to have an intuition on the evolution of the pathology, certainly, but it is much more advanced neuropsychological tests that allow the diagnosis in addition to the interrogation and the elimination of differential diagnoses

Has. The repetition of MMS (Mini Mental State) makes it possible to make the diagnosis of a major neurocognitive disorder

B. True, it makes it possible to rule out an expansive pathology (hematoma, infection, tumor) and to characterize brain damage (hippocampal damage for Alzheimer's and its relatives etc ...)

B. MRI (or failing that, cCT) has an essential place in the evaluation of major neurocognitive disorders

C. Alzheimer's disease and vascular encephalopathies account for the majority of causes of major neurocognitive disorders

D. False, it is quite brief (NFS, CRP, TSH, Ionogram, Glycemia, Albuminemia) and the rest is performed on call point

D. First-line laboratory work-up is comprehensive to eliminate all possible differential diagnoses

E. True, HDJ memories are becoming more and more present, and allow active management of major neurocognitive disorders

E. For the management of major neurocognitive disorders, there are day hospital treatments to perform cognitive remediation


4 grades: no procidence / procidence in the lumen of the anuscope / reducible / irreducible external procidence


The nodule is non-painful according to the College of Urology (4th edition)


Which of the following propositions are true about biological examinations?

Normal apart from flare-ups or complications

High γGT and MCV support an alcoholic cause

Signs of inflammation are found during flare-ups

Lipasemia is elevated in acute pancreatitis


Which of the following propositions are true about MMR?

A morbidity and mortality review (MMR) is a collective, retrospective and systemic analysis of cases marked by the occurrence of a death, a complication, or an event that could have caused harm to the patient.

Its objective is to implement and monitor actions to improve patient care and care safety.

The systemic analysis, conducted during the MMR, is a global analysis of the situation

The medical-nursing team that brings together professionals, who usually work together, and who contribute to the management of a patient.


Which of the following propositions are true about the urinary ionogram?

A plasma urea/plasma creatinine ratio of less than 50 supports organic AKI

A urinary Na/K ratio greater than 1 is in favor of an organic ARI

A urinary Na/K ratio greater than 1 supports a functional ARI

This is the EF threshold for urea. The threshold for sodium is 1%

A sodium excretion fraction of less than 35% would be in favor of a functional origin

Natriuresis can only be interpreted if diuretics have not been put in place


About 1 third of adults are affected by hemorrhoids


In prostate cancer, the fraction of free PSA is lower than in benign prostatic hyperplasia

The actual contribution in clinical practice of urine tests has not been demonstrated

A high PSA must be almost systematically reassessed

The USP questionnaire focuses on sexuality

The IIEF questionnaire focuses on urinary symptoms


Which of these proposals designate a serious access to RCH?

True, severe acute colitis (Truelove-Witts criteria) can be complicated by: colectasia (dilation) and perforation

The Truelove-Witts criteria (💞) define the severe RCH crisis


Which of the following proposals are necessary to diagnose confusion?

True. Indeed, confusion is a clinical diagnosis.


Which of the following are true about shaken baby syndrome?

The CT scan is the exam of choice for the diagnosis of lesions

The absence of bleeding disorders should always be checked

They can also be cephalic, thoracic, ...


The flat-rate remuneration of physicians is paid by:


Regarding resistant hypertension, which of the following propositions are true?

Resistant hypertension = persistent on oral antihypertensive therapy (including at least one diuretic) + HRD well followed

It is defined by the persistence of hypertension despite well-followed hygiene-dietary rules.

It may be due to unknown secondary hypertension.

The patient's adherence to treatment can be assessed by the Girerd questionnaire.

It may be due to excessive consumption of dietary salt.

A cardiological opinion should be systematically requested in front of a resistant hypertension.


Which of the following are possible etiologies of cirrhosis?


Which of the following are symptoms or signs of Gayet-Wernicke encephalopathy?


An X neuroma could mimic lymphadenopathy:

Two differential diagnoses (DD): brachial plexus schwanoma or lung apex cancer

DD of lymphadenopathy concerning this chain: ectopic thyroid, cyst of the thyroglossal tract or laryngocele

2 schwannomas: that of the XI and that of the superficial cervical plexus


Which of the following are RHD treatments for hemorrhoidal disease?


Which of the following are etiologies of non-traumatic coma?


Which of the following are signs and symptoms of distal (intraparotid) facial nerve involvement?

No hearing impairment because we are downstream


From what time frame do we speak of prolonged diarrhea?


Which of the following are the side effects of amiodarone?


Which of the following are extra-digestive signs of celiac disease?


Which of the following proposals are part of the immediate management of postpartum haemorrhage?


Which of the following proposals can increase the PSA?


What time corresponds to the excretory time on the injected scanner?


Which of the following proposals are part of probabilistic antibiotic therapy for ulcerative-necrotizing enterocolitis?


Concerning the fractures of the child, which of the following propositions, which are true?

