Internal Medecine - View Kamer

Welcome to your ECN 2019 - Internal Medecine

1. Of the following common causes of acute mitral regurgitation, one is incorrect, which

A. Rope breakage

B. Hypertrophic and obstructive cardiomyopathy

C. Trauma

D. Bacterial endocarditis

E. Myocardial infarction

2. Osler’s endocarditis on mitral prolapse is responsible for the following complications except one which?

A. Multiple pulmonary septic embolisms

B. Right hemiplegia with aphasia

C. Microscopic hematuria

D. Lumber spondylitis

E. Acute limb ischemia

3. All the following signs are highly suggestive of cardiac tamponade except one which one?

A. Turgor of the jugular veins

B. Slightly mobile cardiac silhouette in fluoroscopy

C. Signs of pulmonary edema

D. Inspiratory decrease in systolic blood pressure

E. Pulse paradox

4. Which of the following medications for use in congestive heart failure is strictly contraindicated?

A. Digitalics

B. Nitro derivatives

C. Beta blockers

D. Diuretics

E. Prazosin

5. Among the following propositions characterizing malignant arterial hypertension, one is incorrect which?

A. Stage 2 fundus

B. Diastolic blood pressure above 130mmHg

C. Presence of signs of left ventricular failure

D. Presence of significant functional neurosensory signs

E. Presence of signs of renal insufficiency

6. All of the following circumstances may increase the risk of digoxin toxicity, except which one?

A. Kidney failure

B. Very advanced heart failure

C. Hyperthyroidism

D. Hyperkalemia

E. Hypercalcemia

7. The following conditions are the paraneoplastic syndromes likely to be observed during bronchial cancer except one, which one?

A. Schwartz-Bartter syndrome

B. Digital clubbing

C. Cushing’s syndrome

D. Hypercalcemia

E. Enophthalmos

8. How is chronic bronchitis diagnosed?

A. Through interrogation

B. By respiratory functional exploration

C. By chest x-ray

D. By bronchial fibroscopy

E. By the assay of the serum alpha I antitrypsin

9. The following conditions are all possible complications of bronchial dilations except one which?

A. Lung abscess

B. Hemoptysis

C. Purulent pleurisy

D. Cystic fibrosis

E. Chronic cor pulmonale

10. Pre-capillary pulmonary arterial hypertension of chronic respiratory failure is associated with

A. Vasoconstriction due to hypoxia

B. Vasodilatation due to hypercapnia

C. Polycythemia

D. An increase in capillary and pulmonary venous pressure

E. A decrease in cardiac output

11. Which of the following clinical signs does not belong to the clinical picture of diffuse interstitial pulmonary fibrosis?

A. Clubbing

B. Dyspnea

C. Left cancer

D. Weight loss

E. Crackles

12. In a 44-year-old man, a former tuberculosis patient, the occurrence of red blood hemoptysis should evoke all of the following conditions except one?

