Which of the following propositions are true with respect to the interim placement order?

True, or by the public prosecutor in case of emergency

It may be pronounced, in urgent cases, by the public prosecutor.

It has an initial validity period of 7 days

Parents lose parental authority for the duration of the OPP


Which of the following proposals are part of the first-line biological assessment in case of pruritus sine materia?

Beta-HCG in women of childbearing potential


Which of the following is a non-spherical ametropia?


Which of the following are organs whose cancers are associated with Lynch syndrome?


An MRI finds an endometrial tumor limited to the uterus, invading no neighborhood structure, infiltrating more than 50% of the myometrium. No lymphadenopathy is visualized

What is the FIGO classification at this stage?

True, stage I because limited to the body of the uterus. Stage Ib because invades >50% of the myometrium


Which of the following proposals is part of the endometrial cancer extension assessment? (except stage III FIGO or histological type II lesion)

True, systematic and necessary for FIGO classification (invasion of the cervix [stage II]? serous or appendages [stage IIIa? of the vagina [stage IIIb]? etc.)


Which of the following proposals corresponds to the type(s) of cancer for which follow-up by CTS may be useful?

True. In the College of Gynecology, the only place where SCC (Squamous Cell Carcinoma) is cited is for the follow-up of squamous cell carcinomas of the cervix.


Which of the following are risk factors for endometrial cancer?

Hormone-dependent cancer, so the more hormone, the more risk there is (so early puberty, late menopause, hormonal treatments)


Heart cells do not renew, or very little. Therefore, there is almost no heart 😊 cancer


Which of the following are indications for colposcopy?

Cytological abnormalities suggestive of low-grade neoplasia on the smear

Cytological abnormalities suggestive of high-grade neoplasia on the smear

AUC-H cytological abnormalities on smear

AUC-US cytology abnormalities on smear without HPV test results

AGC-like cytological abnormalities (ganglion cell atypia) on smear with negative HPV test


Which of the following proposals corresponds to the FIGO stage of invasive endometrioid adenocarcinoma limited to <50% of the endometrium?


A 60-year-old woman comes to your office. She has no family or personal history of cancer. What cancers should she have been screening for until now?

True, screening organized between 50 and 74 years, with a bilateral mammogram with two incidences and double reading, every two years

True, immunological test (hemocult) every two years between 50 and 74 years

True, smear between 25 and 65 years every three years (after 2 normal smears 1 year apart)


True, invasion of the serosa, vagina or pelvic nodes.

This is the case of 4A. 4B = distant metastases

Stage 4B corresponds to rectal metastases

Stage 0 corresponds to a lack of anapath result

Stage 3C2 corresponds to an extension to the lumboaortic nodes

1A = <50% of the myometrium. 1B = >50% of myometrium

Stage 1A corresponds to carcinoma limited to more than 50% of the body


Which of the following proposals for squamous cell carcinoma of the cervix are true?

It develops at the expense of the ectocervix

It develops at the expense of the endocervix

CIN1 corresponds to low-grade intraepithelial neoplasia

CIN3 corresponds to high-grade intraepithelial neoplasia


History of hormone replacement therapy for menopause


Which of the following are true about cancer of the body of the uterus?

The most common histological type is squamous cell carcinoma

The most common symptom is metrorrhagia in postmenopausal women

The endometrium is thickened on intravaginal ultrasound


Regarding the FIGO classification for uterine fibroids. Which of the following are true?

True. It is fibroids that are most at risk of causing bleeding and long-term iron deficiency anemia.

FIGO fibroids 0 to 2 are at risk of causing iron deficiency anemia

False. FIGO 7 is a pedunculated subserous fibroid

FIGO 7 corresponds to a non-pedunculated subserous fibroid

False. This is FIGO 6. The FIGO 5 is a fibroid with more than 50% intramural

FIGO 5: subserous fibroid with less than 50% intramural

FIGO 1: submucosal fibroid with less than 50% intramural


Which of the following are true about colposcopy?

Local anesthesia is sufficient. But if the patient asks for GA, it is possible

True. Page 213 of the College of Gynecology (4th edition)

It requires a binocular 🔎 magnifying glass

The filter is green 🟢 (sorry for the trap 🙏)

The yellow 🟡 filter can be used for vessel observation

It is after the application of the acetic acid solution that the cylindrical-squamous junction can be spotted


At what age should the first cervico-uterine smear be offered?


Which of the following are true about cervical cancer?

Squamous cell carcinoma is the most common pathological expression

The glands are on the endocervix, so adenocarcinoma concerns the endocervix.

The endocervix consists of a squamous epithelium

FIGO III stage has a prognosis of 60% survival at 5 years

The incidence of cervical cancer is down slightly in France


Which of the following corresponds to the FIGO stage of invasive endocervix carcinoma limited to the cervix?

Intraepithelial (carcinoma is invasive here)

Involvement of the vagina (except lower 1/3 -> stage 3) or a parameter

Involvement of the lower 1/3 of the vagina or kidney


Which of the following propositions are true about the FIGO stage of endometrial cancers?

Loco-regional extension: serous (A), vagina (B), pelvic nodes (C1), or lumboarotic nodes (C2)


True, so it must be done outside of menstrual periods

The cervico-uterine smear is not interpretable during menstruation

Vaccines do not target all strains (only oncogenic ones)

A well-conducted vaccination against HPV prevents contamination by the virus


A smear that finds atypical glandular cells (AGC) does not require a colposcopy to be performed immediately

An irregular red collar on colposcopy is suspicious

Possible in case of low-grade dysplasia (LIEBG) but not in ISA

Withholding from surveillance is possible for adenocarcinoma in situ (AIS)

It is mainly found at the endocol-exocervix junction (transformation zone)

The HPV virus is exclusively found in the deep endocervix

It is recommended in humans since the new reco HAS

HPV vaccination is not recommended in humans


Which of the following proposals are part of the mandible retro-dental sector?

Dentate sector. There are some great diagrams here: http://s3.e-monsite.com/2011/02/15/18671683osteologie-cranio-faciale-mandibule-pdf.pdf


Which of the following proposals are part of the dentate sector of the mandible?

True, mandibular arch = symphysis and horizontal branch (parasymphysis)

Retro-dental sector. Super Pattern of Death Kills: http://s3.e-monsite.com/2011/02/15/18671683osteologie-cranio-faciale-mandibule-pdf.pdf


Which of the following proposals are secondary brain aggressions of systemic origin (ACSOS)?

Secondary brain aggression of neurological origin

True. Anemia results in a decrease in oxygen transport to the cerebral parenchyma and is therefore deleterious

True. By decreasing cerebral blood flow, low blood pressure weakens the brain cells included in the ischemic penumbra (= the cells that can still be saved)

True. Hyperthermia is associated with increased brain metabolism


True. We will try to evaluate the degree of autonomy of patients thanks to the PARKER score (yes/no walk (3 pts), with or without technical aid (3 pts), home/outdoor/shopping (1/2/3 pts) for a maximum of 9 points in autonomous patients)


⏰ An open fracture must be managed surgically in the ...


You place your patient in the supine position, knee in flexion. You find pain in axial compression of the knee associated with rotational movements. What is this maneuver?

True. This test is a sign of internal meniscopathy if the pain appears in external rotation. Conversely if the pain appears in internal rotation


We don't really know what to put as other proposals 😕


What is the usual management of a trochanteric fracture? 🤔

The goal is to provide podal support as quickly as possible 🚶 ♀🚶 ♂

False, indicated in cervical fractures (depending on the age and condition of the patient)


This is the case with cervical fractures. The posterior circumflex artery is injured in femoral neck fractures, justifying the placement of a total hip replacement (in patients aged + 60 years).

They are at risk of aseptic osteonecrosis of the femoral 😲 head

Most often: reduction + osteosynthesis. Orthopedic treatment is a waiting treatment (except CI at surgery)


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

This is the case of the Pauwels classification (stability / risk of pseudarthrosis of the fracture). There are 4 in the Garden

It is applicable to all fractures of the femur

It is used to predict the survival of the femoral head

It takes into account the displacement of fractured bones


Which of the following is the normal version of the radial glenoid?


Concerning psychotherapies, which of the following propositions are true?

True, a psychotherapist refers to a psychiatrist, psychologist or someone with necessary training in the field (rarer)

False, it is by far supportive psychotherapy (think of the number of people who consult a psychologist for an unfortunate life event...)

The most practiced psychotherapy in France is T.C.C (Cognitive Behavioral Therapy)

False, she still has some (anxiety disorders, depressive disorders), but often she is preferred the TCC

Analytical psychotherapy no longer has an indication in France

True, it is THE therapy to favor in front of anxiety disorders (OCD, panic disorders, phobias ....)

Cognitive behavioral therapy is very useful and effective on the management of anxiety disorders

False, we must not confuse the "defusing" which is a brief management, directly in post-traumatic, of an EMDR which is a longer-term and often distant management of the trauma

EMDR is a psychotherapy called "defusing", allowing to take charge in direct post-traumatic, the psychic consequences of a traumatic event


Regarding eating disorders, which of the following propositions, are true?

False, it is by far the rarest eating disorder among the 3 main ones (binge eating disorder > bulimia > anorexia)

Anorexia nervosa is the most common eating disorder in France.

True. This is a major point, absolutely essential to remember and research, on which I particularly emphasize.

Eating disorders are very frequently associated with psychiatric and addictological disorders.

True, a thousand times true, it is the main drug, prescribed outside of oral nutritional supplements.

In the management of eating disorders, antidepressants are readily used for their pro-orexigenous or anti-compulsive effect.

False, it is borderline personality disorder (rather in bulimic) or obsessive-compulsive personality disorder (rather in anorexics)

The personality disorder most commonly found in eating disorders is antisocial personality disorder.

False, there are a myriad variety of oral nutritional supplements (cakes, biscuits, soups, soups, juices, desserts, flans etc ...)

Oral nutritional supplements are only in the form of milk or juice.


Which of the following are vulnerability criteria taken into account in criminal law?


Concerning the psychic disorders of the elderly, which of the following propositions, which one or which are true?

True, indeed older people age differently! An 80-year-old person may not have physical or psychological comorbidities (which are the main risk factors for mental disorders) and a 60-year-old person may have them.

Age is not a risk factor for depression in the elderly

True, it is all the more visible in hospitalization

Depression of the elderly may be manifested by functional complaints (asthenia, memory complaint, abdominal pain)

True, if there are more suicide attempts among young people, there are fewer deaths by suicide among young people.