Ultrasound is rare in emergencies. It can be useful for soft tissue lesions

Orthopedic treatment++ in young children <6A, for any diaphyseal / metaphyseal FR (PAS for joint fractures: risk of stiffness)

For a metaphyseal fracture in a 5-year-old child, first-line treatment is orthopedic, with or without reduction

No risk of stiffness for non-articular fractures (see College of Pediatrics)

For a diaphyseal fracture, prolonged orthopedic treatment induces a risk of stiffness

In the opposite position of that which caused the fracture (for example, if wrist fracture in hyperextension: immobilization in flexion)

Concerning orthopedic treatment: the limb must be immobilized in a neutral position

Thromboembolic complications are exceptional in children. Anticoagulant therapy will be discussed only in adolescents

Anticoagulant therapy is indicated in children in case of cast for more than 21 days


Which of the following are causes of idiopathic ICT?

No, abnormal imaging therefore not idiopathic


Which of the following are true about Boerhaave syndrome?

True. They all concern Mallory Weiss syndrome


Which of the following are the risk factors for prolonged febrile seizures >15 minutes?

Personal history of Febrile Crisis > 10min


Which of the following proposals are included in the para-clinical assessment in case of suspected shaken baby syndrome?

True, differential diagnosis of bone lesions

True, looking for papillary edema and hemorrhages


Which of the following are true about migraines?

The opposite: more without aura than with aura

There are more migraines with aura than migraines without aura

Migraine is three times more common in women than in men


What are the mandatory clinical signs to be able to talk about the severe discomfort of the infant?

A change in tone (hypertonia or hypotonia)

Is not a mandatory clinical sign. It may nevertheless be present during severe discomfort.

True. The 2 obligatory clinical signs are a change in tone and a change in the coloration of the integuments. In the absence of one of these 2 clinical signs, we can not speak of the severe discomfort of the infant.

A change in the coloration of the integuments (pallor, cyanosis, sometimes erythrosis)

Not part of the criteria for severe infant discomfort.


Which of the following proposals are part of the supraglottic stage?


In cholitis, ERCP (endoscopic retrograde cholangiography) should be done:


What is Amico's classification of prostate cancer with a PSA of 15 ng/mL, a Gleason of 3+3 and a normal TR?

True. Low: T1C or T2a AND PSA <= 10 AND Gleason <= 6.  Intermediate: T2b OR 10 > PSA < 20 OR Gleason 7. High: T2c and sup OR PSA >= 20 OR Gleason >= 8


When was the Order of Physicians created in France?

Code of Ethics Revision Date (112 articles)

Date of creation of the Medical Association in Great Britain


Mrs. Clauss, panicked, brings you her 14-year-old son, Santa, who "can't stay awake during the day." She worries because his academic performance is declining and she is afraid he may suffer from sleeping sickness. By argument of frequency and in front of this case what are the 2 pathologies that you will suspect first?

False, even if it can stick in this patient, we find more this pathology in older women.

True, you should always think about eliminating cannabis poisoning.

True, caricature in the teenager who goes to bed late and gets up early. Highlighted by a sleep diary and treated by hygienic measures and melatonin.

False, night owlism does not cause daytime sleepiness


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

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

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

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

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

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

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


Which of the following are signs of hepatocellular insufficiency?


Which of the following are criteria for lumbar puncture during a febrile seizure in children?


Malaise and loss of consciousness account for about 60% of emergency room admissions

10 to 20% of syncopes are the expression of a life-threatening pathology in the short or medium term

The etiological diagnosis of malaise is primarily clinical

Capillary blood glucose and electrocardiogram are systematic

The search for orthostatic hypotension is systematic in patients over 35 years of age


What is the Amico classification of prostate cancer with a PSA of 8 ng/mL, a Gleason of 3+3 and a normal TR?


During treatment during pregnancy, the newborn may show signs of overdose at birth

During treatment during pregnancy, the newborn may show signs of withdrawal at birth

The pharmacist may substitute an originator by a generic of himself, unless otherwise stated

Its MA does not require new studies if the molecule is exactly the same.

A generic drug is subject to phase III studies before its marketing authorization

Adherence is one of the important parameters that determines the effectiveness of the treatments put in place


Orthopedic insoles are on medical prescription

Orthopedic insoles do not have an analgesic effect

Standard prostheses are << small appliances>>

Rheumatoid arthritis in flare-up is an indication for spa ♨ treatment

Upper limb prostheses often have a mainly aesthetic role


What time corresponds to the late time on the injected scanner?


Regarding the assessment to be carried out in front of an essential hypertension of grade 1, among the following additional examinations, which are to be carried out in first intention?

fundus if grade 2 or 3 hypertension or diabetic hypertensive patient

If cognitive impairment and/or neurological symptoms.


Regarding the classification of Salter and Harris. Which of the following are true?

True. Growth cartilage is radiolucent. A non-displaced Salter 1 detachment will only be identifiable on the location of the pain and on the thickening of the soft parts.

A non-displaced Salter 1 detachment is invisible on radiography

A Salter V corresponds to a lesion on the germinative layer of cartilage by axial trauma

A Salter II corresponds to a trait that passes through the growth cartilage and epiphysis

A Salter IV corresponds to a trait that passes through the growth cartilage, epiphysis and metaphysis

A Salter III corresponds to a trait that passes through the growth cartilage and metaphysis


Which of the following are scannographic signs of advanced chronic pancreatitis?