A. Bronchial cancer

B. A recurrence of pulmonary tuberculosis

C. Parascaricidal dilatation of the bronchi

D. Aspergillosis on sequence of tuberculosis

E. Bronchial candidiasis

13. All of the following statements concerning gastroesophageal reflux are correct, except which one?

A. It is secondary to retrograde esophageal contractions

B. It can be observed in the absence of hiatal hernia

C. It is often marked by heartburn

D. It can evolve under the mask of pseudoanginal pain

E. It is related to incontinence of the lower esophageal sphincter

14. In young adults, the most common cause of clinical syndrome of pyloric stenosis is

A. Gastric cancer

B. Duodenal ulcer

C. Hypertrophy of the pylorus

D. Gastric ulcer

E. Gastric complications

15. What is the most precise criterion for assessing the importance of an upper algal digestive haemorrhage?

A. Hematocrit

B. The volume of blood aspirated by the nasogastric tube

C. The number of units of blood and fluids infused for hemodynamic maintenance

D. The drop in blood pressure

E. The initial central venous pressure

16. Epigastric pain without late postprandial irradiation, with a rhythmic cramp type during the day, evokes above all

A. Ulcerative pain

B. Gastritis

C. Gastroesophageal reflux

D. Acute hemorrhage pancreatitis

E. Hepatic colic

17. Which of the following clinical and biological signs is in favor of diarrhea due to malabsorption?

A. Significant weight loss

B. Mucous diarrhea

C. Bloody diarrhea

D. Stool weight at 150g/d

E. Steatorrhea at 2g/d

18. Among the following signs, only one is not compatible with the diagnosis of isolated functional colonopathy

A. Abdominal pain

B. Weight loss

C. Constipation

D. Diarrhea

E. Postprandial bloating

19. Which of the following is most often responsible for the acute pancreatitis?

A. Alcohol

B. Cholelithiasis

C. Obesity

D. Clofibrate

E. Hyperparathyroidism

20. Nephrotic syndrome always includes all the following except

A. Hypoalbuminemia less than 30g/l

B. An increase in plasma cholesterol

C. An increase in serum gammaglobulins

D. A low concentration of urinary sodium

E. A risk of vessel thrombosis

21. Nephritic syndrome is characterized by all of the following except

A. Hypertension

B. Hypo protidemia less than 60g per liter

C. Hematuria with cylindruria

D. Edema of the lower limbs

E. Permanent proteinuria

22. Dissolving a uric acid stone requires

A. An acid urinary pH

B. An alkaline urinary pH

C. A neutral urinary pH

D. A high urinary density

E. A high urinary concentration

23. The following propositions relate to acute prostatitis, except which one?

A. Painful prostatitis

B. Acute retention of urine

C. Urinary burns

D. A hard and stony prostatitis

E. A high fever

24. The presence of pus in the urine invites to look for all of the following causes except one, which one?

A. Renal lithiasis

B. A vesico-renal reflux

C. Glomerulonephritis

D. A retained bladder

E. Cystitis

25. Which of the following syndromes definitely contraindicates the prescription of biguanides in diabetes mellitus?

A. Obesity

B. Kidney failure

C. Insulin-dependent diabetes

D. Angina

E. Peripheral neuropathy

26. Type 4 hypertriglyceridemia may be complicated by

A. Atheroma

B. Acute pancreatitis

C. Hypertension

D. Obesity

E. Gout

27. What is the most suggestive clinical sign of acromegaly?

A. Swelling of the fingers

B. Weight gain

C. Hair loss

D. Prognathism of the lower jaw

E. Exophthalmos

28. Indicate among the following biochemical parameters the one that evokes the existence of a Conn’s adenoma in a hypertensive

A. Hypernatremia

B. Hypokalemia

C. Metabolic acidosis

D. Hyperglycemia

E. Normal renin activity in peripheral veins

29. All of the following statements regarding erysipelas are true except one, which one?

A. It is usually located close to the entrance door of the germ

B. It is due to beta hemolytic streptococci A

C. She is a recidivist

D. It is more frequent in the lower limbs than in the face at present

E. It has a gradual, non-painful onset

30. Yeasts of the candida genus can be responsible for all of the following except one, which?

A. Vaginitis

B. Thrush

C. Ringworm of the scalp

D. Black hairy tongue

E. Intertrigo

31. Paget’s disease causes the following changes except one; which?

A. Deafness

B. Heart failure

C. Headaches

D. Hip disease

E. Osteonecrosis

32. For an attack of acute gout in a patient with chronic renal failure, the treatment to be initiated from the outset is

A. Aspirin

B. Phenylbutazone

C. Colchicine

D. Benzobromarone (Desuric)

E. Allopurinol (Zyloric)

33. For the diagnosis of a syphilitic chancre only one of the following examinations is useless, which one?

A. Ultramicroscopic examination

B. The VDRL

C. TPHA

D. Immunofluorescence

E. Nelson’s test

34. After correct treatment of typhoid fever, a subject remains a Salmonella carrier. What should you look for

A. A splenic abscess

B. Cholelithiasis

C. A stomach ulcer

D. A Meckel’s diverticulum

E. Appendicular abscess

35. A 45-year-old farmer has a minor hand wound. He has properly vaccinated against tetanus at the age of 19 with a booster at 20. What are you doing to prevent tetanus?

A. Nothing

B. A toxoid booster and an injection of the human tetanus immunoglobulin

C. Two toxoid injections one month apart

D. A toxoid booster

E. An injection of human tetanus immunoglobulins

36. Which antibiotic is active on the germs responsible for gas gangrene?

A. Gentamycin

B. Colistin

C. Penicillin G

D. Cotrimoxazole

E. Nalidixic acid

37. The diagnosis of cerebral toxoplasmosis in an HIV-infected patient should be considered in the presence of the following conditions except one?

A. A convulsive seizure

B. A fever

C. Hemiparesis

D. Meningeal stiffness

E. Disorders of conscience

38. In the typical form of myeloma or Kahler’s disease, we observe in the blood

A. A plasma cell

B. Eosinophilla

C. Hyper lymphocytosis

D. Neutrophilic polynucleosis

E. None of the above

39. Which of the following hemopathies reminds you of the observation of splenomegaly during the clinical examination

A. Biermer’s disease

B. Chronic myeloid leukamia

C. Kahler’s disease

D. Hemophilia

E. Latrogenic agranulocytosis

40. In a 48-year-old patient, hepatic cirrhosis revealed by signs of portal hypertension was discovered. Biological examinations show a rate of platelets at 50,00/ml and D’dimers below 0.5 mcg/l. what is the probable origin of thrombocytopenia

A. Bone marrow failure

B. A DIC

C. Immunological destruction

D. Hypersplenism

E. Consumption at the level of the esophageal varices