The risk of suicide is greater in the elderly than in the young person

A severe depressive episode is a risk factor for Alzheimer's disease

True, frontal tumors, for example, can mimic depression in the elderly

Brain imaging can help to seek a differential diagnosis (such as a brain tumor) in the elderly person's depression


What is the only cancer in humans that can be managed by hormonal treatments?


Which of the following are hormone-sensitive cancers?


What is the primary outcome of national screening campaigns?


What is the main risk factor for cancer?


What proportion of cancer is nutrition-related risk factor?


What is the proportion of preventable cancers (accessible to primary prevention)?


Regarding Gayet-Wernicke encephalopathy. Which of the following propositions, which one or which are true?

True. It is for this reason that chronic alcoholic patients should not be hydrated with G5, but with saline.

It can be aggravated by carbohydrate intake

True. There may also be oppositional hypertonia

The clinical triad includes oculomotor signs (oculomotor paralysis, nystagmus), static cerebellar syndrome, and delirium syndrome.

False. A hypersignal of the mammillary body

MRI FLAIR shows a hypersignal of the corpus callosum

False. It is reversible, unlike Korsakoff syndrome


Regarding biological markers of excessive alcohol consumption. Which of the following propositions, which one or which are true?

True. This is CDT (Carbohydrate Deficient Transferrin)

Deialylated transferrin is very specific

Gamma-GT is elevated without elevation of PALs


Simple use is a term used only for the use of alcohol

True. This is true for both men and women

According to new WHO recommendations, simple alcohol use means less than 10 glasses of alcohol are consumed per week

1 standard glass of alcohol contains 8g of alcohol

1 glass of wine of 10 cL corresponds to 10g of alcohol

1 glass of whiskey of 2.5 cL corresponds to 10g of alcohol


With regard to meningitis, which of the following proposals are accurate?

True, essential and non-debatable point, the greatest urgency in front of a fever in children, adolescents and even young adults is the search for a purpura fulminans (IM / IV injection of 2g C3G).

It is essential to completely undress any child with unexplained fever and/or suspected meningitis

True, overall there are three situations where the lumbar puncture will not be performed: septic shock, coagulation disorders and similar, signs of cerebral engagement / seizures or serious alertness disorders.

Among the contraindications to lumbar puncture, we have coagulation disorders, thrombocytopenia (<50G / L) and signs of cerebral engagement for example.

False, they are to start in probabilistic once the direct examination is carried out (on the blood or the lumbar puncture)

Except in the context of purpura fulminans, antibiotic therapy is to be started once the results of the culture with susceptibility testing have been received.

False, three times false. As for the suspicion of myocardial infarction, we CALL the SAMU to request a medical transport, which will go directly to intensive care. And we do the C3G IM in the office!

Confirmed or suspected purpura fulminans requires sending the patient to the emergency room with a letter to perform blood cultures and lumbar puncture

False, it is to be proposed in systematics (I was often fooled by this item)

HIV testing, if favourable circumstances, is to be offered to the patient


You are a pediatric intern and you hospitalized little Franz Oberhauser, an Austrian child on holiday in the Alps 🗻, for a suspicion of meningitis (in front of febrile headaches with meningeal syndrome). The laboratory calls you to send you the results of the lumbar puncture, very favorable to meningococcal 🦠 meningitis. Which of the following results are consistent with meningococcal meningitis?

True, we have a decreased glycorachia, because bacteria consume a lot of sugars

True, it is a bacterial infection therefore predominant on PNN, this is what also gives the cloudy character of CSF

Leukocytosis at 3000/mm3, predominant on PNN

False, remember that meningococcal is a gram-negative cocci (diplococcus)

False, lactates most often indicate a bacterial infection so they are increased here


Which of the following propositions are true about cefotaxime?

bactericidal on susceptible gram-negative bacilli


Which of the following are true about amikacin?

It is nephrotoxic and therefore contraindicated in case of PNA


Which of the following are criteria for starting emergency dialysis?

Oliguria resistant to loop diuretics with hydro-sodium overload


Substitute general practitioner, you receive Mr Carver, Elliott, 25 years old, who consults you for a "rotten nail" of the feet, which persists for several months and which he has never really cared about. The clinical examination reveals a classic dermatophytic onyxis. What do you do?

Looking for dermatophytic intertrigos and other dermatophytic onyxis

False, this type of examination can be done in a laboratory

You write a letter for a dermatologist, for a biopsy of an affected nail

You make a prescription for a laboratory, for a biopsy of an affected nail

You make a prescription for an antifungal probabilistic treatment secondarily adapted to the identification of the fungus

You make a prescription once the fungus is identified for an antifungal


Which of the following are complications of chronic pancreatitis?


When should vaccinations be performed in case of scheduled splenectomy without emergency?


Which of the following are some indications of screening for gestational diabetes in a pregnant woman?


Regarding andropause (or age-related testosterone deficiency syndrome), what are the exact proposal(s)?

False, it is the testicles, senescent that have trouble secreting, and it will result in hypersecretion of FSH and LH at the pituitary level

Andropause is linked to an age-related decrease in FSH and LH secretion.

True, this is the most important thing to remember from this little item. Compare the two and you'll see that it's blatant.

Many of the symptoms of andropause are similar to those of menopause

False, this is a diagnosis that combines clinical signs and a drop in total testosterone.

The diagnosis of andropause is biological and based on the dosage, twice, of testosterone

True, testosterone will act on the prostate and testicles mainly

Testosterone treatment involves a prostate and endocrine assessment beforehand

False, the treatment is administered transdermally or intramuscularly, null trap, but you never know...

The treatment of andropause is based on a daily oral intake of free testosterone


Mrs. Marple, a nice patient of 72 years, comes to see you in consultation of general medicine, for urinary problems quite "shameful" according to her own words. Indeed, she has had "urinary leakage" for several months, occurring with laughter or coughing, but sometimes she feels an urgent need to urinate which has caused "some accidents". By quickly going through the patient's file you note as the only antecedent 5 vaginal deliveries and a work in the textile industry. Among the 5 proposals for additional examinations/opinions, which sequence do you choose?

False, as soon as there is an emergency we must eliminate a "local" cause of irritation of the bladder (cancer, stone etc ...) and this requires at least a urologist opinion

Fasting blood glucose, Urine strip - Physiotherapist consultation for pelvic floor strengthening

Fasting blood glucose, Urine strip, ECBU - Renal and bladder ultrasound - Physiotherapist consultation for pelvic floor strengthening

False, the assessment here is too excessive, in imaging only ultrasound is necessary and the liver and kidney assessment is dispensable.

Fasting blood glucose, CBC/Iono/Hepatic test/Renal assessment, BU, ECBU, Urinary cytodiagnosis - Renal and bladder ultrasound + TAP CT - Urologist opinion

True, no more and no less (here urgency + risk factor with the textile industry)

Fasting blood glucose, BU+ECBU, Urinary cytodiagnosis - Renal and bladder ultrasound - Urologist opinion for urethrocystoscopy

False, an emergency is an emergency diagnosis

Voiding schedule and reassessment of symptoms at the next consultation in 3 months


What do you typically find on a voiding calendar?


You are an intern in palliative care and you receive the family of Mrs. Onatopp, Xenia, 45 years old, in a situation of palliative care and limitation of care, for small cell lung cancer. Its situation is deteriorating and you have decided to stop subcutaneous hydration and feeding. The family does not understand why you stop this and let Ms. Onatopp "die". What is your response to the family? (A correct answer)

False, the benefit here of care is very meagre, and there is a greater risk of adverse effects (false roads, edema ...)

"I understand your outrage and I share it. The patient must benefit from the treatments to the end and I reintroduce nutrition and hydration"

False, subcutaneous hydration is at risk of edema

"I understand your concern, but eating for her is too risky of false routes and complications. There is no need to continue feeding. However, we can agree on maintaining hydration which is harmless."

False, parenteral feeding is at high risk of sepsis

"I understand your fears and doubts, but eating for her has become too difficult and there is a risk of wrong routes for nutrition by mouth. However, we can relay the feeding by vein, to avoid as many complications as possible. There is no need to continue hydration, as the patient has enough fluid reserves in her cells."

True, it is the weight of the benefit / risk associated with a relay by comfort care

"I understand your doubts and fears, but today this care is more risky, vis-à-vis the benefit that the patient can expect. However, she will be given oral care to prevent her from being disturbed by dry mouth."

"I understand your resentment, but it is not me who decided but my boss, talk to him"


You attend the morning staff, in the palliative care unit, and you discuss with your senior the case of Mrs. Miranda Frost, 92 years old, hospitalized in your department for the palliative management of Amyotrophic Lateral Sclerosis. You decide to set up a situation of deep and continuous sedation maintained until death. What elements do you need to decide and carry out such care?

True, it allows to have a collegial decision, free from any hierarchical pressure

A decision by two physicians who are not linked by a hierarchical relationship, approved by the health care team

False, morphine and MIDAZOLAM, a kind of super-benzodiazepine that causes deep drowsiness, are used.

Treatments: most often Propofol and Morphine

True, they are essential until death to allow patient calming, dignity and a right to comfort

True, it is essential to know how to evoke this decision to relatives before and after the collegial meeting.

True, it is not because these are treatments that can cause a double effect, that we will let with impunity the adverse effects (especially serious adverse effects) cause an inconvenience for the patient

Regular reassessment of efficacy and safety


Regarding care decisions, relating to a palliative care situation, what is the hierarchy vis-à-vis care decision-makers? Rank from most important > least important (only 1 correct answer)

Patient, verbally > Patient via advance directives> Palliative care physician > Attending physician> Trusted person > Relatives

Patient, verbally > Patient via advance directives> Trusted person > Spouse > Relatives

Palliative care specialist > Doctor in charge of the patient > Attending physician > Patient, orally > Patient, via advance directives > Trusted person > Relatives

True, the patient is the first actor of his care it is he who decides in agreement with the doctor who does not CHOOSE FOR HIM. The doctor informs, collects and argues but does not decide. Then the advance directives are authentic, then the person of trust (who testifies to the patient's will), and finally his relatives

Patient in person> Patient via advance directives > Trusted person > Relatives

Patient in person> Patient via advance directives> Attending physician or trusted person > Relatives


Regarding palliative care in pediatrics and neonatology, what are the exact proposal(s)?

True, it is not because he is in palliative care that we should not provide for his needs

The child in palliative care, requires educational, social and existential needs

False, this trap is absolutely to know, there are NO advance directives among minors, simply because advance directives are the will of the person who writes it.