What is the definition of an infection of ascites fluid that is controlled?


Concerning centrotemporal peak epilepsy (CTEP) in children. Which of the following are true?

This syndrome includes 20% of childhood epilepsies

The EEG is classically in ample and diphasic waves, Centro temporal, calmed by sleep


Regarding the reduction criteria to be checked in a fracture of the lower end of the radius, which of the following propositions, which are true?

Front: a negative radio-ulnar index -2mm non-zero

Front: an anteversion of the radial glenoid

Front: Restoration of the bi-styloid line inclined 15° outwards

In profile: realignment of the cortical of the 2 radial fragments

Front: a negative radio-ulnar index -2mm or zero


What diseases are included in newborn screening?

True, first disease to look for by the blotting paper test (guthria test)

True, not included in the blotting paper test but is part of the screening at birth

True, is part of the blotting paper test, but is not systematic. Targeted according to parents' origins

True, hence the acoustic otoemission test to be done before discharge from maternity


How often is endobrachyoesophagus less than 3 centimetres monitored?

Control every year (2 times in the first year) if low-grade dysplasia


Which of the following are biomarkers that can be found disrupted in neuroblastoma?


An orthosis is a device that compensates for an absent or deficient function

A prosthesis is a device that compensates for an absent or deficient function


Which of the following propositions are true regarding decortication?


With regard to anaemia in children, what are the right proposals?

False, we judge his tolerance to effort classically during feedings.

It is impossible to talk about dyspnea of effort in an infant because he does not have physical activity

True, at birth the child has a high level of hemoglobin that drops sharply between 3 and 6 months to 9.5 g / dL as a low limit. From 6 months his Hb level increases little by little to reach the adult norm from 12 years

From 12 years old anemia is considered with adult norms

True, martial deficiencies of intake may be due to exclusive feeding of breast milk which is low in iron.

It is necessary to diversify food intake from 6 months


Which of the following are criteria for poor prognosis of localized forms? (Cancer Medline, Table 2, page 393, 2018 edition)


What are the indications for surgical management of a fracture of the child

Orthopedic treatment in 1° intention for any diaphyseal / metaphyseal fracture of children under 6 years of age

Femoral diaphyseal fracture in a 3-year-old child

At school age, surgical management is preferred for certain diaphyseal or epiphyseal fractures for a faster resumption of walking (lower limb) or writing (upper limb)

A fracture of the 2 bones of the forearm in an 8-year-old child

Yes, to avoid joint stiffness in case of immobilization

But surgical indication in the case of a pathological fracture (delayed healing in case of orthopedic treatment)

Orthopedic treatment would complicate nursing care, which is already cumbersome in these cases.


How many physicians must be present, at a minimum, for CPR:


Which of these diseases can be revealed by peripheral anemia?

True, it gives a central anemia by default of erythroblast production but also gives toxicity to red blood cells that can hemolyze with a reticulocyte response.

True, also Minkowski Chauffard disease, autosomal dominant disease. By a membrane defect, RBCs are sequestered in the spleen and hemolyze. Classically manifests itself as jaundice of the newborn.

True, it is a thrombotic microangiopathy that by definition gives consumption thrombocytopenia and mechanical hemolytic anemia.

True, it is an enzyme deficiency that gives hemolysis when exposed to an oxidative stressor: infection, bean ingestion, drugs such as quinine.


Which of the following proposals are acts/consultations for which it is not mandatory to go through the general practitioner to be reimbursed?

Psychiatric consultation, up to 25 years

Mammography as part of organized screening


Which of the following are functions performed by the facial VII nerve?

Motor innervation of the skin muscles of the face

Motor innervation of the stapedial muscle

Innervation of the lacrimal and submandibular glands

Sensory innervation of the Ramsey-Hunt area

Sensory innervation of the anterior 2/3 of the tongue


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

A 1st degree burn is only painful erythema

A 2nd degree burn is only a dolourous erythema

Phlyctenes and epidermal detachment are present in 2nd and 3rd degree burns

Discoloration with vitropressure disappears in the 3rd degree

True, in addition the appendages no longer adhere

A 3rd degree burn is sluggish, dry, cardboard, insensitive and painless


In which diseases can Rheumatoid Factor (RF) be found?


Which of the following are true for the treatment of mild esophagitis?


Which of the following propositions concerning polytrauma are true?

A severely traumatized person is a trauma patient whose violence or mechanism of trauma can result in life-threatening injuries.

Injuries are the second leading cause of death among young people under 40

A defect in orientation of a polytrauma patient requiring secondary transfer to a specialized center is associated with excess mortality

Vittel's algorithm can be used to define a severe trauma patient and direct it to a structure adapted to its condition

False, the Glasgow score assesses the severity of head injury. It can be used from the pre-hospital phase

The Glasgow score is not usable in the context of polytrauma


Which of the following proposals are more oriented towards Crohn's disease rather than ulcerative colitis?

True, typical (but not constant) in crohn's

Gigantocellullar granulomas without caseous necrosis


Which of the following proposals are part of the initial additional assessment in case of suspected acute postpartum endometritis?

