English

1
CARDIOLOGY

MALAISE, LOSS OF CONSCIOUSNESS,
COMITIAL CRISIS OF ADULTS

Simple complement:

1. One of these conditions is not part of cardiac causes of lipothymia:
A. Conduction disturbances and bradycardia
B. Hypotension
C. Ventricular tachycardia
D. Massive pulmonary embolism
E. Wolff-Parkinson-White syndrome

Answer: B

2. Which of the following forms of loss of consciousness does not require hospitalization?
A. Typical, disabling vasovagal syncope
B. Temporary loss of consciousness associated to some neurological disorders
C. Temporary loss of consciousness of unknown etiology
D. Arrhythmic or conduction causes proven or suspected on indirect ECG abnormalities
E. Orthostatic hypotension

Answer: E

3. Which of these investigations are not useful in exploring the loss of consciousness?
A. Brain MRI
B. Holter recorder/24 h
C. Electrophysiological exploration
D. Heart ultrasound
E. Tilt test

Answer: A

Multiple complement:

1. The following are not vascular causes of lipothymia or syncope:
A. Wolff-Parkinson-White syndrome
B. Neuro-vegetative dysautonomia
C. Massive pulmonary embolism
D. Subclavian artery steal
E. Atrial fibrillation

Answer: A, C, E

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2. Which of the following statements are true?
A. Completeness (syncope) is an argument in guiding diagnosis
B. ECG may reveal TV discharges
C. ECG may show trifascicular block
D. Loss of consciousness duration has value in orientation
E. The presence of an extended post-critical stage indicates a neurological cause

Answer: B, C, E

3. Which of the following explorations of the second intention has no value in exploring syncope?
A. Holter recorder/24 h
B. Cardiac MRI
C. Tilt test
D. Ventriculography
E. Coronarography

Answer: B, D

4. Which of these disorders is not a syncope cardiac cause?
A. Pulmonary stenosis
B. Vasovagal syncope
C. Prosthetic valve thrombosis
D. Sinoatrial block
E. Orthostatic hypotension

Answer: B, E

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ARTERIAL HYPERTENSION

Simple complement:

1. Which of the following is true?
A. 6 times increased global cardiovascular mortality
B. 7 times CVA risk
C. 5 times heart failure
D. 4 times arteriopathy risk
E. 6 times coronaropathy risk

Answer: A

2. Defining AHT at ABPM in sleep involves:
A. 120/65
B. 125/70
C. 125/65
D. 120/70
E. 125/75

Answer: D

3. Defining AHT at ABPM upon waking involves:
A. 135/85
B. 135/80
C. 130/80
D. 135/80
E. 130/85

Answer: A

4. White coat AHT involves normal ABPM with value in the cabinet >of:
A. 135/85
B. 140/90
C. 145/90
D. 140/95
E. 140/85

Answer: B

5. The following are considered risk factors, except:
A. Age
B. Diabetes
C. Family history of early cardiovascular accident
D. Smoking
E. HDL >0,4g/L

Answer: E

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1. Diagnosis of target organ damage involves:
A. Exercise test
B. Coronarography
C. Left ventricular hypertrophy
D. Creatinine clearance <60ml/minute
E. Significant microalbuminuria

Answer: C, D, E

2. Significant clinical signs of AHT are:
A. Proteinuria (>500 mg/24h)
B. Ischemic CVA
C. Peripheral vascular disease
D. Aortic dissection
E. Aortic stenosis

Answer: B, C

3. Significant clinical signs of AHT are:
A. Congestive heart failure
B. Transient ischemic attack
C. Papilloedema
D. Kidney failure
E. Nephrotic syndrome

Answer: A, B, C, D

4. Systematic examinations in AHT:
A. Blood creatinine
B. Urinary strip
C. Natremia
D. Uric acid
E. Triglycerides

Answer: A, B, D, E

5. Recommended examinations in AHT:
A. Eye fundus
B. Pulse wave velocity
C. Proteinuria
D. Transthoracic ultrasound
E. Doppler echo of aorta

Answer: A, B, C, D

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6. In heart failure recommended medication to treat hypertension is:
A. Anticalcic drugs
B. Beta blockers
C. ACE inhibitors
D. Anti-aldosterone treatment
E. Methyldopa

Answer: A, D
7. In pregnancy recommended medication to treat hypertension is:
A. Thiazide diuretics
B. ACE inhibitors
C. Anti-aldosterone treatment
D. Methyldopa
E. Labetolol

Answer: D, E

8. For the black subjects recommended drugs include:
A. Thiazide
B. Calcium channel blockers
C. ACE inhibitors
D. ARA II
E. Beta blockers

Answer: A, B

9. Iatrogenic causes of secondary hypertension include:
A. Tricyclic antidepressants
B. Acetazolamide
C. Cyclosporine
D. NSAIDs
E. Corticoids

Answer: C, D, E

10. Nephropathies causing secondary hypertension:
A. Acute glomerulonephritis
B. Diabetic nephropathy
C. Unilateral renal destruction
D. Renal artery stenosis
E. Toxic nephropathy

Answer: A, B, C

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11. In regard to coarctation of the aorta the following are true:
A. Hypertension only on lower limbs
B. Hypertension only on upper limbs
C. Murmur of aortic stenosis
D. Aortic isthmus stenosis
E. Heart failure

Answer: B, D, E

12. Regarding pheochromocytoma the following are true:
A. Chromaffin-cell tumors
B. Malignancy in 90% of cases
C. Family forms that integrates in multiple endocrine neoplasia
D. Surgery in the alpha and beta blockers
E. Adrenal cortical location

Answer: A, C, D

13. The following are causes of secondary hypertension:
A. Hyperthyroidism
B. Carcinoid tumors
C. Acromegaly
D. Cushing syndrome
E. Lupus

Answer: A, B, C, D

14. Are antihypertensive of second intention:
A. Diuretics
B. Beta blockers
C. Aliskiren
D. Alpha blockers
E. Calcium channel blockers

Answer: C, D

15. Toxic caused of secondary AHT:
A. Fungi
B. Alcohol
C. Paints
D. Cocaine
E. Amphetamines

Answer: B, D, E

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ACUTE AND CHRONIC CHEST PAIN

Simple complement :

1. The following are not one of the pain characteristics:
A. Tightness or constriction
B. Racking
C. Stab
D. Very fast (angina)
E. (Digestive) burning

Answer: D

2. Chest pain associated fever is caused by:
A. Aortic dissection
B. Myocardial infarction
C. Pneumothorax
D. Gastroduodenal ulcer
E. Pulmonary embolism

Answer: E

3. The following do not characterizes ECG changes of acute pericarditis:
A. Diffuse depression
B. Concave up elevation
C. Convex up depression
D. PQ depression
E. No evolution to Q wave

Answer: C

4. Chest pain associated with blood pressure asymmetry and limb ischemia is found in:
A. Pneumothorax
C. Pericarditis
D. Aortic dissection
E. Pulmonary embolism

Answer: D


1. ECG in chest pain is uninterpretable in these situations:
A. Long QT
B. LV hypertrophy
C. Left bundle branch block
D. Digital
E. Pacemaker

Answer: B, C, D, E

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2. Secondary repolarization disturbances occur in the following, except:
A. Bundle branch block
B. Wolf-Parkinson-White
C. Myocardial infarction
D. Early repolarization
E. Brugada syndrome

Answer: C, D

3. The following statements about d-dimers are true:
A. Grow in case of phlebitis
B. Grow in case of pulmonary embolism
C. Are very specific
D. Are very sensitive
E. There were very few false positive results

Answer: A, B, D

4. The following statements about pulmonary embolism are true:
A. Is confirmed by Doppler pulmonary ultrasound
B. Indication of fibrinolysis in case of pulmonary embolism complicated by pulmonary infarction
C. Anticoagulation only after the diagnosis is confirmed
D. Diagnosis is clinical evoked
E. The diagnosis is supported by ECG, d-dimers

Answer: D, E

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ANGINA PECTORIS AND MYOCARDIAL INFARCTION

Simple complement:

1. In the etiology of stable angina is not included:
A. Takayasu
B. Coronary spasm
C. Atherosclerosis
D. Syphilis
E. Lupus

Answer: E

2. In ischemia tests the following are not included:
A. Exercise ECG
B. Exercise scintigraphy with dobutamine
C. Ultrasound with dobutamine
D. Exercise ultrasound
E. MRI with dipyridamole

Answer: C

3. Which of these tests has not excellent specificity?
A. Ultrasound with dobutamine
B. Exercise ultrasound
C. Exercise scintigraphy
D. Exercise ECG
E. Scintigraphy with dipyridamole

Answer: D


1. Exercise angina treatment includes:
A. Diuretics
B. Beta blockers
C. Statin
D. Angioplasty revascularization
E. Clopidogrel

Answer: B, C, D, E

2. Acute ST elevation myocardial infarction in the antero-septal-apical territory presents ST
elevation in:
A. DI
B. V6
C. V2
D. V4
E. aVF

Answer : C, D
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3. Acute ST elevation myocardial infarction in the inferior-basal-lateral territory presents ST
elevation in:
A. V1
B. V2
C. DI
D. aVF
E. V9

Answer : C, D, E

4. Acute ST elevation myocardial infarction in the apical territory presents ST elevation in:
A. DI
B. V3
C. V4
D. V6
E. aVL

Answer : B, C

5. The treatment of acute ST elevation myocardial infarction includes:
A. ACE inhibitors as of the first days
B. Coronary reperfusion for every infarction
C. Clopidogrel
D. Morphine
E. Aspirin

Answer: C, D, E

6. Killip international classification:
A. Stage I includes cardiogenic shock
B. Stage III has mortality in the acute phase of 80-100%
C. Stage II has mortality in the acute phase of 30%
D. Stage I includes acute pulmonary edema
E. Stage IV involves cardiogenic shock

Answer: C, D, E

7. Post infarction rhythm disorders include:
A. VT
B. AIVB
C. AV block
D. Atrial fibrillation
E. Ventricular extrasystoles

Answer: A, B, D, E

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8. Dressler syndrome is caracterized by:
A. Pericarditis with arthralgia
B. No required treatment
C. Inflammatory syndrome
D. Appears in the fourth week
E. Is treated with inflammatory drugs

Answer: A, C

9. ECG in ST ACS:
A. ST elevation
B. ST depression (mild forms)
C. T-wave inversion
D. Frequently normal
E. Possible evolution to Q wave

Answer: C, D, E

10. Treatment involves:
A. Fibrinolysis
B. Morphine
C. Prasugrel
D. Fondaparinux
E. Treatment of risk factors

Answer: C, D, E

11. Infarction treatment with eplerenone is indicated in case of:
A. In all post-myocardial patients
B. After stent implantation
C. LVEF<40%
D. Clinical signs of LVF
E. In combination with atorvastatin

Answer: C, D

12. ST ACS complications include:
A. Myocardial rupture
B. LV aneurysm
C. Atrial rhythm disorders
D. Heart failure
E. Sudden death

Answer: D, E

12

PERIPHERAL VASCULAR DISEASE OF
AORTA AND LOWER LIMBS

Simple complement:

1. Among the rare etiologies of abdominal aortic aneurysm the following is not included:
A. Behet
B. Elher-Danlos
C. Takayasu
D. Atherosclerosis
E. Posttraumatic

Answer: D

2. Complications of abdominal aortic aneurysm do not include:
A. Thrombosis
B. Rupture
C. Bacterial transplantation
D. Embolism
E. Compressions

Answer: A

3. About Burger thrombangeitis one can say:
A. Affects men under 50 years
B. Common in patients with many risk factors
C. No clinically important rebound
D. It is collagenosis
E. Frequently affects the upper limbs

Answer: E


4. Leriche-Fontaine classification:
A. Stage II: no symptoms
B. Stage IV: permanent pain
C. Stage II: exercise intermittent claudication
D. Stage III: distal trophic disorders
E. Stage I: no symptoms

Answer: B, C

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5. IPS values represent:
A. 0.9 1.3 normal
B. <0.4 Severe chronic peripheral vascular disease of lower limbs
C. >1.3 normal
D. 0.75 0.9 Severe chronic peripheral vascular disease of lower limbs
E. 0.4 0.75 Severe chronic peripheral vascular disease of lower limbs

Answer: A, B

6. Differential diagnosis of chronic peripheral vascular disease of lower limbs in the presence of
intermittent claudication is made with:
A. Aortic dissection
B. Aortic coarctation
C. Diabetic neuropathy
D. Alcoholic polyneuritis
E. Narrow lumbar canal

Answer: B, E

7. Treatment of chronic peripheral vascular disease of lower limbs includes:
A. Bed rest
B. ACE inhibitors
C. Statin
D. Clopidogrel
E. Quitting smoking

Answer: B, C, D

8. Hygienic-dietary recommendations of chronic peripheral vascular disease of lower limbs
include:
A. Stopping smoking
B. Correction of obesity
C. Lowering blood pressure
D. Bed rest
E. Statin

Answer: A, B, C

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ACUTE LIMB ISCHEMIA

Simple complement:

1. Among the acute ischemic embolic mechanisms there are:
A. Atheroma
B. Behet
C. Horton
D. Hyperviscosity syndrome
E. Dilated cardiomyopathy

Answer: E

2. Among acute ischemic embolic mechanisms the following are not included:
A. Myxoma
B. LV aneurysm
C. Aortic dissection
D. Atrial fibrillation
E. Mitral stenosis

Answer: C

3. The following are not one of the clinical signs of acute ischemia:
A. Pale, cold limb
B. Abolished beat
C. Brutal and permanent pain
D. Flat veins
E. Time extension for skin recoloration

Answer: C

4. Absent pulse on ankle means the occlusion of:
A. Aorta
B. Common femoral artery
C. Superficial femoral artery
D. Popliteal artery
E. Calf arteries

Answer: E


1. Purpose of ECG in acute ischemia is:
A. Routine
B. Etiological
C. Diagnosis
D. Severe hyperkalemia
E. Hyponatraemia

Answer: B, D

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2. Classic preoperative results include:
A. Chest X-ray
B. Blood type and Rh
C. CBC
D. Ionogram
E. ECG

Answer: A, B, C, D

3. Fogarty embolectomy probe involves:
A. Approach under general anesthesia
B. Is made at the level of Scarpa's triangle
C. Is the treatment in thrombotic acute ischemia
D. Is the treatment in embolic acute ischemia
E. Creates vascular wall damage

Answer: B, D

4. Amputation is done in case of:
A. Gangrene
B. Failure of revascularization techniques
C. Per primam in all acute ischemia
D. Ischemia exceeded
E. Aortic bifurcation obstructions

Answer: A, B, D

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HEART FAILURE IN ADULTS

Simple complement:

1. What is the Laplaces law?
A. LV dilatation with decreased ejection volume
B. LV dilation to maintain a systolic ejection volume
C. LV hypertrophy to maintain an adequate systolic volume
D. LV hypertrophy to reduce parietal tension
E. None of the above answers

Answer: E

2. Carvalhos sign is:
A. Murmur Z3
B. Murmur Z4
C. Breath of mitral insufficiency
D. Breath of tricuspid insufficiency

Answer: D

3. NYHA class IV means:
A. Transparent limitation of activities
B. Dyspnea on ordinary activities
C. Symptoms occurring also at rest
D. With no rest symptoms

Answer: C

4. The following are causes of increased flow heart failure:
A. HIV
B. Chagas disease
C. Steinert disease
D. Lupus
E. Chronic anemia

Answer: E


1. Heart failure by pressure overload occurs in:
A. Acute mitral insufficiency
B. Aortic stenosis
C. Hypertrophic obstructive cardiomyopathy
D. AHT
E. Acromegaly

Answer: B, C, D

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2. Endocrinopathies with myocardial damage are:
A. Thyrotoxicosis
B. Pregnancy
C. Pheochromocytoma
D. Acromegaly
E. Addison

Answer: A, C, D

3. Negative prognostic clinical factors are:
A. RV dysfunction
B. Increased lung resistances
C. Old age
D. VO2max<14ml/kgc/minute
E. Syncope

Answer: C, D, E

4. Hygienic-dietary rules in heart failure include:
A. Low-sodium diet
B. Moderate physical activity
C. Fluid restriction in case of hyponatremia
D. MenC vaccination
E. Influenza vaccination

Answer: A, B, C, E

5. Medication that has proven effective in lowering mortality is:
A. Beta blockers
B. Nitrates
C. Loop diuretics
D. Antialdosterone drugs
E. ACE inhibitors

Answer: A, D, E

6. Antiarrhythmic drugs indicated in heart failure are:
A. Quinidine
B. Disopyramide
C. Propafenone
D. Beta blockers
E. Amiodarone

Answer: D, E

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7. Which of the following are true:
A. ACE inhibitors reduce mortality by preventing LV remodeling
B. Beta blockers are included in therapy before ACE inhibitors
C. Beta blockers are included in therapy in maximum dose
D. Loop diuretics reduce mortality
E. ACE inhibitors are standard treatment of heart failure

Answer: A, E

8. Indications for resynchronization therapy in heart failure are:
A. Refractory heart failure
B. FEVS<35% regardless NYHA functional class
C. QRS>120 milliseconds
D. Left bundle branch block
E. LVEDD>30mm/m
2

Answer: C, D, E

9. Among diastolic heart failure etiologies there are:
A. Myocardial hypertrophy
B. Mitral insufficiency
C. Ischemic heart disease
D. Constrictive pericarditis
E. Aortic insufficiency

Answer: A, C, D

10. Complications of cardiac transplantation are:
A. Organ rejection
B. Liver failure
C. Kidney failure
D. Lymphomas
E. Opportunistic infections

Answer: A, C, D, E

11. Treatment of acute pulmonary edema includes:
A. Teofine iv
B. Beta blocker in case of tachycardia
C. Nitrate compounds
D. Oxygen therapy
E. Furosemide iv

Answer: C, D, E

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INFECTIOUS ENDOCARDITIS

Simple complement:

1. Heart diseases with increased risk of endocarditis include:
A. Bicuspid aortic valve disease
B. Aortic insufficiency
C. Mitral valve prolapse
D. History of infectious endocarditis
E. Obstructive cardiomyopathy

Answer: D

2. HACEK group does not include:
A. Haemophilus
B. Actinobacillus
C. Chlamydia
D. Eikenella
E. Kingella

Answer: C

3. Atypical and/or intracellular germs do not include:
A. Bartonella
B. Mycoplasma
C. Brucella
D. Coxiella burnetii
E. Cardiobacterium

Answer : E

4. Duck minor criteria are:
A. 2
B. 5
C. 4
D. 3
E. 6

Answer: B


1. Peripheral signs of infectious endocarditis are:
A. Osler nodes
B. Roth nodes
C. Purple petechial rash
D. Splenomegaly
E. Fever

Answer: A, B, C, D

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2. Duck minor criteria do not include:
A. Fever >38 degree Celsius
B. Janeway purple rash
C. Age >60 years
D. Positive blood cultures for HACEK
E. Mycotic aneurysm

Answer: C, D

3. Treatment of endocarditis with methicillin-resistant staphylococci on native valve includes:
A. Oxacillin 6 weeks
B. Aminoside 5 days
C. Amoxicillin 6 weeks
D. Vancomycin 6 weeks
E. Penicillin G 6 weeks

Answer: B, D

4. Renal complications of infectious endocarditis include:
A. Acute pyelonephritis
B. Renal infarction
C. Acute glomerulonephritis
D. Acute renal failure
E. Renal abscess

Answer : B, C, E

5. Treatment of endocarditis on negative blood culture prosthesis includes:
A. Gentamicin 15 days
B. Ceftriaxone 6 weeks
C. Vancomycin 6 weeks
D. Oxacillin 6 weeks
E. Rifampicin 6 weeks

Answer: A, C, E

6. Surgical treatment of endocarditis is made in case of:
A. Shock
B. Routine
C. In extreme emergencies in all patients
D. Uncontrolled infection
E. Prevention of embolic risk

Answer: A, D, E

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ACUTE PERICARDITIS

Simple complement:

1. The following are not met in the clinical examination for acute pericarditis:
A. Precordial pain
B. Fever
C. Paradoxical pulse
D. Pericardial rub
E. Syncope

Answer: E

2. ECG in acute pericarditis does not show:
A. Micro-tension
B. Electric alternance
C. Sinus tachycardia
D. Atrioventricular block
E. Diffuse ST elevation

Answer: D


1. In the etiology of acute pericarditis are included:
A. Sjogren syndrome
B. Lupus
C. Hodgkin
D. Myxedema
E. Acute pancreatitis

Answer: B, C, D, E

2. In the etiology of acute pericarditis are included:
A. Idiopathic
B. Tuberculosis
C. Neoplastic
D. Viral
E. MALT lymphoma

Answer: A, B, C, D

3. Clinical signs of tamponade are:
A. Cardiogenic shock
B. Pulmonary edema
C. Kussmaul pulse
D. Increased blood pressure in inspiration
E. Major right signs

Answer: A, C, E

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4. Pericarditis surgical drainage is performed in case of:
A. Tamponade
B. Voluminous persistent effusion under treatment
C. In all cases of fluid in the pericardium
D. Explorer for diagnostic purpose
E. In case of recurrence

Answer: A, B

5. Which of the following statements about chronic constrictive pericarditis is true:
A. Constriction of the right heart cavities
B. Dip-plateau-type appearance of left ventricular pressure
C. Large amount of pericardial effusion
D. Pericardial thickening
E. Anasarca

Answer: A, D, E

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CHRONIC VENOUS INSUFFICIENCY. VARICES

Simple complement:

1. The main causes of venous insufficiency do not include:
A. Age
B. Obesity
C. Smoking
D. Pregnancy
E. Heredity

Answer: C

2. Venous return is not ensured by:
A. Valves continence
B. Heart muscle pump
C. Residual pressure of arterial network
D. Pressing the plantar arch
E. Negative pressure generated by breathing

Answer: B

3. The following are not part of the medical treatment of venous insufficiency:
A. Embolization
B. Venotonic drugs
C. Variceal sclerosis
D. Thermal cure
E. Strapping

Answer: A


1. Which of the following is true regarding the Porters classification:
A. Class 0: minor venous insufficiency
B. Class 3: major trophic disorders with ulcers
C. Class 2: severe chronic venous insufficiency
D. Class 2: evident trophic disorders, without ulcers
E. Class 1: without functional constraint

Answer: B, D

2. Functional signs include:
A. Discomfort related to unaesthetic varicose veins
B. Standing fatigue
C. Restless legs syndrome
D. Nervous claudication
E. Calf cramp

Answer: A, B, C, D

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3. Trophic skin disorders include:
A. Chronic hypodermitis
B. Varicose ulcer
C. Eczema
D. Telangiectasias
E. Killian white atrophy

Answer: C

4. Which of the following are general measures of treatment:
A. Weight loss
B. Avoiding prolonged orthostatism
C. Bed rest
D. Elastic strapping
E. Tetanus vaccination

Answer: A, B, D, E

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PRESCRIBING AND MONITORING ANTITHROMBOTIC TREATMENT

Simple complement:

1. Which of these thrombolytics is not used in myocardial infarction:
A. Actilyse
B. Streptokinase
C. Urokinase
D. Metalyse
E. Tenecthesis ( telenecteplase )

Answer: C

2. Absolute contraindication to thrombolysis is:
A. Age >70 years
B. Uncontrolled hypertension
C. Infectious endocarditis
D. TIA<6 months
E. Aortic dissection

Answer: E

3. Absolute contraindication to thrombolysis is:
A. Ulcer < 1 month
B. Gastrointestinal bleeding< 1 month
C. Recent heart massage
D. Cirrhosis
E. AVK treatment

Answer: B

4. Side effect of platelets is:
A. Thrombocytopenia
B. Purpura
C. Bleeding
D. Anemia
E. None

Answer: C


1. Absolute contraindication of heparin is:
A. Allergy
B. Haemostasis anomaly
C. Intramuscular injections
D. Severe AHT
E. Pericarditis

Answer: A, B, C

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2. Coagulation vitamin K-dependent factors are:
A. Prothrombin
B. Proconvertin
C. C and S protein
D. VIII factor
E. Stuart factor

Answer: A, B, C, E

3. AVK contraindication is:
A. Malignant hypertension
B. Recent ischemic CVA
C. Second quarter pregnancy
D. Pericarditis
E. Allergy

Answer: A, D, E

4. AVK activity is inhibited by:
A. Cimetidine
B. Chloramphenicol
C. Fibrates
D. Griseofulvin
E. Corticoids

Answer: D, E

5. Which of the following statements are true about Clopidogrel:
A. Inhibits the cyclooxygenase
B. Is compulsorily administered one month in case of covered stent
C. Blocks the aggregation mediated by adenosine diphosphate
D. Should be continued for one year after stented myocardial infarction
E. Is administered in case of allergy to aspirin

Answer: C, D, E

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PRESCRIBING AND MONITORING DIURETICS

Simple complement:

1. Which of the following statements are true about loop diuretics:
A. Natriuresis increase in proximal convoluted tubule
B. Urinary calcium effect in high dose
C. Intravenous effect in 3 hours
D. Logarithmic dose-effect relationships
E. Maximum dose of furosemide=500 mg/day

Answer: B

2. Which of the following statements are true about Thiazide diuretics:
A. Urinary calcium effect
B. Represented by furosemide and bumetamide
C. Are administered in renal failure
D. Linear dose-effect relationship
E. Anti-ADH effect used in nephrogenic diabetes insipidus

Answer: E

3. Which of the following statements are true about potassium-sparing diuretics:
A. Are administered in hyponatremia
B. Are associated with ACE inhibitors
C. Are administered in primary hyperaldosteronism
D. Can be used with lithium
E. Have enzyme inhibitor effect

Answer: C


1. Indications Thiazide diuretics:
A. AHT
B. Hepatic encephalopathy
C. Renal failure
D. Nephrogenic diabetes insipidus
E. Allergy to sulfamide

Answer: A, D

2. Contraindications of loop diuretics:
A. Liver cirrhosis
B. Hypercalcemia
C. Anasarca
D. Urinary tract obstacle
E. Lactation

Answer: A, D, E

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3. Side effects of potassium-sparing diuretics are:
A. Gynecomastia
B. Hypervolaemia
C. Psychomotor agitation
D. Hypokalaemia
E. Hyperchloraemic metabolic acidosis

Answer: A, E

4. Which of the following are true about carbonic anhydrase inhibitors:
A. Important diuretic effect
B. Hypercapnia
C. Indicated in acute glaucoma
D. Cause secondary hyperaldosteronism
E. Metabolic alkalosis

Answer: C, D

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PRESCRIBING A DIET

Simple complement

1. Food balance requires:
A. Food fixed quantity rate
B. Standard dietary recommendations
C. Avoiding long periods of fasting
D. Daily consumption of the four main categories
E. None of the above

Answer: C

2. Decreased caloric density is not indicated in:
A. AHT
B. Obesity
C. Diabetes type 2
D. Hypertriglyceridemia
E. Hypercholesterolemia

Answer: B

Multiple complement

1. Lowering salt intake is recommended in:
A. Chronic respiratory failure
B. AHT
C. Nephrotic syndrome
D. Renal failure
E. Alcoholic liver disease

Answer: B, C, D

2. Decreased protein intake is recommended in:
A. Hypertriglyceridemia
B. Hypercholesterolemia
C. AHT
D. Nephrotic syndrome
E. Renal failure

Answer: D, E

30

LOWER LIMB EDEMA

Simple complement:

1. Unilateral edema occur in:
A. Renal failure
B. Certain drugs
C. Heart failure
D. Filariasis
E. None

Answer: D

2. Fluid retention edema are:
A. Idiopathic cyclic edema
B. Protein denutrition
C. Thrombophlebitis
D. Lymph node metastases of cancer
E. Erysipelas

Answer: B


1. Treatment of edema includes:
A. Antialdosterone diuretic
B. Loop diuretic
C. Fluid retention
D. Supervision of serum proteins
E. Etiologic treatment

Answer: B, C, E

2. Unilateral edema are:
A. Nephrotic syndrome
B. Erysipelas
C. Heart failure
D. Thrombophlebitis
E. Protein denutrition

Answer: B, D

3. Hepatic balance for lower limb edema includes:
A. Liver puncture
B. Paracentesis
C. Transaminases
D. Bilirubin
E. Serum albumin

Answer: C, E

31

PULMONOLOGY

ACUTE AND CHRONIC DYSPNEA

Simple complement:

1. Hypoxia + Hypercapnia is found in:
A. Decompensation of COPD
B. Pulmonary embolism
C. Asthma attack
D. APE
E. Renal failure

Answer: A

2. The following are not among the signs of acute respiratory failure:
A. Cyanosis
B. Polypnea
C. Sweating
D. Intercostal circulation
E. Agitation

Answer: E

3. Dyspnea with auscultated asymmetry appears in:
A. Pulmonary embolism
B. Spontaneous Pneumothorax
C. Paroxysmal asthma
D. Psychogenic Dyspnea
E. APE

Answer: B


4. Causes of chronic Dyspnea are:
A. APE
C. Metabolic acidosis
D. COPD
E. Chronic pericarditis

Answer: D, E

32

5. Acute Dyspnea without abnormal noise is found in:
A. Neuromuscular diseases
B. Cardiac tamponade
C. Massive pleurisy
D. Atelectasis
E. APE
Answer: A, B

6. Hypoxia + Hypercapnia is found in:
A. Alveolar hypoventilation
C. APE
D. Acute pneumopathy
E. Decompensation of COPD

Answer: B, C, D

33

RESPIRATORY ALLERGIES IN ADULTS

Simple complement:

1. Which of the following statements is not true about allergic rhinitis?
A. Generally occurs at 10-15 years
B. Seasonal allergic rhinitis is caused by pollen
C. Allergic perennial rhinitis is caused by domestic allergens
D. There is no chronological order between rhinitis and asthma
E. By type of sensitization, there are three types of rhinitis

Answer: E

2. Which of the following statements is not true in the diagnosis of allergy in adults
A. Anamnesis defines environmental conditions and patients daily lifestyle
B. Specifying the investigation on domestic environmental
C. Skin tests (prick-test)
D. No specific IgE serum determined
E. Specific provocation test

Answer: D

3. Which of the following is not a pneumo-allergen?
A. Dogs
B. Cats
C. Cockroaches
D. Spiders
E. Mites

Answer: E

4. Which of the following therapeutic attitudes is not correct?
A. In intermittent rhinitis the antihistamines are as first
B. In moderate to severe persistent rhinitis inhaled and oral corticosteroids are administered as
first
C. Treatment efficacy is assessed every 1 month
D. Desensitization should be considered in moderate to severe intermittent rhinitis
E. Desensitization is effective in patients with severe form of "hay fever"