If the child is no longer able to express his or her own wishes, we must rely on the advance directives written by the parents.

False, it is the child who has his say and who decides. It is one of the few exceptions in pediatrics

The decision of the parents or holders of parental authority takes precedence over that of the child

False, it mainly concerns the consequences of prematurity

Most palliative care in neonatology concerns fetal malformations and chromosic pathologies

True, it is still a loss and a mourning, so they can intervene in this case too

Paediatric palliative care also includes abortions and IMGs


Regarding euthanasia and assisted suicide, what are the exact answer(s)?

True, you have to know how to evoke and evaluate the three types of pain

Faced with a request for assisted suicide or euthanasia it is imperative to seek physical, psychological and existential pain

False, it is important to know that the Léonetti law dates "ONLY" from 2005 and that it has been revised (Leonetti Claeys Law of 2018)

The laws that frame the definitions and legislation on euthanasia and assisted suicide date from the twentieth century

False, the most important thing in this situation is to understand why the patient is making this request.

Faced with a situation of request for euthanasia or assisted suicide, the main thing to do is to explain to the patient the illegal nature of the thing

True, it is totally obvious, that this gesture is criminally reprehensible, that it can lead to professional and legal sanctions, and that it can lead to compensation...

If a physician performs an act of euthanasia or assisted suicide in France, he is liable to an infringement of his professional, criminal and civil liability.

False, of course it is false. We hear more often that the patient asks to die rather than to want to be euthanized, the difference is important!

There are more requests for euthanasia than requests for death in hospitals


Which of the following are side effects of morphine in children?


Which of the following can be prescribed for a 2-year-old?


Regarding autonomy and dependence in the elderly, what are the exact proposal(s)?

A USLD is a residential service for chronic and disabling pathologies, and a UHR is a residential service for chronic and disabling psychiatric pathologies.

True, it includes an organization of several face-to-face aids

The SSIAD is a service combining personal assistance and administrative assistance

True, it also allows a reassessment of the aid plan to relieve caregivers physically and psychically

"Respite hospitalizations" are hospitalizations to allow caregivers to rest

False, this MCQ was important to know the classic APA criteria (>60 years, France > 3 months) but also to know the IRM grid. It goes from GIR 6 (autonomous) to GIR 1 (moribund) and the APA is given for GIR 1 to 4.

The APA (Personalized Autonomy Allowance) is available to people over 60 years old, living in France for at least 3 months, being classified in the GIR grid 2 to 6

True, three times true. Auxiliaries, remote alarm, carrying meals, housing development, protections, HDJ, temporary accommodation, nursing homes

The APA finances numerous physical, material and financial aids


Which of the following are possible allergens?

True. Allergens are proteins of animal or plant origin.

With some exceptions, carbohydrates (lactose in particular) and lipids are not allergenic.


At what apnea/hypopnea index threshold, are we talking about obstructive sleep apnea syndrome?

False, this is the apnea threshold for the child

False, this is the threshold of severity of sleep apnea


Which of the following propositions regarding obstructive sleep apnea syndrome is true?

True, OSA screening must be carried out in front of a risk terrain (cardiovascular comorbidities, cardiovascular risk factors, metabolic syndrome, respiratory pathologies) and / or revealing symptoms (snoring, pauses, suffocation, apnea, nocturia, anxio-depressive syndrome, daytime sleepiness ...)

Any obese patient with snoring should be referred for consultation or should perform nocturnal oximetry screening for sleep apnea syndrome

False, the Epworth score looks for daytime sleepiness. It is pathological when it is greater than 11

Epworth score looks for nocturnal symptoms of sleep apnea through interrogation elements

False, the screening is done by nocturnal oximetry (imagine it as a Holter of SaO2) and the diagnosis is done by ventilatory polygraphy or polysomnography

Screening for obstructive sleep apnea syndrome is done by nocturnal ventilatory polygraphy.

True, it is part of the comorbidities that may indicate bariatric surgery during a BMI >35 especially because its improvement in post-surgery is quite frequent

Obstructive sleep apnea syndrome may be an indication for bariatric surgery in case of BMI > 35

True, fatal risk to the patient due to drowsiness

Obstructive sleep apnea syndrome is a temporary contraindication to driving


What is the threshold of the Golde score defining intraalveolar hemorrhage?


Regarding febrile rashes, which of these propositions are true?

True, a fever in children is rarely greater than 5 days, Kawasaki syndrome is sought with cardiac ultrasound and CBC

A febrile rash of more than 5 days in children should be tested for Kawasaki syndrome

True, these two forms of rashes are called "large simulators", HIV and syphilis can mimic many dermatological pathologies ...

An atypical, poorly systematized rash in adults should be reminiscent of HIV or syphilis

False, it is an erythema called in "bellows" (bright red cheeks and edematous) and "gloves and socks" (red hands and feet edematous)

A so-called "cervical cache" erythema is found in Parvovirus B19 infection

True, this is scarlet fever caused by a Strepto A infection.

Of the most common febrile childhood rashes, only one is of bacterial origin

False, there is only one flare-up during measles with a start behind the ear and a downward path.

Unlike rubella, measles progresses in several outbreaks


Regarding pruritus, what are the exact proposal(s)?

True, it is to be distinguished from physiological pruritus which has no impact.

Pruritus is said to be pathological when it causes lesions or functional repercussions

False, a pruritus sine materia is a pruritus that does not have lesions except those caused by pruritus itself.

A pruritus sine materia is a pruritus that does not present lesions and therefore and is synonymous with physiological pruritus

False, nasty trap, but urticaria and psoriasis have dermatological lesions...

Causes of pruritus sine materia frequently include dysthyroidism, medications, parasitosis, hives, psoriasis, cholestasis and hemopathies.

The assessment of pruritus sine materia includes: NFS, CRP, Iono, BR, BH, TSH, HIV/HBV/HCV, abdominal ultrasound, chest X-ray

False, we will favor topical treatments and if only the pruritus is too intense we can use antihistamines

Benzodiazepines are the treatment of choice to soothe the patient to avoid pruritus


Luke Marcheciel is a newborn baby who was born 24 hours ago. While you take the time to reread the letters and you have entrusted the clinical examination of the baby to your outpatient, he comes back proud because he thinks he has diagnosed a hemangioma! Suspicious, you congratulate him, but question his diagnosis. What elements of the clinical picture or examination will refute your external hypothesis?

True, a hemangioma usually only sets in after several weeks of life, unlike the vascular malformation that is present from birth.

False, color has no impact on the diagnosis.

True, a hemangioma is flexible, soft and has no pulsations or internal heat. Unlike vascular malformation

True, varicose veins and vascular malformations are characteristic of congenital malformations

False, vascular malformation remains stable, unlike hemangioma


During your Saturday standby, you go to your MPR department and you meet Mrs. Jeanne Dorian, 67 years old, who is gradually recovering from her stroke that occurred 1 month ago. She tells you that if the resumption of walking is gradual, she still has a lot of trouble grasping her glass of water with her right hand which is "paralyzed". She wonders how she will be able to play the violin with such a weak hand... Link the impact of the disability with the examples from the statement.

Difficulty grasping the glass of water = Activity limitation

Stop playing the violin = Restriction of participation

Difficulty grasping the glass of water = Impairment

Stop playing the violin = Activity limitation


Regarding cutaneous-mucosal infections with Candida, what are the exact proposal(s)?

True, this kind of infection is very common

A perlèche is an intertrigo of the labial commissure, which may be of fungal origin

True, this semiological finesse is important to distinguish the two causes and allow an adapted antifungal treatment

Unlike dermatophytes, nail candidiasis has centrifugal extension and perionyxis

False, it is necessary to know what is typical of candidiasis (under breast, abdominal fold, intergluteal) and dermatophyte (inguinal)

An intertrigo of the inguinal folds is classic of candida infections

False, one of the most important points of candidiasis is its physiological presence in the digestive and vaginal mucous membranes

In front of an infection, vaginosis type, a positive Candida sample signs vaginal candidiasis

Topical antifungals are mainly based on fluconazole or amphotericin B


Regarding autoimmune bullous dermatoses which of these propositions are true?

The most common autoimmune bullous dermatosis in France is bullous pemphigoid

True, which makes it can be confused with Behcet's disease or Cowden syndrome (do not remember Cowden syndrome)

Clinically, pemphigus can present only through mouth or genital ulcerations.

False, indeed it is necessary to make several samples, but because there will be one that will be unfixed (for histological analysis) and one that will be fixed to highlight the areas of fixation of antibodies.

It is essential to take several samples during the biopsy, with the main purpose of allowing a second opinion in case of diagnostic doubt

True, these are also the same complications as pressure ulcers if you notice well.

The main complications of autoimmune bullous dermatoses are infections, hypothermia, dehydration and undernutrition.

False, it has been shown for years, that local corticosteroid therapy has a similar effectiveness for fewer adverse effects

The standard of care is based on systemic corticosteroid therapy


Which of the following proposals may be present in a child with autism spectrum disorder?

When parents smile at their child, the child does not smile at them. This is a very early sign of autism.

Children have difficulty accessing implicit and figurative language

These are the difficulties in having reciprocal exchanges. The child will also have remarks that are focused on his own interests and does not take into account the point of life or the words of the interlocutor to register in a turn of turn (social clumsiness).

Conversations tend to be focused on the patient's interests

The child has a lot of difficulty making friends. In addition, they are often not very interested in social relationships with peers (lack of social motivation).

The child has facilities to make friends


Which of the following propositions regarding bipolar disorder is true?

True, hence sometimes the notion of bipolar disorder type III, manic disorders induced by antidepressants etc ...

Although a distinction is usually made between type I and type II bipolar disorder, there are bipolar disorders that do not fit into this classification.

True, this is THE prodrome to know in the bipolar patient

A manic crisis should be evoked in front of a bipolar patient, with recent insomnia without fatigue

False, on the contrary, the fact that he is not "paralyzed" by depression, will promote the passage to the act

In front of a patient with manic syndrome, it is useless to look for suicidal thoughts, since he presents an elation of mood

False, treatment will be implemented remotely, once bipolar disorder is diagnosed and differential diagnoses have been ruled out.

In front of a maniacal patient in the emergency room, lithium treatment must be initiated without delay, because of its long half-life and narrow therapeutic range.

Monitoring of lithium in chronic treatment is based in particular on TSH, urea and annual serum creatinine


Regarding comorbidities with other neurodevelopmental disorders. Which of the following are true?