Vaginal sampling for bacteriological purposes


Which of the following propositions are true regarding UC?

MRI is the exam of choice for a positive diagnosis

Sclerosing cholangitis is a common association


Which of the following are etiologies of gigantoepithelioid granuloma without caseous necrosis?

True, it is very common not to find caseous necrosis in tuberculosis. But it must also be remembered that this pathology gives caseous necrosis


Which of the following propositions are true regarding prophylaxis in a splecnectomized?

Vaccination is combined with antibiotic prophylaxis with oral penicillin. It is generally recommended until adolescence in children and for one or two years in children.
the adult.

It is based on oral penicillins and vaccination

Oral penicillin is to be taken for 3 months in adults

Oral penicillin is usually to be taken until adolescence in children


Which of the following are causes of malabsorption diarrhea?


Which of the following proposals favor peripheral nystagmus?

No change of meaning depending on the look


Which of the following are true about tularemia?

Tularemia is caused by Francisella tularensis

Cervical lymphadenopathy most often (especially in hunters)

Fluoroquinolones as a first-line treatment

It is treated with C3G IM monodose in first line


Sudden infant death syndrome (SIDS) is an unexpected infant death (MIN) with no etiology found despite extensive investigations.

Unexpected infant death (MIN) is sudden infant death syndrome (SIDS) with no etiology found despite exhaustive investigations.

Sudden infant death syndrome accounts for 6% of infant mortality.

Unexpected infant death is defined as a sudden death in a child under 2 years of age, when nothing in its known history could have predicted it.

Unexpected infant death is defined as a sudden death in a child under 3 years of age, when nothing in his known history could have predicted it.

Abuse, acute dehydration and bedding accidents are among the most common etiologies of MIN.

The male sex of the infant, a young mother and the winter period are risk factors for sudden infant death syndrome (SIDS).

The male sex of the infant, the old age of the mother and the summer period are risk factors for sudden infant death syndrome (SIDS).


Which of the following are complications of centromedullary nail osteosynthesis?

displacement (scanning) of the cervical screw

Aseptic osteonecrosis of the femoral head


Which of the following are complications of repeated vomiting?


What elements are part of the C.A.M. classification useful in detecting and reassessing confusion?

True, confusion can settle in a few minutes, hours or days and we are talking about a break with the previous state

Wrong, having a major neurocognitive disorder is different from being confused, certainly, but you can have both!

Absence of major neurocognitive disorder

False, they are not part of the C.A.M. classification.

True, this very item is used very often in emergencies to detect confusion

Temporo-spatial disorganization and thought and language

True, remember that a confusion is equal to a Glasgow at 14!


The only clearly established exogenous risk factor for pancreatic adenocarcinoma is tobacco

The only clearly established exogenous risk factor for pancreatic adenocarcinoma is alcohol

Obesity is a risk factor as it is for many other cancers

The existence of an affected first-degree relative and tobacco use increase the risk of developing pancreatic adenocarcinoma by 5

Pancreatic conditions predisposing to an endogenous risk of pancreatic cancer are diabetes and chronic alcoholic pancreatitis in particular


Which of the following are factors in poor prognosis for idiopathic (or frigore) paralysis?

Poor prognosis factor = quick installation


Which practitioners can set up in sector 2?

Part-time hospital practitioners after 3 years


Which of the following are relevant tips for the management of irritable bowel syndrome?

Anti-diarrheals may have their place depending on the type of IBS


Which of the following are modifiable cardiovascular risk factors?

Age, sex and heredity are non-modifiable risk factors


What is the most common infectious entry point in case of septic shock?


False. This is invasive carcinoma of nonspecific type (or invasive ductal carcinoma or invasive ductal adenocarcinoma)

The most common type of cancer is invasive lobular carcinoma

Screening is routine for all women who are asymptomatic or without risk factors for BRCA1/2 between 45 and 75 years of age

The most common metastatic sites are the bone, lungs and liver.

False. It is a humanized antibody (-zumab). The suffix -mumab means that the monoclonal antibody is human.

Trastuzumab is a human monoclonal antibody targeting HER2


Which of the following are signs of peripheral facial paralysis?


Regarding level II analgesics, what are the exact proposal(s)?

False, nefopam (or ACUPAN) is not a level II analgesic, but a co-analgesic.

Level II analgesics include codeine, tramadol and nefopam among others

True, the very definition of level II analgesics being "weak opioids".

False, three times false. This is a mistake that is unfortunately very common, because even if the combinations of level 1 and level 2, specialties such as Lamaline or Izalgi are ALREADY a combination of opium powder and Paracetamol (+/- caffeine). Prescribing these specialties with Paracetamol leads to an overload of Paracetamol harmful to the liver.

It is not forbidden to prescribe combinations of level I and II together, such as Paracetamol + Lamaline or Paracetamol + Izalgi

True, this is THE drug contraindication of tramadol

False, it is with level III analgesics (strong opioids). For level analgesics it is according to the symptoms

The prescription of a laxative is systematic with opioid analgesics of level II


Which of the following proposals should be sought primarily in case of Turner syndrome?