Answer: B


1. Diagnosis of allergy in adults involves the following steps:
A. Detailed anamnesis
B. CBC
C. Plethysmography
D. Multi-allergen screening test
E. Skin tests

Answer: A, B, D, E
34

2. Which of the following statements about moderate-severe rhinitis are true?
A. Social activities disrupted
B. School/work activities disrupted
C. Normal sleep
D. Weak discomforting symptoms
E. Discomforting symptoms

Answer: A, B, E

3. Which of the following statements is true?
A. The new classification takes into account extensively the symptoms
B. Depending on the number of symptomatic days there are two types of rhinitis
C. Intermittent rhinitis is defined as symptoms less than 4 times / week
D. Persistent rhinitis is defined as symptomatology duration > 4 weeks
E. Intermittent rhinitis is defined as symptomatology duration > 4 weeks

Answer: A, B, C, D

4. Which of the following statements about specific serum IgE determination are true?
A. Is limited to 5 pneumo-allergens
B. Is useless if skin tests are negative
C. Is useful when there are differences between the clinical history and skin tests
D. Is useful when skin tests are not available
E. Is useless if clinical examination is less evocative

Answer: A, B, E

5. Which of the following is a pneumo-allergen?
A. Ficus benjamina (ficus tree)
B. Mites
C. Moulds
D. Cockroaches
E. Pollen

Answer: A, B, C, D

6. Which of the following statements about the treatment of allergy in adult is true?
A. Efficacy must be assessed every 3 months
B. In case of ineffectiveness it can be associated with two treatments (antihistamine and inhaled
corticosteroids)
C. Patients education plays an important role in the course of treatment
D. In intermittent rhinitis the treatment of choice is antihistamine or inhaled corticosteroid
E. In intermittent rhinitis the treatment of choice is antihistamine or oral corticosteroid

Answer: B, C, D

35

ASTHMA IN ADULTS

Simple complement:

1. Which of the following statements is not true?
A. Asthma is a chronic inflammatory affection of the aerial ways
B. It is characterized by recurring wheezing episodes
C. In the inflammation participate the mastocytes, eosinophils and T lymphocytes
D. The symptoms are associates with restrictive syndrome
E. The inflammation is associated with bronchial hyper-reactivity

Answer: D

2. Which of the following statements is not true about asthma symptomatology?
A. Wheezing
B. Dyspnea
C. Thoracic oppression
D. Cough
E. Occurs at noon

Answer: E

3. Which of the following statements is not true regarding the aggravation of the
asthma symptoms?
A. Presence of allergens
B. Physical effort
C. Irritating factors
D. Nocturnal symptomatology
E. Parasites

Answer: E

4. Which of the following statements related to the physical examination is not true for
the patient with asthma?
A. Sibilant rales
B. Prolonged expiration
C. Thickening of the nasal mucous membrane
D. Sinusitis
E. Subcrepitant rales

Answer: E

36


1. The differential diagnosis of asthma on the thoracic x-ray includes:
A. Endo-bronchial foreign bodies
B. Bronchial cancer
C. Heart block
D. Extrinsic bronchial compression
E. Pleural spillage

Answer: A,B,C,D

2. Which of the following statements are true regarding asthma exacerbation?
A. Reflects a defect in asthma management
B. Exposure to triggering factors
C. May threaten life on short-term
D. Functional, PEF<40%
E. Gasometric, severe crisis with normocapnia

Answer: A,B,C,E

3. Which of the following statements are true regarding the seriousness signs of
asthma?
A. PaCO2>40 mmHg
B. Cardiac frequency >120/min
C. Anxiety
D. Cyanosis
E. Breathing frequency < 30/min

Answer: A,B,C,D

4. Which of the following statements are true regarding the seriousness signs of
asthma?
A. PaCO2<40 mmHg
B. Perspirations
C. Coma
D. Auscultatory silent gap
E. Paradoxical breathing

Answer: B,D

37

5. Which of the following statements are true regarding the signs that impose
spontaneous ventilation?
A. Hypercapnia >50 mmHG
B. Cyanosis
C. Consciousness disturbances
D. Paradoxical breathing
E. Agitation

Answer: A,C,D

6. Which of the following statements are true about supra-acute asthma?
A. Evolution towards asphyxia
B. The triggering factor is represented by a conflict or by massive allergenic exposure
C. Supra-infection is often incriminated
D. Affects men <30 years old
E. Exitus in hours

Answer: A,B,D

7. Which of the following criteria of unstable asthma are true?
A. Aggravation at dawn
B. Ala PEF variations 30%
C. Pluri-daily crises
D. Aggravation at night
E. Increase of 2 agonists consumption

Answer: B,C,E

8. Which of the following statements is true about the treatment of severe
exacerbations?
A. The basic asthma treatment is maintained
B. The basic treatment must not be intensified
C. It is necessary an oral cortico-therapy in short dosage
D. There will be administered Prednison 1-1.5 mg/kgb/day
E. Drainage kinetotherapy is indicated in case of major bronchial obstruction

Answer: A,C,E

9. Which of the following statements is true about severe acute asthma?
A. Immediate treatment with 2 agonists inhaler
B. Hospitalization need
C. Must not be monitored
D. Oxygen is administered nasally
E. Does not require hydration

Answer: A,B,D
38

10. Which of the following statements characterizes severe persistent asthma?
A. Daily symptoms
B. Exacerbations that may influence activity and sleep
C. Frequently symptoms of nocturnal asthma > 1 time/week
D. Daily use of 2 agonists inhaler with short term action
E. PEF or VEMS <60% of the prescribed values, with variability >30%

Answer: C,E

39

TUBERCULOSIS

Simple complement:

1. Which of the following statements regarding tuberculosis is false?
A. The pathogenic agent is the Koch bacilli?
B. The transmission manner is aerial
C. The pulmonary form is rare
D. The treatment consists of association of antibiotics for more than 6 months
E. It is a contagious disease

Answer: C

2. Which of the following statements regarding pulmonary tuberculosis is false?
A. Nocturnal perspirations
B. Hemoptysis
C. Thoracic x-ray indicates infiltrates, nodules, caverns of the superior lobes
D. Bacteriological exploration direct examination of BAAR
E. Confirmation through culture in solid environment (Bactec)

Answer: E

3. Regarding military tuberculosis, one of the following statements is false:
A. Represents hematogenous dissemination of BK
B. The thoracic x-ray makes positive diagnosis
C. On the thoracic x-ray: diffuse and intense micronodular interstitial syndrome
D. Clinically: fever, rapid alteration of the general condition, dyspnea
E. It is necessary to perform an extension review

Answer: B

4. Does not represent an extra-pulmonary localization of tuberculosis:
A. Ganglions
B. Kidneys
C. Urogenital
D. Bone
E. Myocardium

Answer: E

40


A. The biological review before instituting the tuberculostatic treatment comprises:
B. VHB, VHC serology
C. HIV serology
D. Full blood count
E. Transaminases, alkaline phosphatase, GT range
F. Antiphospholipid antibodies

Answer: A,B,C,D

5. Anti-tuberculosis quadri-therapy comprises the following, except:
A. Procainamide
B. Isoniazid
C. Pyrazinamide
D. Esmolol
E. Rifampicin

Answer: A,D

6. The following statements are false, except:
A. The stage of maximum contagiousness persists 1-3 weeks after the administration
of treatment
B. Patient isolation is compulsory in case of pulmonary affection
C. Pyrazinamide has teratogenic effects
D. In children, treatment with embutalol is compulsory
E. In patients with HIV in treatment, rifampicin is replaced with rifabutin

Answer: A,B,C,E

7. The monitoring of the tuberculostatic therapy implies:
A. Hepatic review at 15 days after initiating treatment
B. Thoracic x-ray in the second month of treatment
C. Bacteriological exam between the 10
th
and the 15
th
day of treatment
D. Hepatic review once every 2 months
E. In case of cytolysis>5 times the normal, isoniazid will be stopped

Answer: A,B,C

41

8. The localization of the extra-pulmonary tuberculosis comprises:
A. Pericarditis
B. Meningitis
C. Hepatic affection
D. Splenic affection
E. Cutaneous affection

Answer: A,B,C,D

42

CHRONIC OBSTRUCTIVE BRONCHOPNEUMOPATHY

Simple complement:

1. Does not characterize obstructive chronic bronchitis:
2. Dyspnea with VEMS>80%
3. Persistent obstruction of the small aerial ways
4. Can be associated with partial reversibility
5. Can be associated with a pulmonary emphysema
6. Can be associated with a bronchial hyper-secretion

Answer: A

2. Does not characterize obstructive chronic bronchitis with chronic respiratory
failure:
A. Is associated with rest hypoxemia
B. Rest dyspnea
C. PaO2>60 mmHg
D. VEMS<35%
E. PaCO2<2kPa

Answer: C

3. Which of the following statements is false regarding BPOC:
A. For a positive diagnosis respiratory functional explorations are performed, with
bronchial reversibility test
B. Is aggravates slowly progressively
C. Comprises chronic bronchitis with bronchial obstruction
D. Comprises para-cicatricial emphysema
E. Is characterized by chronic limitation of aerial flows

Answer: D

4. The following are true regarding panlobular emphysema:
A. Poliglobulia
B. Cardiomegaly
C. Cyanosis
D. Obesity
E. Young man

Answer: E

43

5. The following are true regarding centrolobular emphysema:
A. Normal pulmonary artery
B. Very high CPT
C. Low DLCO
D. Low O2 pressure
E. Normal O2 pressure

Answer: D


6. The following are true regarding panlobular emphysema:
A. It affects all structures of the lobes
B. It is due to the exogenous toxics
C. Intense dyspnea
D. Without cyanosis
E. Subnormal CPT

Answer: A,B,C,D

7. The following are true regarding centrolobular emphysema:
A. Frequent IVD
B. Is due to smoking
C. Increased pulmonary artery, without cyanosis
D. Normal CO
2
pressure
E. Low DLCO

Answer: A,B,C

8. Which of the following are risk factors for BPOC?
A. Stone dust
B. Alpha 1 antitrypsin deficit
C. SO
2

D. Pollen
E. Cotton

Answer: A,B,C,E

9. Clinical examination of the patient with BPOC may reveal:
A. Hoover syndrome
B. Digital hypocratism
C. Leukonychia
D. Weight drop
E. Boldness

Answer: A,B,D
44

10. Which of the following investigations will complete the BPOC clinical
examination?
A. Cranium x-ray
B. Gasometry
C. Spirometry
D. Cardiac echography
E. Hemogram

Answer: B,C,E

11. Which of the following statements regarding spirometry is true?
A. It is not compulsory for the positive diagnosis
B. May reveal obstructive ventilator dysfunction
C. DVO represents the ratio CPT/VEMS < 0.7
D. DVO is defined through the VEMS value
E. DVO represents the ratio CV/VEMS < 70%

Answer: B

12. Stage III BPOC comprises:
A. Inconsistent effort dyspnea
B. VEMS/CV < 0.7
C. Effort dyspnea
D. Continuous bronchodilators
E. 50%< VEMS<80%

Answer: B,C

13. Represents an indication for performing gasometry:
A. SaO
2
<92%
B. VEMS<45%
C. VEMS<50%
D. Cardiovascular comorbidity
E. Clinical-functional discordance

Answer: A,C,D,E

14. Represent seriousness criteria in BPOC:
A. PaCO
2
>45 mmHg
B. SaO
2
<80%
C. pH<7.2
D. Respiratory frequency >25/min
E. PaO
2
>60%

Answer: A,D
45

15. Represent seriousness criteria in BPOC:
A. Fever >38.5 degrees C
B. Decrease of vigilance
C. Shock signs
D. PaCO
2
>70 mmHg
E. Alcoholism

Answer: A,B,E

16. Which of the following alarm signs require mechanical ventilation:
A. PaCO
2
<60 mmHg
B. pH<7.3
C. Coma
D. PaCO
2
>70 mmHg
E. Paradoxical abdominal breathing

Answer: B,C,D,E

17. Which of the following alarm signs require mechanical ventilation:
A. Confusion
B. Shock signs
C. Recent disturbances of superior functions
D. PaO
2
<45 mmHg
E. PaCO
2
>45 mmHg

Answer: A,B,D

18. Which of the following statements regarding the antibiotic treatment in BPOC is
true?
A. Rest dyspnea: without antibiotic
B. Rest dyspnea: cephotaxin
C. Effort dyspnea: antibiotic compulsory
D. Effort dyspnea with purulent expectoration: amoxicillin
E. Without dyspnea: levofloxacin

Answer: B,D

19. Which of the following statements regarding treatment in BPOC are true?
A. Smoking will stop
B. Anti-influenza vaccination
C. Re-training for effort
D. Respiratory kinetotherapy
E. Compulsory oral corticotherapy

Answer: A,B,C,D

46

20. Which of the following statements regarding the monitoring of the patient with
oxygen-therapy at home are true?
A. Thoracic x-ray 1 time/year
B. Spirometry 1 time every 2 years
C. Arterial gasometry / 3-6 months
D. Arterial gasomerty 1 time/year
E. SaO
2
at intervals

Answer: A,C,E

47

BRONCHOPULMONARY INFECTIONS IN ADULTS

Simple complement:

1. In relation to pneumonia in adults, the following statements are true, except:
A. Does not present vital risk
B. Present condensation syndrome
C. AV>100/min
D. Crepitant rales
E. Fever >37.8 degrees C

Answer: A

2. In pneumonia, the thoracic x-ray may reveal the following, except:
A. Opacities in multiple focuses
B. Diffuse interstitial opacities
C. Parenchymatous opacity with aerial bronchogram
D. Cavity-like image
E. Unique parenchymatous opacity

Answer: D

3. Do not represent hospitalization criteria in pneumonia:
A. The affection of several lobes
B. Pleural spillage
C. Arterial pressure CO
2
<50 mmHg
D. Thrombocytopenia
E. Renal failure

Answer: C

4. The CRB65 score comprises the following, except:
A. Systolic TA <90 mmHg
B. Respiratory frequency >30/min
C. Diastolic TA <50 mmHg
D. Confusion
E. Age >65 years old

Answer: C

48


1. Which of the following elements recommends hospitalization?
A. Cardiac frequency >100/min
B. Temperature <35 degrees C
C. Temperature >40 degrees C
D. Cyanosis
E. TA >9/60 mmHg

Answer: B,C,D

2. Represents indication for hospitalization in the ICU:
A. Systolic TA <90 mmHg
B. Other severe organic affections
C. Urinary flow >20 ml/hour
D. Severe acidosis
E. Diastolic TA <50 mmHg

Answer: A,B,D

3. Which of the following elements are in favour of pneumonia with pneumococcus?
A. Risk situation context
B. Thoracic pang
C. Presence of extra-thoracic signs
D. Leukocytosis with neutrophilia
E. Systematized alveolar opacity

Answer: B,D,E

4. Which of the following elements are in favour of pneumonia with Legionella?
A. Progressive debut
B. Brutal debut
C. Frequent comorbidities
D. Neurological manifestations
E. Digestive manifestations

Answer: A,C,D,E

49

5. Which are the most frequently met pathogen agents in at home pneumonia?
A. Moraxella catarrhalis
B. Klebsiella pneumonia
C. Haemophylus influenza
D. Golden staphylococcus
E. Mycoplasma pneumonia

Answer: A,C,D,E

6. Which of the following statements regarding antibiotic treatment are true?
A. 21 days for pneumonia with L. pneumophyla
B. 10-14 days for the stafilococcus aureus
C. 21 days for severe pneumonia
D. In case of pulmonary abscess: amoxicillin 1g every 8 h + clavulanic needle
E. Evaluation of the therapeutic response after 24-48 h

Answer: A,C,D

7. Which of the following are characteristic for pneumonia with pneumococcus?
A. Treatment with amoxicillin
B. Hack
C. Condensation syndrome
D. Moderate hyponatremia
E. Inflammatory syndrome (CRP>200mg/l)

Answer: A,C,D,E

8. Which of the following are characteristic for pneumonia with anaerobes?
A. Treatment with macrolides for 10-14 days
B. Hyponatremia
C. Eradication of the infectious focuses
D. Frequently negative hemo-cultures
E. Excavation with hydro-aerial level

Answer: C,D,E

9. Which of the following elements are true about the nosocomial pneumonias?
A. Mortality 20-50%
B. Are favoured by high age
C. Signs appear after 72 h of hospitalization
D. Sepsis is a favouring factor
E. Immobilization is a favouring factor

Answer: A,B,D

50

10. Which of the following information regarding acute bronchitis are true?
A. It is frequent in the summer
B. It is favoured by domestic pollution
C. Cyto-bacteriological exam of the spit is performed as an obligation
D. The cough may persist even for months
E. Thoracic x-ray is golden standard

Answer: B,D

11. Which of the following information regarding treatment of acute bronchitis are
true?
A. Stopping of smoking
B. Sedatives of the cough
C. Macrolides
D. Hypo-sodium diet
E. Penicillin G

Answer: A,B,C

51

ACUTE RESPIRATORY DISTRESS IN ADULTS.
FOREIGN BODIES AT THE LEVEL OF THE SUPERIOR AERIAL WAYS

Simple complement:

1. Represents SDRA cause by extra-thoracic traumatism:
A. Wide burns
B. Mendelson syndrome
C. Septicemia
D. Hemopathies
E. Collagenases

Answer: A

2. Which of the following statements regarding SDRA management is false?
A. Requires mechanical ventilation under sedatives
B. Sometimes ventilation in ventral decubitus
C. Administration of NO
2

D. Antibiotherapy
E. Avoidance of certain medicine interactions

Answer: C


3. Represent principles of SDRA etiological diagnosis:
A. Bronchoscopy for LBA
B. Does not require extrarespiratory infectious review
C. Medicine toxicity
D. Thoracic CT per primam
E. Differential diagnosis with pancreatitis, peritonitis

Answer: A,C,E

4. Represent risk factors for inhaling foreign bodies:
A. Epilepsy
B. Lean dentition
C. Goitrogenic cretinism
D. Alcoholism
E. Parkinson

Answer: A,B,D,E

52

5. The clinical examination in case of inhaling a foreign body may reveal:
A. Fever
B. Weight drop
C. Wheezing
D. XXX cough (tuse chintoasa)
E. Bilateral present vesicular murmur

Answer: A,C,D

6. Which of the following statements regarding the inhalation of foreign bodies are
true?
A. Frequently the thoracic x-ray is abnormal
B. CT can visualize the foreign body
C. It does not complicate with bronchial perforation
D. May evolve with pulmonary abscess
E. On the x-ray is not emphasized the counter-lateral deviation of the mediastinum

Answer: B,D

7. What is the therapeutic attitude in case of complete obstruction of the aerial ways?
A. The Heimlich maneuver
B. Manual extraction of the foreign body
C. Frequently, surgical extraction
D. Rigid bronchoscopy under local anaesthesia
E. Rigid bronchoscopy under general anaesthesia

Answer: A,B,E

53

HAEMOPTYSIS

Simple complement
1. Which of the following statements about haemoptysis is false?
A. It represents the elimination of red, aerated blood, through the mouth
B. Requires monitoring in hospital 24-48 h
C. Originates from the subglottic aerial ways
D. Takes into account the hemodynamic rebound

Answer: B

2. Regarding the need to quantify haemoptysis, the following is false:
A. Massive haemoptysis: more than 300-500 ml/24 h
B. Fudroaiant haemoptysis: death in minutes
C. Haemoptysis in small quantity: bloody sputum 50 ml/24h
D. Massive haemoptysis: more than 250 ml once
E. Haemoptysis in medium quantity: 50-200 ml/24h

Answer: D


1. Represents cardiovascular cause of haemoptysis:
A. Mitral stenosis
B. Haemostasis disturbances
C. Pulmonary embolism
D. Arterial-venous aneurism of Rendu-Osler disease
E. Bronchial endometriosis

Answer: A,C,D

2. Represents alveolar cause of haemoptysis:
A. Bronchial-pulmonary cancer
B. Common pulmonary tuberculosis
C. Goodpasture syndrome
D. Lupus
E. Churg-Strauss syndrome

Answer: C,D,E

54

3. Represent management principles for massive haemoptysis:
A. Asphyxia prevention
B. Perfusion with macromolecular solutions
C. Bronchial arteriography +/- embolization
D. Oxygen therapy not administered
E. Haemostasis surgery

Answer: A,B,C,E

55

DIFFUSE INTERSTITIAL PNEUMOPATHY

Simple complement:

1. Thoracic x-ray reveals:
A. Cystic images which predominate in the superior lobes
B. Linear opacities which draw a network with small eyes
C. At debut, aspect of matt glass
D. Predominant peri-bronchial distribution
E. None

Answer: C

2. Alveolitis with neutrophils occurs in:
A. Lupus
B. Sjogren syndrome
C. Sclerodermitis
D. x histiocytosis
E. None

Answer: C

3. The specific image of x histiocytosis at thoracic CT is of:
A. Linear opacities
B. Cystic images that predominate in the superior lobes
C. Reticulo-nodular images
D. Peri-bronchial distribution
E. None

Answer: B


1. Among the medicines that cause diffuse interstitial pneumonia are:
A. Gold salts
B. Amiodarone
C. Beta blockers
D. Ciprofloxacin
E. Nalidixic acid

Answer: A,B,C

56

2. The communitarian acute infections that cause diffuse interstitial pneumonia are:
A. Roseola
B. Pneumonia micoplasma
C. Golden staphylococcus
D. Pneumonia staphylococcus
E. Chlamidiae

Answer: A,B,E

3. Primitive pulmonary fibrosis is characterized by:
A. LBA: alveolitis with neutrophils
B. Aspect of honey comb at thorax CT
C. Corticotherapy
D. Average age of debut 60 years old
E. Digital hypocratism

Answer: A,C,E

4. Alveolitis with eosinophils occurs in:
A. Sarcoidosis
B. x histiocytosis
C. Sclerodermitis
D. Medicine pneumopathy
E. Rheumatoid polyarthritis

Answer: B,D

5. x histiocytosis is characterized by:
A. Affects young people 20-40 years old, great smokers
B. LBA: cells that express CD 1a
C. Aspect of honey comb at thorax CT
D. Associated with the consumption of certain medicines
E. LBA: alveolitis with eosinophils

Answer: A,B,C

57

PRIMITIVE AND SECONDARY LUNG TUMORS

Simple complement:

1. Cancers without small cells do not comprise:
A. Epidermoid
B. Mesoteliom
C. Adenocarcinoma
D. With large cells
E. None

Answer: B

2. Schwarts-Bartter syndrome:
A. Unilateral cecity
B. Bi-tonal voice
C. Paralysis of unilateral upper limb
D. Inadequate anti-diuretic hormone secretion
E. Thrombosis of superior vena cava

Answer: D

3. Loco-regional extension of the bronchial-pulmonary cancer is characterized
through the following, except:
A. Digital hypocratism
B. Vena cava syndrome
C. Thoracic pain
D. Wheezing
E. Dysphagia

Answer: A

4. The professional factors involved in cancers without small cells include:
A. Manganese
B. Chromium
C. Iron
D. Nickel
E. Asbestos

Answer: A

58


1. The causes of vena cava syndrome include:
A. Lymphoma
B. Thymome
C. Endothoracic goiter
D. Carcinoma with small cells
E. Carcinoma with large cells

Answer: A,B,C,D

2. Lymphangitis carcinomatosis does not appear in cancers of:
A. Lung
B. Breast
C. Prostate
D. Kidney
E. Esophagus

Answer: D,E

3. Which of the following are true:
A. Colon cancer evolves with lymphangitis carcinomatosis
B. Kidney cancer may give lung metastasis several years later
C. Stomach cancer frequently gives pulmonary nodules
D. Metastatic miliary is more frequently met in thyroid medular carcinoma
E. Mediastinal adenopathies are frequent in case of testicular cancer

Answer: B,D,E

4. In the presence of a mutation of EGFR gene, first line treatment has as basis:
A. Inhibitor of tyrosine-kinase
B. Gefitinib
C. Third generation chemotherapy in monotherapy
D. Cysplatin
E. Platinum salts

Answer: A,B,D

59

CARDIO-CIRCULATORY ARREST

Simple complement:

1. The main cause of cardiac arrest is:
A. Cerebral vascular accident
B. Acute pulmonary edema
C. Atrial fibrillation
D. Acute myocardium infarct
E. Pulmonary thromb-embolism

Answer: D

2. The electro-mechanical dissociation is defined as:
A. The persistence of the electrical activity of the heart or haemo-dynamic efficiency
B. The persistence of the electrical activity without haemo-dynamic efficiency
C. Absence of the electrical activity
D. TV
E. Asystole

Answer: B

3. What is the most frequent form of cardio-respiratory arrest:
A. FV
B. Asystole
C. Electro-mechanical dissociation
D. Tv
E. FIA

Answer: B

4. What is the adrenalin dose for initiating the resuscitation of the cardiac arrest:
A. 3 mg
B. 4 mg
C. 1 mg
D. 1g
E. 10 mg

Answer: C

60

5. What is the time interval after which can be administered a new dose of adrenalin
during cardiac resuscitation:
A. 1 min
B. 2 min
C. 3 min
D. 40 min
E. 4 min

Answer: E

6. Regarding FV is true the statement:
A. Does not always trigger a cardiac arrest
B. Is spontaneously reversible
C. Represents the most frequent form of cardiac arrest
D. Responds to the administration of atropine
E. Cardiac resuscitation starts with SEE

Answer: E

7. The basic resuscitation techniques comprise the following maneuvers, except:
A. Clearing of the respiratory ways
B. Intubation and mechanical ventilation are not necessarily required
C. Alternation of 30 thoracic compressions every 2 instilations
D. The performing of the cardiac massage is the most important maneuver
E. The rhythm of the cardiac massage is 100 compressions/min

Answer: B

8. The basic resuscitation techniques comprise the following maneuvers, except:
A. External cardiac massage in a rhythm of 120 bpm
B. Mouth-to-mouth ventilation
C. Ventilation with a manual instiller
D. Intubation and mechanical ventilation must be performed as fast as possible
E. Alternation of 30 thoracic compressions every 2 instilations

Answer: A

61

9. Regarding TV the following statements are true, except:
A. Never triggers cardiac arrest
B. The circumstances in which can trigger cardiac arrest can be rapid cardiac
frequency
C. There are cases of tv with slow rhythm in a healthy heart that presents few
symptoms
D. May trigger cardiac arrest
E. The circumstances in which can trigger cardiac arrest can be an altered sub-
adjacent cardiac function

Answer: A

10. The alkalinization through the administration of bicarbonate can be performed in
the following cases, except
A. In any case of cardio-respiratory resuscitation
B. Confirmed hyperpotassemia
C. Suspected hyperpotassemia
D. In case of cardiac arrest in an intoxication with membrane stabilizers
E. In case of cardiac arrest in an intoxication with tri-cyclic anti-depressives

Answer: A

11. Regarding therapeutic hypo-thermization in cardiac resuscitation the following
statements are true, except:
A. It is indicated especially after the patients post-cardiac arrest recovery in FV
B. Targets coronary protection
C. It is achieved by cooling the patient to 32-34 degrees
D. The cooling is performed for 12-24 hours
E. Targets the brain protection from the brains re-perfusion

Answer: B

12. The adrenalin dose administered intra-tracheal during cardiac resuscitation through
asystolia is of:
A. 4 mg diluted in 10 ml saline solution
B. 5-10 mg diluted in 20 ml saline solution
C. 5-10 mg diluted in 10 mg saline solution
D. 5-10 mg diluted in 10 ml sodium bicarbonate
E. 5-10 mg diluted in 10 ml glucose

Answer: C

62

13. The first SEE administered during the resuscitation of the cardiac arrest through
FV has the following power:
A. 100J mono-phase
B. 50J
C. 300J
D. 150-200 J mono-phase
E. 150-250 J bi-phase

Answer: E

14. What is the dose of amiodarone administered in resuscitation in case of cardiac
arrest through FV is of:
A. 150 mg
B. 1 vial
C. 300 mg
D. 600 mg
E. 1200 mg

Answer: C


1. Examples of situations in which electro-mechanical dissociation may occur may
be:
A. Massive pulmonary embolism
B. Unruptured aorta aneurism
C. Aorta dissection
D. Ischemia of inferior limbs
E. Acute pulmonary edema

Answer: A,C

2. Of the basic resuscitation maneuvers are part:
A. Internal cardiac massage
B. Alternation of 30 thoracic compressions with 6 instilations
C. External cardiac massage with 100 compressions per minute
D. Internal cardiac massage with 100 compressions per minute
E. Alternation of 30 thoracic compressions with 2 instilations

Answer: C,E

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A. Oro-tracheal intubation as fast as possible
B. Freeing of the aerial ways
C. Internal cardiac massage with 100 compressions per minute
D. Recording the time when the resuscitation maneuvers began
E. Oro-tracheal intubations do not represent immediately necessary maneuvers

Answer: A,B,D

A. Mouth-to-mouth, mouth-to-nose or manual blower respiration
B. Oro-tracheal intubation and mechanical ventilation as precautious as possible
C. External cardiac massage with 60 compressions per minute
D. Alternation 30 compressions : 5 instilations
E. External cardiac massage with 100 compressions per minute

Answer: A,B,E

5. Regarding TV the following statements are true:
A. Never triggers cardiac arrest
B. The circumstances in which cardiac arrest can be triggered may be rapid cardiac
frequency
C. There are cases of slow pace tv in a healthy heart which presented few symptoms
D. May trigger cardiac arrest
E. The circumstances in which cardiac arrest can be triggered may be an altered sub-
adjacent cardiac function

Answer: B,C,D,E

6. Alkalinization through the administration of bicarbonate can be performed in the
following cases:
A. In case of cardio-respiratory resuscitation
B. Confirmed hyperpotassemia
C. Suspected hyperpotassemia
D. In case of cardiac arrest in an intoxication with membrane stabilizers
E. In case of cardiac arrest in an intoxication with tri-cyclic anti-depressives

Answer: B,C,D,E

64

E. It is achieved by cooling the patient to 26-30 degrees

Answer: A,C,D

A. It is indicated especially after the patients post-cardiac arrest recovery in asystole
E. Targets the brains protection

Answer: C,D,E

B. Targets the brains protection
E. The cooling is performed for 48 hours

Answer: A,B,C,D

10. Regarding the resuscitation of the cardio-circulatory arrest the following
statements are true:
A. If it is assumed that FV occurred more than 4 minutes before, a 150 j mono-phase
SEE is administered
B. After SEE administration it is not necessary to resume the resuscitation maneuvers
with external cardiac massage
C. Adrenalin is the only catecholamine administered in case of asystole
D. When administering adrenalin in case of asystole, amiodarone can also be
administered
E. In case of FV cardio-circulatory arrest which does not respond to SEE, it can be
administered a bolus of adrenalin in order to restore arterial tonus