30% of children with ASD have an intellectual disability

20% of children with ASD have attention deficit hyperactivity disorder

20% of children have oral language acquisition disorders

10% of children with autism spectrum disorder will have epilepsy at some point in their lives


Which of the following are risk factors for postpartum mental disorders?


Among the following proposals, which additional examinations are part of the assessment to look for differential diagnoses of pervasive developmental disorders?

Only to make the diagnosis of associated disease. Epilepsy is not a differential diagnosis.

Search for differential diagnoses and also associated diagnoses

These are scores to make the positive diagnosis. The ADI-R is a semi-structured interview with parents, which examines the current symptomatology as well as the developmental history of the child. ADOS is a semi-structured observation of the child's symptomatology.

These diagnostic tests are useful for diagnosing ASD syndromes, not for finding a differential diagnosis.

Neurological, genetic, metabolic and brain MRI assessments


True, at the maneuver we can observe a fall behind the head up to 2 months of age

The pull-and-sit maneuver is used to evaluate the holding of the head

False, at 4 months, he sits with support. At 8 months only, without support

From 4 months, the child must sit without support

True, walking alone can be observed from 9 to 18 months.

True, reflex from bending the fingers to stimulating the palms of the hands or feet

The reflex grasping is a reflex of the newborn

False, she becomes a volunteer around 4-5 months. At 9 months the child can manipulate with 2 hands and also appears the thumb clamp index

The grip becomes voluntary from 9 months


Regarding the schooling of patients with ASD, which are true?

The type of schooling adapted to the child will depend on the level of severity of ASD, the impact
functional disorder and associated neurodevelopmental disorders and parental choice.

The children have an ordinary schooling, but there will be adjustments. The Personalized Support Project (PAP) and the Personalized Schooling Project (PPS) specify the arrangements that should allow schooling in an ordinary environment. Some patients will therefore be able to benefit from a School Life Assistant (AVS) when they have learning difficulties or difficulties with autonomy.

Patients with mild ASD without another neurodevelopmental disorder
associated, and with a slight functional impact, have schooling in an ordinary environment, and will have no accommodation.

Patients with mild ASD, another associated neurodevelopmental disorder (for example, mild intellectual disability), and with mild or moderate functional impact will be enrolled in ULIS (Localized Units for Inclusive Education) classes.

Patients with moderate to severe ASD and another associated neurodevelopmental disorder (e.g., moderate intellectual disability), and with moderate or severe functional impact: IME orientation.

The statement is true, except for the PAP. Simple school arrangements made by the PAP do not need notification to the MDPH: the project is only validated by the school doctor.

The implementation of school facilities (PAP, PPS, AVS) and school orientations (ULIS, IME) always require notification from the MDPH, which requires the drafting of a reasoned medical certificate.


Regarding the links between pain and mental health, what are the exact proposition(s)?

True, it is quite logical, psychic pain leads to physical pain and vice versa

Patients with a characterized depressive episode more often have chronic pain complaints and vice versa

True, the pathophysiological cause/consequence is more difficult to pin down, but it does exist...

A fibromyalgia patient has a higher risk of developing bipolar disorder than a person without chronic pain

False, the urgency is the chest pain here that must quickly perform an ECG

In front of a patient in the emergency room having a panic attack, who complains of chest pain at the same time, the urgency is to calm the patient by words or by a benzodiazepine

False, the schizophrenic patient feels the pain but does not recognize it and cannot express it clearly

The schizophrenic patient develops anesthesia to pain, which explains why he expresses it less because he feels it less

True, a bit like the schizophrenic patient, he has trouble expressing his pain clearly and therefore the pain is to be sought!

Children with autism spectrum disorder may exhibit withdrawal, aggression or mutilation behaviours in the face of pain


Regarding somatoform disorders, which of these propositions are true?

True, like any psychiatric illness. A child of a depressed parent is more likely to develop depression. Same with somatoform disorder

There is polygenic genetic transmission of somatoform disorders

True, extremely frequent. Any doctor will face this situation at some point.

Among the functional signs often expressed in somatoform disorders, we readily find chest and abdominal pain

False, it is an entire part of it. It is the erroneous belief of being overweight or obese.

Dysmorphophobia is not part of somatoform disorders

False, somatoform disorder is a diagnosis of elimination. Just because a patient has psychiatric disorders doesn't mean they can't have a heart attack or stroke!

Faced with a physical complaint in a patient with multiple psychiatric history, it is necessary to know how to quickly evoke somatoform disorders

False, the patient is convinced that he has a medical pathology, and the perpetuation of negative examinations only reinforces his certainty (the idea that his disease is not known to doctors, is not diagnosable etc ...)

It is often recommended to multiply additional examinations and medical opinions in front of a somatoform disorder, to reassure the patient


Concerning mental disorders in the elderly, which of the following propositions are true?

True, these units are frequently found in geriatric clusters.

The management of patients with chronic psychiatric disorders or psychiatric manifestations of neurodegenerative pathologies can be done in U.C.C (cognitive-behavioral units)

Schizophrenia in the elderly will manifest itself by a predominance of negative symptoms and disorganization and a lesser presence of positive symptoms

False, usually we find delusions of persecution or misidentification

In the psychiatric manifestations of neurodegenerative diseases we will find delusional ideas of grandeur or megalomania

False, usually we start at half dose, to avoid the main side effects

To prescribe psychotropic drugs in the elderly, we start at the same dose as in adults, but we increase the doses more gradually.

True, benzodiazepine abuse and addiction is extremely common in the general population.

A memory complaint may be related to chronic addiction to benzodiazepines


What are the additional examinations of acute non-serious pyelonephritis without risk of complications probably diagnosed?

If PNA severe or at risk of complication


Which of the following propositions concerning pre-eclampsia are true?

False, in 4 to 12% of pre-eclampsia. Pre-eclampsia affects 3 to 10% of pregnancies.

HELLP syndrome occurs in 4 to 12% of pregnancies

Immediate hospitalization is indicated before the discovery of pre-eclampsia

In front of any visual abnormality it is necessary to make a fundus in search of hypertensive complications.

True, others are acute fatty liver disease (SHAG), HUS or thrombotic thrombocytopenic purpura (TTP)

One of the differential diagnoses of pre-eclampsia is thrombotic microangiopathy.

False, it is only necessary to undertake a vascular filling when a risk of hypovolemia is predictable. Overfilling can precipitate the occurrence of an OAP.

Vascular filling of patients with pre-eclampsia is essential.


Regarding fractures of the upper end of the femur. Which of the following are true?

The typical deformation is in Shortening, Internal Rotation, Adduction.

The trochanterian massif is mainly trabecular bone.

The little trochanter is the insertion site of the gluteus medius

The great trochanter is the insertion site of the Psoas

During a pertrochanteric fracture, there is a risk of osteonecrosis of the femoral head.


Regarding superior femoral epiphysiolysis. Which of the following proposition(s) are true?

It is the second cause of hip lameness during the pubertal period, after osteoarticular infection.

There are two forms: the stable form and the unstable form

It is a growing cartilage disease of unknown cause.


Among the main germs found in children, we find which germ at what age?

Kingella kingae in children from 6 months to 4 years

Staphylococcus aureus is the majority in children with sickle cell disease

Pneumococcus is the most common germ in children from 6 months to 4 years

Staphyloccocus aureus is the majority in children over 4 years of age

E. coli and group B streptococcus are the majority in infants less than 3 months of age


Which one(s) is part of the systematic assessment in the face of a suspicion of acute osteoarticular infection in children?

Ultrasound of the affected joint, often comparative

False. It is the best test for diagnosing IOA (more sensitive and specific than bone scan), but it is not indicated systematically.


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

Extension is provided by the radial nerve


Which of the following propositions refer to muscles of the hypothenar compartment?

True, all the muscles mentioned in these propositions are innervated by the ulnar nerve


Which of the following are muscles innervated by the ulnar nerve?


It is the evolution of a buttonhole finger

It reflects the chronic involvement of the IPD extender

It reflects chronic involvement of the IPD flexor

It reflects chronic involvement of the PPI extender


Which of the following are true about Zenker's diverticulum?

Nasofibroscopy regains the sign of the tide 🌊


Which hepatitis virus(s) is/are usually asymptomatic in the acute phase?


What is the lifetime prevalence of hemorrhoids?


Regarding hernia, what are the exact answer(s)?

It is the passage of abdominal contents through a natural orifice

True, in front of the coral and umbilical

25% of the child's hernias are congenital


Which of the following are possible complications of H. pylori infection?

Acute viral gastritis without chronicity


Which of the following are true for irritable bowel syndrome (IBS)?

Absent at night, predominates in the morning and post-prandial

Yes, we can have both (typical pain + <3 bowel movements per week)

There are no organic abnormalities of the intestine


Which of the following is one or more of the potential cause(s) of hepatomegaly?


How does the incidence of lithiasis change with age?

It was necessary to find 4 distractors 😂


Which of the following are the providers of diarrhoea?

True, it is one of the most common treatments for diarrhea^^

True, so important that it can go so far as to require stopping the treatment

True, it is an antimetabolic (the lining of the intestine is renewed very quickly)


Which of the following are anti-emetic drugs?

6 effects: anxiolytics, hypnotics, anti-convulsants, orexigen, muscle relaxants, amnesiacs

True, it is used in particular to counter the adverse effects of chemotherapy


Which of the following are signs of dehydration?


Which of the following are tests to request in the face of suspicion of Crohn's disease?

Gastro-duodenal endoscopy + systematic staged biopsies

Colonoscopy + biopsies if macroscopic abnormalities

True, Essential to assess hail. The 3 systematic examinations are: endoscopy + ileocolonoscopy + entero-MRI. Biopsy is done anywhere it can :)


Which of the following are possible etiologies of cirrhosis?


Never chronic hepatitis (but acute hepatitis possible)


Which of the following are causes of primitive achalasia?


Which of the following are true for gastroduodenal endoscopy in duodenal ulcer?

True, clinical signs, even typical, are not enough

It is essential for the positive diagnosis of ulcer

Duodenal ulcers never degenerate into cancers

In case of hemorrhage, Forrest's classification can be used

Systematic search for Helicobacter pylori

It allows the systematic search for CMV infection


Regarding sigmoid diverticulosis and acute diverticulitis what are the exact proposal(s)?