Which of the following propositions regarding compartment syndrome is true?

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

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

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

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

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

A discharge aponeurotomy is indicated within 6 hours

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

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

Volkmann syndrome is responsible for a claw deformity of the hand


Which of the following are compatible with cirrhosis?


Regarding endometrioma. Which of the following are true?

True. Endometrioma is ovarian endometriosis. See HAS 2017 recommendations.

Pelvic ultrasound and pelvic MRI have similar performance for the diagnosis of endometriosis

If endometriosis is diagnosed, it is necessary to look for associated deep endometriosis

The diagnosis of endometrioma should be made with caution after menopause so as not to ignore a malignant tumor

False. Not at all. Endometrioma = ovarian endometriosis. Adenomyosis is the presence of endometrial cells in the myometrium.

Endometrioma is synonymous with adenomyosis


Which of the following propositions are true about the MIN, when the doctor arrives at home?

Resuscitation maneuvers will be interrupted within a reasonable time in the absence of resumption of cardiac activity

The doctor may propose to the parents, if they wish, to be present during the resuscitation

If resuscitation maneuvers are undertaken, parents must leave the room

In the presence of the parents if they wish, it is recommended that the deceased child be completely stripped naked to be examined

Intervention sheet + Examination of the child (as early as possible)

No post-mortem gesture should be performed at home

The child's body must be transported to an MIN reference centre


Which of the following are enzymes that sign cholestasis?


What is Amico's classification of prostate cancer with a PSA of 18 ng/mL, a Gleason of 3+5 and a normal TR?

True. Low: T1C or T2a AND PSA <= 10 AND Gleason <= 6.  Intermediate: T2b OR 10 > PSA < 20 OR Gleason 7. High: T2c and sup OR PSA >= 20 OR Gleason >= 8


Which of the following proposals are additional examinations to be carried out systematically upon discovery of hepatomegaly?


With regard to sexual violence, which of these proposals are true?

16% of women say they have been raped or attempted rape in their lifetime

True, DNA being fragile, it is necessary to take samples urgently to detect the presence of DNA to identify the aggressor

A rape of less than 72 hours is a therapeutic emergency

False, the lubricant may destroy the DNA or semen elements present in the vagina and thus "contaminate" the samples

The clinical examination is done with caution, with a lubricated speculum

False, the presence of toxic is made only if an element of the anamnesis or clinical examination indicates that there has been a possible consumption of toxics

Among the samples systematically taken, we will look for STIs, the presence of pregnancy and the presence of toxic

True, as well as the medical certificate that will be given to the patient or to the authorities in case of requisition

Conventionally, among the documents given to the patient in case of rape there will be a prescription for emergency contraception, a prescription for preventive antibiotic therapy and a work stoppage


From what time frame do we talk about chronic diarrhea?


Which of the following are signs of hepatic encephalopathy?

Insomnia at night, hypersomnia during the day


Which of the following propositions are true with regard to febrile seizures?

A generalized febrile attack of 16 minutes with a fever at 41 ° C, in a child of 3 years without post-critical deficit, without particular history, with a normal neurological examination requires a lumbar puncture.

A generalized febrile attack of 2 minutes with a fever at 38.5 ° C, in a child of 3 months without post-critical deficit, without any particular history, with a normal neurological examination requires a lumbar puncture.

A generalized febrile attack of 2 minutes with a fever at 38.5 ° C, in a child of 3 months without post-critical deficit, without particular history, with a normal neurological examination requires monitoring of 4 hours in hospital.

A febrile seizure with a focal onset of 22 minutes with a fever at 38.5 ° C, in a child of 3 years without post-critical deficit, without particular history, with a normal neurological examination requires the introduction of a background epileptic treatment.


Which of the following are true for the treatment of severe esophagitis?


Which of the following proposals are among the risk situations where screening for HCV infection is recommended?


A generic must have a qualitative composition in active substance equivalent to that of the originator medicinal product

A generic must have a quantitative active substance composition equivalent to that of the originator medicinal product

Same scientific name but trade name (trademark) protected by intellectual property

A generic can have the same trade name as the originator drug

A generic may be offered by the pharmacist instead of an originator drug

A generic has excipients exactly identical to the originator drug


Which of the following proposals regarding breast cancer is true?

True. Extension assessment to be carried out if invasive cancer T3/T4 or N+

Extension assessment is indicated in case of invasive ductal carcinoma stage T3

True. The extension assessment is based on: TAP CT + bone scintigraphy OR PET-CT. Chest X-ray + abdo echo + bone scintigraphy is no longer done today (reason why it has disappeared from some referentials)

The extension assessment can be based on the couple CT-TAP + bone scintigraphy

True since the tumor is at the T2N0Mx stage. So no need a priori for an extension assessment if we stick to the recommendations of the reference system

A patient with invasive ductal carcinoma of 3 cm on mammogram without lymph node involvement will not need an extension workup (a priori)

FALSE, archi false!! The risk of lymphedema of the upper limb is major if we do this! This is a contraindication. For information, upper limb lymphedema and its management fell at the 2021 national white competition

In case of axillary dissection, radiotherapy of the axillary hollow will be performed in addition

TRUE:
- Before menopause: anti-estrogens
- After menopause: anti-aromatase

Discriminating notion: It is said in the course that anti-estrogens are responsible for endometrial cancers while they have a beneficial action on breast cancer...