Answer: C,E

65

statements are false:
A. Lidocaine is recommended as anti-arrhythmia treatment
B. The purpose of administering adrenalin in FV non-responsive to SEE is to
reestablish the arterial tonus
C. The administration of adrenalin is accompanied by the administration of atropines
in asystole
D. Amiodarone is administered in asystole
E. The only catecholamine administered is adrenalin

Answer: A,C,D

12. Regarding the adrenalin administered in asystole the following statements are true:
A. It is the only catecholamine indicated
B. Has negative batmotropic action
C. Has positive batmotropic action
D. It is vaso-dilator
E. It is vaso-pressing

Answer: A,C,E

13. Regarding the adrenalin administered in asystole the following statements are true:
A. Has positive batmotropic action
B. Has vaso-pressing action susceptible of reinstating diastolic pressure
C. Can be administered in association with 3 mg of atropine
D. Asystole is the only indication for adrenalin administration
E. The initial dose is of 1 mg IV

Answer: A,B,E

statements are false:
A. Cardiac rhythm recovered after the injection of adrenalin is almost always FV
B. The reanimation of the cardiac arrest is interrupted if non-responsive 15 minutes
after the initiation of the resuscitation maneuvers
C. Cardiac massage is performed intermittently in case the patient is mechanically
ventilated
D. Cardiac massage is performed continuously regardless of the mechanical
ventilation rhythm
E. The cardiac rhythm recovered after the administration of adrenalin is most
frequently a sinus rhythm

Answer: A,B,C

66

15. In case of asystole, adrenalin is administered as follows:
A. If there is no venous approach, it is administered intra-tracheal
B. The initial dose administered IV is of 4 mg
C. The intra-tracheal administration dose is of 5-10 mg diluted in 10 ml saline
solution
D. Once administered the adrenalin via intra-tracheal, it does not require multiple
instillations
E. Repetition of 1 mg adrenalin every 4 minutes

Answer: A,C,E

16. Amiodarone administered in FV resuscitation has the following characteristics:
A. Initial dose is of 150 mg
B. Initial dose is of 300 g
C. The bolus is followed by the administration with automated syringe
D. Can be administered intra-tracheal
E. Initial dose is of 300 mg

Answer: C,E

67

SHOCK STATE

Simple complement:

1. Regarding the hypovolemic shock the following statement is true:
A. Increases the volume circulated
B. Increases cardiac flow
C. Increases the contribution of oxygen to the cells
D. Decreases the blood volume circulated
E. Increases cardiac pressure

Answer: C

2. What is the false statement regarding cardiogenic shock:
A. Decreases the function of cardiac pump
B. Decreases cardiac flow
C. Increases cardiac pre-loading
D. Decreases the contribution of oxygen to the tissues
E. Decreases cardiac flow

Answer: B

3. What is the value of minimal cardiac pressure targeted in the volemic repletion
within shock:
A. <65 mmHg
B. >=85 mmHg
C. >=100 mmHg
D. >=65 mmHg
E. <=55 mmHg

Answer: D


1. Regarding the hypovolemic shock the following statements are false:
A. Cardiac flow increases
B. Cardiac pressure drops
C. Cardiac post-load drops
D. The contribution of tissue oxygen increases
E. The blood volume circulated decreases

Answer: A,C,D

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2. Regarding the hypovolemic shock the following statements are true:
A. The function of cardiac pump decreases
B. Cardiac pre-load increases
C. The contribution of tissue oxygen decreases
D. Pre-load decreases
E. Cardiac flow decreases

Answer: C,D,E

3. Adaptative mechanisms in hypovolemic shock are the following:
A. Stimulation of the parasympathetic
B. Stimulation of the sympathetic
C. Sympathetic inhibition
D. Vasoconstriction
E. Tachycardia

Answer: B,C,E

A. Stimulation of the sympathetic
B. Bradycardias with the increase of the oxygen extraction at the tissue level
C. Tachycardia
D. Sympathetic inhibition
E. Stimulation of the parasympathetic

Answer: A,C

A. Stimulation of the parasympathetic
B. Vasoconstriction
C. Vasodilatation
D. Tachycardia
E. Stimulation of the sympathetic

Answer: B,D,E

6. Of the pathological mechanisms of the septic condition are true:
A. Massive vasodilatation
B. Increase of the O2 extraction through the peripheral tissue
C. Always the decrease of the cardiac pumping function
D. Increase of the O2 extraction through the peripheral tissue
E. Perfusion decrease of the organs

Answer: A,D,E

69

7. Of the pathological mechanisms of the septic condition are false the following:
A. Increase of the cardiac pre-loading
B. Cardiac touch is inconsistent
C. Peripheral vasoconstriction
D. Decreases O2 extraction through the peripheral tissue
E. Massive vasodilatation

Answer: A,C

8. Regarding the anaphylactic shock the following statements are false:
A. The pathological mechanism if massive vasoconstriction
B. The pathological mechanism if massive vasodilatation
C. Adaptative mechanism parasympathetic stimulation
D. Efficiency of the sympathetic stimulation is increased
E. Efficiency of the sympathetic stimulation is decreased

Answer: A,C,D

9. Regarding the anaphylactic shock the following statements are false:
A. The function of cardiac pump decreases
B. Pathological mechanism massive vasoconstriction
C. Adaptative mechanism sympathetic inhibition
D. Adaptative mechanism sympathetic stimulation
E. Adaptative mechanism parasympathetic stimulation

Answer: A,B,C,E

10. List the clinical signs of shock:
A. Tachycardia
B. Marbling
C. Decrease of the cutaneous harvesting time (especially in children)
D. Polyuria
E. Oliguria

Answer: A,B,E

11. List the clinical signs of shock:
A. Bradycardias
B. Oliguria
C. Bradypnea
D. Tegument marbling
E. Increase of the cutaneous harvesting time

Answer: B,D,E

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12. Polypnea that occurs within sepsis may have the following causes:
A. Metabolic acidosis
B. Parasympathetic stimulation
C. Pulmonary affection
D. Sympathetic stimulation
E. Sympathetic inhibition

Answer: A,C,D

13. Biological signs which may occur in shock condition may be:
A. Hyperlactacidemia (>12 mmol/l)
B. Hypoxia in case of respiratory detresse
C. Hepatic colestasis and cytolisis always occur
D. Disseminated intravascular coagulation
E. Metabolic acidosis

Answer: B,D,E

14. Metabolic acidosis with anionic hole in the shock state occurs in:
A. Respiratory failure
B. Hyperlactacidemia
C. Renal failure
D. Traumatism
E. Hypolactacidemia

Answer: B,C

15. List biological signs which may occur in the shock condition:
A. Hypoxia may occur
B. Hepatic cytolisis
C. Disseminated intravascular coagulation
D. Functional renal failure
E. Hepatic colestasis constantly

Answer: B,C,D

16. During the intravascular coagulation disseminated from shock the values of the
following parameters are modified:
A. Leukocytes
B. Platelet
C. D-dimers
D. Fibrinogen
E. Monocytes

Answer: B,C,D

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17. From the non-specific treatment in shock are true:
A. Hospitalization in the reanimation ward is not necessary
B. Mounting feeding tube is compulsory
C. Oxygen-therapy
D. Oro-tracheal intubation in case of respiratory detresse
E. Mechanical ventilation in some cases

Answer: C,D,E

18. From the non-specific treatment in shock are false:
A. The need for 2 central venous lines is compulsory
B. Urinary tube
C. Oxygen-therapy is not necessary
D. In some cases, mechanical ventilation
E. Oro-tracheal intubation in case of respiratory detresse

Answer: A,C

19. The volemic repletion in shock can be done with:
A. Crystalloids (glucose)
B. Colloids (hydroxiethylamidone)
C. Administration as quick as possible of 500 ml physiological serum
D. Albumin in case of hypoalbuminemia of hepatic cirrhosis
E. Platelet concentrate in case of anemia

Answer: B,C,D

20. The volemic repletion in shock can be done with:
A. Albumin in some cases
B. Crystalloids (physiological serum)
C. Colloids (glucose)
D. Erythrocytary concentrate in case of anemia within hemorrhagic shock
E. Crystalloids (hydroxiethylamidone)

Answer: A,B,D

21. Vasopressing treatment in shock can be done with:
A. Noradrenalin
B. Dopamine
C. Physiological serum
D. Colloids
E. Adrenalin

Answer: A,B,C

72

DEEP VENOUS THROMBOSIS AND PULMONARY EMBOLISM

Simple complement:

1. Local signs of deep venous thrombosis are the following, with one exception:
A. Calf edema
B. Rough venous belt
C. Loss of the legs balancing ability
D. Cold teguments
E. Inflammatory edema

Answer: D

2. Is not part of the functional signs:
A. Spontaneous pain at the calf level
B. Homans sign
C. Pain along the venous tract
D. Pain caused at the calf level
E. Sub-febrility

Answer: E

3. Together with the local signs, in venous deep thrombophlebitis occur general
signs, except:
A. Bradycardias
B. Tachycardia
C. Mahlers tendril pulse
D. Progressive classical tachycardia
E. Sub-febrility

Answer: A

4. The treatment of venous deep thrombophlebitis does not require hospitalization in
the following conditions:
A. Ilio-cava localization
B. Severe venous obstructive syndrome
C. Patients are treated exclusively at home
D. If optimum care is not possible at home
E. In case of hemorrhagic risk

Answer: C

73

5. The treatment of venous deep thrombophlebitis requires hospitalization in the
following conditions:
C. In case of severe renal failure
E. In case of popliteal localization

Answer: E

6. The indications of anti-thrombosis prophylaxis are the following, except:
A. Patients age > 75 years old
B. Patients with age lower than 40 years old, immobilized for more than 3 days for
cardiac decompensation
C. Patients with age lower than 40 years old, immobilized for more than 3 days with
thrombo-embolic priors
D. Patients with age lower than 40 years old, immobilized for more than 3 days for
severe infection
E. Patients with age lower than 40 years old, immobilized for more than 3 days for
mielo-proliferative syndrome

Answer: B

7. The indications of anti-thrombosis prophylaxis may be:
A. Patients with surgery in the digestive sphere
B. Patients with surgery in the non-endoscopic urology sphere
C. Orthopedics patients with surgery
D. All patients admitted to the hospital
E. Patients with surgery in oncologic surgery

Answer: D

8. The clinical signs of pulmonary embolism may be, except:
A. Dyspnea
B. Bradypnea
C. Cough
D. Haemoptysis
E. Strengthening of noise 2

Answer: B

74

9. Clinical signs of pulmonary thrombo-embolism may be, except:
A. Tachycardia
B. Anxiety
C. Perspiration
D. Syncope
E. Coma occurs always

Answer: E

10. The EKG modifications that cannot occur within a pulmonary embolism are:
A. S1Q1 aspect
B. Sinus tachycardia
C. S1Q3 aspect
D. Right branch block
E. Deviation to the right of the QRS complex

Answer: A

11. Pulmonary x-ray in pulmonary embolism may present the following modifications,
except:
A. Hyper-transparency
B. Triangular opacity on pleural background
C. Westermark sign
D. Supra-elevation of the pleural dome
E. Pachypleuritis

Answer: E

12. Of the predisposing factors of pulmonary embolism comprised in the Wells score
are not part:
A. Priors of deep venous thrombosis
B. Priors of pulmonary embolism
C. Cardiac frequency < 100 bpm
D. Haemoptysis
E. Cardiac frequency >100 bpm

Answer: C

75

13. Regarding the diagnosis means of pulmonary embolism are true, except:
A. A value of the D-dimers <500 micrograms/dl is certainly negative predicative
B. Spiraled angio-CT of the pulmonary arteries has high sensitivity for the embolisms
located upstream of the sub-segmentary arteries
C. The ventilation-perfusion pulmonary scintigraphy emphasizes a perfusion defect
correlated with a ventilation defect
D. The venous echography of the lower limbs is used less frequently in the diagnosis
algorithm of pulmonary embolism
E. Pulmonary angiography emphasizes a perfusion defect of the arteries

Answer: C

14. The dose of Fondaxaparin is the following:
A. For a weight of 50-100 kg 7.5 UI/24 hours sc
B. For a weight of <50kg 7.5 mg/24 hours sc
C. The dose depends on creatinine clearance
D. For a weight of 50-100 kg 7.5 mg/24 hours iv
E. For a weight of >100 kg 10 mg/24 hours iv

Answer: A

15. Anticoagulation in deep venous thrombosis is achieved with:
A. Non-fractioned heparin bolus iv 80 UI/kgb, then 2500 UI/kg/day iv
B. Non-fractioned heparin bolus iv 80 UI/kgb, then 500 UI/kg/day iv
C. Non-fractioned heparin bolus iv 50 UI/kgb, then 800 UI/kg/day iv
D. Non-fractioned heparin bolus iv 50 UI/kgb, then 2500 UI/kg/day iv
E. Non-fractioned heparin bolus iv 50 UI/kgb, then 500 UI/kg/day iv

Answer: B


1. The clinical functional signs of deep venous thrombosis are:
A. Spontaneous pain at the calf level
B. Homans sign
C. Pain along the venous tract
D. Rough venous belt

Answer: A,B,C

76

2. Local signs of deep venous thrombosis are:
A. Bulky, white calf edema
B. Rough venous belt
C. Loss of the legs balancing ability
D. Cold teguments

Answer: B,E

3. Together with the local signs, in deep venous thrombosis occur general signs, such
as:
A. Bradycardias
B. Tachycardia
C. Mahlers tendril pulse
D. Fever never occurs
E. Sub-febrility

Answer: B,C,E

4. The diagnosis of deep venous thrombosis presupposes:
A. In case of increased probability, D-dimers are dosed
B. Negative Doppler echography does not exclude the diagnosis
C. In case of low probability, D-dimers are dosed
D. A negative result of the dosing of D-dimers excludes the diagnosis
E. Doppler echography is compulsory in case of a positive D-dimers test

Answer: C,D,E

5. The treatment of deep venous thrombosis requires hospitalization in the following
conditions:
C. In case of light renal failure
E. In case of popliteal localization

Answer: A,B,D

77

6. The treatment of deep venous thrombosis requires hospitalization in the following
conditions:
C. Never requires hospitalization
E. In case of hemorrhagic risk

Answer: A,B,D,E

7. Efficient anticoagulation in deep venous thrombosis requires can be achieved as
follows:
A. It is started from the moment of certainly setting the diagnosis
B. With non-fractioned heparin initial dose 50 UI/kg
C. The dose of non-fractioned heparin in continuous perfusion is of 1000 UI/kgb/h
D. The dose of non-fractioned heparin administered in continuous perfusion is of 500
UI/kgb/h
E. The administration of non-fractioned heparin requires PTT dosage

Answer: A,E

follows:
A. The administration of non-fractioned heparin is initially performed with a bolus of
80 UI/kg
B. Requires the maintaining of a PTT of 1.5-3.5 in case of administering non-
fractioned heparin
C. The administration of non-fractioned heparin with small molecular weight if
creatinine clearance is < 30 mg/min
D. Administration of enoxaparin
E. Administration of tinzaparin

Answer: A,D,E

follows:
A. Non-fractioned heparin
B. Heparin with small molecular weight
C. Selective inhibitor of factor IXa
D. Selective inhibitor of factor X
E. Selective inhibitor of factor Xa

Answer: A,B,E

78

10. The dose of fodaxaparin is the following:
A. For a weight of 50-100 kg 7.5 UI/24 hours sc
B. For a weight of <50kg 7.5 mg/24 hours sc
C. The dose depends on creatinine clearance
D. For a weight of 50-100 kg 7.5 mg/24 hours iv
E. For a weight of >100 kg 10 mg/24 hours iv

Answer: D,E

11. About the curative treatment of deep venous thrombosis are true the following:
A. Total duration is of 1 month
B. Total duration is of 3 weeks
C. Treatment with anticoagulants may begin since the first day
D. Treatment with heparin or factor Xa inhibitor will be stopped at the association
with oral anticoagulants when an optimum INR is reached at two determinations
E. Treatment with oral anticoagulants is of at least 3 months

Answer: C,D,E

12. Preventive treatment of deep venous thrombosis can be done with:
A. Exclusively with medicine
B. Exclusively through mechanical methods
C. Precocious post-surgical mobilization
D. Heparins with small molecular weight
E. Fondaparinux

Answer: C,D,E

13. Preventive treatment of deep venous thrombosis can be done with:
A. Exclusively with medicine
B. With non-fractioned heparin in case of creatinine clearance > 30 ml/min
C. With heparin with small molecular weight in case creatinine clearance is < 30
ml/min
D. Fondaparinux (arixtra 2.5 mg/24 hours) s.c.
E. Calcium heparin

Answer: D,E

79

14. Indications of antithrombotic prophylaxis:
A. Patients with age lower than 40 years old, immobilized for more than 3 days for
acute respiratory decompensation
B. Patients with age higher than 40 years old, immobilized for more than 3 days for
C. Patients with age higher than 40 years old, immobilized for more than 3 days for
severe infection
D. Patients with age higher than 40 years old, immobilized for more than 3 days for
severe infection
E. Patients with age higher than 40 years old, immobilized for more than 3 days for
acute inflammatory affection

Answer: B,C,D,E

A. Patients with age lower than 40 years old, immobilized for more than 3 days for
acute respiratory decompensation
C. Patients with age higher than 40 years old, immobilized for more than 3 days for
severe infection
severe infection
E. Patients with age lower than 40 years old, immobilized for more than 3 days for
acute inflammatory affection

Answer: C,D

A. Patients age > 75 years old
C. Patients with age higher than 40 years old, immobilized for more than 3 days with
thrombo-embolic priors
severe infection
E. Patients with age higher than 40 years old, immobilized for more than 3 days with
mielo-proliferative syndrome

Answer: A,C,D,E

80

17. Indications of antithrombotic prophylaxis may be:
A. Patients with surgery in the digestive sphere
B. Patients with surgery in the non-endoscopic urology sphere
C. Orthopedics patients with surgery
D. All patients admitted to the hospital
E. Patients operated in ambulatory surgery

Answer: A,B,C

18. Clinical signs of pulmonary embolism may be:
A. Dyspnea
B. Bradypnea
C. Cough
D. Haemoptysis
E. Strengthening of noise I

Answer: A,C,D

19. Clinical signs of pulmonary thromb-embolism may be:
A. Tachycardia
B. Anxiety
C. Perspiration
D. Syncope may never occur
E. Coma occurs always

Answer: A,B,C

20. Clinical signs of pulmonary thromb-embolism may be:
A. Association, always, of the deep venous thrombosis signs
B. Strengthening of noise 2 in the pulmonary focus
C. Fever
D. Left cardiac congestive symptoms
E. Thoracic pain

Answer: B,C,E

21. The EKG modifications that may occur during a pulmonary embolism are:
A. S1Q1 aspect
B. Sinus tachycardia
C. Left branch block
D. Right branch block
E. Deviation to the left of the QRS complex

Answer: B,D

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22. The EKG modifications that may occur during a pulmonary embolism are:
A. Right branch block
B. Deviation of QRS to the right
C. Negative T waves in V1-V3
D. S1Q3 aspect which is specific to pulmonary embolism
E. Sinus tachycardia

Answer: A,B,C,E

23. Pulmonary x-ray in pulmonary embolism may present the following modifications:
A. Can never be normal
B. Triangular opacity on pleural background
C. Watermark sign
D. Supra-elevation of the pleural dome
E. Pachypleuritis

Answer: B,C,D

24. The pulmonary x-ray may present the following modifications in case of
pulmonary embolism:
A. Pleurisy
B. Hyper-transparency of a pulmonary field
C. Atelectasis in band
D. There cannot exist radiological images suggestive of pulmonary embolism
E. Pachypleuritis

Answer: A,B,C

25. List the predisposing factors for pulmonary embolism comprised in the Wells
score:
C. Cardiac frequency < 100 bpm
D. Haemoptysis

Answer: A,B,D,E

82

26. List the predisposing factors for pulmonary embolism comprised in the Wells
score:
C. Clinical signs of pulmonary embolism do not represent a risk factor
D. Cough

Answer: A,C

27. Diagnosis methods of pulmonary embolism may be:
A. Echocardiography
B. Dosage of D-dimers
C. Spiraled angio-CT
D. MRI
E. Pulmonary x-ray is the only diagnosis method

Answer: A,B,C

28. Regarding the means of diagnosing pulmonary embolism are true:
A. A value of the D-dimers <500 micrograms/dl is certainly negative predicative
B. Spiraled angio-CT of the pulmonary arteries has high sensitivity for the embolisms
located upstream of the sub-segmentary arteries
C. The ventilation-perfusion pulmonary scintigraphy emphasizes a perfusion defect
correlated with a ventilation defect
D. The venous echography of the lower limbs is used less frequently in the diagnosis
algorithm of pulmonary embolism
E. Pulmonary angiography emphasizes a perfusion defect of the arteries

Answer: A,B,D,E

29. The paraclinical examinations targeting the seriousness of pulmonary embolism
are:
A. I cardiac troponine
B. C cardiac troponine
C. PCR
D. VSH
E. BNP

Answer: A,B,E

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30. List the 3 criteria for pulmonary thrombo-embolism risk assessment:
A. Arterial hypo-tension
B. Bradycardias
C. Myocardium affection supported by an increase of I or C troponine
D. Right cardiac dysfunction
E. Arterial hyper-tension

Answer: A,C,D

31. The duration for following the anticoagulant treatment after a first thrombo-
embolic accident is of:
A. In the absence of a favourable factor 3-6 months
B. In case of neoplasia 1 year
C. Life treatment in case of protein S deficit
D. In the presence of a reversible favorable factor 6 months
E. Life treatment in case of protein C deficit

Answer: A,C,E

32. Life anticoagulant treatment in case of existence of a first episode of pulmonary
embolism is performed in the following cases, except:
A. Te presence of the lupic anticoagulant
B. Protrombine deficit
C. Factor V deficit
D. Protein S deficit
E. Protein C deficit

Answer: B,C

33. Which are the genetic tests that can be performed for the elucidation of a
thrombophilia:
A. Factor XI
B. Factor V Leiden
C. Homocysteinemia
D. Antiphospholipidic syndrome
E. Factor X

Answer: B,C,D

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34. Regarding massive pulmonary embolism, the following statements are true:
A. Occurs when more than 30-50% of the vascular bed is obstructed
B. The special clinical sign is a state of shock with systolic arterial pressure < 110
mmHg
C. Differential diagnosis is made with cardiac tamponage
D. Cardiac echography suggests the major dilatation of the right cavities
E. The visualization of the thrombus at the level of the right cavities always occurs

Answer: A,C,D

35. The symptomatic treatment of massive pulmonary embolism comprises:
A. Does not require hospitalization in reanimation
B. 2 peripheral venous ways
C. Oxygen therapy with small flow
D. Intubation and mechanical ventilation in case of severe hypoxemia
E. Volemic expansion of first intention

Answer: B,D,E

36. List the substances that administer in case of non-responsiveness at the volemic
expansion of hypo-tension in massive pulmonary embolism:
A. Dobutamine 10 micrograms/kg/minute
B. Noradrenalin
C. Dobutamine 5 micrograms/kg/hour
D. Noradrenalin 0.5 mg/h
E. Dobutamine 5 micrograms/kg/minute

Answer: B,D,E

37. Regarding the intravenous thrombolysis within massive pulmonary embolism the
following statements are true:
A. It is indicated in confirmed pulmonary embolisms with shock state
B. Can be done with alteplasis, followed by an efficient anticoagulation solution
C. Is done with alteplasis, not followed by subsequent anticoagulation treatment
D. Not indicated in forms without arterial hypo-tension
E. Does not require the probable formal confirmation of the diagnosis

Answer: A,B,D

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CHRONIC RESPIRATORY FAILURE

Simple complement:

1. The following affections represent neurological or muscular causes of restrictive
chronic respiratory failure, except:
A. Acute prior poliomyelitis
B. Amyotrophic lateral sclerosis
C. Guillan-Barre syndrome
D. Ankylosing spondyloarthritis
E. Hypocalemia

Answer: D

2. The following affections do not represent mechanical causes of restrictive chronic
respiratory failure, except:
A. Obesity
B. Botulism
C. Myopathies
D. Myositis
E. Hypo-phosphoremia

Answer: A

3. The following statements do not represent muscular and neurological causes of
restrictive chronic respiratory failure, except:
A. Parietal affectation
B. Cyphoscoliosis
C. Important thoracic deformation
D. Hypokalemia
E. Ankylosing spondyloarthritis

Answer: D

4. The diagnosis of restrictive ventilator disturbance has as basis the following,
except:
A. CPT increase
B. CPT decrease
C. Sometimes, the diminishing of the pulmonary compliant
D. Diminishing of the DLCO/VA ratio only in case of interstitial pathology
E. Sometimes, the diminishing of the parietal compliant

Answer: A

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5. The following statements represent hygienic-dietetic measures in the therapeutic
attitude in chronic respiratory failure, except:
A. Stopping smoking
B. Hyper-protidic alimentation
C. Prevention of respiratory infections
D. Anti-pneumococcal vaccination every 5 years
E. Assisted ventilation

Answer: E

Multiple complement

1. The following statements represent hygienic-dietetic measures in the therapeutic
attitude in chronic respiratory failure, except:
A. Respiratory kinetotherapy
B. Stopping smoking
C. Hyperlipidic alimentation
D. Annual anti-influenza vaccination
E. Anti-pneumococcal vaccination every 5 years

Answer: A,C

2. The following statements represent measures of oxygenation alimentation in
chronic respiratory failure:
B. Stopping smoking
C. Prevention of respiratory infections
D. Long-term oxygen therapy
E. Assisted ventilation

Answer: A,D,E

3. The following statements represent measures of oxygenation alimentation in
chronic respiratory failure:
B. Short-term oxygen therapy
C. Spontaneous ventilation with inspiration positive pressure
D. Assisted ventilation
E. Spontaneous ventilation with expiration positive pressure

Answer: A,D,E

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4. The following represent action mechanisms of mechanical ventilator assistance:
A. Increase of alveolar ventilation
B. Putting to rest the respiratory muscles
C. Decrease of alveolar ventilation
D. Normalization of the respiratory command secondary to the nocturnal alterations
of the gaseous exchanges
E. Increase of pulmonary and thoracic compliant secondary to the use of important
current volumes during the night

Answer: A,B,D,E

5. The following represent methods of home ventilation:
A. Ventilation with intermittent positive pressure
B. Ventilation with continuous positive pressure
C. Ventilation with continuous negative pressure
D. Ventilation through tracheotomy
E. Ventilation with negative pressure on the nasal mask during the night

Answer: A,D

6. The following therapeutic attitudes represent methods of etiologic treatment:
A. Scoliosis-correcting surgery
B. Pleural decortication
C. Pleural cortication
D. Loss of weight is necessary in all patients
E. Diaphragm stimulation through diaphragmatic pacemaker during neurological
affections

Answer: A,B,E

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NEUROLOGY

CEREBRAL AND MENINGEAL VASCULAR PATHOLOGY
CEREBROVASCULAR ACCIDENTS

Simple complement:

I. Any central focal deficit brutally installed must be considered until proven otherwise:
A Brain tumor
B. Stroke
C. Cerebral thrombophlebitis
D. Encephalitis
E. Epilepsy

Answer: B

2. The differential diagnosis of strokes is made with:
A. Hypoglycemia
C. Retroperitoneal hematoma
D. Peripheral obliterating arteriopathy
E. Amyotrophic lateral sclerosis

Answer: A

3. In practice, the proportion between ischemic CVA and hemorrhagic CVA is the following:
A. 80% hemorrhagic and 20% ischemic
B. 80% ischemic and 20% hemorrhagic
C. 50% ischemic and 50% hemorrhagic
D. 99% ischemic and 1% hemorrhagic
E. 99% hemorrhagic and 1% ischemic

Answer: B

4. The Locked-in syndrome is secondary to lesions located:
A In the dominant hemisphere
B. In the spinal bulb
C. Bilateral pontine
D. Unilateral pontine
E. Bilateral thalamic

Answer: C

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5. Wallenberg syndrome is secondary to ischemia:
A Laterobulbar
B. Pontine
C. Peduncular
D. Thalamic
E. Hemispheric

Answer: A
6. Deep Sylvian infarction (internal capsular) is characterized by:
A. Visual agnosia
B. Ataxia
C. Proportional massive hemiplegia
D. Hypoaesthesia on the same part with the injury
E. Hyperpathia

Answer: C

7. The thalamic infarction occurs in case of occlusion of the following artery:
A. Internal carotid
B. Middle cerebral
C. Anterior cerebral
D. Posterior cerebral (deep territory)
E. External carotid

Answer: D

8. In front of an acute stroke, the hypertension should be treated if it exceeds the value of:
A. 140/90 mm Hg
B. 220/120 mm Hg
C. 160/90 mm Hg
D. 135/85 mm Hg
E. 165/95 mm Hg

Answer: B

9. The carotid surgery (endarterectomy) is recommended for the prophylaxis of CVA in the
symptomatic stenoses exceeding:
A. 50%
B. 60%
C. 70%
D. 80%
E. 90%

Answer: C

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10. The main cause of cerebral infarction in subjects under 45 is represented by:
A. Diabetes
B. Hypertension
C. Smoking
D. Emboligen cardiopathies
E. Cervical artery dissection

Answer: D


A. Total Sylvian infarction is characterized by:
A. Signs on the same part with the injury
B. Aphasia if the minor hemisphere is affected (nondominant)
C. Massive and proportional sensitive- motive deficiency
D. Lateral homonym hemianopsia
E. Consciousness disorder of the stroke size

Answer: C, D

2. The infarction of the anterior cerebral artery is characterized by:
A. Crural motive deficiency
B. Cerebellar syndrome
C. Aphasia / apraxia
D. The deficiency is controlateral to the injury
E. Frontal syndrome

Answer: A, D, E

3. The alternate syndromes, are:
A. Signs of impaired brainstem
B. Sensitive or motive impairment on the injury controlateral hemibody
C. Sensitive or motive impairment on the hemibody on the same part of the injury
D. Impairment of cranial nerves controlateral with the injury
E. Cranial nerve damage on the same part of the injury

Answer: A, B, E

4. The pseudobulbar syndrome is characterized by:
A. Normal phonation
B. Small footsteps walk
C. Normal swallowing
D. Spasmodic laugh and cry
E. Bilateral pyramidal syndrome