True, you have to enjoy as much as you can 🎉

These pathologies are very rare before the age of 30

Not since the last recommendation in 2017. It is indicated in case of non-response to symptomatic treatment or in case of signs of severity

Antibiotic treatment in uncomplicated diverticulitis is routine

Unnecessary ultrasound. We make the diagnosis on the bio and the angioscan

Diagnosis of diverticulitis is based on ultrasound

Bristol scale = stool 💩 consistency. We are talking here about the Hinchey classification

Bristol scale classifies complicated diverticulitis

True, risk of perforation and peritonitis

Active diverticulitis contraindicates colonoscopy


Which of the following are complications of cholecystectomy?

Complication of unoperated cholecystitis


Which of the following propositions are true about physiological jaundice in newborns?

False, it appears only after 24 hours of life (free interval)

The neuronal toxicity threshold is 340 micromoles/litre


Which of the following are classic signs of cholitis?


Which of the following are among the following proposals for complicated diverticulitis?


Which of the following proposals are features of unranged hernia?

True, impulsive = extensive = no strangulation


Up to what age is loperamide contraindicated?

True. It is contraindicated before 2 years. Some adapted presentations are valid between 2 and 8 years.


Which of the following are criteria of severity leading to the treatment of uncomplicated sigmoid diverticulitis with antibiotics?

Tachycardia is not a criterion of severity (unless really high)


Which of the following are etiologies of brown urine jaundice?


Which of the following are recognized risk factors for ulcers?

True, several causes including PPIs, H. Pylori, autoimmune, ...


Which of the following are included in the treatment of uncomplicated diverticulitis?

Antibiotic therapy if symptomatic treatment failure

Laparoscopy explorer if pain persists for > 10 days


Which of the following are true for the treatment of GERD without esophagitis that occurs less than once a week?

Not in the first intention. This is the case if GERD happens more than once a week


Which of the following propositions are true about primitive achalasia?

Manometry is the exam of choice for a positive diagnosis


What is the treatment of choice for primary biliary cirrhosis?


Which of the following are risk factors for chronic pancreatitis?


Regarding the incidence of gastric ulcer in developed countries:

It is not a DO disease but epidemiological studies can be done on all diseases

It is not calculable because it is not a reportable 😏 disease


If chronic pancreatitis is suspected, what is the imaging test to perform as a first-line treatment?

No longer done (useless in this indication)


Which of the following should be avoided in case of celiac disease?


Which of the following are recommended vaccines for splenectomized?


What is the PNN threshold that defines an infected ascites fluid? (mm3)


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

It is a disease with genetic polymorphism

It is an unconjugated bilirubin jaundice


What test can determine whether GERD is acidic or non-acidic?


Mallory Weiss syndrome corresponds to a rupture of:


What does bimuthea quadritherapy contain?

Non-bismutheic therapy: amoxicillin, curative PPI, metronidazole, clarithromycin/levfloxacin


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


Which of the following are true for antibiotic treatment of uncomplicated sigmoid diverticulitis?

After failure of symptomatic treatment (or in case of signs of severity)

Second-line therapy is fluoroquinolones (or C3Gs) combined with metronidazole

Antibiotic treatment lasts less than 7 days

True, this is most often the case (oral treatment)

Treatment can be done on an outpatient basis


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


Which of the following are ultrasound signs of lithiatic cholecystitis?

Increased pain when passing the ultrasound probe

Hypodensity representing the calculation


Which of the following are indications for gastroduodenal endoscopy in GERD?

False, on the other hand newly discovered asthma (contemporary with GERD may be an extradigestive sign)


Which of the following are signs of hepatic encephalopathy?


Which of the following are signs of portal hypertension?


Which of the following are true about vomiting during pregnancy?

They are physiological in the second trimester

They disappear spontaneously during pregnancy

Pre-eclampsia may be accompanied by vomiting


Which of the following propositions are true regarding chemical trauma?

True, they penetrate longer and deeper into the eye

Basic chemical burns are more serious than acid burns

it is the Roper-Hall classification that is used

The ASA classification is suitable for burns of chemical origin

The classification ranges from grade I to grade IV, with grade I being the best prognosis

True with absence of limbic ischemia and corneal opacity

Grade I is for pure epithelial involvement


In what structure is the origin of the optic nerve inserted?


Which of the following proposals are pathological in 1-year-olds?


Which of the following are possible infectious causes of prenatal hearing loss?

Mnemonic medium: TORCH (Toxoplasmosis, Mumps, Rubella, CMV, HSV)

Infection of the mother with toxoplasmosis


Which of the following propositions designate the nerve on which the palpebral occlusion depends?

IV nerve, innervates the superior oblique

Nerve VI, innervates the external/lateral right

Nerve III, innervates the upper right, the medial right, the lower right and the inferior oblique


What is the interval for mild hearing loss?

light = PAM between 21 and 40 dB; mean = PAM between 41 and 70 dB; severe = PAM between 71 and 90 dB; deep = PAM ≥ 90 dB; total (cophosis) = PAM ≥ 120 dB.


What is the field of action of the superior oblique muscle?


It is a question of sphericity, not depth, the refraction of the eye differs according to the plane in which the incident rays are located.


What is the field of action of the inferior oblique muscle?


Which of the following are true for congenital hip dislocation (CHL)?

Ultrasound (if risk factor or suspicion)

Low radiation hip X-ray is the first-line additional examination in case of suspicion of LCH

Adduction limitation is a clinical sign of CHL

Limb length asymmetry is a clinical sign of CHL


Which of the following proposals are correct and expected for a 3-month-old child born at term?


This is the size of the newborn. The expected PC is 35 cm

At birth, the expected head circumference (CP) is 50 cm

This is the newborn's PC. The expected size is 50 cm

At 4 years old, the child measures about 1m25


Which of the following proposals suggest pathological strabismus?

According to the COUF: "It should be remembered that strabismus is never normal and that any child with strabismus must benefit from a rapid specialized examination. This assertion must be qualified in the baby less than 3 months in whom an intermittent deviation can be tolerated."

The child's strabismus is only a symptom. Any strabismus must seek an underlying organic pathology.

Convergent and intermittent strabismus require simple monitoring at the beginning


Which of the following proposals are part of the previous segment?


What is the formula for estimating the expected head circumference during the first year of life?


What is the interval of profound hearing loss?


Which of the following are true for genu varum at 1 year?

It justifies a bilateral F+P radiological assessment

It corresponds to a normal evolutionary phase of the growing skeleton in most cases


Which of the following are drugs that decrease the secretion of aqueous humor?

They increase the elimination of aqueous humor


Which of the following are risk factors for hearing impairment?


Which of the following propositions are true about AEPs?

They do not allow it, it is one of their limits. Other limitations: profound deafness hinders the interpretation of latency curves, and the ranges explored concern only the treble

They allow a frequency by frequency study

True, by studying the latencies and conduction delays of the five peaks: I (cochlea), II (auditory nerve), III, IV, V (brainstem)

They have topographic value in sensorineural hearing loss

High frequencies, this is one of their limits

It is an objective examination, to be used especially in infants or non-cooperating patients


Which of the following are functions of the outer 👂 ear?

Amplification of conversational frequencies

No role of the outer ear in balance. This is the case of the inner ear


Which of the following are true about the parotid gland?

There are three main salivary glands: parotid, submandibular, sublingual 😊

It is one of the two main salivary glands

Steno Canal. Wharton's duct is the duct of the submandibular gland

Its excretory canal is the Wharton Canal

It is the most common site of salivary lithiasis


Regarding the salivary glands, which of the following propositions, which is/are true?

False, if the excretory duct of the parotid gland is indeed the Steno duct, it is blocked at the level of the homolateral upper 2nd molar (namely)

The excretory duct of the parotid gland is the Steno duct and it plugs at the sublingual wattle.

False, do not confuse the sublingual glands (two small glands under the floor of the mouth) and the accessory salivary glands (there is, indeed, a multitude)

There are multitudes of sublingual glands (about a thousand)

True, these are the two main pathologies to master.

While viral sialitis mainly affects the parotid glands, lithiasic sialitis mainly affects the submandibular glands

False, it is pleomorphic adenoma, and it is a benign 😅 tumor

The most common tumor of the parotid is a malignant 😱 tumor

True, a low risk, but sufficient to indicate surgery for any pleomorphic adenoma.

Pleomorphic adenoma has a risk of cancerization


Which of the following propositions are true about acoumetry?

It is a qualitative measure of hearing (we have no number, the answer is a yes/no)

It can be performed at the patient's bedside

True, i.e. the patient hears less well in air conduction than in bone conduction (which is not normal)

Rinne's test is negative in case of conductive hearing loss

Weber's test consists of placing the tuning fork on the vertex

The Weber is non-lateralized in case of left unilateral transmission hearing loss


Which of the following suggestions can guide you towards right otosclerosis?

Weber on the right because right transmission deafness

Tonal audiometry regains right-sided one-sided conductive hearing loss


Which of the following propositions are true for pleiomorphic adenoma?


Management is exclusively drug (antimitotics)


Which of the following are true about salivary lithiasis?

Glandular swelling is often per-prandial

They are most common in the submandibular gland

MRI is often needed to confirm lithiasis

Dental panoramic imaging is first-line imaging


Regarding the salivary glands among the following propositions, which one is/are true?

True, it is the same radiological semiology for all lithiasis: hyperechoic with posterior umbral cone. This is the case of renal lithiasis and cholelithiasis too 😊

The first-line examination for lithiatic sialois is ultrasound to demonstrate hyperechogenicity with posterior shadow cone

False, they are rare! But this risk of sequelar orchitis is the main justification for mumps 😏 vaccination

Viral sialitis is formidable because it frequently leads to sequelar 😱 orchitis.

True, parotid involvement is found in Heerfordt and Mikulicz 🤓 syndromes

Bilateral chronic parotid sialosis should suggest sarcoidosis

False, a biopsy of the salivary glands ACCESSORIES (the famous BGSA)

Sjögren's syndrome, a bilateral chronic sialosis, is diagnosed by a biopsy of the main salivary glands

True, this is an exception in the tumor family...

Malignant parotid tumors are most often painful


In chronic inflammatory enterocolopathies, classically, peripheral involvement evolves parallel to digestive involvement, unlike axial involvement which evolves on its own account.

Physical activity and physiotherapy are essential to reduce the progression of ankylosis in a bad position

In ankylosing spondylitis, physiotherapy is not essential

The syndesmophyte is an ossification of a vertebral enthesis, specific to spondyloarthritis, unlike enthesophytes which can be the result of mechanical overloads

Syndesmophyte is not specific for Spondyloarthritis

At least 2 NSAIDs should be tried successively over a total of 4 weeks before concluding that they have failed.