This is because they act:
- on receptors in the breast as inhibitors to the action of estrogen = rotector role against cancer

- on endometrial receptors as ACTIVATORS to the action of estrogen = pro-oncogenic

The hormone therapy of choice after menopause are anti-aromatase


At what stage of the Hinchey classification is surgery mandatory?

Radiological drainage possible (if >3-5 cm depending on the source)


Outside the care pathway, what percentage of the tariff is covered by social security (excluding exceptions such as emergencies)?

This is the case when it is in the care pathway


Regarding vaccination in pregnant women. Which vaccine(s) are not recommended during pregnancy?

True. It is not a live vaccine so it is not contraindicated during pregnancy, but it is not recommended to vaccinate pregnant women in France. On the other hand, it is desirable to vaccinate women before or after childbirth.

True. It is a live vaccine and therefore contraindicated in pregnant women. On the other hand, it is recommended to vaccinate all women with rubella-negative serology pre-conceptional. Women who have received 2 prior vaccinations should not be vaccinated, regardless of the result of serology if it is performed. Due to the teratogenic risk, it is necessary to ensure the absence of an early pregnancy and to avoid any pregnancy within 2 months of vaccination.

True. It is a live vaccine with a teratogenic risk. Women of childbearing age who have no history of chickenpox should be vaccinated. Vaccination is possible if the pregnancy test is negative. Effective contraception for 3 months is recommended after each dose of vaccine.

The flu vaccine is recommended for pregnant women because pregnant women are a population at risk of severe influenza (fetal death and maternal death, refractory hypoxemia, etc.).

True. It is a live vaccine, therefore teratogenic.


Which of the following are differential diagnoses (DD) of right supraclavicular lymphadenopathy?

It would give lymphadenopathy of the submandibular chain

Not a DD but a sign + lymphadenopathy would be on the left

It would give pre-laryngeal lymphadenopathy


How many years should a medical record be kept after a person's death?


Which of the following signs indicate the severity of aortic insufficiency?

FALSE: The breath of aortic insufficiency is HOLODIASTOLIC decrescendo. The ejective systolic murmur is not a sign of severity but an added noise that can be heard in the IAo

FALSE: Abolition of B2 is a criterion of severity of aortic stricture

True. In total, the signs of severity of aortic insufficiency are: - apexian flint rolling (= functional mitral narrowing) - protodiastolic gallop (B3) - enlargement of the peak shock - the regurgitated volume > 60 mL at ETT


True, MisMatch Repair -> we can no longer repair errors😥

The gene is caused is part of the MMR system

The risk of developing colorectal cancer is 70 to 80% over the course of a lifetime.


Which of the following are true about Meld's score?


How many years should a medical record of a minor patient be kept?

10 years after reaching the age of majority


Which of the following is an additional examination(s) to be performed to confirm diverticulitis?

True, cornerstone of diagnosis. We see diverticula, a colonic wall > 4mm, and fatty infiltration

Transaminases are useless. A NFS-P CRP (for PNN hyperleuco and biological inflammatory syndrome) Creatinine (before angioscan) is done. In women of childbearing age who do not have well-followed contraception, it is thought to ask for DDR +/- b-HCG 🙃

Don't go too far ahead on confirming diverticulitis 😬


Which of the following are true about peripheral facial paralysis?

There is no automatic-voluntary dissociation

It concerns damage to the facial nerve VII

There is a frank automatic-voluntary dissociation

The motor deficit concerns only the lower part of the face


Which of the following are treatments for acute cholecystitis?


Which of the following is the main precursor of cutaneous squamous cell carcinomas?

It is the main precursor of mucosal squamous cell carcinomas

Bright red erythematous lesion of the glans, well
limited, sometimes discreetly erosive -> it is carcinoma in situ

Benign epithelial tumor without malignant potential


Which of the following are tumours with a risk factor for sun exposure?

True, short sun exposure, no precancerous lesion, clear phenotype

True, chronic and prolonged sun exposure


Which of the following propositions are true about brachytherapy?

It is a permanent implantation of iodine-125 grains perineally under ultrasound control

As well as two subgroups of intermediate risks: PSA between 10 and 15 and/or presence of minority grade 4 (GG2)

It concerns the low-risk group of Amico exclusively

It is contraindicated if the prostate is more than 60 mL

This is the standard treatment option with the lowest risk of leading to erectile dysfunction.

The risk of erectile dysfunction is maximum


Which of the following are PSRs for treating physicians?


Which of the following proposals are shocks with decreased cardiac output?