Answer: B, D, E

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5. The physiopathlogical mechanisms of cerebral infarction are:
A. Diseases of the small veins
B. Thoracic aortic dissection
C. Moderate physical exercise
D. Atherosclerosis
E. Cardiogenic embolisms

Answer: D, E

6. Risk factors for atherosclerosis are:
A. Hypotension
B. Smoking
C. Diabetes insipidus
D, Hypercholesterolaemia
E. Young Age

Answer: B, D

7. About CT brain in cerebral infarction, the following statements are true:
A. It is not indicated
B. Initially normal
C. Sometimes the early signs of ischemia (lack of white matter differentiation from the grey one)
D. View of intravascular thrombus appearing hyper dense
E. Hypersignal on FLAIR sequences several hours after the ischemia

Answer: B, C, D

8. The AIT evoking semiology may be:
A. Transitory monocular blindness
B. Language disorders (aphasia)
C. Lateral homonym hemianopsia
D. Cerebellar ataxia
E. Sphincter incontinence;

Answer: A, B, C, D

9. The hypertension related intraparenchymatous hematomas are located with predilection:
A. Cortical
B. Subcortical
C. In the basal nuclei
D. In the central capsule
E. In the semi-oval centre

Answer: C, D

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10. The cerebral venous thrombosis is manifested clinically by:
A. Acute or progressive cephalalgia
B. Partial epilepsy seizures
C. Focal neurological deficits
D. Parkinson syndrome
E. Sometimes intracranial hypertension

Answer: A, B, C, E

11. The following are true about the intravenous thrombolytic therapy on cerebral infarction:
A. It can also be made in case of recent surgery interventions
B. It allows the improving functional prognostic in time
C. It is indicated in cerebral infarction dating under 4 hours and 30 minutes
D. It can be postponed until 6 hours after the debut
E. It applies even if the patient is under effective anticoagulation

Answer: B, C;

12. The anti-plague treatment in cerebral infarction is made with:
A. Aspirin
B. Atorvastatin
C. Clopidogrel
D. Aspirin-dipyridamole
E. Fenofibrate

Answer: A, C, D;

13. The superficial posterior cerebral artery infarction is characterized by:
A. Controlateral lateral homonym hemianopsia
B. Alexia and visual agnosia (in the dominant hemisphere)
C. Predominantly facio-brachial hemiplegia
D. Aphasia
E. Confusion (in the minor hemisphere)

Answer: A, B, E

14. The neurosurgical treatment in cerebral infarction comes into discussion in certain rare
particular cases:
A Lacunar infarction
B. Cerebellar infarction with mass effect
C. Minor Sylvian stroke
D. Thalamic infarction
E. Hemispheric infarction with extensive malignant brain edema

Answer: B, E

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15. The secondary prophylaxis is made with:
A. Anti-plague
B. Statins
C. Anti-HTN
D. Total and definitive tobacco deprivation
E. Total physical rest

Answer: A, B, C, D

16. About the intraparenchymatous hematoma appearing under anticoagulant therapy, the
A. They occur under a subdose
B. The occur under an overdose
C. They occur under sudden HTN
D. The protamine sulfate has a clear and proven efficiency for hematomas appearing under
heparin
E. The administration of heparin is totally contraindicated

Answer: B, C

17. The amyloid angiopathy related intraparenchymatous hematomas:
A. Suspected diagnosis in a young person
B. Suspected diagnosis in an old individual
C. The small brain arteries are weakened by amyloid deposits
D. Hematomas localized especially deep (basal ganglions)
E. Mainly localized lobar hematomas (cortico-subcortical)

Answer: B, C, E

18. Cerebral venous thrombosis favoring lands are:
A. Thrombophilia
B. Sub-adjacent cancers
C. Estroprogestative contraceptives
D. Post-partum
E. Excess of C, S proteins

Answer: A, B, C, D

19. The cerebral venous thromboses are clinically manifested by
A. Acute cephalalgia
B. Progressive cephalalgia
C. Partial debut epilepsy seizures
D. Focal neurological deficits
E. Legs edema

Answer: A, B, C, D

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20. The following statements are true referring to cerebral arteriovenous malformations:
A. Determine hematomas with deep localization (basal ganglia, internal capsule)
B. Determine mainly lobar localization hematomas (cortico-subcortical)
C. Emergency cerebral arteriography is contraindicated especially in young subjects
D. Neurosurgical consultation is not necessary
E. They are between a high flow artery and drainage veins without interposed capillary

Answer: B, E

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MENINGEAL HEMORRHAGE

Simple complement:

A. The meningeal hemorrhage is defined by:
A. Blood presence in the sub-arachnoid space
B. Blood presence in the subdural space
C. Blood presence in the peridural space
D. Blood presence at the intraparenchymatous cerebral level
E. Intramedullar blood presence

Answer: A

2. The incidence of nontraumatic meningeal hemorrhage is:
A. 1/100.000
B. 2/100.000
C. 3/100.000
D. 4/100.000
E. 5/100.000

Answer: E

3. The nontraumatic meningeal hemorrhage is caused by a ruptured aneurysm in the following
proportion:
A. A case out of two
B. Two cases out of three
C. Three cases out of four
D. Four cases out of five
E. Three cases out of five

Answer: E

4. The first intention imagistic exploration in cases of suspected nontraumatic meningeal
hemorrhage is:
A Transcranial Doppler ultrasound
B. Brain MRI
C. Carotid Doppler ultrasound
D. Brain CT
E. PET-CT

Answer: D

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5. Any cephalalgia with abrupt debut justifies the performance of an emergency CT (or even
lumbar puncture) as it is considered to be, until proven otherwise:
A. Arterial dissection
B. Meningeal hemorrhage by ruptured aneurysm
C. Cerebral thrombophlebitis
D. Pituitary necrosis
E. LCR blocking

Answer: B


1. The following are complementary examinations in cases of suspected nontraumatic meningeal
hemorrhage:
A Lumbar MRI
B. Brain CT
C. Cerebral arteriography
D. Lumbar puncture
E. PET-CT

Answer: B, C, D

2. In case of suspected nontraumatic meningeal hemorrhage, the following measures need to be
taken:
A. Prevention of vasospasm by administration of nimodipine
B. Moderate physical exercise
C. Antiepyleptic treatment as needed
D. Analgesic treatment with salicylates
E. Combating hyperglycemia, hypertension, hyperthermia

Answer: A, C, E

3. The nontraumatic meningeal hemorrhage is manifested by:
A. Brutal cephalalgia
B. Unsteady meningeal syndrome (stiff neck, Kerning sign, Brudzinski sign)
C. Aphasia
D. Sometimes consciousness disorders
E. Sometimes associated with convulsive seizure

Answer: A, B, D, E

4. The early complications of meningeal hemorrhage:
A. Sudden death during aneurysm ruptures
B. Arterial vasospasm
C. Acute hydrocephalus
D. Motive sequelae
E. Secondary epilepsy

Answer: A, B, C

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5. The paraclinical supervision in case of meningeal hemorrhage involves:
A. PET-CT
B. Repeated transcranial Doppler ultrasound to identify the arterial vasospasmo arterial
C. Classic cranial radiography
D. CT brain for any aggravation (the identification of a re-bleeding or hydrocephalus)
E. Functional MRI

Answer: B, D

6. Hakim and Adams triad which occurs in normal pressure hydrocephalus consists in:
A. Hemibalism
B. Apraxia
C. Small footsteps walking
D. Sphincter disorders
E. Cognitive impairment

Answer: C, D, E

98

INFECTIOUS DISEASES

ACUTE FEVER IN THE ADULT

Simple complement:

A. Signs of severity of acute fever are the following, except for:
A. Decompensation of concomitant diseases
B. Severe sepsis
C. Extreme ages
D. Subjects carriers of foreign material
E. Chronic respiratory insufficiency

Answer: E

2. Among the parasitic etiologies that can cause acute fever in adults, we enumerate:
A. Pinworm
B. Amebiasis
C. Paludism
D. Ascaridiosis
E. Lambiasis

Answer: C

3. The acute fever in drug addicts is due to the following pathologies, except for:
A. Pneumopathy by inhalation
B. Cellulite
C. Infection with HIV
D. Right endocarditis
E. Left endocarditis

Answer: E

4. The alcoholic patient may present acute fever in the following situations, except for:
A. Acute pancreatitis
B. HIV infection
C. Ascites liquid infection
D. Acute alcoholic hepatitis
E. Delirum tremens

Answer: B;

99

5. Poor social context can cause acute fever in these situations, except for:
A. Tuberculosis
B. Hepatitis B virus
C. Hepatitis C virus
D. Infection with HIV
E. Delirum tremens

Answer: E

6. In front of an acute fever, the infectious emergencies are the following, except for:
A. Meningoencephalitis
B. Ascites liquid infection
C. Bacterial meningitis
D. Plasmodium falciparum malaria
E. Fever in an immuno-depressed patient

Answer: B


1. Important aspects of acute fever in adults, are:
A. Fever is synonymous with infection
B. All infections cause fever
C. Fever should be thoroughly investigated in the absence of signs of severity
D. Fever is not synonymous with infection
E. Some infections may not cause hypothermia

Answer: C, D, E

2. The acute fever in adults, can be defined as follows:
A. Central temperature above 38C in the morning
B. Central temperature above 38,3C in the evening
C. A fever developing for less than 20 days
D. The temperature can be measured at the eardrum level
E. The recent acute fever dates for less than 15 days

Answer: A, B, C, D

3. To correctly identify the fever, you need the following:
A. It is not related to the patient's weight
B. It is measured axillary
C. It is measured at the mouth level
D. It is made distinctively between the recent acute fever and the recent acute fever of
intermediary duration
E. A value of 0,5C is added at the eardrum level

Answer: B, C, D

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4. About the acute fever, from a physio- pathological point of view, the following statements are
true:
A. It is due to a thermoregulatory dysfunction
B. The thermoregulatory function is provided by the thalamus
C. It is due to pyrogenic substances
D. The pyrogenic substances modify the balance of heat production/ loss mechanisms at the
peripheral level
E. The pyrogenic substances are not produced by cells

Answer: A, C, D

5. The following statements are true on pyrogenic substances:
A. They are produced by cells
B. They are represented by the tumor necrosis factor
C. They are represented by the interleukins
D. They are represented by interferon
E. They do not interfere in the mechanism involved in the heat production/ loss mechanisms at
the peripheral level

Answer: A, B, C, D;

6. The conduct to be followed in case of acute fever in adults, is the following:
A. Fever is not an immediate emergency
B. Any fever should be assisted
C. It will look for signs of seriousness of a septic condition
D. The fever tolerance will be appreciated
E. Fever should be investigated as emergency

Answer: B, C, D, E

7. Signs of severity of acute fever are:
A. Coma
B. Poor social condition
C. Acute dehydration
D. Purpura
E. The signs of gravity do not influence the further evolution of fever

Answer: A, B, C, D

8. "The risk field" may be a sign of severity in acute fever. This is about:
A. The recently operated subject
B. Pregnancy
C. Extreme ages
D. Acute dehydration
E. Acute respiratory infection

Answer: A, B, C

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9. The history for acute fever brings important information about:
A. The consumption of toxic substances
B. Whether the patient's vaccinations are up-to-date
C. He/ she is the carrier of foreign material
D. He/ she has been consulted for this fever
E. The patient's clinical examination is more important thank his/ her history

Answer A, B, C, D

10.In the history of the adult acute fever, the following aspects are taken into consideration:
A. The patient usually follows treatments
B. The fever's characteristics
C. To what extent were these treatments effective
D. What is the patient's history
E. The circumstances of fever's occurrence are not important

Answer: A, B, C, D

11.Etiologies of acute fever, can be:
A. Bacterial
B. Viral
C. Parasitic
D. Noninfectious
E. There is no specific pathology of acute fever

Answer: A, B, C, D

12. The noninfectious pathologies incriminated in acute fever are:
A. Solid tumors
B. Metabolic diseases
C. Thromboembolic disease
D. Drug allergy
E. The presence of a foreign body

Answer: A, B, C, D

13. Depending on the field of developing of the acute fever as etiology, we can mention:
A. Subjects of any age
B. Apparition within the sanitary environment
C. Drug addicts
D. Alcoholic patient
E. It is not involved in the poor social context

Answer: B, C, D

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14. The apparition of acute fever in the sanitary environment is due to:
A. Infections of surgical wound
B. Urinary tract infections in probed patients
C. Thromboembolic diseases
D. Infections associated with foreign materials
E. Pulmonary infections

Answer: A, B, C, D

15. The apparition of acute fever in drug addicts is due to:
A. Infection with HIV
B. Infections with hepatitis B and C viruses
C. Left endocarditis
D. Cellulite
E. Tuberculosis

Answer: A, B, D
16. The apparition of acute fever in alcoholic patients is due to:
A. Chronic pancreatitis
B. Inhalation pneumopathy
C. Delirum tremens
D. Hepatitis B or C
E. Ascites liquid infection

Answer: B, C, E

17. The poor social context may lead to acute fever in the following situations:
A. Tuberculosis;
B. already existing urinary infections in the patient
C. Infection with HIV
D. Cellulite
E. Infection with hepatitis B and C viruses

Answer: A, C, E

18. In front of an acute fever, infectious emergencies are:
A. Septicemia
B. Purpura fulminans
C. Infectious endocarditis
D. extensive cellulite
E. Thromboembolic disorders

Answer: A, B, C, D

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19. The additional examinations specific to a certain etiology in acute fever are:
A. Viral serologies
B. Bacterial serologies
C. Dental panoramic radiography
D. Sinus radiography
E. Full blood count

Answer: A, B, C, D

20. The orientation paraclinical examinations for acute fever are:
A. VSH
B. C-reactive protein
C. Blood cultures
D. Urinary bandelet Urine cyto-bacteriologic examination
E. Tomographies;

Answer: A, B, C, D

21. The tests for microbiological analyzes will be conducted before any antibiotherapy, except
for:
A. Extensive cellulite
B. Septic shock
C. Fever in an immuno- depressed patient
D. Purpura fulminans
E. Infectious endocarditis

Answer: B, D

104

INFLUENZA

Simple complement:

1. The important aspects of influenza are the following, except for:
A. Low direct mortality
B. Epidemic evolution
C. Endemic evolution
D. Low infectivity
E. Annual vaccination

Answer: D

2. From a physio- pathological point of view, 4 stages are distinguished within the group, except
for:
A. Cellular penetration due to haemagglutinin
B. The release of virions, due to neuraminidase
C. Intracellular replication
D. Without cell lise
E. Inflammatory reaction and potential bacterial superinfection

Answer: D

3. About the epidemic evolution of influenza, the following statements are true except for:
A. It is due to a genetic slide
B. It appears biannually
C. It is caused by influenza viruses A and B
D. A minor modification of the genome occurs
E. Influenza viruses A give more serious clinical pictures

Answer: B

4. The pandemic evolution of influenza is characterized by the following, except for:
A. It appears due to an antigenic breach
B. The genetic changes occur more rarely than the antigenic slides
C. Diffusion of pandemic is rapid
D. Minor modification of the genome
E. Only A viruses have pandemic potential

Answer: D

5. Prodromes are characterized by the following, except for:
A. Chills
B. Cephalalgia
C. General malaise
D. Fatigue
E. Prodromes are less specific

Answer: D

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6. The simple form in the clinical diagnosis of influenza is characterized by, except for:
A. Chills
B. Arthromyalgias
C. Fatigue
D. Anorexia
E. High fever 38-40C

Answer: B

7. Complications of influenza are the following, except for:
A. Tares decompensation
B. Bacterial over- infections
C. malignant influenza
D. Arthromyalgias
E. Pneumococcal pneumopathy

Answer: D

8. Biological explorations of respiratory secretions, involve the following, except for:
A. Virus isolation on cell cultures - Reference method
B. Virus isolation on cell culture performed in the first 3 days
C. Indirect immunofluorescence on nasal sample, to be performed during the first seven days
D. Detection of viral antigens by ELISA
E. Direct genome detection by RT-PCR

Answer: C

9. The specific treatment of influenza is performed as follows, except for:
A. Zanamivir administration
B. Oseltamivir administration
C. Antivirals administration
D. Amantadine is administered frequently
E. The action of antivirals is limited

Answer: D

10. The interruption measures in case of flu transmission consist in, except for:
A. Hand washing with hydro-alcoholic solutions for caring staff, patients, visitors
B. The caring staff must wear glasses, protection gloves and gown on their contact with patients
C. Visits should be limited
D. Patients and suspected cases should not be isolated if they started the antiviral treatment
E. Patients and suspected cases are isolated

Answer: D

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11. The following statements about H1N1v virus are true, except for:
A. Combines genomic sequences of avian, swine and human type
B. It replaced the old strain A/H1Nl
C. It did not have a high rate of mortality
D. It affected mostly elder people
E. It allowed early arrangement of a very effective vaccine

Answer: D


1. Important aspects related to influenza are:
A.Related to the genetic diversity
B. Annual vaccination
C. Infectiousness
D. High morbidity
E. It only has endemic evolution

Answer: A, B, C, D;

2. The virus elements incriminated in the occurrence of influenza are:
A. RNA viruses
B. Orthomyxoviridae viruses
C. Myxovirus influentza are pathogenic to humans
D. Viruses are responsible for acute respiratory infections in humans only
E. Viruses are responsible for acute respiratory infections in humans and animals

Answer: A, B, C, E

3. Myxoviruses influences are:
A. Myxovirus influences A
B. Myxovirus influences B and C
C. Myxovirus influences B, it is a strictly human virus
D. Myxovirus influences C, it infects various animals
E. Myxovirus influences A, it is a strictly human virus

Answer: A, B, C

4. About Myxovirus A viruses influences, the following statements are true:
A. They infect various animals
B. They infect canine mammals
C. They infect horses
D. They infect sheep
E. Birds are the reservoir of influenza

Answer: A, B, C, E

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5. About Myxovirus influences viral subtypes, the following statements are true:
A. They are classified according to the types of hemagglutinin
B. They are classified according to the types of neuraminidase
C. They are only classified according to the types of hemagglutinin
D. They are classified only according to the types of neuraminidase
E. 16 types of hemagglutinin and 9 types of neuraminidase are identified.

Answer: A, B, E

6. Referring to the genetic recombinations of influenza, the following statements are true:
A. They are frequent
B. They are made intrinsically
C. They are due to the exchange of genes between species
D. They are only responsible for influenza epidemics
E. They are responsible only for the annual influenza epidemics as well as for pandemics

Answer: A, B, C, E

7. From a physio- pathological point of view, 4 stages are distinguished in the influenza:
A Cellular penetration due to neuraminidase
B. Intracellular replication
C. The release of virions, due to haemagglutinin
D. Cellular lise
E. Inflammatory reaction and potential bacterial superinfection

Answer: B, D, E

8. From a physio- pathological point of view, the following aspects are characteristic for
influenza:
A. Viraemia is inconstant
B. Viraemia is constant
C. The infectiousness begins before the debut of clinical signs
D. The infectiousness begins after the debut of clinical signs
E. The infectiousness begins after the debut of clinical signs

Answer: A, C

9. Epidemiologically, the influenza is characterized by:
A. Interhuman transmission
B. On respiratory path
C. Highly contagious
D. It has only an epidemic evolution
E. It has an epidemic, but also a pandemic evolution

Answer: A, B, C, E

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10. The epidemic evolution of the flu epidemic is characterized by:
A. Minor genome modification
B. It occurs during autumn - winter
C. Epidemics are caused by viruses A and B
D. Viruses B give more serious clinical pictures
E. Viruses A give more serious clinical pictures

Answer: A, B, C, E

11. The pandemic evolution of influenza is characterized by:
A. High modification of the genome
B. High morbidity
C. High mortality
D. Only A viruses have pandemic potential
E. Only B viruses have pandemic potential

Answer: A, B, C, D
12. The clinical diagnosis of influenza is done going through the following steps:
A. The notion of contamination and epidemic
B. Incubation
C. Simple form
D. Prodromes
E. Without complications

Answer: A, B, D

13. The clinical diagnosis of influenza is suggested by:
A. The epidemic context is important
B. 1-3 days incubation
C. Prodromes with sudden onset
D. The simple form is not characterized by fever
E. Complications are represented by bacterial superinfections

Answer: A, B, C, E

14. The notion of contamination and epidemic, as well as clinical diagnosis of the flu is defined
by:
A. The clinical context is important
B. The period of infectiousness extends from two days before the appearance of clinical signs
C. The period of infectiousness takes up to six days after the appearance of clinical signs
D. The notion of contamination must be searched within its history
E. The clinical context is not important

Answer: A, B, C, D

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15. Prodromes are characterized by:
A. High fever
B. Cephalalgia
C. Arthromyalgias
D. General malaise
E. Prodromes are characterized by manifest symptoms

Answer: A, B, C, D

16. The simple from in the clinical diagnosis of the flu is characterized by:
A. Chills
B. Asthenia
C. Anorexia
D. High fever 38-40C
E. Fever and chills are missing in the simple form of flu

Answer: A, B, C, D

17. Influenza complications are:
A. Bacterial superinfections
B. tares decompensation
C. Malignant influenza
D. Pneumococcal pneumopathy
E. The signs of complications are ameliorated with 4-7 days

Answer: A, B, C, D
18. The following are true about the biological explorations for flu diagnosis:
A. Of the salivary secretions
B. Of respiratory secretions
C. Of the blood
D. The blood serology has a great diagnostic interest
E. The biological explorations are not relevant to diagnosis

Answer: B, C

19. The biological explorations of respiratory secretions include:
A. Virus isolation on cell cultures
B. Direct detection of the genome by RT-PCR
C. Detection of viral antigens by ELISA
D. Indirect immunofluorescence on nasal taken
E. The isolation of the virus on cell culture is achieved within the first 5 days

Answer: A, B, C, D

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20. The differential diagnosis is done with other respiratory tropism viruses, such as:
A. Coronavirus
B. Adenovirus
C. Intracellular bacteria
D. Enterovirus
E. Epstein-Barr virus

Answer: A, B, C, D

21. We can state the following about influenza treatment:
A. It is specific
B. Measures are needed to interrupt its transmission
C. It is symptomatic
D. It requires supervision
E. It does not require special treatment

Answer: A, C, D

22. The flu specific treatment is done as follows:
A. Antivirals administration
B. Oseltamivir administration
C. Zanamivir administration
D. Amantadine is frequently administered
E. No antivirals are administered

Answer: A, B, C

23. The symptomatic treatment of influenza consists in:
A. Rest
B. Sick leave
C. Antalgics
D. Antipyretics
E. The flu does not require any rest

Answer: A, B, C, D
24. Flu prevention consists in:
A. Vaccination
B. Antivirals
C. Measures to discontinue transmission
D. Supervision
E. Symptomatic

Answer: A, B, C

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25. The following statements are true about flu vaccination:
A. It presents a major individual interest
B. It presents a major collective interest
C. It should be repeated every year
D. It should not be repeated every year
E. Vaccination is cost- efficiency effective

Answer: A, B, C, E

26. The following are true about flu vaccine:
A. It is an inactivated vaccine
B. It is an annual product on embryonated egg
C. The vaccine starts from a combination of strains from previous epidemics
D. The vaccine appears several times a year
E. The vaccine starts from one single stem from past pandemics

Answer: A, B, C

27. The following statements are true about flu vaccination:
A. Its effectiveness depends on intrinsic factors
B. Its effectiveness depends on extrinsic factors
C. It is effective to reduce morbidity
D. It is effective to reduce mortality
E. It is not influenced by genetic variations of influenza viruses

Answer: A, B, C, D

28. The anti-influenza vaccine is recommended for:
A. Subjects under 65
B. Staff from abroad
C. People in sanitary units with medium or long hospitalization, over 65
D. Family contacts of infants under 6 months
E. Patients presenting associated tares (of over 6 months)

Answer: B, D, E

29. The following tares require anti-flu vaccination:
A. Chronic bronchopulmonary diseases
B. Severe heart insufficiencies
C. Homozygous drepanocytoses and double heterozygous S/C
D. HIV Infection
E. Only insulin diabetes

Answer: A, B, C, D

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30. Children presenting risk factors in severe influenza are:
A. Prematures
B. Children with congenital cardiopathy
C. Children with pulmonary pathology
D. Children with neuromuscular pathology
E. Any child exposed to a risk of developing severe flu

Answer: A, B, C, D

31. The following statements are true about antivirals:
A. They are prescribed systematically
B. Oseltamivir may be administrated
C. The precocity of treatment is the key element
D. It is treated up to 7 days after the last case appearance
E. It is treated up to 10 days after the last case appearance
Answer: A, B, C, D

32. Regarding the measures to be taken for the transmission interruption with influenza, the
A. They are not fundamental to avoid the spread of an epidemic
B. They are not fundamental to avoid the spread of a pandemic
C. They consist in avoiding air transmission
D. They consist in avoiding indirect transmission by contact
E. They are fundamental to avoid the spread of an epidemic or pandemic

Answer: C, D, E

33. The measures for the interruption of flu transmission consist in:
A. Patients and suspected cases are isolated
B. Visits are limited
C. The care staff and the patients must wear protective masks
D. Hands wash with hydroalcoholic solutions is done only for the care staff
E. Visits should not be limited

Answer: A, B, C

34. H5N1 virus:
A. It is an avian virus
B. It appeared in 2003
C. It does not cause high mortality
D. There were no confirmed cases of inter-human transmission
E. It can lead to a very serious pandemic if the virus adopts itself more in humans

Answer: A, B, E

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35. HlNlv virus:
A. Appeared in 2009
B. Combines avian and human genomic sequences
C. Had a high rate of mortality
D. Replaced the old strain of A / HlNl
E. Combines avian, swine and human genomic sequences

Answer: A, D, E

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HIV INFECTION

Simple complement:

1. The initial balance in HIV infections is done taking into consideration the following, except
for:
A. Eye bottom if CD4 <100/mm3
B. Metabolic balance
C. Full blood count
D. Chest MRI
E. Genotypic resistance test

Answer: D

2. The antiretroviral therapy is not recommended if:
A. The patients are over 50
B. If the patient is symptomatic
C. CD4> 500/mm3
D. Rapid decrease in CD4
E. Co-infection of HBV or VHC

Answer: C

3. The most frequent localization of Cytomegalovirus infection in HIV infections is:
A. Cerebral
B. Gynecologic
C. Retinal
D. Digestive
E. Respiratory

Answer: C

4. Statements about pulmonary pneumomatosis in HIV infections are true, except for:
A. It looks like a febrile interstitial pneumopathy
B. Resistance to classical antibiotics
C. The treatment is done with Cotrimoxazole
D. No corticosteroids therapy administered
E. The treatment with cotrimoxazole lasts 3 weeks

Answer: D

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1. The following are important aspects in HIV infection:
A. The importance of confidentiality
B. Accidental Discovery
C. Prophylaxis of opportunistic infections
D. Serology performed only with the patient's consent
E. Chronic infection with healing chances

Answer: A, B, C, D

2. The following statements are true referring to the natural history of HIV infections:
A. It is a chronic infection that lasts for a lifetime
B. There is no viral cure
C. It is caused by a RNA retrovirus
D. There are no genomic variabilities of virions
E It affects certain tissues

Answer: A, B, C

3. The following statements are true referring to HIV infection:
A. Acute Infection
B. Clinical Manifestations dominated by opportunistic infections
C. The ineffectiveness of the immunity response
D. Progressive immunity deficiency (CD4 lymphocytes)
E. There is a viral cure

Answer: B, C, D

4. The HIV infection has four stages. Which of the following statements are true about them?
A. Primary infection is often asymptomatic
B. Acute latent stage
C. Pausymptomatic stage
D. Symptomatic stage
E. AIDS stage

Answer: A, C, D, E

5. The primo-infection in HIV infection is characterized by the following:
A. It is a symptomatic phase
B. It decreases transient CD4
C. The evolution is spontaneously spontaneous
D. There appears a peak of viral replication
E. It increases the viral load

Answer: B, C, D

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6. The latency phase in HIV infection is characterized by the following:
A. It is a chronic phase
B. Gradual reduction of CD4
C. This phase lasts depending on each patient
D. Opportunistic infections occur
E. HIV encephalitis usually appears in this stage

Answer: A, B, C

7. The paucisymptomatic phase in HIV infection is characterized by the following:
A. No immune deficiency
B. Oral candidoses
C. Zoster herpes
D. Tumors
E. Hairy leukoplasia

Answer: B, C, E
8. The symptomatic phase in HIV infection is characterized by the following:
A. It is the AIDS phase
B. Cachexy
C. Severe immune deficiency
D. Toxoplasmosis may occur in this phase
E. Moderate immune deficiency

Answer: A, B, C, D

9. The following are true about CDC classification in HIV infection:
A. A-primo-infection, latent phase
B. A-primo-infection, acute phase
C. B-symptomatic with A or C criteria
D. B-symptomatic without A or C criteria
E. C - AIDS defining symptoms

Answer: A, D, E

10. The 3 biological stages in the CDC classification are:
A. 1 (<500CD4/mm
3
and> 29%)
B 1 (> 500CD4/ mm
3
and> 29%)
C. 2 (200-499CD4/ mm
3
and 14-29%)
D. 3 (<200/ mm
3
and <14%)
E. 3 (> 200/ mm
3
and <14%)

Answer: B, C, E

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11.The following statements are true about the diagnosis of HIV infections:
A. It is based on serology
B. The serology is falsely negative during the serological window
C. The result should not be communicated to the patient
D. Do not test the partners or children
E. The serology will only be done with the consent of the patient

Answer: A, B, E

12. The following statements are true about the serological diagnosis in HIV infection:
A. Negative test = absence of infection
B. Positive test = confirmed by Western blot on the same sample
C. If the Western blot is negative a viral load is made
D. If the Western blot is positive - recent infection
E. The serology is no longer done on the ELISA test

Answer: A, B, C, D

13. The following statements are true about the therapeutic attitude and monitoring of HIV
infection:
A. The initial balance is not necessary
B. Antiretroviral treatment
C. The combination of two retrovirals
D. It is sufficient to follow only opportunistic infections
E. Adherence to treatment is important

Answer: B, E
14. The initial balance in HIV infections includes:
A. Confirmation HIV serology
B. Search for other sexually transmitted infections
C. Patterns lymphocytic CD4/CD8
D. Plasmatic HIV viral load
E. Without chest radiograph

Answer: A, B, C, D

15. The antiretroviral therapy indication in HIV infections is done under the following conditions:
A. The patient has CD4 <200/mm
3