After 4 weeks of treatment with the same NSAID without results, it can be concluded that the treatment has failed and it is then necessary to move on to background treatments

Fiessinger-Leroy-Reiter syndrome is the most complete form of reactive arthritis, defined by the urethritis-conjunctivitis triad-arthritis.


Regarding coxarthrosis, what are the exact proposal(s)?

True, congenital hip dislocation and other dysplasias lead to early coxarthrosis

A coxarthrosis of the young subject must seek a history of hip dysplasia

False, it is the coxodynias, which can give projected pain in the knee

Differential diagnoses include classical projected gonarthrosis

False, it is the internal rotation that will lead to a functional limitation of the joint.

The clinical examination will look for a limitation of external rotation, the first clinical sign of the functional limitation of the joint

True, to put it simply, the covers are what allow the good mechanics of the joint

The front X-ray and the false profile of Lequesne look for insufficient coverage of the VCE (external cover of the roof of the acetula) and the VCA (anterior coverage of the femoral head)

True, be careful not to forget the hygiene-dietary rules (regular walking, possibly cane in contra-lateral, weight loss if obesity ...)

First-line treatment is based on conventional level 1 analgesics and rehabilitation by physiotherapy


Which of the following proposition(s) is or is true?

An effusion of a joint is always the translation of intra-articular suffering

MRI is the exam of choice to quickly confirm or rule out joint effusion

True. Sternoclavicular involvement should be investigated for SAPHO syndrome.

SAPHO syndrome includes synovitis, acne, palmoplantar pustulosis, hyperostosis and osteitis

Digital osteoarthritis affects the proximal and distal interphalangeal joints with respect for the metacarpophalangeal joints

Thrombocytopenia at 70 G / L contraindicates joint puncture


Which of the following proposals corresponds to the first-line management of inflammatory spondyloarthritis?

NSAIDs in the absence of contraindications

No MA for spondyloarthritis (except psoriatic arthritis)


Which of the following are elements indicating urgent neurosurgical management?


Which of the following are found in an inflammatory joint puncture fluid?


Which of the following proposals can lead to a disco-radicular conflict in case of lumbo-cruralgia L4?

True, foraminal or extraforaminal -> touches the first digit (here L4)

foraminal or extraforaminal -> touches the first digit (here L3)

True, median or paramedian -> touches the second digit (here L4)

True, median or paramedian -> touches the second digit (here L5)


You perform a knee puncture. The liquid returns purulent. On direct examination, gram-positive cocci are observed in clusters. Which germ is most likely to be involved?

Rather found in case of infection associated with care (catheter, tube, etc.). But, indeed, it is a gram cocci + in clusters (this is the case of all staphylococcus).


How to treat latent tuberculosis before starting biotherapy?

Rifampicin + Isoniazid + Ethambutol + Pyrazynamide for 3 months

It is the same treatment as tuberculosis disease

Possible treatment 3 weeks after the end of well-conducted TB treatment

Biotherapy is contraindicated for life because of the risk of tuberculosis reactivation


Dactylitis is an inflammatory condition of the entire finger or toe

In young adults. Forms with late onset (after 45 years) are rare

The majority of cases of spondyloarthropathy begin in the elderly

In spondyloarthritis, all entheses can be affected, but enthesitis preferentially sits in the upper limbs

The sacroiliitis results in the appearance of pain of the buttock of schedule most often inflammatory

Entheses are the bony insertions of tendons, ligaments, capsules and fascia.


Which of the following is the score assessing spondyloarthritis activity?

Score assessing the functional impact (there is an F in it) of spondyloarthritis (AS for Ankylosing Spondylitis)


Which of the following propositions, is/are true?

Local anesthesia can be performed urgently or programmed by any doctor, regardless of his specialty

There are 2 loco-regional anesthesia techniques: perimedullary (around the spinal cord) or peripheral (around the nerve)

The anesthesia consultation must be done at least 3 days before surgery

The pre-anesthetic visit must be done a maximum of 24 hours before surgery

True, written consent is only required for certain specific acts: genetic research, clinical trial, organ removal, tissues, cells from living persons, gamete donation and use, sterilization, abortion.

Oral consent is sufficient for anesthesia during surgery outside of emergency situations


Which of the following are complications of anti-TNF-alpha therapy?

True, dermatological consultation 1x/year

True, annual influenza and pneumococcal vaccination + discontinuation of therapy in case of infection


False! Red flag, in the first place eliminate an organic cause.

In front of back pain, the most likely cause is a static disorder, an X-ray face + profile of the dorsolumbar spine is sufficient

The search for an indolent or pauci-symptomatic "sausage" toe is also very important, justifying the careful examination of patients' feet.

In conventional radio, the different evolutionary stages of enthesopathy are 3 in number.

In the context of spondyloarthritis, there may be anterior acute uveitis, non-granulomatous in most cases, often pauci-symptomatic but sometimes severe.

False, MRI has no contribution to the diagnosis, if the sacroiliitis is visible on radiography.

In case of sacroiliitis on conventional radio, MRI may have an interest to confirm the diagnosis


Which of the following proposals correspond to the management of common (non-symptomatic) low back pain without red flag, neither deficit nor hyperalgic?

Analgesics level I and II according to the EVA

Nonsteroidal anti-inflammatory drugs in the absence of contraindications, suitable for pain


According to the French vaccination schedule in force since 2018, the MMR vaccination schedule recommended in France includes:

2 doses of primary vaccination at 2 and 4 months

The dose at 16-18 months is not a booster, but a catch-up. It is part of the basic vaccination schedule


Which of the following are true about Syphilis?

The infection is said to be late if it is more than a month old

The chancre testifies to the replication of treponema at the front door


With regard to tetanus, at what age are vaccinations associated with diphtheria and poliomyelitis done?


You are following Jean-Paul. He is 75 years old and has type 2 diabetes. He tells you he hasn't had a vaccination in a very long time and asks you which ones he should do. Your answers:

True, reminders at 6 years, 11-13 years, 25 years, 45 years, 65 years, 75 years and then every 10 years

True. Diabetic = immunocompromised = antipneumococcus + antiinfluenza


What are the hospitalization criteria for a non-serious NAP?

3 reasons: signs of severity, hyperalgic form, non-observant patient

Doubts about the patient's ability to adhere to antibiotic treatment

The presence of bacteremia (when tested) does not change management

The intensity of the fever without other argument of sepsis, and without particular terrain, is not in itself an indication of hospitalization

Especially an argument to look for a favoring factor


Mr. X brings you his 2-year-old son for a fever. "He's not like usual, he's all grumpy," he explains. You notice when you undress the child a necrotic-looking purpura appeared in the morning. What is the course of action?

You contact the SAMU for a medical transfer to the nearest hospital

You immediately perform an injection of parenteral C3G IM or IV

Purpura fulminans = immediate life-threatening emergency, requiring urgent parenteral C3G antibiotic therapy and resuscitation

You prescribe symptomatic treatment with paracetamol and ask to see the child again the next day

You send the child to perform a biology at the local laboratory

You ask the father to take his child to the emergency room right away


Regarding menorrhagia and metrorrhagia, which of these propositions are true?

False, we talk about menorrhagia when the Higham score is >100

We talk about menorrhagia when the Higham score is >200

True, these are the main consequences of bleeding.

In the face of bleeding of gynecological origin it is essential to assess tolerance by looking for signs of shock and anemia

False, the main causes of bleeding in the 3rd trimester of pregnancy are placenta previa and retroplacental hematoma

In front of a hemorrhage of the 3rd trimester of pregnancy, the main causes of metrorrhagia to evoke are late miscarriage and ectropion

False, pelvic ultrasound is performed as a first-line procedure, easier to access and practice than pelvic MRI

In the event of genital bleeding, the complementary first-line examinations are BHCG, CBC and pelvic MRI

False, any gynecological bleeding is cancer of the BODY of the uterus until proven otherwise (the endometrium is the cause of gynecological bleeding and is in the uterus not on the cervix)

Any postmenopausal gynecological bleeding is cervical cancer until proven otherwise.


Which of the following proposals are routinely included in the blotting paper biological newborn screening test?


Which of the following proposals are part of the ASD assessment?

For the assessment of IQ, adaptive behaviour (e.g. Vineland scale) and attentional abilities

For the evaluation of verbal and non-verbal language and language pragmatics

Look for epilepsy (present in 20% of ASD)

Systematics for the diagnosis of syndromic forms of ASD


Which of the following are true about the baby blues?

It must be treated with SSRIs for 6 weeks

Patients do not understand their symptoms ("I have everything to be happy")

It can be very transient and last only a few hours (College of Gynecological)


True
Think that PC as weight starts with 35 it helps :).

The average parameters of birth of a term newborn are a weight of 3500g, a height of 50cm and a PC at 35cm.

FALSE
It is doubled at 4 months of life.

The birth weight of a child is doubled at 1 year.

During the first trimester of life, an infant is expected to take 25g per day.

False
Definition of a statural growth anomaly
- Size< -2 DS according to the curves of the general population.
- And/or size< -1.5 SD relative to genetic target size
- And/or slowing down (or breaking the growth rate) (< 4cm per year after 4 years)

A child with a height of -1.5 DS, has a delay in stature.

True
Important to know how to calculate. We must be careful because sometimes we can know a statural delay if we rely only on the "raw" size, with for example a child at -0.8 DS, which is absolutely normal if we look at that, but if there is a high parental target size, let's admit +2 DS, it will be late (because 2.8 DS difference).
Hence the importance of the 3 criteria in the definition.

To calculate the genetic target height of a boy, it is necessary to: (Mother's height + father's height)/2 +6.5


In the case of intentional violence, what is the threshold of days modifying the classification of the offence?

True. Below ➡ police court ticket ➡. Above ➡ misdemeanor ➡ criminal court

Three months. This is the case for unintentional violence


The prevalence of ASD is 1% and the sex ratio is 4:1 in favour of boys

Like all neurodevelopmental disorders, ASD has a multifactorial origin

That's why we talk about autism spectrum disorders.

There is significant clinical heterogeneity of ASD

Heterogeneity is related to the severity of symptoms in the 2 clinical areas of ASD as well as the presence of comorbidities with other neurodevelopmental disorders

No, there are children who have a normal IQ (> 70). This is called Asperger's syndrome.

All children with autism spectrum disorder have a mental disability


Which of these propositions are true among bipolar disorder?