True, DC = LVEF x FC. Decrease in LVEF in hypovolemic shock

True, DC = LVEF x FC. Decreased HR in cardiogenic shock


False, renin is the enzyme that cleaves angiotensinogen into angiotensin I. Angiotensinogen is of hepatic origin. Renin is of renal origin

Renin is responsible for the secretion of angiotensinogens that will be metabolized to give angiotensin I

True, renin is secreted in response to sympathetic nervous system stimulation, hypovolemia or increased natriuresis

Autonomic neuropathy may decrease renin secretion

False, angiotensin vasoconstrict large vessels as well as efferent arterioles of the glomeruli

Angiotensin II is a powerful vasodilator

True, angiotensin II stimulates vasoconstriction as well as adrenal aldosterone secretion

Angiotensin stimulates the secretion of aldosterone


Which of the following are causes of dilated cardiomyopathies?


How many health professionals are there in France approximately?

This is the approximate number of doctors


What is the estimated survival of 1 year for Child Pugh A?


Regarding infant epilepsy. Which of the following are true?

A fall of the head with elevation of the arms must evoke West Syndrome.

False: infantile spasms of West syndrome are to be distinguished from myoclonus

Myoclonus in flexion should evoke West Syndrome.

Psychomotor regression or stagnation of acquisitions associated with MRI hypsarrhythmia should suggest West Syndrome.

Dravet syndrome is rare, and usually gives an intellectual disability

Dravet syndrome is resistant to treatment


Traumatology is the leading cause of death between the ages of 1 and 19 years

Cancers are the leading cause of death between the ages of 1 and 19

Before two years any trauma with invoice must always evoke abuse

Solitary bone cyst is a cause of pathological fracture

The ligament structures of the child are more resistant than the metaphyses

True sprains and isolated dislocations are more common than fractures


Which of the following proposals reduces the risk of hyaline membrane disease in premature infants?


Regarding the abnormalities of the menstrual cycle which of these propositions are true?

Wrong, it's the other way around. In addition, the terms oligomenorrhea and spaniomenorrhea are synonymous.

Hypomenorrhea are too infrequent, while oligomenorrhea are too low periods

True, this is what corresponds to the rating of the Higham score which must be >100 to talk about menorrhagia

To assess the abundance of gynaecological bleeding at the interrogation it is necessary to ask the number of protections used as well as the amount of blood on them.

True, hence the adage "every woman of childbearing age is pregnant until proven otherwise"

Pregnancy should be systematically considered and ruled out by a BHCG assay

False, in front of bleeding and a positive pregnancy test, the first cause to eliminate is ectopic pregnancy.

Bleeding associated with a positive BHCG assay should eliminate a spontaneous miscarriage as a first line

True, but also adenomyosis, bleeding disorders etc...

Causes of menometrorrhagia include fibroids, myomas or endometrial cancers.


Which of the following proposals regarding the hospital management of a polytraumatized patient are true?

The biological assessment of a polytrauma patient necessarily contains the grouping and search for RAI

Transcranial Doppler looks for cerebral hypoperfusion in the anterior communicating artery.

False, FAST is a rapid abdominal, pleural and cardiac ultrasound.

FAST ultrasound verifies the integrity of the vascular axes of the 4 limbs

False, the whole body scanner is performed in 2nd step, without, then with injection of iodinated contrast medium.

The BodyCT, performed during the 3rd phase of management as part of the lesion assessment, is a whole body scanner without injection.

The thoracic part of the bodyCT allows among other things to find the 10-20% of pneumothorax that are not visible on the standard X-ray


Which of the following proposals designate oncogenic viruses?


Which of the following are the following proposals for a normal umbilical cord?


From a certain volume (2L or 5L depending on the source)

It is done regardless of the volume of ascites punctured

1 L of ascites corresponds to 20 g of albumin

It is only below a certain blood pressure threshold


Which of the following are causes of osmotic diarrhea (by attraction of water into the intestinal lumen)?


NIMs would occur more frequently when the socio-economic conditions of the family are unfavourable.

NIMs would occur more frequently when the socio-economic conditions of the family are favourable.

Co-sleeping (the fact that the infant sleeps in the same bed as the parents) is a risk factor for MIN.

To avoid unexpected infant death, co-sleeping should be encouraged.

Unexpected infant death most often occurs in infants between 2 and 4 months of age

In France, approximately 500 infants under 2 years of age die unexpectedly annually

To prevent unexpected infant death, the temperature of the chamber should be maintained at 24ºC.


What is the main etiology of chronic calcifying pancreatitis in developed countries?


Which of the following are signs of facial paralysis?

No ptosis but, on the contrary, a difficulty in closing the eye


Which of the following are true about abiraterone acetate?

It is contraindicated in case of treatment-refractory hypertension

The appearance of oedema should be monitored

The toxicity of prednisone 10mg/day should be monitored

Concomitant corticosteroid therapy is too low to require monitoring


What is the proportion of asymptomatic cholelithiasis?


Bilirubin is a breakdown product of platelets

True, upstream of the liver so unconjugated

Hemolysis is a possible etiology of unconjugated bilirubin jaundice

Gilbert's disease is inherited autosomal recessive

A normal billirubine is below about 20 millimoles


What is the prevalence of pregnant women not immune to toxoplasmosis?


Which of the following are true about corneal transplantation?

Existing and mandatory national waiting list

Unlike other types of transplants, there is no national waiting list for corneal transplantation.