B. CD4 <350/mm
3

C. HIV nephropathy
D. In patients over 50
E. CD4> 500/mm
3

Answer: A, B, C, D

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16. The treatment with antiretrovirals for HIV infections includes:
A. 3 antiretrovirals
B. 2 nucleotide inhibitors of the reverse transcriptase
C. Protease inhibitor
D. Ritonavir potentiation
E. Without ritonavir

Answer: A, B, C, D

17. The following statements are true referring to HIV infection treatment:
A. The opportunistic infections prophylaxis is made with co-trimoxazole
B. The antialergenic treatment is also necessary
C. Clinical and immuno-virologic supervision
D. Adherence to medications is important
E. The treatment begins with two antiretrovirals

Answer: A, B, C, D

18. The following statements are true about the toxicity of antiretrovirals:
A. Have no skin toxicity
B. Have mitochondrial toxicity
C. Cardiovascular complications occur
D. Lipodystrophy appears
E. There is no impaired lipid metabolism

Answer: B, C, D

19. The main complications in HIV infections are:
A. The appearance of opportunistic infections
B. At a CD4 value below 200/mm
3

C. At a CD4 value above 200/mm
3

D. Various neoplasias
E. The complications are not related to the CD4 values

Answer: A, B, D
20. The main opportunistic infections in HIV infections are:
A. Pulmonary pneumocytosis
B. Toxoplasmosis
C. Cytomegalovirus infection
D. Acute leukemia
E. Tuberculosis

Answer: A, B, C

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21. The following statements are true about pulmonary pneumocytosis in HIV infections:
A. It appears less frequently in HIV infections
B. It is connected by a fungus, Pneumocystis jiroveci
C. The pulmonary X-ray shows an alveolo-interstitial damage
D. No antibiotics are administrated
E. The positive diagnosis is made by showing cysts or trophozoites in the broncho- alveolar wash

Answer: B, C, E

22. The following can be stated about the cerebral toxoplasmosis in HIV infection:
A. It is a reactivation of the Toxoplasma gondii parasite
B. Brain imagistic examinations (CT or MRI) are performed for diagnosis
C. Positive serology positive for Toxoplasma
D. The imagistic shows rounded-looking target lesions
E. No clinical neurological signs appearing

Answer: A, B, C, D

23. The following statements are true about the treatment of cytomegalovirus infections in HIV
infections:
A. It requires emergency medical management
B. It is done with Ganciclovir
C. It is done with Valganciclovir
D. It is done with Foscarnet
E. It is done with cotrimoxazole

Answer: A, B, C, D

24. The diagnosis of cytomegalovirus infection, in HIV infections, is done using:
A. The full blood count
B. The pp65 antigen
C. Retinal secretion
D. PCR
E. Imagistic investigations

Answer: B, C

25. Types of opportunistic infections in HIV infection are:
A. Cryptococcosis
B. Meningitis
C. LEMP
D. With atypical mycobacteria
E. Osteomyelites

Answer: A, B, C, D

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26. The following statements are true about progressive multifocal leukoencephalopathy (LEMP)
in HIV infections:
A. It is a demyelinating disease
B. It is due to JC virus
C. It is responsible for severe neurological disorders
D. It is responsible for serious digestive disorders
E. There is no specific treatment

Answer: A, B, C, E

27. The following statements are true about Cryptococcosis:
A. It is responsible for serious digestive disorders
B. It is determined by Cryptococcus neoformans
C. It is responsible for meningoencephalitis
D. The direct examination of LCR with China ink gives the diagnosis
E. It is responsible for meningites

Answer: B, C, D, E

28. Cancers frequently appearing in HIV infections are:
A. Kaposi's sarcoma
B. Non Hodgkin Lymphomas
C. Brain primitive lymphomas
D. Solid cancers
E. Digestive cancers

Answer: A, B, C, D

29. The following statements are true about Kaposi's sarcoma appearing in HIV infections:
A. It is a cutaneous-mucous-looking purple tumor
B. It can affect deep organs
C. The diagnosis is histological
D. The antiretroviral therapy causes Kaposi's lesions to regress;
E. No cytotoxic chemotherapies administered

Answer: A, B, C, D

30. Solid cancers in HIV infections are:
A. Ovarian cancer
B. Cervical cancer
C. Anal cancer
D. Lung cancer
E. Digestive cancers

Answer: B, C, D

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31. The prophylaxis in HIV infections involves:
A. Blood prophylaxis
B. Beware of possible exposure accidents
C. Materno- fetal transmission prophylaxis
D. Updating vaccinations
E. Digestive prophylaxis

Answer: A, B, C, D

32. The blood prophylaxis in HIV infections is done as follows:
A. Exclusion of blood donation from infected patients
B. Selection of donors
C. No need to select donors
D. Detection of blood products
E. Psychological therapy in the infected patients

Answer: A, B, D

33. The prophylaxis of materno-fetal transmission in HIV infection involves:
A. Treatment of the mother during pregnancy
B. Prophylactic treatment for infants for 6 weeks
C. Breastfeeding is contraindicated
D. Birth assisted by a specialized team
E. Breastfeeding is allowed

Answer: A, B, C, D

122

SEXUAL TRANSMITTED DISEASES:
GONOCCOCI, CHLAMYDIOSIS, SYPHILIS

Simple complement:

1. The following are risk factors for sexually transmitted infections:
A. Males
B. IST history
C. Immuno- depression
D. History of liver diseases
E. Diabetes

Answer: B

2. They are local signs of sexually transmitted infections, less:
A. Rash
B. Prostatitis
C. Inguinal adenopathies
D. Pelvic pain
E. Leucorrhea

Answer: A

3. The following statement is true about extragenital signs of the sexually transmitted infection:
A The urethral burning sensation occurs
B. Fever occurs
C. The Fiessinger-Leroy- Reiter syndrome appears
D. The extrapyramidal syndrome appears
E. Signs of peritoneal irritation appear

Answer: C

4. The clinical balance in sexually transmitted infections, includes the identification of:
A. Functional signs
B. Serology HIV 1 and 2 (with the patients consent)
C. Inflammatory genital signs
D. Vaginal sampling in leucorrhoea
E. Sexual habits

Answer: C

5. Identify the wrong statement on biological balance in sexually transmitted infections:
A. Urethral sampling in case of losses or burning sensation
B. TPHA-VDRL
C. Serology HIV 1 and 2 (with the patients consent)
D. VSH
E. Serology of Hepatitis A, B and C viruses

Answer: D
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6. The following are correct statements about secondary prophylaxis in sexually transmitted
infections, less:
A. The anti- HPV vaccine is recommended for all 14-year old girls
B. It includes information on the ITS and risk factors
C. It includes systematic identification of associated ITS
D. It includes detection and treatment of partners
E. It involves treatment compliance

Answer: A

7. They are clinical manifestations in the Gonococcal infection, with one exception:
A. Salpingitis with tube sterility risk
B. Anorectitis
C. Unilateral or bilateral orchiepididymitis
D. Hematuria
E. Cervicitis

Answer: D

8. The following statement is true about the treatment of Gonococcal infection:
A. The quick treatment is preferred with ceftriaxone intramuscularly
B. Third generation cephalosporin administered for 7-14 days
C. Antiobiotherapy associated to corticosteroid therapy is the first choice treatment
D. Ampicillin + gentamicin i.v. is prescribed
E. No answer is correct

Answer: A

9. These statements are false on clinical manifestations chlamydia infection:
A. Fitz-Hugh-Curtis syndrome is a perihepatitis miming acute cholecystitis
B. Fiessinger-Leroy-Reiter syndrome associates urethritis, conjunctivitis and poly-arthritis
C. The third phase of LGV associates fibrosis and lymphatic drainage disorders
D. The secondary phase of LGV involves the appearance of papular cutaneous mucous lesions
at the anal level
E. Chlamydia trachomatis is frequently involved in urethritis and cervicitis

Answer: D

10. Identify the true statement about the treatment of Chlamydia infection:
A. Cephalosporin is administrated in prostatitis
B. Gentamicin i.v. is administrated in LGV
C. In salpingitis: Amoxicillin-Clavulanic Acid + Doxycycline
D. In urethritis and cervicitis: Ciprofloxacin 7 days
E. Penicillin G i.v. in orchiepididymitis

Answer: C

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11. The following are true about syphilis:
A. In the primary syphilis the incubation is about 3 months
B. The neurosyphilis may occur in secondary and tertiary stages
C. The syphilitic canker appears in the tertiary stage
D. Syphilids are early injuries within the secondary stage
E. Syphilitic roseola appears within the primary stage

Answer: B

12. Choose the false statement on clinical manifestations in secondary syphilis:
A. It appears two weeks after the canker
B. The syphilitic roseola includes pink maculas, non-pruriginous, with intervals of healthy skin
C. Late lesions appear on the palms and soles generally
D. At this stage general signs may be present: fever, adenopathy, hepatosplenomegaly
E. Neuro- syphilis may occur in this stage

Answer: A

13. The following are false about the interpretation of serological diagnosis in syphilis:
A-VDRL / TPHA-: absence of syphilis or incubating period
B. VDRL + / THPA +: syphilis
C. VDRL-/THPA +: a serologic scar of an old syphilis
D. VDRL + / TPHA-: false positive
E. VDRL-/THPA +: venereal treponematosis venereal

Answer: E

14. Among the following statements about the treatment of syphilis, only one is true:
A. Penicillin M is used
B. In late syphilis: Benzatin benzylpenicillin: 2,4 M UI i.m. x 3 injections, at 3 weeks distance
C. In early latent syphilis: Doxycycline 200 mg / day for 30 days, in case of allergy to Penicillin
D. Gentamicin perfusions in neuro-syphilis
E. In primary syphilis: Penicillin M 18-24 M UI / day;

Answer: B

15. The Herxheimer reaction in secondary and tertiary syphilis involves the following, except for:
A. Treatment with paracetamol and corticosteroids
B. Rash
C. Fever
D. Bronchial spasm
E. Polyadenopathies

Answer: D

125


1. The following are local signs in sexually transmitted infections:
A. Mouth canker
B. Pelvic pain
C. Orchiepididymitis
D. Salpingitis
E. Inguinal adenopathies

Answer: B, C, D, E

2. They are general signs of sexually transmitted infections:
A. Conjunctivitis
B. Fever
C. Rash
D. Leucorrhea
E. Mouth canker

Answer: A, C, E

3. The following are false about the serologic balance in sexually transmitted infections, less:
A. Parasitosis serology
B. TPHA-VDRL
C. Vaginal sampling in case of leucorrhoea
D. Copro- parasitological exam
E. Urine culture

Answer: B, C

4. The following are clinical manifestations in the Gonococcal infection:
A. Priapism
B. Erectile dysfunction
C. Cervicitis
D. Anorectitis, often asymptomatic
E. Abdominal pain

Answer: C, D

5. The following are false answers on clinical manifestations in gonococcal infection:
A. The salpingitis presents tube infertility risk
B. Secondary to an untreated infection, a disseminated form with fever, arthritis, pustulosis may
appear
C. Inguinal adenopathies are common manifestations
D. Cervicitis is often evidenced by leucorrhoea
E. Laryngitis is often asymptomatic

Answer: C, E

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6. The following are true statements about gonococcal infection diagnosis:
A. It is suggested by the clinical examination in the purulent forms
B. Direct examination is conclusive only for women
C. Cultures are realized in the neo-classical forms
D. A urethral sampling is performed, before the first miction
E. In case of suspicion, samples can be taken from the pharynx and anus

Answer: A, C, D, E
7. The following statement is true about chlamydiosis:
A. Chlamydia trachomatis is an extracellular bacterium
B. Chlamydia is responsible also for digestive infections
C. Chlamydia can give trachoma
D. Venereal lymphogranulomatosis (VLG) evolves in four phases
E. Fiessinger-Leroy-Reiter syndrome associates urethritis, conjunctivitis and polyarthritis

Answer: C, E

8. The following statements are true about venereal lymphogranulomatosis:
A. It develops in 3 phases
B. In the early stages papular anal cutaneous- mucous lesions appear
C. The secondary phase appears years away after the occurrence of primary phase
D. Adenopathies occur during the secondary stage, mostly inguinal
E. The tertiary phase is characterized by the appearance of fibrosis and lymphatic drainage
disorders

Answer: B, D, E

9. The following are false about chlamydiosis diagnosis, except for:
A. The PCR is the reference technique
B. The serology is the reference technique
C. The PCR is less relevant and it is performed only for the diagnosis of deep forms or
complications
D. The serology does not dissociate Chlamidiae trachomatis from the Chlamidiae pneumoniae
E. A sample of the urethral mucous, a urine sample or a cervical-vaginal smear is taken

Answer: A, D, E

10. The following are correct statements regarding the treatment of chlamydosis:
A. It depends on the infected place
B. In venereal leukogranulomatosis: Penicillin G i.v.
C. In prostatitis and orchiepididymitis: fluoroquinolones
D. In salpingitis: Amoxicillin-clavulanic acid (10 days) + doxycycline (21 days)
E. In urethritis and cervicitis: Ciprofloxacin

Answer: A, C, D

127

11. The following are characteristic to primary syphilis:
A. At this stage neurosyphilis can occur
B. The syphilitic canker appears most frequently on the palms and soles
C. The syphilitic canker is an ulceration often unique, superficial, painless
D. The canker scars spontaneously
E. There may be general signs as fever or hepatosplenomegaly

Answer: C, D, E

12. The following are false statements about secondary syphilis:
A. Syphilids are late lesions
B. Syphilitic roseola is highly contagious
C. General signs are absent
D. It appears about six weeks after the canker
E. Mucous or alopecia plagues can be met

Answer: B, C
13. Identify the correct statements referring to neurosyphilis:
A. Its late forms are tabes, syphilitic gomma and general paralysis
B. It may appear in secondary and tertiary stages
C. The meningitis may be identified
D. late forms occur frequently
E. Ophtalmic damage can be met

Answer: A, B, C

14. The following are true about the diagnosis in syphilis:
A. VDRL- is a non-treponemal test
B. VDRL + / THPA-: a serological scar of an old syphilis (or non venereal treponematosis);
C. The indirect immunofluorescence test is to confirm the disease in case of VDRL-/THPA-;
D. The THPA is a non treponemal test
E. The direct diagnosis is specific, but often difficult in practice

Answer: A, C, E

15. The following are true statements about syphilis:
A. In primary syphilis penicillin G is administrated 18-24 M UI / day in six perfusions for 14-21
days
B. general manifestations appear in tertiary syphilis
C. The canker is often situated at the glands or vulva level
D. The direct diagnosis involves the performance of VDRL and THPA
E. Syphilids are papular lesions, ruddy, squamiferous

Answer: B, C, E

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16. The following statements are true about syphilis, less::
A. Fluoroquinolones are administrated in case of allergy to Penicillin G,
B. VDRL + / THPA-means a false positive test
C. Benzatin benzylpenicillin M UI i.m. x 3 injections at one week distance is prescribed in
primary syphilis
D. The canker presents satellite non- inflammatory adenopathy
E. The syphilitic roseola is an early lesion in secondary syphilis

Answer: A, C

17. The balance to be done in sexually transmitted infections, must include:
A. Serology HIV 1 and 2 (with the patient's consent)
B. Clinical examination
C. The history of functional signs
D. Immunohistochemical examination
E. Biopsies

Answer: A, B, C

18. The following statements are false statements about sexually transmitted infections, except
for:
A. Chlamydia is responsible for eye infections
B. In gonococcal infection the treatment involves the administration of Norfloxacin
(250 mg i.m.)
C. The canker is characteristic of secondary syphilis
D. Fiessinger-Leroy-Reiter Sindrornul associates balanitis/ vaginitis, inguinal adenopathies and
sterility
E. In the treatment of secondary syphilis, Doxycycline is administrated in case of allergy to
penicillin G

Answer: A, E

19. The Herxheimer reaction in syphilis involves:
A. Urethral losses
B. Fever
C. Polyadenopathies
D. Hepatosplenomegaly
E. Rash

Answer: B, C, E

20. The following are risk factors recognized for sexually transmitted infections:
A. Drug i.v. consumption
B. History of sexually transmitted infections
C. Unfavorable socio-economic level
D. Female gender
E. During the first two decades of sexual life

Answer: B, C, D, E

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SEPTICEMIA

Simple complement:

1. The important aspects of septicemia are the following, except for:
A. Assessment of tolerance
B. Research of severity signs
C. Identification of gateways
D. Without identification of secondary localizations
E. Confirmation of bacteremia by blood culture

Answer: D

2. The clinical definition of the systemic inflammatory response syndrome (SIRS), includes the
following, except for:
A. Respiratory rate over 20/min
B. Heart rate over 90/min
C. Hyperleukocytosis over 20000/mm3
D. Fever below 36C
E. Leukopenia more than 10% immature cells

Answer: C

3. The sepsis picture of sepsis associated with organ dysfunction is manifested as follows, except
for:
A. Respiratory insufficiency
B. Hematologic consequences
C. Hypotension
D. Severe heart insufficiency
E. Hemodynamic consequences

Answer: D

4. The neurological consequences appearing in the sepsis picture, associated with organ
dysfunction, are:
A. Confusion
B. Agitation
C. Disorientation
D. Torpor
E. Fever

Answer: E

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5. The risk of tissular hypoperfusion characterizing the septic shock, appears:
A. When [(PAS+2PAD/3)] is less than 70mmHg
B. When [(PAS+2PAD/3)] is less than 90mmHg
C. When [(PAS+2PAD/3)] is more than 70mmHg
D. When [(PAS+2PAD/3)] is more than 90mmHg
E. When [(PAS+2PAD/3)] is equal to 70mmHg

Answer: A

6. In the diagnosis of systemic inflammatory response syndrome, the immediate severity signs
are, except for:
A. Hypotension
B. Marbling
C. Local reduction of skin temperature (knee)
D. Oliguria
E. Hypertension

Answer: E

7. Blood cultures can be sampled at any time in the following affections:
A. Meningitis
B. Urinary infections
C, Endocarditis
D. Meningoencephalitis
E. Pneumonia

Answer: C

8. Elements in favor of organ failure are, except for:
A. Renal insufficiency
B. Metabolic acidosis
C. Thrombocytosis
E. Hepato- cellular insufficiency

Answer: C

9. Clinically oriented exams for septicemia are, except for:
A. Specific imagistic examination of the infected situs
B. Thorax radiography
C. Sputum cytobacteriological examination
D. Sinus puncture
E. ECBU

Answer: D

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10. If the gateway is the digestive tract, factors favoring the occurrence of septicemia, are, except
for:
A. Tumors
B. Diverticulosis
C. Portal hypertension
D. Old age
E. Surgery

Answer: D

11. If the gateway is the urinary system, the factors favoring the occurrence of septicemia are,
except for:
A. Obstacles on the urinary tracts
B. Instrumental handling
C. Permanent bladder probe
D. Parenteral nutrition
E. Pregnancy

Answer: D

12. Anti-infective therapy in case of septicemia is done as follows, except for:
A. It is initiated in emergency after microbiological sampling
B. The duration of the treatment is 10-15 days
C. The treatment can be extended if needed
D. The first choice antibiotherapy depends on the suspected germ
E. The treatment is not guided by the clinical context

Answer: E

13. The clinical monitoring in case of septicemia considers the following, except for:
A. Heart and respiratory rate
B. Blood pressure
C. Tolerance to antibiotics
D. Lower functions
E. Clinical exam

Answer: D

14. The supervision of treatment from a clinical point of view is made considering the following,
except for:
A. The general state
B. The gateway
C. The thermal curve
D. Secondary localizations
E. Repeated blood cultures

Answer: E

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1. The term of bacteriemia means:
A. The presence of the bacteria in the blood
B. The objectification of bacteriemia in a blood culture;
C. The objectification of bacteriemia in several blood cultures
D. The preferred term is bacteriemia, not septicemia
E. The preferred term is septicemia not bacteriemia

Answer: A, B, C, D

2. The clinical definition of systemic inflammatory response syndrome (SIRS), includes:
A. Lack of fever
B. Leukopenia <4000/mm3
C. Fever above 38 degrees C
D. Hyperleukocytosis over 12000/mm3
E. Normal respiratory and cardiac rate

Answer: A, B, C, D

3. The sepsis picture associated with organ dysfunction, is manifested by the following:
A. No hemodynamic consequences
B. Marbling
C. Normal breathing
D. Renal insufficiency
E. Coagulation disorders

Answer: B, D, E

4. The following statements are true about mortality in septic shock:
A. It is not high
B. It is relative
C. It is of 50%
D. It is not influenced by other comorbidities
E. The greater the more the patient has a fragile field

Answer: C, E

5. Immediate severity signs in the diagnosis of SIRS are:
A. Spontaneous diuresis below 0.5 ml / kg / hour
B. Hypotension
C. Hypertension
D. Skin signs
E. Signs of tissue perfusion abnormality

Answer: A, B, D, E

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6. Purpura fulminans:
A. Sometimes associates fever
B. Purpura with rapid expansion
C. The patient can be treated in ambulatory
D. Purpura fulminans is an absolute vital emergency
E. It is manifested with meningeal syndrome

Answer: B, D, E

7. The risk field in the occurrence of purpura fulminans is:
A. Drug addiction
B. The presence of foreign material
C. Late postoperative period
D. Acquired immunosuppression
E. Without congenital immunosuppression

Answer: A, B, D
8. The following statements are true about blood cultures:
A. They are sampled before any antibiotherapy
B. Two bottles per set are sampled
C. 3 sets of blood cultures/24 hours are made
D. About 30ml of blood are sampled
E. About 10ml of blood are sampled

Answer: A, B, C

9. The following are true about positive blood cultures in septicemia:
A. Confirm bacteriemia
B. If the identification shows more different germs, a private gateway is taken into consideration
(cutaneous, digestive)
C. It is preferable that more blood culture samples to be positive
D. It usually is about one germ
E. It cannot be about the cutaneous gateway

Answer: A, B, C

10. One positive blood culture suggests:
A. The germ is a pathogen
B. The germ is a skin commensal
C. Potentially a contaminant during the sampling act
D. It is a diagnosis of bacteriemia certainty
E. It is not necessary to take another sample

Answer: A, B, C

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11. The following are true about negative blood cultures:
A. Eliminate the diagnosis of bacteriemia
B. Can be germs or fungus with slow growth
C. Do not eliminate the diagnosis of bacteriemia
D. There may be negative blood culture in case of recent antibiotic treatment
E. In case of sampling, there is no possibility to have negative blood cultures

Answer: B, C, D

12. The following may appear in the biological inflammatory syndrome:
A. Hyperleukocytosis
B. Thrombocytosis
C. Increased PCR
D. Increased procalcitonin
E. VSH with normal values

Answer: A, B, C, D

13. The elements influencing the diagnosis in favor of organ insufficiency are:
A. The increase in blood urea and creatinine
C. Reduction of the coagulation factors
D. Hepato-cellular insufficiency

Answer: A, B, C, D

14. The clinically oriented exams in septicemia are:
A. Lombar puncture
B. Sputum cytobacteriological examination
C. Specific imagistic examination of the infected situs
D. Without chest radiograph
E. ECBU

Answer: A, B, C, E

15. If the gateway is the teguments, the factors favoring the occurrence of septicemia are:
A. Surgery
B. Wounds
C. Drug addiction
D. Catheter installation
E. Burns

Answer: B, C, D, E

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16. If the gateway if the bile ducts, the factors favoring the occurrence of septicemia are:
A. Cholelithiasis
B. Retrograde catheterization
C. Surgery
D. Alcoholism
E. Drug abuse

Answer: A, B, C

17. If the gateway is the endocardium, the factors favoring the occurrence of septicemia are:
A. The existence of a valvulopathy
B. Dental surgery
C. Retrograde catheterization
D. Venous catheter
E. Drug addiction

Answer: A, B, D, E

18. The differential diagnosis of septicemia is made with the following diseases:
A. Cardiogenic shock
B. Acute fever
C. Pulmonary embolism
D. Tuberculosis
E. Hypovolemic shock

Answer: A, C, E
19. The management principles in septicemia consist in:
A. Emergency hospitalization
B. Ambulatory hospitalization
C. Installation of a venous access catheter
D. Installation of a nasal-gastric probe
E. Clinical supervision

Answer: A, C, E;

20. Maintaining vital functions in case of shock is done as follows:
A. Oxygenotherapy
B. Without intubation or mechanical ventilation
C. Extrarenal emergency purification
D. Volemic expansion
E. Treatment of circulatory insufficiency

Answer: A, C, D, E

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21. The following statements are true about anti-infective therapy in case of septicemia:
A. It is a safe treatment from the beginning
B. The antibiotic treatment is made in intravenous
C. Bitherapy is most often performed
D. The duration of treatment is usually more than 20 days
E. The treatment is initially probabilistic

Answer: B, C, E

22. The clinical monitoring in septicemia takes into consideration the following parameters:
A Temperature
B. Intolerance to antibiotics
C. Pulse oximetry
D. Superior functions
E. Diuresis

Answer: A, C, D, E

23. The clinical supervision of treatment is made taking into consideration:
A. The thermal curve
B. The gateway
C. Repetition of blood cultures
D. Identification of iatrogenic complications
E. Secondary localizations

Answer: A, B, E

24. The biological supervision of treatment is made taking into consideration:
A. The blood count
B. The thermal curve
C. CPR
D. Secondary localizations
E. Haemostasis

Answer: A, C, E
25. In case of persistent fever, the following are necessary:
A. Repeated blood cultures
B. Checking the input gate
C. Identification of iatrogenic complications
D. Verification of the adequacy of the antibiotherapy
E. CPR is determined

Answer: A, B, C, D

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INFECTIOUS MENINGITIS AND MENINGOENCEPHALITIS IN ADULTS

Simple complement:

1. In a purulent liquid meningitis, if the bacteriological examination shows positive gram cocci, it
is the most likely about:
A. Streptoccocus pneumoniae
B. Meningococi
C. Haemophilus influenzae,
D. Haemophilus pneumoniae
E. Listeria monocytogenes

Answer: A

2. The following statements are true referring to the "purulent" liquid meningitis, if the direct
bacteriological examination shows "positive gram cocci", except for:
A. It is determined more by pneumococci
B. The debut is abrupt
C. If the patient has asplenia, the attitude is towards vaccination and long-term penicillin
administration
D. If there is a history of head injury, the attitude to follow is the identification and treatment of
the possible osteomeningeal breach
E. It usually occurs following a nasopharyngitis

Answer: E

bacteriological examination shows "negative gram cocci", except for:
A. The onset is usually abrupt
B. It appears as a result of a nasopharyngitis
C. The curative treatment lasts for 7 days
D. It is determined rather by miningococi;
E. If there is a history of head injury, the attitude to be considered is the identification of the
possible osteomeningeal breach

Answer: E

bacteriological examination shows "positive gram bacilli", except for:
A. The installation is brutal
B. The installation is subacute
C. It's probably a listeriosis
D. The cranial nerves may be affected
E. It occurs more often during pregnancy

Answer: A

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5. The following statements are false referring to the "purulent" liquid meningitis, if the direct
A. The installation is sudden
B. No cranial nerves are affected in this pathology
C. It appears frequently in the carriers of an osteomeningeal breach
D. It appears the most frequently in cirrhotic patients
E. The prevention consists in vaccination

Answer: D


15.The meningeal syndrome is defined by the following:
F. Fever
G. Shivering
H. Intense cephalalgia
I. Meningeal stiffness
J. Photophobia

Answer: C, D, E

16. The following statements are true about the LCR examination:
A. It is made by lumbar puncture
B. It is made by stern puncture
C. The diagnosis of meningitis is made if there are more than 5 elements / mm
3

D. The meningitis is called "purulent" if most elements are polynuclear
E. The meningitis is called "purulent" when most elements are lymphocytes;

Answer: A, C, D

17. The following statements are true about the LCR examination:
A. It is made by lumbar puncture
B. The diagnosis of meningitis is made if there are more than 5 elements / mm
3

C. The meningitis is called "with clear liquid" if most elements are polynuclear
D. The meningitis is called "with clear liquid" if most elements are lymphocytes
E. The meningitis is called "purulent" if most elements are polynuclear

Answer: A, D, E

bacteriological examination shows "positive gram cocci":
A. The debut is generally insidious
B. The debut is generally brutal, with vigilance disorders
C. It appears in particular in splenectomized patients
D. The curative treatment is of 15 days
E. If there is a history of head injury, the attitude to be considered is the identification of the
possible osteomeningeal breach

Answer: B, C, D, E

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bacteriological examination shows "negative gram cocci":
A. It is probably about pneumococci
B. It is probably about meningococci
C. The vaccination is impossible for the serotypes A and B
D. The debut is usually insidious
E. The debut is usually brutal.

Answer: B, E

bacteriological examination shows "negative gram cocci":
A. The debut is brutal
B. It usually appears following a nasopharyngitis
C. It appears rather in old patients
D. It appears rather in young adults
E. As a prevention method, the diagnosed subjects must be declared

Answer: A, B, D, E

bacteriological examination shows "positive gram bacilli":
A. It appears following a nasopharyngitis
B. The installation is brutal
C. The installation is subacute
D. It is most frequent in pregnancy, in the new- born and in the cirrhotic patients
E. The curative treatment lasts for 21 days

Answer: C, D, E

A. The installation is brutal
B. The installation is subacute
C. It appears following a nasopharyngitis
D. The curative treatment lasts for 7 days
E. The curative treatment lasts for 21 days

bacteriological examination shows "negative gram bacilli":
A. It is most likely about Listeria monicytogenes
B. It is most likely about Streptococcus pneumoniae
C. It is most likely about meningococci
D. It is most likely about Haemophilus influenzae
E. A possible cause is an ENT infection in non- vaccinated children

Answer: D, E

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23. The following statements are true about neuropaludism:
A. The debut is insidious
B. The debut is rapid
C. Convulsions may appear
D. It leads to death in the absence of treatment
E. Higher values of glycemia appear frequently

Answer: B, C, D

24. The following statements are true about neuropaludism associated disease:
A. Hypoglycemia occurs
B. Hyperglycemia occurs
C. Respiratory insufficiency occurs
D. Renal insufficiency occurs
E. Intravascular coagulation is rarely associated

Answer: A, C, E

25. The differential diagnosis of a HSV meningitis is made with:
A. Neuropaludism
B. Listeriosis
C. Neuro-meningeal tuberculosis
D. HIV infections and AIDS stage complications
E. Bronchial asthma

Answer: A, B, C, D

26. The meningoencephalitis complications with HSV are as follows:
A. In the acute phase edema and even death
B. In the chronic phase edema and even death
C. Refractory epilepsy
D. Memory disturbances
E. Aphasic disorders

Answer: A, C, D, E

27. The following statements are true about HSV meningoencephalitis:
A. This diagnosis is suspected in case of brutal or rapid installation
B. The meningeal syndrome occurs (memory disturbances, behavior disturbances)
C. Encephalic signs occur (memory disturbances, behavior disturbances)
D. The meningeal syndrome occurs (intense cephalalgia, neck stiffness)
E. The complications are more frequent, the more the treatment is begun later

Answer: A, C, D, E

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28. The following statements are true about HSV meningoencephalitis:
A. The clinical picture is installed insidiously
B. The clinical picture is installed suddenly
C. The direct LCR examination does not identify a germ
D. The MRI or CT typically shows bilateral lesions
E. The MRI or CT typically shows unilateral lesions

Answer: B, C, D
29. The following represent complications of the purulent meningitis:
A. Septic shock
B. Hydrocephaly with increased intra-cranial pressure
C. Coma
D. Epilepsy
E. Hydro- electrolytic disorders

Answer: A, C, D, E

30. The following represent complications of the purulent meningitis:
A. Hydrocephaly
B. Disseminated intravascular coagulation
C. Renal insufficiency
D. Hepatic insufficiency
E. Deafness

Answer: A, B, E

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HEPATO-GASTROENTEROLOGY

ACUTE DIARRHEA AND DEHYDRATION IN ADULT

Simple complement:

1. Acute diarrhea is defined as:
A. Emission of more than 4 stools/ day;
B. Emission of soft/liquid stools;
C. Emission of soft stools insidious installed;
D. Diarrheic stools present for approximately 10 days;
E. Diarrheic stools present for approximately one month.