False, bipolar disorder usually appears between 15 and 25 years but it is often diagnosed at more than 30 years ...

Bipolar disorder is a disorder that appears around the age of 30

False, a bipolar disorder type 1 is diagnosed by the presence of a manic episode +/- a depressive episode! (We cannot talk about bipolar disorder if there is only one depressive episode...)

Bipolar disorder type 1 is diagnosed by the presence of a manic episode or a characterized depressive episode.

False, the semiology of a hypomanic syndrome being more frustrating, to speak of a bipolar disorder it is necessary the association of one or more hypomanic episodes and one or more depressive episodes

Bipolar disorder type 2 is diagnosed by the presence of one or more hypomanic episodes

True, lithium is one of the rare cases of the use of a metal as a medicine in medicine.

Treatment of choice for bipolar disorder uses metal-based medication

Cognitive remediation is a psychological rehabilitation technique


Regarding benzodiazepine addiction, which of the following propositions, which one or which are true?

True, these are the main actions of treatments

Benzodiazepines are anxiolytic, hypnotic, amnesiac, anticonvulsant and muscle relaxant drugs

True, this is why there is an addiction to benzodiazepines.

Benzodiazepines are part of the treatments with tolerance and withdrawal

True, the main cause of benzodiazepine addiction is "automatic" prescription renewal.

When prescribing a benzodiazepine, it should always be considered that it is only a temporary treatment, and should be discontinued.

False, we never put more than one benzodiazepine.

For the management of anxiety, a maximum of two anxiolytics can be combined, one short-lived and one long-lived

True, abrupt withdrawal increases the risk of physical withdrawal syndrome.

A gradual cessation is preferred to a sudden withdrawal.


Which of the following are genetic or metabolic diseases causing autism spectrum disorder?

Rett syndrome is a genetic disease. The disease causes a severe and comprehensive disorder of the development of the central nervous system, occurring only in girls. It results in multiple disabilities with intellectual disability and motor disability, which are often severe. (Source: https://www.orpha.net/data/patho/Pub/fr/Rett-FRfrPub91.pdf)

Autonomic recessive genetic disease linked to a deficiency of phenylalanine hydroxylase, an enzyme that allows the transformation of phenylalanine into Tyrolean. It is responsible, in the absence of treatment, for severe psychomotor retardation. The disease is screened for blood (Guthrie) on Day 3 by measuring phenylalanine.

Trisomy 21 is not in itself a genetic cause of ASD, but is an associated risk factor. 3% of children with trisomy 21 have ASD (p. 154 8th edition of the College of Pediatrics)


Which of the following proposals should be acquired at 2 months?


The Tanner classification evaluates the appearance of secondary sex characteristics for monitoring the pubertal evolution of girls and boys.

True Hence the boys who often make small in middle school compared to girls 1) their puberty begins physiologically + late, 2) the statural acceleration begins at a later stage of puberty.

The acceleration of the rate of stature growth begins at the first signs of puberty in girls (S2) and staggered in boys (G3) and rises up to 8 to 10 cm per year.

The appearance of the sesamoid of the thumb is contemporary with the onset of puberty, at a bone age of 11 years in girls and 13 years in boys.

The appearance of the sesamoid of the thumb means that the growth of the child is almost complete.

Bone maturation in children can be assessed by bone age, which is obtained by taking an X-ray of the left hand and wrist from the front.

Wrong, it's the other way around. Early puberty is defined as breast development in girls before the age of 8 and in boys testicular development before the age of 9.                          Puberty physio in girls 8-13 years, 9-14 years in boys.

Precocious puberty is defined as breast development in girls before the age of 9 and in boys testicular development before the age of 8.


Which of the following are teratogenic drugs?

False. A pregnant woman with lupus can continue to take her background treatment.

True. All ACE inhibitors and angiotensin II receptor antagonists (sartans) are contraindicated in the 2nd and 3rd trimesters of pregnancy. They are not contraindicated in the first trimester, but it is not advisable to maintain them during pregnancy.

True. Effective contraception should be initiated during this acne treatment, and maintained 4 weeks after stopping treatment.


You have in hospitalization in infectious disease Mrs. Bouvier, Pamela, 76 years old, who has a febrile heart murmur newly appeared for 1 week, poorly tolerated. Although you suspect infective endocarditis, blood cultures persist in coming back negative, and yet you have not initiated any antibiotic therapy 😑. You then think about the causes of negative blood culture endocarditis, what are they? 😏

True, the causes of negative blood culture endocarditis are: Whipple, Bartonella, Brucella, Coxiella, Chlamydia, H.A.C.E.K. but also Legionella, Mycoplasma, Rickettsia, Aspergillus, etc....

Bacterial endocarditis of the H.A.C.E.K. group


Which of the following are true for the diagnosis of infective endocarditis? 🤯

CT angiography is the first-line examination

The ETO is very often done as a second intention, after the ETT

ETO is only needed in case of negative 🤷 ♂ angioscan

Not always, it is not found in 10% of cases ➡ bacteria of the HACCEK group (slow growing), prior antibiotic therapy, etc. In all cases, blood cultures must be repeated several times 😋

True, they contraindicate thrombolysis in stroke

The presence of two major criteria (ultrasound + blood culture) make it possible to make the diagnosis of infective endocarditis


Which bacteria are most common in infective endocarditis? 🙌

Gram-negative cocci that lead to ear and upper and lower respiratory tract infections

This is not the most common. This germ often has a digestive origin (➡ perform a colonoscopy)


The germ mostly found is Staphylococcus aureus

The right heart is more often affected than the left 💔 heart

IV addiction is an important risk factor for endocarditis of the right heart

True, risk of rupture of mycotic aneurysm

IV thrombolysis in stroke is contraindicated (relatively) in case of a history of AE


Which of the following are true about fungal endocarditis?

It is often necessary to combine surgical treatment with medical treatment

IV addiction is an important risk factor


What is the procedure to take in case of dental avulsion in a patient who has had infective endocarditis and proven allergy to amoxicillin?

Sound familiar? 😋 This is the prophylaxis of pneumocytosis in immunocompromised 😉 people

Prolonged antibiotic prophylaxis with bactrim 3x per week

2g of amoxicillin 1 hour before the gesture


Which of the following are major criteria in infective endocarditis?


Which of the following are signs or symptoms of infective endocarditis?

True, always think about it in front of a prolonged fever! 🚨

Cerebral mycotic aneurysms (these are fake aneurysms eh)


Which of the following are true for Libman-Sacks endocarditis?

True, a bit of history 🧐 (from Wikipedia we admit 😇)

The lesions were described by Emanuel Libman and Benjamin Sacks in 1924.


Which heart diseases are at high risk of developing infective endocarditis? 🤔

True, hence the need for antibiotic prophylaxis in case of invasive dental procedure


What is the mortality rate of fungal endocarditis? 🍄

Surgical treatment should be discussed concomitantly with medical treatment

More reserved prognosis (mortality rate of bacterial AEs around 20%)

The prognosis is better than that of bacterial endocarditis


Which of the following proposals can result in blood culture negative endocarditis?


What is the procedure to take in case of dental avulsion in a patient who has had infective endocarditis?

This is the case in prophylaxis of pneumocytosis in immunocompromised people

True, indicated in case of infective endocarditis, cyanogenic heart disease or new valve. If allergy: clindamycin

2g of amoxicillin 1 day after the gesture

Too long, I remind you that beta-lactam have a short lifespan (we made a fairly complete topo on insta, you can find it on the storys on the front page)

1g of amoxicillin 1 week before the gesture


Which of the following diseases are notifiable diseases?

True, it is a notifiable disease because it is necessary to identify the food source to limit the risk of epidemic

True, it is a reportable disease because it is necessary to identify the environmental source to limit the risk of epidemic.

True since 2021 due to the implantation of this virus in the on of Europe (this is also the case for the tick-borne encephalitis virus which has become the 3rd cause in France of encephalitis)

True, like almost all arbroviruses (Dengue, Yellow fever, Zika)

False, invasive meningococcal invasions are reportable


In front of bronchiolitis of the child, what are the criteria of severity?

False, it has been changed it is an age of less than 8 weeks

Difficulties of living conditions, precariousness

False, it has been changed it is below 92%

False, it is severe signs of struggle that count!


What is the first-line treatment for Treponema pallidum infection?


While visiting with your favourite outpatient in the infectious diseases department, you go to the room of Mrs. Solitaire, 55, who has gram-negative bacillus bacteremia. Your external will ask you if there is a need to do further examinations to look for a secondary location of bacteremia. You answer him that no, this is not the case here, but that there are certain germs for which it is necessary in case of bacteremia to systematically look for a secondary location or an endovascular relay. What are these germs?

False, we do not systematically look for a secondary location to this germ

True, there is a very significant risk of Staphylococcus aureus endocarditis, which requires a transthoracic ultrasound

True, a candida fungemia must be sought for cardio and ocular localization and requires a transthoracic ultrasound and fundus

False, we do not systematically look for a secondary location of this germ


Which of the following are viruses against which vaccines exist?


What is the first-line treatment for Chlamydia trachomatis infection?

True, replaced azithromycin as first-line treatment


While you are an outpatient in your general medicine department, the nurse approaches you by telling you that Mrs. King, Elektra, 55 years old, admitted for 8 days for biological inflammatory syndrome, has a fever of 38.2 ° C.  Not knowing where to start you will see your intern who tells you to apply the rule of P, which makes it easy to look for nosocomial fevers. What are the "Ps" that are part of it?

True, the 5P rule is not to know for the ECN but it seems essential to me for your internships. The 5 Ps are Pee (Urinary Tract Infection), Lung (Pneumonitis), Skin (Erysipelas), Phlebitis (DVT) and Peripheral Puncture (Catheter)


Which of the following are true about influenza vaccination?

Immunity appears 10-15 days after vaccination


Which of the following are true about BCG vaccination?

True, it is a M. bovis attenuated in its pathogenicity

It is mandatory in a child born in a country with a high tuberculosis endemic

It is mandatory in a child with a family history of tuberculosis

True, due to a risk of vaccine disease, as with all live attenuated vaccines

It is contraindicated in case of cellular immunosuppression


Which of the following are true about HPV?

Infection is asymptomatic most of the time

The treatment of condylomas is based, depending on their size and location, on the use of laser, local treatments (especially imiquimod) or surgery

Treatment of warts is based on antivirals such as acyclovir

Bivalent vaccine is preferred in most cases

The HAS recommended in December 2019 to vaccinate all boys with the same vaccination schedule as in girls: two doses of Gardasil 9 vaccine (M0-M6) in 11-14 years old and catch-up in 15-19 year olds with 3 doses (M0-M2-M6). This recommendation has been in effect since January 1, 2021.