The eye stays in place, we just scalp the cornea

It consists, in the donor, in removing the eyeball

No impact of age or abnormalities of refraction

The transplant success rate is high (>80%)

Hepatitis infection is a contraindication to corneal sampling


Which of the following propositions are true regarding uterine rupture?

True. Text the explanatory sentence of the msd manual: https://www.msdmanuals.com/fr/professional/gyn%C3%A9cologie-et-obst%C3%A9trique/anomalies-et-complications-du-travail-et-de-accouchement/rupture-ut%C3%A9rine

Uterine rupture is a spontaneous tear of the uterus that can cause the fetus to expel into the peritoneal cavity.

We think about it especially in case of history of caesarean section

It is an absolute emergency, putting the child's ⚡ prognosis at stake

The vital prognosis of the fetus is not at risk in the short term

sudden acute pain, uterine deformity, red blood metrorrhagia (arterial) 🔴

We find the triad: chronic pain gradually ascending, uterine deformity, metrorrhagia of blackish ⚫ blood

Fetal heart rhythm abnormalities are almost always found


Which of the following are systematic additional reviews for INM? (based on HAS, 2009)

X-ray of the spine from the front and profile


How often is endobrachyoesophageal monitoring longer than 6 centimeters?


Which of the following proposals is (are) a marker(s) of organ-specific autoimmune diseases?

True, autoimmune diseases of the intestine

Anti-cytoplasmic antibodies of neutrophils

Anti-mitochondrial antibodies of type M2


What is the examination to request in first line in case of suspicion of non-traumatic subarachnoid hemorrhage?

False, IC if signs of commitment or ICH (common in case of subarachnoid hemorrhage)


Which of the following propositions are true about transfusion-transfusion syndrome (TTS)?

It is also known as feto-fetal transfusion syndrome

True, 60-100% in severe cases (wikipedia)

It concerns monochorionic twin pregnancies

It appears in the first half of pregnancy


True. The onset of puberty is defined in girls by the appearance of breasts that occurs physiologically between 8 and 13 years of age.

The onset of puberty is defined by the appearance of breasts (thelarche).

The onset of puberty in boys is defined by the increase in testicular volume (volume > 4ml) observed between 9 and 14 years.

The onset of puberty in boys is defined by an increase in the size of the penis.

Voice molting in boys usually occurs between the ages of 14 and 15.

True On side in SX/GX-PX Sometimes you can see AX that corresponds to the development of axillary pillosity that we also side in practice?

The Tanner classification is used to assess an individual's pubertal development.

FALSE. There is no stage 0 in the Tanner classification. The absence of breast development corresponds to S1.

In the Tanner classification, S0 corresponds to the absence of breast development.


What is the amount of the medical deductible in the general case for a consultation with a doctor?


Asthma is often associated with allergic rhinitis

Asthma is responsible for about 1000 deaths per month

Asthma results from an interaction between genes and the environment


Adherence is often better in chronic pathologies than in acute pathologies

Adherence is often better in acute pathologies than in chronic pathologies

Lack of adherence can cause treatment failure

Adherence can be improved by simplifying medication intake

Generics can help reduce healthcare costs


True, flat-rate contribution = deductible (it's the same thing)

It corresponds to the co-payment + flat-rate participation

It corresponds to the flat-rate contribution + medical deductible


Regarding infant epilepsy. Which of the following are true?

Perinatal asphyxia is an etiology of West Syndrome, and gives it a poor prognosis

Bourneville's tuberous sclerosis, which gives brown spots, is a poor prognosis in West Syndrome

In 15% of cases, there is no underlying cause of West syndrome: it is therefore idiopathic

West syndrome is a therapeutic emergency: the appropriate treatment is often vingabatine

The EEG characteristic of a West Syndrome gives continuous slow waves, diffuse multifocal peaks, synchronous amplitude, without background activity


Which of the following are the causes of secondary constipation?


Which of the following proposals make it possible to assess the general condition of the patient?


Which of the following are clinical signs of hemorrhoidal thrombosis?


You are a pediatric intern and the baby in front of you is in pain. What are the analgesic means you can use in this baby?

FALSE. The MEOPA has the MA from 1 month

FALSE. The WMA says that EMLA patches are only possible in a full-term child. Even if in practice it can be prescribed off-label, for the ECNi we must stay on the rules of the CNG which say that we MUST stay on the MA

EMLA patch in premature infants possible according to the MA

FALSE. Sugar solutions up to 6 months MAXIMUM!

Sugar solutions if it is a 9-month-old infant

True. Not exceeding 60 mg/kg/24h [or even 30 mg/kg/24h in the < 1 year or < 10 kg] when taken PO


Which of the following are known carcinogens?


Which of the following proposals should be sought primarily in case of Di-Georges Syndrome?


Training to use equipment is part of what is called <<rehabilitation>>

The integration of the equipment into daily life is part of what is called << rehabilitation>>

Not all of course (reading glasses for example)

All devices require a medical prescription

Most equipment requires monitoring and follow-up


Uncomplicated diverticulitis is, according to Hinchey's classification, stage:

Purulent generalized peritonitis ( ➡ surgery)