Answer: B

2. Which of the following statements is true regarding to the acute diarrhea?
A. Approximate 1% of the acute diarrheas needs hospitalization;
B. Represents a major problem only in developing countries;
C. Represents approximate 5 millions of the consultations at the family doctor;
D. Does not have infectious cause in general;
E. Represents the cause of approximately 2 millions from the medical holidays.

Answer: A

3. Acute diarrhea associates the following extra digestive signs:
A. Vomiting;
B. Thirst;
C. Alteration of the general condition;
D. Fever;
E. Arthralgias

Answer: E

4. The following statements represent dehydration signs in acute diarrhea, except:
A. Palpitations;
B. Vertigo in orthostatism;
C. Thirst;
D. Alteration of the general condition;
E. Dryness of the mucosae.

Answer: D

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5. Gastroenteric syndrome is characterized by the following:
A. Invasive colic affection;
B. Banal diarrhea;
C. Profuse and watery diarrhea;
D. Frank septic syndrome;
E. Diarrhea with numerous stools.

Answer: B

6. The dysenteric syndrome presents the following, except:
A. Cellular destruction;
B. Toxic megacolon;
C. Perforation risk;
D. Pseudo influenza syndrome;
E. Rectal syndrome.

Answer: D

7. Hydroelectrolitic diarrhea is characterized by:
A. Profuse diarrhea;
B. Invasive diarrhea;
C. Easy dehydration;
D. Presence of phlegms
E. Presence of blood.

Answer: A

8. The parasitological examination of the stool is indicated in case of:
A. Nosocomial diarrhea;
B. Persistent diarrhea;
C. Diarrhea more than 7 days, despite the antibiotic treatment;
D. Diarrhea accompanied with severe dehydration;
E. Dysenteric syndrome.

Answer: C

9. Which of the following statements about the sanguine exploration in acute diarrhea is true?
A. Hemoculture only in case of fever;
B. Usually CRP;
C. Hepatic balance if exists suspicion of typhoid fever;
D. Hemocultures only if exists hypothermia;
E. Electrophoretrogram is not necessary.

Answer: C

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10. Which of the following statements about the Golden Staphylococcus is true?
A. Has long incubation period;
B. Has short incubation period;
C. There are 2 enterotoxins;
D. Produces a choleriform syndrome;
E. Produces the tourists diarrhea.

Answer: B

11. Which of the following statements about cholera is true?
A. The contamination is alimentary;
B. It is frequent in Romania;
C. Vomiting represents a foreground symptom.
D. The clinical picture is generally less severe.
E. Produces quick dehydration.

Answer: E

12. Regarding the tourists diarrhea, the following statements are true, except:
A. It is also called the tourist;
B. It is produced by enterotoxigenic E.coli;
C. The incubation is short;
D. Contains thermostable toxins;
E. Contains thermolables.

Answer: C

13. Which of the following statements characterizes the dysenteric syndrome produced by
Campylobacter Jejuni?
A. The clinical picture is severe
B. Guillain-Barre Polyradiculoneuritis is recognized as being a post infectious complication;
C. Produces nodal fever;
D. Produces hemolytic syndrome;
E. Produces uremic syndrome.

Answer: B

14. The following statements characterize the dysenteric syndrome produced by Salmonella,
except:
A. Lenticular spots;
B. Widal serology can help in establishing the diagnostic;
C. Diarrheic stools with yellow, melon juice aspect;
D. Declaration is mandatory;
E. The prognostic is good, even in the absence of the treatment.

Answer: E

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15. Which of the following statements about acute diarrhea with Yersinia is true?
A. The treatment is only symptomatic;
B. Morphine derivates in invasive diarrhea;
C. 5 days Salmonellosis macrolide;
D. Cholerae Vibrio Doxicillin in unique dose;
E. 10 days Clostridium difficile empirical treatment with Vancomicina i.v;

Answer: D

16. Which of the following statements about the treatment principles in acute diarrhea is true?
A. Yersinia Enterocolitis produces a classical dysenteric syndrome;
B. There are numerous serotypes;
C. The clinical picture is severe;
D. The incubation is short;
E. Produces a roseoliforme eruption.

Answer: A

17. Acute diarrhea with Shigella is characterized by the following:
A. Produces the famous uremic-hemolytic syndrome;
B. Produces a choleriform syndrome;
C. There are numerous serotypes;
D. Contains a pathogen thermostable enterotoxin;
E. Diarrhea is a symptom that appears in the background.

Answer: C

18. Which of the following statements characterized diarrhea with Clostridium perfrigens?
A. The incubation is long;
B. The clinical picture is analogue with the one from Golden Staphylococcus infection;
C. It is also called the tourist;
D. Produces life-threatening dehydration;
E. Post infectious complications appear.

Answer: A

19. The viral gastroenteritis is characterized by the following, except:
A. Is most frequent;
B. Is produced by Calcivirus, Rotavirus;
C. The transmission is interhuman;
D. The contagiosity is high;
E. Occurs frequently in summer.

Answer: E

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20. The global dehydration in acute diarrhea is described by:
A. Intense thirst;
B. The dryness of the mucosae;
C. Fever;
D. Neuropsychic disorders;
E. Signs of peritoneal irritation.

Answer: E


1. Which of the following statements about acute diarrhea are true?
A. Represents the first cause of infantile mortality in the third world;
B. Represents a major problem of public health;
C. Approximately 3 % of the acute diarrheas need management from a specialist doctor;
D. A small number of diarrheas have infectious cause;
E. Diarrhea is defined by emission of soft or liquid stools, longer than 14 days.

Answer: A, B

2. Which of the following statements characterize the acute diarrhea?
A. The main goal is identifying the profile of diarrhea;
B. The associated general signs: thirst, cutaneous eruption;
C. The associated digestive signs: nausea, vomiting;
D. The associated extra digestive signs: cutaneous eruption, arthralgias, myalgias;
E. Dehydration signs: thirst, sensation of dry mucosae.

Answer: C, D, E

3. Global dehydration in acute diarrhea is described by:
A. Dryness of the mucosae;
B. Fever;
C. Septic shock;
D. Thirst more intense;
E. Neuropsychic disorders.

Answer: A, B, D, E

4. Extracellular dehydration in acute diarrhea is characterized by the following:
A. Orthostatic hypotension;
B. Palpitations;
C. Persistent cutaneous fold;
D. Fever;
E. Hypotony of the eyeballs.

Answer: A, C, E

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5. Gastroenteric syndrome is defined by the following:
A. Intestinal affection;
B. Profuse and watery diarrhea;
C. Moderate septic syndrome;
D. Frank septic syndrome;
E. Favorable quick evolution.

Answer: A, E

6. Gastroenteric syndrome is defined by the following, except:
A. Intestinal affection;
B. Banal diarrhea;
C. Hydroelectrolytic diarrhea;
D. Invasive diarrhea;
E. Associates pseudo influenza syndrome.

Answer: C, D

7. Choleriform syndrome is characterized by the following:
A. Intestinal affection by toxic mechanism;
B. Profuse diarrhea;
C. Invasive diarrhea;
D. Associates subfebrility;
E. The diagnostic is eloquent by presence of phlegms

Answer: A, B

8. Choleriform syndrome is characterized by the following, except:
A. Hydroelectrolytic diarrhea
B. Moderate septic syndrome
C. Severe dehydration
D. Does not present mortality risk
E. Colic affectation with cellular destruction

Answer: D, E

9. Dysenteric syndrome is characterized by the following:
A. Numerous stools;
B. Less abundant stools;
C. Absent septic syndrome;
D. Risk of toxic megacolon;
E. There is no risk of colonic perforation.

Answer: A, B, D

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10. Coproculture on selective environments is indicated in the following situations:
A. Dysenteric syndrome;
B. Diarrhea more than 7 days;
C. Diarrhea with severe dehydration;
D. Diarrhea at an immunodeppressed patient;
E. Diarrhea at returning from a stay in tropical areas.

Answer: A, C

11. The toxins for Clostridium difficile are caused in the following conditions:
A. Diarrhea that persists after an antibiotic treatment;
B. Diarrhea more than 3 days;
C. Diarrhea more than 7 days;
D. Inexplicable severe infectious syndrome;
E. Nosocomial diarrhea.

Answer: A, E

12. Which of the following investigations are parts of sanguine examinations in acute diarrhea?
A. Hemocultures;
B. Complete blood count;
C. CRP
D. Sanguine electrophoretrogram;
E. Coproculture.

Answer: A, B, C, D

13. Endoscopic examination in acute diarrhea has the following indications:
A. Diffuse abdominal pains;
B. Invasive diarrhea;
C. Diarrhea more than 3 days;
D. Persistent diarrhea;
E. Negative coprocultures.

Answer: B, D, E

14. Viral acute gastroenteritis is characterized by the following:
A. Are rare;
B. Appear frequently in spring;
C. Responsible viruses: Calvirus, Rotavirus;
D. The transmission is interhuman
E. The evolution is spontaneous favorable

Answer: C, D, E

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15. The choleriform syndromes can generate the following pathogenic agents:
A. Cereus bacillus
B. Enteroinvasive E. Coli
C. Shigella
D. Campylobacter jejuni
E. Golden Staphylococcus

Answer: A, E

16. Diarrhea with Clostridium difficile is characterized by:
A. The incubation is short
B. The incubation is long
C. Diarrhea and abdominal pains are foreground
D. The clinic picture is less severe
E. There are only two possible enterotoxins

Answer: B, C

17. Which of the following statements about the acute diarrhea with Bacillus cereus are true?
A. Presents a thermostable toxin - analogue picture of the one from the infection with Golden
Staphylococcus
B. The pathogenic toxin induces a holeriform picture with quick dehydration
C. Presents a thermolable toxin - analogue picture of the one from the infection with Clostridium
perfigens
D. Produces an invasive diarrhea
E. Can produce Guillain-Barre polyradiculoneuritis

Answer: A, C

18. Acute diarrhea with Yersinia can have the following particularities:
A. Nodose erythema;
B. Enterocolitic yersinia produces classical dysenteric syndrome;
C. There are numerous serotypes;
D. Yersinia pseudotuberculosis - appendicular picture;
E. Yersinia is responsible for the majority of colliquative food toxiinfections;

Answer: A, B, D

19. Which of the following statements about acute diarrhea with Salmonella are true?
A. Produces extra digestive manifestations frequently
B. Dissociate pulse can appear
C. Hepatic cytolysis can appear
D. Leukocytosis can appear
E. The hemocultures can establish the diagnosis

Answer: B, C, E

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20. Which of the following statements about the symptomatic treatment from the infectious acute
diarrheas are true?
A. Oral hydration
B. Motility modulators
C. Antisecretory per bone
D. Absorbent topical
E. Quinolones

Answer: B, C, D

21. The stool parasitological examination is indicated in the following situations:
A. Diarrhea more than 3 days
B. Diarrhea more than 7 days despite antibiotic treatment
C. Persistent diarrhea antibiotic post treatment
D. Diarrhea at an immunosuppressant patient
E. Inexplicable severe infectious syndrome

Answer: A, B, D

22. Which of the following statements about the acute diarrhea treatment are true?
A. Motility modulators are not administrated
B. Racecadotril can be administrated
C. Antiemetics are not administrated
D. Preparations with Morphine can be administrated
E. Empirical antibiotic treatment can be administrated

Answer: B, D

23. Which of the following statements about antibiotic treatment of acute diarrhea are true?
A. Empirical treatment - invasive aspect
B. In diarrhea with Salmonella quinolone is administrated 5-7 days
C. In diarrhea with Campylobacter jejuni Metronidazol is administrated 14 days
D. In diarrhea with Vibrio cholerae, Doxicillin 300 mg in unique dose is administrated
E. In diarrhea with Clostridium difficile responsible antibiotic administration is suppressed and
Metronidazol is administrated

Answer: A, B, D, E

151

DIGESTIVE HEMORRHAGE

Simple complement:

1. About the superior digestive hemorrhage, the following are true:
A. It is determined by injuries of the digestive tube downstream of duodenum-jejunal angle;
B. Frequent cause - Malory-Weiss;
C. Ulcerous pathology main cause;
D. Is manifesting only by melaena;
E. Is manifesting by minor rectal bleeding.

Answer: C

2. Which of the following signs and symptoms can be taken into account in the algorithm of
differential diagnostic in the superior digestive hemorrhage?
A. Hemoptysis;
B. ENT type bleeding;
C. Vomiting with gastric content of red beet;
D. All variants are true;
E. None of the variants is correct.

Answer: C

3. About Forrest classification, are true:
A. Class IA - spurting hemorrhage;
B. Class IB - oozing hemorrhage;
C. Class IA - adherent clot;
D. Class IIA - adherent clot;
E. Class IIC - pigmentation spots;

Answer: E

4. The severity of a digestive hemorrhage is evaluating by the following clinical signs:
A. Thoracic pain;
B. Vertigo;
C. Shock signs;
D. Coagulation tests;
E. Electrophoretogram.

Answer: C

5. Inferior digestive hemorrhage is characterized by:
A. The bleeding source is downstream of the duodenum-jejunal angle;
B. Is manifesting by hematemesis;
C. Rare diverticular hemorrhages;
D. Is stopping spontaneous frequent;
E. Frequently the source of bleeding is a rectal neoplasia.

Answer: D

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6. Which of the following pathologies represent frequent causes of HDS?
A. Portal hypertension;
B. Peptic esophagitis;
C. Posterior epistaxis;
D. Gastric neoplasm;
E. Mallory-Weiss syndrome.

Answer: A

7. Regarding to IDH, the following statements are true:
A. The most frequent cause is colon neoplasm;
B. Its origin is in the small intestine in 90% from cases;
C. Its origin is in colon in 10% from cases;
D. The anticoagulant treatment represents the frequent source of IDH;
E. Diverticular hemorrhages represents the frequent source of IDH.

Answer: E

8. Which of the following statements about diverticular hemorrhages is true:
A. Occur dependent of the inflammatory complications of a diverticulitis;
B. The endoscopic hemostasis is never tented because of the major risks;
C. Represent the frequent cause of IDH;
D. They are not dependent of NSAID consumption;
E. The diagnostic is realized endoscopically.

Answer: C

9. The following represent the cause of SDH/IDH, except:
A. Gastrotoxic drugs;
B. Antiagreggatory drugs consumption;
C. Hepatic insufficiency;
D. Renal insufficiency;
E. Anticoagulants consumption.

Answer: E

10. Which of the following statements regarding the digestive hemorrhages is true?
A. EDS is realized even if the patient is hemodynamically instable;
B. Forrest classification guides only the endoscopic treatment;
C. Ulcerative lesions are favored only by aspirin;
D. Empiric treatment is represented by PPI on injector;
E. Endoscopy has only diagnostic role.

Answer: D

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1. Endoscopic hemostasis can realize in case of SDH episodes, by the following:
A. Administration of adrenalinated serum;
B. Elastic ligatures for ulcer;
C. Thermal methods;
D. Clips for esophageal varices;
E. A, C and D are the incorrect variants.

Answer: A, B, C, D.

2. Regarding at SDH, the following statements are true:
A. The bleeding source is upstream by the duodenojejunal angle;
B. Never generates instability;
C. Is frequent severe;
D. Is manifesting by hematemesis;
E. One of the frequent causes is the peptic esophagitis.

Answer: A, C, D

3. Which of the following statements about SDH are true?
A. Forrest classification guides the pharmacological treatment;
B. The ones from Forrest class IIC and III receive treatment with PPI p.o;
C. In case of those from Forrest class IIC adrenalinated serum can be used;
D. In case of those from Forrest classes IA-B, i.v treatment with PPI for 72 hours is
administrated.
E. In case of those from classes IIA-B, i.v treatment with IPP for 24 hours is administrated.

Answer: A, B, D

4. In case of SDH the therapeutic conduct can be represented by:
A. Endoscopic ligature of the esophageal varices;
B. Administration of Ocreotide in peptic ulcer;
C. IPP on injector;
D. Ulcerated lesions - use of adrenalinated serum;
E. Clips for VE.

Answer: A, C, D, E

5. Mallory-Weiss syndrome is characterized by:
A. Subcardial longitudinal rupture;
B. Unfavorable prognostic;
C. Appears secondary to vomiting effort;
D. Represents frequently a complication of cirrhosis;
E. Analogue treatment to ulcerated lesions is established.

Answer: C, E

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6. Which of the following attitudes represent the therapeutic conduct/ diagnosis for the existence
of an IDH with normal colonoscopy?
A. IPP on injector;
B. Video capsule endoscopy;
C. Administration of Octeotrid i.v;
D. Celiomesenteric artheriography;
E. Radiological embolization.

Answer: B, D, E

7. Which of the following pathologies represent rare causes of SDH?
A. Dieulafoy ulcers;
B. Tumors;
C. Wirsungorragies;
D. Peptic esophagitis;
E. Hemobilia

Answer: A, B, C, E

8. Forrest classification is characterized by:
A. IA- projectile hemorrhages;
B. IB- nonhemorrhagic visible vessel;
C. IIA - white background;
D. IIB- adherent clot;
E. IIC - pigmented spots.

Answer: A, D, E

9. Which of the following statements represent reanimation measures?
A. Oxygen therapy
B. IPP administration
C. MER administration
D. Mounting a peripheral venous route
E. Filling the vascular bed

Answer: A, C, E

10. The following are considered causes of gastric/duodenal ulcer:
A. Presence of Helicobacter pylori;
B. Portal hypertension;
C. NDAID consumption;
D. Repeated vomiting;
E. Aspirin consumption

Answer: A, C, E

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11. Superior digestive endoscopy has the following roles:
A. Diagnostic
B. Decreasing the portal hypertension;
C. Prognostic;
D. Therapeutic
E. Emptying the stomach

Answer: A, C, D

12. Superior digestive endoscopy in urgency can be made in the following conditions:
A. Hemodynamic instable patient;
B. Even if the patient is intubated and ventilated;
C. At a patient with an empty stomach for 6 hours;
D. After empting the stomach with slow PEV with erythromycin;
E. In case of apparition of conscious state disorders.

Answer: C, D, E

13. When the vital functions have been controlled, in SDH the anamnesis is completed by clinical
exam that consists of:
A. Rectal examination;
B. ENT examination;
C. Identification of portal hypertension;
D. Palpation of the abdomen that can detect a tumor formation;
E. Identification of hepatocellular insufficiency.

Answer: A, C, E

14. Which of the following statements regarding IDH are true?
A. The source in 90% of the cases is represented by colon;
B. The source in 10% of the cases is represented by rectum;
C. Colon cancer is frequently the bleeding source;
D. Colitis are manifesting frequently by diarrhea and rarely by rectal bleedings;
E. Merkel diverticulum represents a frequent cause of bleeding.

Answer: A, D

15. Which of the following premises belong to the small intestine and generated IDH?
A. Ulcers due to NSAID;
B. Ulcers from ulcero-hemorrhagic rectocolitis;
C. Tumors;
D. Diverticulums;
E. Angiodysplasia;

Answer: A, C, E

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16. Which of the following statements characterized angiodysplasia?
A. Is manifesting by repeated rectorragies less abundant;
B. Vascular anomalies;
C. Are favored by NSAID consumption;
D. Premises - the colon;
E. Premises - small intestine.

Answer: B, D, E

17. Which are the true statements about Colonoscopy?
A. Is made without the colon preparation;
B. Is made under general anesthesia;
C. Can be made urgently;
D. Is made in diagnostic goal;
E. Does not have therapeutic role.

Answer: B, C, D

18. In Forrest IA lesions, the therapeutic attitude is characterized by:
A. Endoscopy with local hemostasia;
B. Can be intervened again endoscopically if the hemorrhage continues;
C. Pharmacologic treatment with Octreotid;
D. Surgery intervention;
E. Arterial embolisation under radiological control.

Answer: A, B, D, E

157

VIRAL HEPATITIS. HEPATIC BIOLOGICAL ANOMALIES IN
ASIMPTOMATIC SUBJECT

Simple complement:

1. Which of the following statements regarding to the viral hepatitis A is true?
A. A hepatic virus is a DNA virus;
B. Is transmitted by blood products;
C. Diagnostic is made with the use of IgG anticorps;
D. Is an infectious frequently symptomatic;
E. Has an incubation of 2-6 weeks.

Answer: E

2. The following statements about viral hepatitis B are true, except:
A. Hepatic virus B is a DNA virus;
B. The incubation period is between 6-12 weeks;
C. Initial infection is frequently symptomatic;
D. In France approximately 0,5% of population is infected;
E. The contamination is horizontal.

Answer: C

3. About delta hepatitis, the following statements are true, except:
A. Hepatic virus D is a DNA virus;
B. Assumes coinfection with VHB;
C. Acute infection is often asymptomatic;
D. Superinfection with VHB has a bad prognostic;
E. Hepatic virus D is a defective virus.

Answer: A

4. Regarding viral hepatitis E, the following are true:
A. Is produced by a DNA virus;
B. The contamination is vertical;
C. The incubation lasts 6 weeks-6 months;
D. It is endemic in France;
E. Can generate a fulminant hepatitis in pregnant women.

Answer: E

5. Regarding viral hepatitis C, the following statements are true:
A. The contamination is parenteral;
B. Virus incubation lasts 6-8 weeks;
C. The initial infection is frequently symptomatic;
D. Never generates fulminant hepatitis;
E. Can generate extrahepatic manisfestation.

Answer: C

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6. The antiviral treatment in viral hepatitis C has the following indications:
A. Is indicated at a Metavir F0 score;
B. Is indicated administration of such treatment in decompensated cirrhosis;
C. Is not administrated at patients with extrahepatic manifestations;
D. Is indicated inclusively in the absence of significant fibrosis;
E. Is proposed for those with phenotype 1.

Answer: D

7. Which of the following viruses are hepatotrope nonspecific?
A. VHA;
B. VHB;
C. VHC;
D. HSV;
E. VHE.

Answer: D

8. Which clinical form is most frequent in acute viral hepatitis?
A. Cholestatic form;
B. Prolonged form;
C. Anicteric form;
D. Form associated with extra hepatic manifestations;
E. Fulminant form.

Answer: C

9. The abdominal echography has the following indications in infection with VHB, except:
A. Annual echography for the patients with cirrhosis;
B. Biannual echography for the patients with cirrhosis;
C. Annual echography for the patients with hepatitis;
D. Helps at searching the cirrhosis signs;
E. Can precociously detect the presence of hepatocellular carcinoma.

Answer: A

10. Antiviral treatment is indicated in patients with chronic hepatitis with VHC, in the following
situations:
A. DNA-VHB 2000 copies;
B. Persistent increase of ALAT with undetectable viremia;
C. Metavir score < A2;
D. Metavir score F2;
E. DNA-VHB 10000 U/L.

Answer: D

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11. Which of the following statements represent therapeutical strategies in viral B hepatitis?
A. Monotherapy with pegylated Interferon if ALAT > 2N;
B. Good virusologic answer, ALAT > 2N and moderate viral reapplication monotherapy with
pegylated IFN;
C. In patients with cirrhosis are preferred nucleotides analogues;
D. In patients with cirrhosis is preferred pegylated Interferon;
E. Treatment with Netecavir, is administrated on an undetermined period.

Answer: C

12. The balance in viral hepatitis B is based on the following, except:
A. Determination of the viral load;
B. Punction - liver biopsy;
C. Abdominal echography;
D. Hepatic balance;
E. ANA

Answer: E

13. Immunoelimination in VHB is characterized by:
A. High viral replication;
B. Normal transaminase;
C. Seroconversion in Hbe system;
D. Minimal hepatic lesions;
E. Variable hepatic lesions.

Answer: C

14. Diagnostic in HBV considers the following:
A. HBs Ag;
B. Anti- HBs antibodies;
C. Anti- HCV antibodies;
D. Anti- HDV IgG;
E. Anti- HAV IgA.

Answer: A

15. Which of the following statements about HBV is true?
A. Currently there are 350000 persons with chronic hepatitis;
B. In France approximately 5% are infected;
C. In France the prevalence is two times more then HCV;
D. 2 billion people from the world population entered already in contact with HBV;
E. 2 of 3 persons entered in contact with HBV.

Answer: D

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16. The natural history of hepatitis has the following succession, except:
A. The initial phase of contamination;
B. The incubation phase;
C. The preicteric phase;
D. The icteric phase;
E. No correct answer.

Answer: E

17. Fulminant hepatitis is defined by the following:
A. Mortality < 50%;
B. Hepatic encephalopathy at a week after the apparition of the jaundice;
C. Ip < 25%;
D. The treatment can be made ambulatory also;
E. Does not represent a severe form of disease.

Answer: C

18. In viral hepatitis C is recommended the identification of the associated comorbidities, looking
for the following biological parameters, except:
A. Antityroperoxidasa antibodies;
B. Plain muscular anti-fiber antibodies;
C. Anti LKM1;
D. TSH;
E. Anti Ro antibodies.

Answer: E

19. The diagnostic of Hepatitis E virus is realized with the help of:
A. HEV Ag;
B. DNA - HEV - blood;
C. DNA - HEV - stool;
D. Anti HEV anti bodies;
E. No variant is correct.

Answer: D

20. Which of the following viruses is part of the Herpes group?
A. HAV;
B. BEV;
C. HBV;
D. HDV;
E. HCV.

Answer: B

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21. The following statements about viral E hepatitis are true, except:
A. RNA virus;
B. Fecal-oral contamination;
C. Is severe at pregnant women;
D. Incubation lasts 2-6 weeks;
E. Endemic in developed countries.

Answer: E


1. Which of the following statements about hepatitis are true?
A. All hepatotrope viruses are RNA;
B. HAV + HEV give exceptionally fulminant hepatitis;
C. HBV + HCV are responsible for the chronic hepatitis too;
D. HDV can only super infect a HBV + host;
E. The way of transmission is particular to any virus.

Answer: B, C, D

2. The preicteric phase in case of acute hepatitis is characterized by:
A. Asymptomatic;
B. Flu-like syndrome;
C. Cutaneous eruption;
D. Lasts 2-6 weeks;
E. Can generate right subcostal discomfort.

Answer: B, C

3. The icteric phase in case of acute hepatitis is characterized by:
A. Optional pruritus;
B. Jaundice with increased unconjugated bilirubinemia;
C. Hepatomegaly sensitive to palpation;
D. Associated polyradiculoneuritis;
E. Maximum duration 2 weeks.

Answer: A, C

4. Fulminant forms of hepatitis are characterized by:
A. Mortality > 50 in the absence of the treatment;
B. IP > 25%;
C. The treatment is made in ATI sections;
D. Is applied to hepatic transplant in all situations;
E. Hepatic encephalopathy appears at less than 2 weeks from the onset of the jaundice.

Answer: A, C, E

162

5. Viral A hepatitis is characterized by:
A. Is rare in developing countries;
B. Incubation lasts 2-6 weeks;
C. Frequently is asymptomatic;
D. The contamination is horizontal;
E. There is not specific treatment.

Answer: B, C, E

6. The contamination in hepatitis with B virus can be made:
A. Sexually;
B. Parenterally;
C. Vertically;
D. Horizontally;
E. Fecalo-orally.

Answer: A, B, C, D.

7. The antiviral diagnostic in HBV is indicated in the following situations:
A. DNA - HBV 2000 copies/ml;
B. DNA - HBV 10000 copies/ml;
C. The persistent increase of ALAT with detectable viremia;
D. Metavir score A2;
E. Metavir score F2.

Answer: B, C, E

8. Hepatic balance in HBV accomplished the following criteria:
A. Hepatic balance;
B. Determination of the viral load;
C. Biopsy does not represent the golden standard for fibrosis evaluation;
D. Metavir score;
E. Annual ecography at patients with cirrhosis.

Answer: A, B, D

9. Which of the following statements about the viruses from Herpes group are true?
A. Are hepatotropic;
B. Hepatitis is frequent at immunosuppressant patients;
C. Fever and angina characterize HSV1 primo infection;
D. Viral hepatitis is often asymptomatic;
E. Vesicular eruption at the mucosae level characterizes the infection with Herpes Zoster.

Answer: A, B, D

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10. The following statements about hepatitis with Delta virus are true:
A. Are produced by a DNA type virus;
B. Are produced by a defective virus;
C. Can co-infect or super-infect HBV;
D. The infection is frequently asymptomatic;
E. The super infection has a good prognostic.

Answer: B, C

11. Which are the main side effects of Interferon?
A. Anemia;
B. Hemolytic anemia;
C. Thrombocytopenia;
D. Like-flu syndrome;
E. Leukocytosis.

Answer: A, C, D

12. The following statements about viral E hepatitis are true, except:
A. It is produced by an RNA virus;
B. The transmission is fecal-oral;
C. Appears frequently in France;
D. Ribavirin is administrated empirically p.o to all patients;
E. Diagnostic is based on anti HEV serology.

Answer: C, D

13. The antiviral treatment is indicated in patients with HCV in the following situations:
A. Metavir F2;
B. Patients with genotype 2;
C. Dose of Ribavirin depends only by the viral genotype;
D. Pegylated Interferon is administrated 3 times per week;
E. Metavir F4.