Vaccination of boys and girls is recommended


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

The period of contagiousness extends from 5 days before to 5 days after the rash

True, these are the white/bluish rashes on the inner side of the cheek appearing at the 36th hour of the fever and persisting until the rash.

The maculopapular exanthema is itchy and begins behind the ears

Biological confirmation can be done by PCR or serology in blood or saliva

The disease leads to eviction from the community up to 15 days after the eruption


Which of the following are criteria for classifying pyelonephritis as at risk?

Age > 75 (or >65 with +2 Fried criteria), Urinary tree abnormality, pregnancy, IR or severe DI, male sex


With regard to acute fever, which of the following propositions, are true?

False, naughty trap, but to emphasize the importance of qSOFA, easy to perform and of which 2 of the 3 items among the following allows to define a serious sepsis (FR greater than or equal to 22, acute impairment of higher functions, TAs less than or equal to 100mmHg)

In the emergency room, an assessment of the potential severity of the fever can be made via the SOFA

True, let's particularly insist on dehydration especially on fragile grounds (elderly)

The main complications of fever itself are dehydration, decompensation of comorbidities and neurological disorders.

True, this is the great fear of gynecologists and attending physicians.

Any fever with flu-like illness in pregnant women should be tested for blood culture listerias.

False, it is often in these cases a urinary colonization, it is necessary to know how to look for clinical signs and urinary functional signs

A positive ECBU in a febrile elderly should lead to the offer of antibiotic treatment

True. For once, very tricky painting and already seen in internship

A fever in children with abdominal pain and vomiting may indicate pneumonia


Regarding acute community lung disease, which of these propositions are true?

False, in ambulatory the ONLY necessary examination is chest X-ray

During an outpatient consultation at the general practice, additional examinations are limited to chest radiography and minimal inflammatory blood test (CBC, CRP)

False, ECBC should be prescribed in case of productive cough because they make it very easy to identify germs

In standard hospitalization, the biological assessment to identify the infecting germ is mainly based on blood cultures, the yield of ECBC being low, the latter are no longer widely used

The reference antibiotic for pneumococcal pneumonitis is Amoxicillin

False, it is recalled here that legionellosis is an infection that is transmitted from the environment (here infected water networks) to humans, but that there is no human-to-human transmission.

When legionellosis is suspected, in addition to mandatory reporting, the patient should be isolated in a room with additional "droplet" type protection.

True, this is the main complication to look for

In case of dyspnea or febrile desaturation or reascent after the start of antibiotic therapy, a chest X-ray should be done to look for pleural effusion


With regard to whooping cough, which of the following propositions, which one or which are true?

False, it's a gram bacillus -! Remember that cocci gram + it is staphylococcal / pneumococcus / enterococcal / streptococcus, bacillus gram + it is Listeria, Cocci gram _ it is meningococcal and gonococcal and the rest or almost it is bacillus gram -!

Bordetella Pertussis is a small gram+ bacillus

False! Big trap that I often got screwed on SIDES, whooping cough usually does NOT give a fever.

Pertussis can be confused with CoVID 19 infection or with viral pneumonitis because of symptomatology functional signs ENT-fever-cough-muscle pain

True, one of the only indications for nasal PCR after CoVID and influenza

The diagnosis of pertussis is made by nasal swab PCR

False, pertussis is a notifiable disease in clustered/nosocomial cases

True, it is the strategy of cocooning consisting in vaccinating the entourage of infants not yet vaccinated (vaccination starting at 2 months of life) in order to reduce the risk of potentially serious pertussis in the infant.

Although boosters after age 25 are not mandatory, there is an infant protection strategy based on vaccinating adults and the elderly in preparation for pregnancy.


Genital ulcers are mainly due to: (2 responses)

non-sexual acquiring urinary tract infection


You receive in general medical consultation, the young Jeppe, 16 years old, who comes to see you because he has just changed partners, and that his new partner has told him about the screenings of "STDs". You decide to prescribe the standard screening, what tests do you do?

True, followed by a VDRL only in case of positivity.

Automated Qualitative Treponemal Test (EIA or ELISA)

False. Hepatitis B screening is based on HBsAg, HBcAg and HBsAc.

True, it is one of the two valid methods to look for local infections (gonococcus, chlamydia) in humans.

Urethral swab self-sampling to be brought to the laboratory for Gonococcus and Chlamydia PCR.

Collection of the first urinary stream for Gonococcus and Chlamydia PCR.


You are a general practitioner in office and you receive in consultation Mr Kananga, type 2 diabetic for 40 years who has a superinfected plantar perforating disease. As a result, you explain that he will require hospitalization to assess his infection, with specialized care. But what will this support entail?

True, plantar perforating disease arises from a combination of neuropathy and arterial disease.

An evaluation of the vascular trunks with at least one IPS and at most an Echo-Doppler of the lower limbs

True, the plantar perforating disease signs an imbalance of diabetes, so it is necessary to evaluate the biological impact.

A reassessment of diabetes balance by fasting blood glucose and HbA1c

False, the superficial sample would only show the saprophytic bacteria of the skin, it requires a deep sample, even surgical

Bacteriological sampling of the wound by swab

Local management with discharge of the foot and debridage of the wound

Reassessment of tetanus vaccination status


Which of the following propositions are true about syphilitic chancre?

Associated with one or more lymphadenopathy(s), most often inguinal(s) (depending on the site of the chancre), NOT inflammatory(s) 😬

It is accompanied by lymphadenopathy (often inguinal) inflammatory


In the northern hemisphere, influenza is rare in winter

Some coronaviruses can infect patients returning from the Arabian Peninsula

Diagnosis of certainty of coronavirus infections is impossible

PCRs are available for most respiratory viruses

True, especially in the elderly or immunocompromised

These respiratory infections can be life-threatening


In case of late syphilis, the IM injection of penicillin G in the form of delay should be repeated:


With regard to Community infectious spondylodiscitis, which of the following proposals are correct?

S. aureus spondylodiscite indicates a probable dermal origin of the infection

True, like ANY involvement of the spine, it is necessary to look for a lesional syndrome (radiculalgia ...) and / or under lesional (urine retention, pyramidal irritation ...)

If spondylodiscitis is suspected, always look for signs of spinal cord compression.

False, it's the opposite, tell yourself that infectious lesions in 99% of cases are hyper T2 and hypo T1 on MRI

Signs of spondylodiscite on MRI are T1 hypersignal and T2 hyposignal

First-line antibiotic therapy is based on IV vancomycin

False, it is only an analgesic immobilization and it is associated with rehabilitation from the first day

Immobilization is necessary at the beginning of treatment to avoid creating a vertebral fracture


What are the additional examinations of acute non-serious pyelonephritis with risk of complications probably diagnosed?

If second episode of a non-serious ANP without risk of complication (or hyperalgic form)


Urethritis and cervicitis are mainly due to: (2 responses)


What are the additional tests for a severe acute pyelonephritis probably a diagnosis?


With regard to the salpigites, which of these proposals are correct?

True, salpingitis causes lateralized pelvic pain.

Appendicitis, appendix torsion and ectopic pregnancy are the main differential diagnoses of salpingitis

True, by definition, one STI always calls for another.

Salpingitis is an indication to look for local and general STIs

Pelvic ultrasound can highlight pyosalpinx

Salpingitis is treated first-line with Metronidazole monotherapy

True, violin string syndrome, sequelae of chamydia in the liver capsule

Complications of salpingitis include Fitz High Curtis syndrome


Which of the following are ophthalmological manifestations of secondary syphilis?

Only two etiologies to remember for NEC: Sarcoidosis and MS


Which of the following are true about neurosyphilis?

It can be present at all stages of the disease

Early neurosyphilis can be expressed as meningitis

posterior radiculocord syndrome found in TARDIVE neurosyphilis

Early neurosyphilis can be expressed in the form of tabes

Late neurosyphilis can be expressed as dementia

Early neurosyphilis can manifest as memory problems


What is (are) the possible complication(s) of chickenpox in children?


You are a general practitioner in the countryside. On a beautiful Saturday morning (where you work, because you are motivated and passionate about your job 🔥🚀❤❤), Mrs. Carrière, 32, brings you her son. A very energetic little boy of 13 months, he has had a temperature of 40 ° C for 48 hours. He is grumpy and has vomited 3 times 🤮. On clinical examination he presents axial hypotonia and the fontanelle is bulging. What diagnoses do you mention in view of these elements?

Does not explain the fever (you may have a fever, but not a fever at 40)


Which of the following propositions are true about the hamartochondrome?

Often easy diagnosis on pathognomonic CT data of "popcorn" appearance, combining calcifications and fat densities

The spiculated nodule appearance is pathognomonic 🤔

Not mandatory in front of the popcorn appearance and the absence of malignancy criteria

True, note that histological verification (not excision) is desirable


You are a doctor of the ARS and you are dispatched to the sausage fair of Bourg en Bresse Peyronnas, in front of a strong suspicion of Collective Food Poisoning (at least 30 cases). On the road, you remember in mind which samples you are going to make... What are they?

False, canteens/catering places are obliged to keep control food, in case all food is eaten

In case all the food has already been eaten, you can not take a sample from the food

True, this is the only indication to vomiting sampling that you need to know for ECN

Vomiting sampling of symptomatic persons

Stool collection from symptomatic individuals

False, it's not up to you to do the hygiene surveys of the place!

Sampling at storage and refregiration sites


During which diseases are ENT involvement observed (rhinitis, sinusitis, nasal polyposis)?

Eosinophilic granulomatosis with polyangiitis

Rather a pulmonary involvement type of intraalveolar hemorrhage


Which of the following are true for periarteritis nodosa?

In periarteritis nodosa, ANCA is ALWAYS negative

C-ANCA are relatively susceptible to this disease

It can cause vascular nephropathy (malignant nephroangiosclerosis) without glomerulonephritis

Puncture renal biopsy is contraindicated

There is necrotizing vasculitis of medium-sized vessels


Which of the following are true for IgA vasculitis?

It is also called Henoch Schonlein Syndrome

It mainly affects children but remains possible in adults

It mainly affects men over 50 years of age


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

It affects large arteries: aorta and its main branches, with a predilection for the carotid territory and subkeyboard

It affects the vessels of the microcirculation

Especially women under 50 (++ different with Horton)

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