Answer: A, B

14. Noninvasive evaluation of hepatic fibrosis is made by:
A. Abdominal ecography;
B. Fibroscan;
C. Hepatic biopsy;
D. Fibro test;
E. Unidimensional transient elastography.

Answer: B, D, E

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15. Which of the following statements represent temporary or definitive contraindications of
antiviral treatment?
A. Xerophthalmias;
B. Pregnancy;
C. Hypertiroidy;
D. Psychiatric affections;
E. Rheumatologic diseases.

Answer: A, B, D

16. The specific measures in hepatitis with HBV are represented by the following:
A. Prohibion of consumption of hepatotoxic drugs;
B. Unprotected sexual contact;
C. Care for the long term affections;
D. Vaccination of the patient;
E. Limitation of alcohol consumption.

Answer: A, C, E

17. Which are the steps to follow if HCV RNA is detectable?
A. Complete hepatic balance;
B. Alfa fetoprotein;
C. Viral genotype is not determined;
D. Other comorbidities will not be identified;
E. Determination of the viral load is optional.

Answer: A, B

18. Delta hepatitis is characterized by the following, except:
A. Is determined by an RNA virus;
B. Contamination is identical with HBV;
C. Infection is frequently asymptomatic;
D. Positive diagnostic is based on HDV Ag.
E. Is indicated the appreciation of the fibrosis grade.

Answer: C, D

19. Treatment in HAV is characterized by the following:
A. Is not specific;
B. Is recommended transitory rest;
C. Consumption of hepatotoxic drugs is avoided;
D. Ribavirin p.o;
E. Pegylated Interferon- once per week.

Answer: A, B, C

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20. Acute viral hepatitis is characterized by:
A. Constant cytolysis;
B. The levels of transaminases 10 times more than normal;
C. The main cholestasia predominates;
D. HAV IgG;
E. Anti HBc IgM;

Answer: A, B, E.

21. Which of the following statements about viral hepatitis are true?
A. HBs Ag, HBc IgG - chronic hepatitis HBV;
B. HAV IgG - acute hepatitis HAV;
C. HBs antibodies - HBV vaccination;
D. HEV Ag acute hepatitis HEV;
E. HBs Ag + HBc + HDV IgM coinfection HBV + HDV.

Answer: A, B, C, E

22. Form of hepatitis with extra hepatic manifestations is characterized by:
A. Autoimmune hemolytic anemia;
B. Hepatic encephalopathy;
C. Glomerulopathy;
D. Leucopenia;
E. Polyradiculoneuritis.

Answer: A, C, E.

23. Which of the following statements about hepatitis are true:
A. Hepatitis with HAV does not become chronic;
B. HBV - RNA virus;
C. HCV incubation 2-4 weeks;
D. Severe acute hepatitis is an acute hepatitis with IP > 50%;
E. Severe acute hepatitis is an acute hepatitis with IP > 50%.

Answer: A, C, E

24. In HBV hepatitis immune tolerance is characterized by:
A. Low viral replication;
B. Increased transaminases;
C. Absent hepatic enzymes;
D. Normal transaminases;
E. Seroconversion in Hbe system.

Answer: C, D

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25. Immune elimination in HBV has the following characteristics:
A. Decrease of viral replication;
B. Variable hepatic lesions;
C. Increase of transaminases;
D. Is also called inactive portage;
E. Is also called immune answer.

Answer: B, C, E

26. Non-replicative phase in HBV represents the following criteria:
A. Normal transaminases;
B. Increased transaminases;
C. Variable hepatic lesions;
D. Seroconversion with Hbe system;
E. Undetectable viral replication.

Answer: A, B, C, E

27. Antiviral treatment is administrated in hepatitis with HBV if:
A. In case of decompensated cirrhosis, treatment is initiated urgently;
B. In case of complensated cirrhosis, treatment is initiated if DNA - HBV > 2000 I.U./ml;
C. Metavir score A2;
D. DNA HBV > 10000 IU/ml;
E. Detectable viremia and persistent increase of ALAT.

Answer: A, C, E

28. About antiviral treatment in HCV, the following are true:
A. The treatment depends by viral genotype;
B. After initiation of the treatment quantitative CRP will be made at 12 weeks;
C. At 12 weeks the viral load must decrease at least 3 log;
D. If viremia does not decrease at 12 weeks the treatment is continued;
E. Antiviral treatment is administrated one year without interruption.

Answer: A, B

167

GASTRIC AND DUODENAL ULCER

Simple complement:

1. Which of the following statements regarding ulcer is true?
A. Ulcer = loss of substance of the digestive wall, that affects the serosa;
B. Ulcer = loss of substance of the digestive wall, that affects the mocosis;
C. The incidence is increasing;
D. Gastric ulcer is 3 times more frequent;
E. Duodenal ulcer is rarer than the gastric one.

Answer: B

2. The diagnostic circumstances in gastric and duodenal ulcer can be:
A. Typical ulcer pain in 2/3 from cases;
B. Premises in hypogastrium;
C. Does not improve with diet;
D. The pain is rhythmed by meals;
E. The pain has burning character.

Answer: D

3. Which of the following statements about ulcer treatment is true:
A. Is administrated triple therapy regardless infection with Heliobacter pylori is present or not
B. Eradication of Heliobacter pylori is realized only by administration of protons pump inhibitors;
C. Treatment prescription with protons pump inhibitors has a fixed period;
D. Treatment in ulcer with risk caused by nonsteroidal anti-inflammatory drugs consists of
administration of protons pump inhibitors for 6 weeks;
E. In gastric ulcer endoscopic control is made at 6 weeks.

Answer: E

4. Which of the following statements about the perforated ulcer is true?
A. Is medical emergency;
B. Is surgical emergency;
C. Appears abdominal diffuse pain;
D. Is a rare complication;
E. The treatment is endoscopic.

Answer: B

5. The stenosis from gastric or duodenal ulcer is characterized by:
A. Preferential localization at the little curve level
B. Postprandial food vomiting immediately
C. Endoscopic diagnostic and biopsies taking off
D. Medical first intention treatment with protons pump inhibitors;
E. First intention surgery treatment.

Answer: C

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1. Which of the following statements about ulcer can be true?
A. Ulcer is defined by loss of substance from the digestive wall affected muscular
B. Abrasions and exulcerations are superficial;
C. The incidence is increasing;
D. Gastric ulcer appears more frequently;
E. The frequency of duodenal ulcer is 3 times bigger.

Answer: A, B, E

2. Which are the main factors that favor ulcer appearance?
A. Increased gastric acid secretion
B. The affection of gastric mucosal barrier
C. Consumption of nonsteroidal anti-inflammatory drugs
D. Infection with Helicobacter pylori
E. Ingestion of toxic substances

Answer: C, D

3. The clinical picture in ulcer is characterizing by the following:
A. Typical ulcerous pain
B. The typical pain appears at approximately of the patients
C. The premises is epigastric
D. Pain has burn character
E. Pain has painful hunger nature

Answer: A, C, E

4. Which of the following statements can constitute diagnostic circumstances in ulcer?
A. The pain is atypical with epigastric premises
B. Pyrosis
C. Accidental discovery in endoscopy - rare
D. Typical pain rhythmed by meals
E. Pain relieved by alimentation

Answer: A, D, E

5. Which of the following statements represent arguments for gastric neoplasm diagnostic?
A. Alteration of general condition
B. Palpable abdominal mass
C. Adenopathies
D. Weight loss
E. Carcinomatous nodules at rectal examination

Answer: A, B, C, E

169

6. Which of the following statements about superior digestive endoscopy are true?
A. Does not permit ulcer diagostic
B. Represent a key exam for diagnostic
C. Can visualize one or more substance loss
D. Permit biopsies taking off
E. Does not permit gastric neoplasm diagnostic

Answer: B, C, D

7. Which of the following statements about ulcer treatment are true?
A. Depends of the premises of the lesion
B. Depends if there is an infection with Helicobacter pylori
C. The treatment is the same regardless the cause
D. Consumption of gastro toxic drugs change the period of treatment administration
E. The treatment of ulcer does not differ according to the premises of the lesion

Answer: A, B, D

8. The treatment of eradication of Helicobacter pylori is characterized by:
A. Of first intention - double therapy
B. Of first intention - triple therapy
C. Triple therapy = protons pump inhibitors in unique dose + Amoxicillin + Metronidazol
D. Triple therapy = protons pump inhibitors in double dose + Amoxicillin + Clarithromycin
E. The triple therapy is administrated 7-10 days.

Answer: B, D, E

9. The treatment with protons pump inhibitors is continued 3 weeks in standard dose in the
following situations:
A. Uncomplicated duodenal ulcer;
B. Gastric ulcer;
C. Administration of nonsteroidal anti-inflammatory drugs
D. Administration of anticoagulants
E. Age over 50 years old

Answer: C, D

10. Which of the following statements about the ulcer complications are true?
A. Hemorrhage is only acute
B. Perforation represents a medical urgency;
C. Surgery treatment is of first intention in stenosis;
D. Diagnostic of stenosis is realized endoscopically;
E. First intention in stenosis consists in administration of protons pump inhibitors.

Answer: D, E

170

THE JAUNDICE

Simple complement:

1. Which of the following statements about jaundice is true?
A. It is defined by yellow discolouration of the skin only
B. It is defined by yellow discolouration of the mucous membranes only
C. Subject is defined by bilirubin > 30 mol/L
D. Evident jaudice is defined by bilirubin > 30 mol/L
E. Evident jaudice is defined by bilirubin < 50 mol/L

Answer: C

2. Gilbert syndrome is characterized by the following statements, except:
A. Total glucuronidation deficiency of the bilirubin
B. Autosomal recessive transmission
C. Affects 5% of the population
D. Normal clinical picture, except for mild and fluctuating jaundice
E. No treatment

Answer: A

3. Which of the following statements about jaundice with unconjugated bilirubin is true?
A. Hemolysis and Gilbert syndrome are the main causes;
B. Hemolysis is due to partial glucuronidation deficiency of the bilirubin
C. Gilbert syndrome - Hemoglobin has low values
D. Liver balance is abnormal in Gilbert syndrome
E. Treatment consists of intravenous human albumin administration

Answer: A

4. Which of these malignancies may cause jaundice of extrahepatic origin?
A. Biliary lithiasis
B. Chronic pancreatitis
C. Vaterian ampulloma
D. Primary sclerosing cholangitis
E. Primary biliary cirrhosis

Answer: C

5. The presumptive diagnosis of a hilar region tumor is achieved by:
A. Echoendoscopy
B. Puncture biopsy
C. MRI
D. Cholangio-MRI
E. Abdominal ultrasound

Answer : D

171

Multiple complement :

1. Jaundice is defined by :
A. Yellow discolouration of skin
B. Yellow discolouration of mucous membranes
C. Sub-jaundice bilirubin >30 mol/L
D. Evident jaundice - bilirubin >50 mol/L
E. Itching

Answer: A, C, D

2. Which of the following statements about jaundice is true?
A. Jaundice with mixed bilirubin has not the same semiological value as jaundice with conjugated
bilirubin
B. Jaundice with conjugated bilirubin associates with dark urine
C. Pale stools are specific to jaundice with unconjugated bilirubin
D. Light urine characterizes the jaundice with unconjugated bilirubin
E. Jaundice with mixed bilirubin associates with pale stools

Answer: B, D, E

3. Intrahepatic cholestasis may be caused by:
A. Bile duct obstruction
B. Intrahepatic bile duct obstruction
C. Biliary channels damage
D. Hepatocyte dysfunction
E. Bile duct compression

Answer: B, C, D

4. Extrahepatic cholestasis may be caused by:
A. Intrahepatic bile duct obstruction
B. Bile duct obstruction
C. Bile duct compression
D. Hepatocyte dysfunction
E. Biliary channels damage

Answer: B, C

5. Gilbert syndrome has the following features, except:
A. Partial glucuronidation deficiency of the bilirubin
B. Autosomal dominant transmission
C. Affects 5% of the population
D. Determines the mild increases of conjugated bilirubin <60 mol/L
E. Hemoglobin is normal

Answer: B, D

172

6. Which of the following pathologies are causes of jaundice with unconjugated bilirubin?
A. Vaterian ampulloma
B. Primary biliary cirrhosis
C. Primary sclerosing cholangitis
D. Hemolysis
E. Gilbert syndrome

Answer: D, E

7. Which of these malignancies may cause jaundice of extrahepatic origin?
A. Pancreatic head neoplasms
B. Vaterian ampulloma
C. Autoimmune hepatitis
E. Cholangiocarcinoma

Answer: A, B, E

8. Which of the following benign conditions may cause jaundice of extrahepatic origin?
A. Biliary lithiasis
B. Infiltrative tumors
C. Chronic pancreatitis

Answer: A, C, D

9. Jaundice of intrahepatic origin may be caused by:
A. Bile duct obstruction
B. Intrahepatic bile duct obstruction
C. Hepatocellular dysfunction
D. Biliary channels damage
E. Intrahepatic bile duct compression

Answer: B, C, D

10. The presumptive diagnosis of extrahepatic cholestasis may be achieved by means of the
following explorations:
A. In chronic pancreatitis: - echoendoscopy
B. In biliary lithiasis - of first intention cholangio-MRI
C. Hilar region tumors CT and cholangio-MRI
D. Biliary lithiasis of first intention abdominal ultrasound
E. Tumors of duodenal-pancreatic confluent CT and echoendoscopy/puncture

Answer: C, D, E

173

CIRRHOSIS AND ITS COMPLICATIONS

Simple complement:

1. Which of the following conditions frequently produces cirrhosis?
A. Autoimmune hepatitis
B. Wilson disease
C. Budd Chiari syndrome
D. Non-alcoholic steatohepatitis

Answer: D

2. The following conditions that can cause cirrhosis are rare, except:
A. Hereditary alpha 1 antitrypsin deficiency
B. Hemochromatosis
C. Wilson disease
E. Autoimmune hepatitis

Answer: B

3. Budd-Chiari syndrome is defined by:
B. Primary biliary cirrhosis
D. Cardiac liver
E. Supra-hepatic veins thrombosis

Answer: E

4. Which of the following clinical signs are signs of portal hypertension?
A. Stellar angioma
B. Palmar erythrosis
C. Ascites in case of decompensated cirrhosis
D. Leukonychia
E. Portacaval-type abdominal collateral venous circulation

Answer: E

5. The following clinical signs makes the hepatocellular failure evident, except:
A. Digital hippocratism
B. Palmar erythrosis
C. Ascites decompensated cirrhosis
D. Leukonychia
E. Jaundice decompensated cirrhosis

Answer: C

174

6. The following biological changes are present in cirrhosis, except:
A. Anemia
B. Thrombocytopenia
C. Leucopenia
D. Low gamma - GT
E. Variable hepatic cytolysis

Answer: D

7. Liver Doppler ultrasound may reveal the following complications occurred in cirrhosis:
A. Dilatation of the portal trunk
B. Diversion routes
C. Portal thrombosis
D. Splenomegaly
E. Reversal of portal flow

Answer: C

8. In case of ascites in cirrhosis, the biological balance consists in the following, except:
A. Hemoleucogram
B. Alpha-fetoprotein
C. Creatinine
D. Serum Protein Electrophoresis
E. Hemocultures to all patients

Answer: E

9. The treatment for spontaneously infected ascites is done with:
A. Cefotaxime
B. Ceftriaxone
C. Amoxicilline
D. Clavulanic acid
E. Albumin in the 1
st
day

Answer: A

10. Diagnosis of spontaneous ascites infection is done by:
A. Cultures which are always positive
B. PMN>500/mm
3
in ascites
C. PMN>1000/mm
3
in ascites
D. PMN>250/mm
3
in ascites
E. PMN<250/mm
3
in ascites

Answer: D

175

11. Supervision of treatment efficacy is achieved by:
A. Abdominal circumference
B. Anorexia
C. Denutrition
D. Functional renal failure
E. Lower limbs swelling
F. Gynecomastia

Answer: C

12. In the liver cirrhosis the supervision of tolerance to treatment in terms of the regimen is
achieved by:
A. Hyponatraemia
B. Hypokalaemia
C. Hyperkalaemia
D. Denutrition
E. Functional renal failure

Answer: D

13. Secondary prophylaxis of UGIB in esophageal varices is achieved by:
A. TIPS
B. Endoscopic haemostasis
C. Liver transplant
D. Blackmore probe
E. Non-cardioselective blockers

Answer: E

14. Differential diagnosis of hepatic encephalopathy is done by the following, except:
A. Hypernatraemia
B. Hyponatraemia
C. Hypoglycemia
D. Delirium tremens
E. Meningitis

Answer: A

15. Which of the following factors can trigger hepatic encephalopathy?
A. Traumatism
B. Alcohol consumption
C. Cerebrovascular accident
D. Upper gastrointestinal bleeding
E. Hypoglycemia

Answer: D

176

16. Which of the following statements is a possible trigger of hepatorenal syndrome?
A. Hyponatraemia
B. Acute alcoholic hepatitis
C. Hypoglycemia
D. Cerebrovascular accident
E. Gayet-Wernicke encephalopathy

Answer: B

17. Major criteria for diagnosis of hepatorenal syndrome are:
A. Diuresis<500 cm
3
/24 h
B. Natriuresis<10 mol/L
C. Proteinuria<0,5g/24 h, in the absence of the urinary tract obstruction
D. Natraemia<130 mol/L
E. Urinary osmosis>Plasmic osmosis

Answer: C

18. About hepatic hydrothorax the following statements are true:
A. Protein-rich fluid (>20g/L)
B. Associated with ascites
C. Common location is the left one
D. No treatment
E. No cardiac ultrasound performed

Answer: B


1. Cirrhosis is histologically defined as:
A. Diffuse process
B. Mutilating fibrosis
C. Does not distort the normal architecture
D. Isolates nodules with abnormal structures

Answer: A, B, D

2. Which are the most common causes of chronic hepatopathy?
B. Alcohol consumption
C. Primary biliary cirrhosis
E. Thrombosis of the suprahepatic vein

Answer: B, D

177

3. The following statements are common causes of chronic hepatopathy:
A. Chronic HBV hepatitis
B. Wilson disease
C. Hereditary alpha 1 antitrypsin deficiency
D. Primary biliary cirrhosis
E. Chronic HCV hepatitis

Answer: A, E

4. Which of the following conditions are rare causes that might generate cirrhosis?
A. Viral hepatitis with HBV+HDV
B. Cardiac liver
C. Hereditary hemochromatosis
D. Budd-Chiari syndrome

Answer : B, D, E

5. Which of the following conditions are rare causes for chronic hepatopathy?
A. Primary biliary cirrhosis
B. Secondary biliary cirrhosis
E. Alcohol chronic consumption

Answer: A, B, C

6. Which of these statements are signs of portal hypertension?
A. Palmar erythrosis
B. Splenomegaly
C. Leukonychia
D. Ascites in case of decompensated cirrhosis
E. Jaundice

Answer: B, D

7. The following signs may suggest hepatocellular failure:
A. Digital hippocratism
B. Stellar angioma
C. Ascites
D. Splenomegaly
E. Abdominal collateral circulation

Answer: A, B

178

8. Which of the following statements are true about portocaval-type abdominal collateral
circulation?
A. Centre is epigastric
B. Centre is in mezogastrium
C. Centre is on flanks
D. Centre is periumbilical
E. Centre is in the right hypochondrium

Answer: A, D

9. Which of the following biological exploration can be modified in hypersplenism?
A. Anemia
B. Elevated GGT
C. Thrombocytopenia
D. Elevated alkaline phosphatase
E. Leukopenia

Answer: A, C, E

10. Hepatocellular failure may cause alteration of the following biological constants:
A. Elevated alkaline phosphatase
B. Decreased prothrombin index
C. Decreased factor V
D. Hypoalbuminemia
E. Hyperbilirubinemia

Answer: B, C, D, E

11. When performing Doppler liver ultrasound the following may be signs of portal hypertension:
A. Portal thrombosis
B. Reversal of portal flow
C. Splenomegaly
D. Collateral circulation
E. Suspicious nodule of hepatocellular carcinoma

Answer: B, C, D

12. Which of the following statements are complications of cirrhosis?
A. Dilation of the portal trunk
B. Portal thrombosis
C. Splenomegaly
D. Suspicious nodule of hepatocellular carcinoma
E. Slowing down of the portal flow

Answer: B, D

179

13. Cirrhosis gravity evaluation is done using Child-Pugh score. Which of the following
statements is correct?
A. Hepatic encephalopathy absence = 1 point
B. Ascites controlled with diuretics = 1 point
C. Total bilirubin >50 mol/L = 2 points
D. Albumin 28-35g/L=2 points
E. Prothrombin index = 1 point

Answer: A, D, E

14. Which of these statements are part of the management of cirrhosis?
A. Vaccination against Haemophilus
B. Influenza vaccination
C. Vaccination against HAV
D. No treatment for cause
E. No medical contraindications

Answer: B, C

15. Which of these statements are part of the biological investigation balance of ascites?
A. Serum ionogram
B. Urea
C. Creatinine
D. Abdominal ultrasound
E. Microbiological examination of ascites

Answer: A, B, C

16. Spontaneous infection of ascites fluid is made evident by the following signs:
A. Fever
B. Absence of abdominal pain
C. Malaise
D. Aggravated hepatic encephalopathy
E. Decreased volume of ascites

Answer: A, D

17. Emergency treatment in spontaneous infection of ascites involves:
A. Empirical antibiotherapy
B. Ceftriaxone
C. Cefotaxime
D. Amoxicillin
E. Intravenous human albumin on the 1
st
and the 3
rd
day

Answer: A, C, E

180

18. Ascites treatment may be achieved with:
A. Low-sodium diet
B. Distal diuretics
C. Evacuating puncture only in case of refractory ascites
D. Administration of loop diuretics only
E. Treatment of hepatotoxic co-factors

Answer: B, E

19. Clinical supervision of ascites treatment efficacy is achieved by:
A. Hyponatraemia
B. Natriuresis repeat
C. Hypokalaemia
D. Lower limbs swelling
E. Hyperkalaemia

Answer: B, D

20. Supervision of ascites treatment tolerance is done by the following:
A. Functional renal failure
B. Anorexia
C. Lower limbs swelling
D. Gynecomastia
E. Hypokalaemia

Answer: A, D, E

21. Supervision of ascites treatment tolerance in terms of regimen is made by monitoring:
A. Hyponatraemia
B. Gynecomastia
C. Anorexia
D. Denutrition
E. Hyperkalaemia

Answer: C, D

22. Controlling digestive bleeding in broken esophageal varices is made by:
A. Hydration
B. Administration of octreotide
C. Endoscopy in emergency<4 h
D. Endoscopic ligation
E. Vitamin therapy

Answer: B, D

181

23. Preventing encephalopathy in digestive bleeding within esophageal varices is made by the
administration of:
A. Vitamin therapy
B. Antibiotics orally
C. Lactulose orally
D. Hydration
E. Lactulose by enema

Answer: C, E

24. Staging of hepatic encephalopathy is the following:
A. Stage I asterixis
B. Stage II asterixis + reversal of nictemeral rhythm
C. Stage II asterixis + confusional syndrome
D. Stage III coma
E. Stage III - possible extrapyramidal signs

Answer: C, D, E

25. Differential diagnosis of hepatic encephalopathy is made with the following affections of
toxic nature:
A. Acute drunkenness
B. Hyponatraemia
C. Dilirium tremens
D. Hypoglycemia
E. Gayet-Wernicke encephalopathy

Answer: A, C, E

26. Which of these statements are triggering factors of hepatic encephalopathy?
A. Infections
B. Gastrointestinal bleeding
C. Consumption of hepatotoxic drugs
D. Cerebrovascular accident
E. Subdural hematoma

Answer: A, B, C

27. Which of the following factors may trigger the hepatorenal syndrome?
A. Gastrointestinal bleeding
B. Injuries
C. Acute alcoholic hepatitis
D. Infections
E. Cerebrovascular accident

Answer: A, C, D

182

28. Which of the following criteria are major are necessary in the diagnosis of hepatorenal
syndrome?
A. Elevated cretinine over 130 mol/L in the absence of diuretic therapy
B. Absence of other causes of kidney failure
C. Diuresis <500 cm
3
/24 h
D. Proteinuria <0,5g/24 h, in the absence of urinary obstruction
E. Natremia<130 mol/L

Answer: A, B, D

29. Which of these statements are diagnostic minor criteria of hepatorenal syndrome?
A. The absence of improvement in renal function
B. Natriuresis <10 mol/L
C. Urinary osmolality>plasma osmolality
D. Creatinine clearance<40ml/minute
E. Natremia<130 mol/L

Answer: B, C, E

30. Prophylaxis of hepatorenal syndrome is made by:
A. Contraindicating nephrotoxic drugs
B. Nonsteroidal anti-inflammatory drugs can be administrated
C. Antibiotic treatment of spontaneous infection of ascites
D. Detection and treatment of alcoholic hepatitis
E. Compensation of ascites puncture over 3 L by administration of albumin iv

Answer: A, D, E

31. Hepatic hydrothorax is characterized by:
A. Protein-rich fluid
B. Is associated with ascites
C. Locates frequently on the right
D. Treatment of ascites
E. Pleural puncture

Answer: B, C, D, E

32. Which of these statements characterizes the hepatopulmonary syndrome?
A. The presence of pulmonary vascular dilatations
B. Hypoxemia is not related to the existence of intrapulmonary shunts
C. Dyspnea accentuated in dorsal supine
D. It is diagnosed by lung scintigraphy
E. The only treatment is the oxygen therapy

Answer: A, D

183

33. Which of the following statements are true about portopulmonary hypertension?
A. Possible complication - right heart failure
B. Characterized by platypnea
C. Administration of beta-blockers is contraindicated
D. Liver transplantation is the appropriate treatment option
E. Is associated with the presence of pulmonary vascular dilatations and intra-pulmonary shunts

Answer: A, C, D

184

VISCERAL SURGERY

OCCLUSIVE SYNDROME

Simple complement:

1. Most frequent from the occlusive etiologies of the small bowel, is:
A. The volvulus
B. Acute intestinal intussusception
C. Meckels diverticulum
D. Adenocarcinoma of the small intestine
E. Occlusion through bundle

Answer: E

2. All the occlusions are accompanied by the following complications, except:
A. Appearance of a third section
B. Acute renal failure
C. Hypovolemia
D. Metabolic alkalosis
E. Metabolic acidosis

Answer: E

3. Represent reasons of blockade at small intestine level, by suffocation, the following, except:
A. The bundle
B. Strangulated hernia
C. Polypus
D. Meckels Diverticulum
E. Acute intestinal intussusception

Answer: C


1. The risk factors for cecal volvulus:
A. Age > 60 years old
B. Constipation
C. Age between 50 and 60 years old
D. The absence posterior juxtaposition of cecum
E. Short intestine syndrome

Answer: A, B, D, E

185

2. Risk factors for Ogilvy syndrome:
A. Age between 50 and 60 years old
B. Age > 60 years old
C. Cardiac failure
D. Hyperpotassemia
E. Hypopotassemia

Answer: B, C, E

3. The treatment of Ogilvy syndrome assumes:
A. Colectomy and sending the piece to patologic anatomy
B. Occlusion medical treatment
C. Etiological treatment of hyperpotassemia
D. Etiological treatment of hypopotassemia
E. In the absence of severity signs occlusion suppression

Answer: B, D, E

4. The treatment of Ogilvy in the absence of severity signs, assumes:
A. Faucher sonda
B. Neostigmine- prostigmine i.v. slow
C. Colo- exsufflation in case of failure
D. Subtotal colostomy/colectomy
E. Cecostomy in accordance with local observations

Answer: A, B, C

5. Represents risk factors for apparition of sigmoid volvulus:
B. Constipation
C. Megadolico-sigmoid
D. Absence of the posterior juxtaposition of the sigmoid
E. Hypopotassemia

Answer: A, B, C

6. Are involved in the occlusions etiology by suffocation at the colon level, the following
pathologies, except:
A. Sigmoidian volvulus
B. Cecal volvulus
C. Strangulated hernia
D. Meckels Diverticulum
E. The bundle

Answer: D, E

186

7. Are involved in the occlusions etiology by obstruction at the colons level:
A. Metastases
B. Fecaloma
C. Diverticulosis with pseudotumor
D. Foreign body
E. Crohn disease

Answer: B, C, D

8. Are involved in the occlusions etiology by obstruction at the small bowel:
A. Polypus
B. Diverticulosis with pseudotumor
C. Hematoma of the wall
D. Crohn disease
E. Carcinomatosis

Answer: A, C, D, E

9. The urgent surgery treatment of the occlusions presumes:
A. Exploration
B. Drawing of the eventual peritoneal fluid
C. Treatment of the cause and of a complication
D. Restoration of the digestive continuity is never made
E. In case of digestive necrosis, it will be made an excision and an anatomopathological
examination

Answer: A, B, C, F

187

APPENDICITIS AT CHILDREN AND ADULTS

Simple complement:

1. The most frequent position of the appendicitis is:
A. Lateral to cecum
B. Retrocecal
C. Pelvic
D. Left upper quadrant
E. Subhepatic

Answer: A

2. Appendicitis cannot be echographically visualized in:
A. 30% of the cases
B. 40% of the cases
C. 50% of the cases
D. 25% of the cases
E. 20% of the cases

Answer: A

3. Investigation with the best negative predictive value in acute appendicitis diagnosis is:
A. Pelvic NMR
B. CT
C. Abdominal ecography
D. Simple abdominal radiography
E. Pelvic ecography

Answer: B

4. Represents complicated forms of acute appendicitis, the following, except:
A. Abscess
B. Generalized peritonitis
C. Febrile occlusion
D. Psoitis
E. Acute intestinal invagination

Answer: E

5. Differential diagnosis of acute appendicitis, is not made with:
A. Cecal volvulus
B. Mesenteric lymphadenitis
C. Acute intestinal invagination
D. Renal colic
E. Pregnancy

Answer: A

188

6. The correct treatment in case of an abdominal abscess with appendicitis origin, assumes:
A. Immediate surgery or percussive drainage and remote appendectomy
B. Initial medial treatment and remote appendectomy
C. Abundant peritoneal lavage
D. At least 5 days antibiotherapy

Answer: A


1. There are clinical criteria of acute appendicitis:
A. Pain in the right iliac fossa
B. Vomiting
C. Nausea
D. Fever 37.5- 38.5 degrees Celsius
E. Painful rectal examination

Answer: A, B, C, D

2. Represents echographic diagnosis criteria in acute appendicitis:
A. The increase of the appendicitis diameter > 5 mm
B. The increase of the appendicitis diameter > 8 mm
C. The increase of the walls thickness > 3 mm
D. Echographic detection of a stercolith
E. Periappendicular free fluid and in the Douglas pouch

Answer: B, C, D, E

3. About the imagistic diagnosis with CT help in acute appendicitis, can be stated that:
A. Is the examination with the best negative predictive value
B. Offers additional signs towards echography
C. Offers the same signs as at echography
D. Can detect strengthening of the appendicitis mucous contour, in case of making CT with
contrast substance
E. Can detect the infiltration of the periappendicular fat

Answer: A, B, C, D

4. Represents complicated forms of acute appendicitis:
A. Abscess
B. Shirt front
C. Generalized peritonitis
D. Febrile occlusion
E. Acute intestinal invagination

Answer: A, B, C, D

189

5. Differential diagnosis of acute appendicitis is made with:
A. Mesenteric lymphadenitis
B. Urinary infection
C. Testicular torsion
D. Ovarian torsion
E. Crohn disease

Answer: A, B, D, E

6. Diffential diagnosis of acute appendicitis is made with:
A. Tuberculosis
B. Appendicular mucocele
C. Sarcoidosis
D. Cystic vibrosis
E. Salpingitis

Answer: A, B, C, E

7. Etiologic treatment of acute appendicitis presumes:
A. Appendectomy
B. 24-48 hours intravenous antibiotheraphy
C. Fluid drawing for bacteriological examination
D. Peritoneal cavity lavage
E. Sending the appendicitis to anatomopathological examination

Answer: A, C, D, E

8. Symptomatic treatment of acute appendicitis presumes:
A. Analgesics
B. Correction of electrolytic disorders
C. Appendectomy
D. Peritoneal cavity lavage
E. Fluid drawing for bacteriological examination
Answer: A, B

9. Symptomatic treatment of acute appendicitis presumes:
A. Analgesics
B. Correction of electrolytic disorders
C. Preoperational balance
D. Anesthesia consultation
E. Appendectomy
Answer: A, B, C, D

10. The correct treatment in case of a peritonitis of appendicular cause is:
A. Abundant peritoneal lavage
B. Appendectomy
C. At most 5 days antibiotic treatment
D. At least 5 days antibiotic treatment
E. Initial medical treatment and remote appendectomy

Answer: A, B, D
190

CHOLELITIASIS AND ITS COMPLICATIONS

Simple complement:

1. Represents clinical forms of acute cholecystitis, the following, except:
A. Alitiasic cholecystitis
B. Gangrenous cholecystitis with subhepatic abscess
C. Mirizzi syndrome
D. Gangrenous cholecystitis with bile peritonitis
E. Scleroatrophic cholecystitis

Answer: E

2. The evolution of a calculus present in the main biliary tracts, is:
A. Asymptomatic, being echographically tracked down or by an operative cholangiography
B. Can cause a lithiasic migration reaction
C. Can cause an acute pancreatitis
D. Determines frequently a cronic pancreatitis
E. Can cause an angiocholitis

Answer: A, B, D, E

3. Are risk factors for the appearance of bladder lithiasis:
A. Age < 50 years old
B. Masculine gender
C. Obesity
D. Patological personal record of left colon cancer
E. Patological personal record of left colon cancer

Answer: C

Multiple Complement

1. Clinical diagnosis in acute cholecystitis is suggested by:
A. Pain at the right hypocondrium level, which persists more than 4 hours
B. Pain at the right hypocondrium level, which persists more than 6 hours
C. Fever 38-38,5 degrees Celsius
D. Icterus
E. Without signs of occlusion

Answer: A, B, C, E

2. Abdominal echography at the patients with acute cholecystitis can detect:
A. Calculus in cholecyst
B. A calculus in infundibulum or in the cystic duct
C. Thickening of the bladder wall ( 4 mm), sometimes with bifidus aspect
D. Presence of calculus in main biliary tracts
E. Presence intra or extrahepatic biliary tracts dilatations

Answer: A, B, C

191

3. Acute lithiasis cholecystitis treatment presumes:
A. Hospitalization
B. Symptomatic treatment
C. Intravenous antibiotheraphy
D. Cholecystectomy in the first 48 hours from the start
E. Cholecystectomy in the first 24 hours from the start

Answer: A, B, C, E

4. Regarding the ileus bladder, the following statements are true:
A. Appears secondary to a fistula between gallbladder and duodenum
B. It is clinic suggerated by repetead episodes of cholecystitis
C. The icterus is always present
D. The presence of aerobilia
E. Can be imagistically detected the presence of a calculus (hyperdense) in the right iliac fossa

Answer: A, B, D, E

5. Regarding to Charcot triad, the following are true:
A. Assumes the presence of biliary pain, followed by fever and then icterus
B. Presence of muscular defense
C. Presence of transit disorders
D. Stool discoloration, dark color urine
E. Presence of chill

Answer: A, D, E

6. Angiocolitis treatment assumes:
A. Symptomatic treatment
B. Urgent attitude, hospitalization
C. 10 days intravenous antibiotheraphy
D. ERCP is the first attitude
E. In case of favorable evolution, must be treated the lithiasis of the main biliary tract
Answer: A, B, C, E

7. Represent risk factors the appearance of bladder lithiasis:
B. Feminine gender
C. Obesity
D. Gastric cancer record
E. Chronic hemolysis
Answer: A, B, C, E

8. The typical pain for uncomplicated symptomatic bladder lithiasis is:
A. Is present in epigastrium or in the right hypochondrium
B. Has a brutal onset with irradiation to the left shoulder
C. Has a brutal onset with irradiation to the right shoulder
D. Is amplified by deep inspiration
E. Last more than 6 hours

Answer: A, C, D, E
192

9. Etiological treatment of uncomplicated bladder lithiasis presumes the following:
A. Cholecystectomy always open
B. Laparoscopic cholecystectomy
C. Operative cholangiography- in case of the calculus hunting out in the main biliary - their
extraction
D. Sending the piece for anatomopathological examination
E. Is always recommended hygienic-dietary diet, after cholecystectomy, at the discarge from
hospital

Answer: B, C, D

193

ACUTE PANCREATITIS

Simple complement:

1. Are etiologies of the acute pancreatitis the following, except:
A. Alcohol consumption
B. Bladder lithiasis
C. Hypercalcemia
D. Tobacco intoxication
E. Abdominal traumatism

Answer: D

2. Are etiologies of the acute pancreatitis the following, except:
A. Hypercalcemia
B. Hypertriglyceridemia
C. Hypercalcemia
D. Viral infections
E. Cystic fibrosis

Answer: C

3. Pancreatitis is considered grave if Ranscon score is:
A. 3
B. 5
C. 7
D. 3
E. 5

Answer: A

4. Infection of pancreatic necrosis typically occurs in week:
A. 3
B. 2
C. 5
D. 4-6
E. One

Answer: A

5. Clinical diagnosis of the acute pancreatitis is sustained by:
A. The increase of serum lipase 3 N
B. The increase of 2 N
C. The increase of 4 N
D. The increase of 5 N
E. The increase of 6 N

Answer: A

194


1. Concerning pancreatic pain specific to acute pancreatitis, is true that:
A. It is at the epigastric level
B. It is transfixing/ penetrating
C. Radiates towards posterior
D. Radiates to the right shoulder
E. It is calmed by the trunks anteflexion

Answer: A, B, C, E

2. Are considered signs of gravity in acute pancreatitis:
A. Obesity, increases the risk of severe AP
B. Hypotension
C. Oliguria
D. Presence of periumbilical bruises and hematic infiltration of the flanks
E. in antecedents

Answer: A, B, C, D

3. Ranson score calculation at hospitalization assumes the following elements:
A. Bood sugar value
B. Age 45 years old
C. Leucocytosis 18000/mm
3

D. Age 55 years old
E. Leucocyitosis 16000/mm
3

Answer: A, D, E

A. Decrease of bicarbonates 4 mmol/l
B. Decrease of bicarbonates 4 mmol/l
C. ASAT 6 H
D. LDH 1,5 N
E. ASAT 6 N

Answer: C, D

A. Decrease of bicarbonates 4 mmol/l
B. Decrease of bicarbonates 4 mmol/l
C. ASAT 6 H
D. Calcemia 2.00 mmol/l
E. Decrease of hematocrit at 10 10%

Answer: A, C, E

195

6. Represents local complications of acute pancreatitis:
A. Accumulation
B. Abscesses
C. Infectious pancreatic necrosis
D. Perforation of the organs from neighborhood
E. Hyperglicemia

Answer: A, B, C, D

7. Represents general complications of acute pancreatitis:
A. Septic shock
B. Multiorganic failure
C. Hyperglycemia
D. Infectious pancreatic necrosis
E. Acute renal failure with hypercalcemia

Answer: A, B, C

8. Represents general complications of acute pancreatitis:
A. Septic shock
B. Multiorganic failure
C. Hyperglycemia
D. Acute renal failure with hypocalcemia
E. Acute renal failure with hypercalcemia

Answer: A, B, C, D

9. About the infection of pancreatic necrosis, the following statements are true:
A. Typically occurs in the third week
B. It is the worst infection, the mortality being of 50%
C. Is the worst infection, the mortality being of 20 %
D. Confirmation is made by puncture of the necrosis and direct examination + culture
E. The most common germs are: Staphylococcus aureus and beta- hemolytic streptococcus

Answer: A, C, D

10. Regarding the infection of the pancreatic necrosis the following statements are true:
A. It is the worst infection, mortality being almost 80%
B. The clinical picture is brutal
C. The most common germs are Staphylococcus aureus and E.Coli
D. The clinical picture is discrete
E. Confirmation is made by puncture of the necrosis and direct examination + culture

Answer: C, D, E

196

11. The initial treatment of acute pancreatitis assumes:
A. Mandatory hospitalization in the resuscitation section
B. Always mounting nasogastric tube of without exception
C. Correction of electrolyte disorders
D. Absolutely rest
E. Etiological treatment

Answer: C, D, E

12. Treatment of severe acute pancreatitis assumes:
A. Reanimation
B. Correction of organ deficiencies
C. Artificial feeding- parenteral in ileal or enteral way
D. Artificial feeding- enteral in ileal or parenteral way
E. Always intravenous antibiotherapy

Answer: A, B, D

13. Treatment of severe acute pancreatitis assumes:
A. Mounting nasogastric tube at all patients
B. Artificial feeding - enteral in ileal or parenteral way
C. Necrosis, accumulations drainage endoscopic or surgical
D. In case of angiocolitis or obstructive icterus are indicated ERCP and SE, regardless the
severity grade of PA
E. Intravenous antibiotherapy with wide spectrum even in cases where infection at necrosis level
is not proven

Answer: B, C, D

14. About acute pancreatitis of lithiasic etiology the following affirmations are true:
A. Treatment of the severe form is made away from complications
B. Treatment of the severe form is made in the same time with the complications
C. Treatment of the benign form of acute pacreatitis of lithiasic etiology assumes colecystectomy
with operative cholangiography which can be realized during the same hospitalization
D. Biliary etiology should be eliminated by making an abdominal ecography
E. Gallstones smaller than 5 mm are more frequently implicated in the appearance of acute
pancreatitis episodes

Answer: A, C, D, E

197

ACUTE PERITONITIS

Simple complement:

1. About acute peritonitis, the following statement is true:
A. It is a medical emergency
B. The main prognosis factor is the patient age
C. The abdominal pain with colliquative nature is characteristic for this pathology
D. The majority of the peritonitis is tertiary
E. The infectious agents are most of the times multiple, in the cases of secondary peritonitis

Answer: E

2. About acute peritonitis, the following statement is true:
A. Postoperative peritonitis (anastomotic dehiscence) is always easy to diagnose, the clinical
picture of such a patient being typical
B. The main prognosis factor is the patient age
C. Abdominal CT is made at all patients
D. The brutal abdominal pain that increases periodically is characteristic
E. Only the secondary peritonitis is monomicrobial

Answer: D

3. Regarding the acute peritonitis, the following statements are true, except:
A. Secondary peritonitis corresponds to a perforation of the cavitary organ
B. Only primitive peritonitis is monomicrobial
C. The infectious agents are most of the times multiple, in the cases of secondary peritonitis
D. The main prognosis factor is the short period of time till the surgery
E. The antibioteraphy with large spectrum always begin 12 hours from hospitalization

Answer: E

4. The lavage of the abdominal cavity is made with:
A. 8 l of serum
B. 5 l of serum
C. 2 l of serum
D. 20 l of serum
E. 10-15 l of serum

Answer: E

5. The etiologic treatment of acute peritonitis assumes the following, except:
A. Laparotomy
B. Exploration of the peritoneal cavity
C. Local cleaning with solution diluted by antibiotics
D. Treatment of the cause
E. Lavage of the peritoneal cavity

Answer: C

198

6. Regarding the etiologic treatment of acute peritonitis, the following are true, except:
A. Laparoscopy is never taken into account when the clinic picture suggests an acute peritonitis
B. Laparotomy
C. Exploration of the peritoneal cavity
D. Takeoff multiple bacteriological samples
E. Treatment of the cause

Answer: A


1. Regarding the acute peritonitis the following statements are true:
A. Are described three types of acute peritonitis
B. Primitive peritonitis corresponds to the persistent intraabdominal infections after an already
diagnosticated infection
C. Primitive peritonitis corresponds to peritonitis of hematogenic origin (tuberculosis, ascite
infection, peritoneal dialysis)
D. Secundary peritonitis corresponds to a perforation of cavitary organ
E. The majority of acute peritonitis is tertiary

Answer: A, C, D

2. Referring to the acute peritonitis, the following statements are true:
A. Localized peritonitis appears only when the defense mechanism of the abdominal cavity are
exceeded by the infectious process
B. The infectious agents are mostly multiple in the case of secondary peritonitis
C. The infectious agents are mostly multiple in the case of tertiary peritonitis
D. Only the primitive peritonitis is monomicrobial
E. The germs are most frequent resistant to antibiotics in case of secondary peritonitis

Answer: B, D

3. Diagnostic of peritonitis produced by perforation of the sigmoidian diverticulum is suggested
by:
A. Brutal abdominal pain, that grows progressively
B. Abdominal contraction
C. Rectal examination in normal limits
D. Presence of the septic syndrome
E. Hyperleucitosis on the base of PMN growth

Answer: A, B, D, E

4. The medical symptomatic treatment assumes:
A. Reanimation
B. Oxygen therapy
C. Mounting 2 venous tracks
D. Analgesia
E. Mounting of urinary tube and nasogastric tube

Answer: A, B, C, D

199

5. Are signs of a postoperative peritonitis:
A. Fever
B. Conscious disorders
C. Restlessness
D. Acute renal insufficiency
E. Simple abdominal radiography is mostly necessary to confirm the diagnostic

Answer: A, B, C, D

200

CRONIC PANCREATITIS

Simple complement:

1. The following represent causes of chronic pancreatitis, except:
A. Alcohol
B. Chronic hypocalcemia
C. Chronic hypercalcemia
D. Presence of a tumor that obstruct the main pancreatic tube
E. Genetic heritage

Answer: B

2. The main initial manifestation of a chronic pancreatitis is:
A. Nausea
B. Vomiting
C. Pain
D. Losing weight
E. Bloating

Answer: C

3. Regarding the natural evolution of a chronic pancreatitis, the following statements are true
except:
A. During the first 5 years of the disease, the pains are prevailing ones in the clinical
characteristics of the disease
B. During the first 5 years of the disease complications never appear
C. During the next 5 years, after the first 5 is observed a decrease in pains
D. During the next 5 years, after the first 5 is observed some extinction of acute outbreak
E. After around 10 years from the diagnosis of a chronic pancreatitis, the pains totally disappear,
and the manifestations of pancreatic failures are foreground

Answer: B

4. The morphological examinations follow the identification of many types of anomalies. Which
of the following are not detected?
A. Parenchymatous calcification
B. Stenoses
C. Dilatations
D. Cysts
E. Pseudocysts

Answer: D

201

5. Regarding the treatment of the complications from the chronic pancreatitis, the following
A. Pseudocyst - supervision, endoscopic treatment
B. Pseudocyst supervision and surgery treatment if needed
C. Organ comprehension surgery treatment of first intention
D. Pleurisy or ascites - endoscopic implantation of a prostesis in the pancreatic tube
E. Exocrine pancreatic deficiency enzymotheraphy with pancreatic enzymes

Answer: C

6. Observation and clinical, biological, morphological monitoring of a patient with chronic
pancreatitis presumes the following, except:
A. Renal balance
B. Clinical examination
C. Blood sugar test on an empty stomach (a jeun)
D. Hepatic balance
E. Abdominal echography

Answer: A


1. Regarding the differential diagnosis of the acute pancreatitis, the following affirmations are
true:
A. The diagnosis of a tumor can be taken into account mostly after the age of 50 years old
B. A pancreatic tumor can be the cause of an acute or chronic pancreatitis
C. It is taken into account a pancreatic tumor when cysts dilatation of the pancreatitis tubes
appear
D. The risk of malignant transformation of the epithelium of the pancreatic canaliculi should be
taken into account mostly when recurent pancreatic pains appear at an old subject
E. ?

Answer: A, B, D, E

2. Regarding the pseudocyst appeared in a chronic pancreatitis, the following affirmations are
true:
A. It is an extra or intrapancreatic accumulation fluid, whose wall is fibroinflammatory
B. The mechanism is retentional or necrotic
C. After forming of one or many pseudocysts the pain does not appear
D. The organ comprehension can appear (Coledoc, portal vessels, duodenum)
E. Superinfection can appear

Answer: A, B, D, E

202

3. Regarding the pseudocyst appeared inside of a chronic pacreatitis, the following statements are
true:
A. Can complicate with the break of the pseudocyst with the apparition of the pancreatic ascites
B. Can complicate with hemorrhage by arterial erosion
C. Can superinfect
D. Can never regress
E. The formation mechanism is always retentional

Answer: A, B, C

4. Morphologic complementary examinations of acute pancreatitis diagnosis are the following:
A. Abdominal CT of first intention
B. Pancreatic NMR of first intention
C. Pancreatic NMR - of second intention
D. Ecoendoscopy
E. Ecography

Answer: A, C, D

5. Regarding the pain treatment from chronic pancreatitis, may represent variations of attitude:
A. Antalgics in successive levels are given
B. Lithotrity for distruction of the calculi
C. Canalary prostesis
D. Transgastric drainage of the pseudocyst
E. NSAID administration

Answer: A, B, C, D

6. Regarding the complications treatment from chronic pancreatitis, the following statements are
true:
A. Pseudocyst observation and surgery treatment if needed
B. Organs comprehension surgery treatment of first intention because of the major risks the
patient is subjected
C. Organs comprehension endoscopic treatment of first intention
D. Pleurisy or ascitis - implantation of a prostestis in the fistulized pancreatic tube by
endoscopic way
E. Diabetes insulin - therapy is frequently necessary

Answer: A, C, D, E

203

RHEUMATOLOGY

POLYARTICULAR RHEUMATOID ARTHRITIS
Simple complement:

1. The most frequent chronic inflammatory rheumatism is represented by:
A. Rheumatoid polyartritis
B. Ancylosing spondylitis
C. Lupus erythematosus
D. Psoriatic arthritis
E. Seronegative arthritides

Answer: A

2. Rheumatoid polyarthritis is commonly an empty polyarthritis, namely does not present:
A. Articular tumefaction
B. Rheumatoid factor
C. Extraarticular symptoms/signs
D. Synovitis
E. Arthralgias

Answer: C

3. The treatment goal in rheumatoid polyarthritis is:
A. Treatment of clinical symptoms
B. Healing of the illness
C. Disparition of the rheumatoid factor from serum
D. Disappearance of anti - CCP antibodies from serum
E. Obstruction of the appearance of radiological injuries

Answer: E

4. About anti - CCP antibodies in rheumatoid polyarthritis, are true:
A. They are useful in the subsequent observation of the disease after the diagnosis has been
established
B. They are present in other inflammatory rheumatism (sclerodermia, lupus, Sjogren syndrome)
C. Signalise rheumatoid polyarthritis diagnosis
D. Have low sensitivity for rheumatoid polyarthritis diagnosis
E. Their presence is mandatory for rheumatoid polyarthritis diagnosis

Answer: C

204

5. Differential diagnosis of rheumatoid polyarthritis with onset at the elders with rizomelic
presentation is made with:
A. Ancylosing spondylitis
B. Rheumatoid polymialgia
C. Systemic erythematosus lupus
D. Polymyositis
E. Psoriatic arthritis

Answer: B

6. Background treatment, of reference in rheumatoid polyarthritis is represented by:
A. Leflunomide
B. Hydroxiclorochine
C. Sulfasalazine
D. Methotrexate
E. Solu - Medrol

Answer: D

7. The following joints are respected in rheumatoid polyarthritis:
A. Proximal interphalangeal
B. Metacarpophalangeal
C. Distal interphalangeal
D. Metatarsophalangeal
E. Large joints

Answer: C


1. Autoantibodies on which bases rheumatoid polyarthritis can be sustained are:
A. Rheumatoid factor (FR)
B. Anti - myeline antibodies
C. Ant MuSK antibodies
D. Anti - DNA antibodies
E. Anti - citrullinated peptides (anti-CCP) antibodies

Answer: A, E

2. Distal interphalangean joints are effected preferable in:
A. Ankylosing spondylitis
B. Digital arthrosis
C. Psoriatic arthritis
D. Rheumatoid arthrosis
E. Systemic lupus

Answer: B, C

205

3. The inflammatory synovial fluid in rheumatoid polyarthritis presents, exept:
A. Cristals with uric acid
B. Lymphocytes
C. Neuthrophiles
D. Gram-negative bacteria
E. Proteins

Answer: A, D

4. Diagnosis factors of the rheumatoid polyarthritis severity are:
A. Polyarticular acute onset
B. Extraarticular affection
C. Presence of radiographic erosions at diagnosis
D. High inflammatory syndrome
E. High material incomes

Answer: A, B, C, D

5. Rheumatoid polyarthritis complications are:
A. Rheumatoid nodules
B. Rheumatoid vasculitis
C. Pulmonary fibrosis
D. Sjogren syndrome
E. Synovitis of the distal interphalangean joints

Answer: A, B, C, D

6. Caplan syndrome represents association by:
A. Systemic lupus
B. Rheumatoid polyarthritis
C. Silicosis
D. Amyloidosis
E. Pneumocystosis

Answer: B, C

7. Felty syndrome represents:
A. Ankylosing spondylitis
B. Splenomegaly
C. Hepatomegalia
D. Rheumatoid polyarthritis
E. Neutropenia

Answer: B, D, E

206

8. Background treatment of rheumatoid polyarthritis can be made with:
A. Aspirin
B. Metotrexate
C. Leflunomide
D. Diclofenac
E. Sulfasalazine

Answer: B, C, E

9. Biologic therapy in rheumatoid polyarthritis can be made with:
A. Prednison
B. Etanercept
C. Adalimumab
D. Infliximab
E. Hidroxiclorochine

Answer: B, C, D

10. Surgery treatment in rheumatoid polyarthritis assumes:
A. Artroscopic synovectomy
B. Articular replacement (prostesis)
C. Osteotomy
D. Arthrodesis
E. Open synovectomy

Answer: A, B, D,

207

ANKYLOSING SPONDILITIS

Simple complement:

A. The following antigen is present in ankylosing spondilitis:
B. HLA B17
C. HLA B27
D. HLA DR 4
E. HLA DQ 8

Answer: B

2. The sign Romanus signifies:
A. Radiological aspect of square vertebrae
B. Presence of anterior uveitis
C. Presence of cancaneal osteophytes
D. Pain at the mobilization of the cervical spine
E. Peripheral articular destructions

Answer: A

3. An efficient treatment of the enthesopathies from ankylosing spondilitis is made with:
A. Sulfasalazine
B. Salazopirine
C. Metotrexate
D. NSAID
E. Eritromicine

Answer: D

4. The treatment of spondylartropaties was revolutionized by the apparition of:
A. Immunosuppressants
B. Aspirin
C. Alfa anti-TNF
D. Prednison
E. Salazopirine

Answer: C

5. In the case of background treatment intitiation with anti-TNF for ankylosing spondilitis must
be excluded the history of:
A. Primary tuberculosis
B. Ulcerohemoragic rectocolitis
C. Crohn disease
D. Anterior uveitis
E. Psoriasis

Answer: A

208


1. SAPHO syndrome includes the following entities:
A. Synovitis
B. Pimple
C. Pustulosis
D. Osteitis
E. Psoriasis

Answer: A, B, C, D

2. Ankylosing spondilitis includes the following group of diseases:
A. Lupus erythematosus systemic
B. Reactive arthritis
C. Psoriatic arthritis
D. Spondilartrites associated with intestinal inflammatory ilnesses

Answer: B, C, D

3. The exam with urinary bandelet is indicated in ankylosing spondilitis for detecting:
A. IgA nephrophaty
B. Amyloidosis
C. Immune complex Glomerulonephrytis
D. Goodpasture syndrome
E. Membranoproliferative glonerulonephritis

Answer: A, B

4. Sacroiliac affection from ankylosing spondilitis is manifesting by:
A. Buttock edema
B. Thoracic pain
C. Buttock pain
D. Pain at the knee mobilization
E. Pain at sacroiliac manoeuvres

Answer: C, E

5. Enthesis affection from ankylosing spondilitis is manifesting by:
A. Calf pain on walking
B. Inflammatory heel pain
C. Positive Lasegue maneuvre
D. Trochanterian pains
E. Sternum pains

Answer: B, D, E

209

6. Extraarticular manifestations from ankylosing spondilitis are:
A. Uveitis
B. Conjunctivitis
C. Intestinal inflammatory disease
D. Psoriasis
E. Retinitis

Answer: A, B, C, D

7. Cervical rachidian affection in ankylosing spondilitis is distinguished by:
A. Schober index
B. Occiput - wall distance
C. C7 - wall distance
D. Menton-sternum distance
E. Acromion-ear distance

Answer: B, C, D, E

8. A diagnosis test of ankylosing spondilitis is represented by NSAID sensitivity thus:
A. Speediness of action
B. Slowness of action
C. The symptoms are not influenced by AINS treatment
D. Rebound of the symptoms in the next 48 hours from the end
E. The symptoms do not appear anymore at the treatment interruption

Answer: A, D

210

OSTEOPOROSIS

Simple complement:

1. The following statements about osteoporosis are true, except:
A. It is a malady of the skeleton
B. Associates bone mass decrease
C. Determines the deterioration of mycroarchitecture of the bone tissue
D. Presents increased bone fragility
E. Has low fracture risk

Answer: E

2. T score for osteopenia is:
A. > - 1
B. Between -1 and - 2,5
C. > - 2
D. < - 2,5
E. < 3,5

Answer: B

3. The teriparatide represents fragment recombined by:
A. STH
B. FSH
C. Parathyroid hormone
D. Thyroxin
E. Prolactin

Answer: C

4. At patients with osteoporosis between 70 years old prevails the risk of:
A. Vertebral fracture
B. Hip fracture
C. Forearm fracture
D. Humerus fracture
E. Femur fracture

Answer: A

5. The osteoporosis treatment is made for at least:
A. 1 year
B. 6 years
C. 3 years
D. 4 years
E. 5 years

Answer: D

211


1. The usual localizations of the osteoporotic fractures are:
A. Vertebral fractures
B. Distal phalanx fractures
C. Fractures of the superior extremity of the femur
D. Fracture of the distal extremity of the forearm
E. Rib fractures

Answer: A, C, D

2. There are arguments in favor of the osteoporotic origin of the vertebral fractures:
A. Do not represent neurologic/deficit signs
B. Lysis of the pedicle
C. Visible asymmetry from the side of the vertebra
D. Recession of the posterior wall
E. Do not affect the cervical spine

Answer: A, E

3. The cases of secondary osteoporosis are:
A. Endogenous hypercorticism
B. Primary hyperparathyroidism
C. Gastrectomy
D. Sistemic mastocytosis
E. Acromegalia

Answer: A, B, C, D

4. There are general cases of fragilisant non-osteoporotic osteopathy:
A. Myeloma
B. Bone metastasis
C. Diabetes
D. Renal osteodystrophy
E. Hypercolesterolemia

Answer: A, B, D

5. The indications for the prescription of a bone densitometry are:
A. Vertebral fracture in context of an obvious tumor
B. Systemic therapy with corticosteroids at least three consecutive months at a dose > 7,5 mg/day
equivalent to prednisone
C. Menopause before 40 years old
D. Femoral neck fracture after a smash-up
E. Documented history of prolonged hypogonadism

Answer: B, C, E

212

6. Primary osteoporosis prevention is made by:
A. Fight against smoking
B. Weight gain
C. Sedentariness
D. Fight against alcoholism
E. Calcium and vitamin D intake

Answer: A, D, E

7. Which of the following medicines can be used for osteoporosis treatment?
A. Alendronate
B. Adalimumab
C. Risendronate
D. Natalizumab
E. Rituximab

Answer: A, C

8. In osteoporosis treatment, the strontium ranelat has the following effects:
A. Reduces the skull fracture risk
B. Reduces the fingers fracture risk
C. Reduces the hip fracture risk
D. Reduces the costal fracture risk
E. Reduces the vertebral fracture

Answer: C, E

9. Therapeutic decision in osteoporosis is taken according with the following factors:
B. 1 month systemic treatment with corticoids
C. Orthopedic disorders
D. Decrease of the visual acuity
E. Weight under 19 kg/m
2

Answer: C, D, E

10. Which of the following fractures is considered of not being osteoporotic:
A. Hip fracture
B. Pouteau-Colles fracture
C. Cervical vertebrae fractures
D. Skull fractures
E. Dorsal vertebras fractures

Answer: C, D

213

RADICULALGIA AND NERVOUS COMPRESSION SYNDROME

Simple complement:

1. Triceps reflex closes at level:
A. C5
B. C6
C. C7
D. C8
E. D1

Answer: C

2. Lumbar pain irradiated on the hip and calf anterior side and who associates the eventual motor
deficit of the anterior quadriceps and anterior sural is met in the affection of the root:
A. L1
B. L2
C. L3
D. L4
E. L5

Answer: D

3. In the case of an over 65 years old patient with carpal tunnel syndrome should not be
overlooked the possibility of diagnosis of:
A. Amyloidosis
B. Hypertension
C. Hypertrigliceridemia
D. Hyperthyroidism
E. Diabetes insipidus

Answer: A

4. Differential diagnosis of lumbar vertebral stenosis is made with:
A. Deep venous thrombosis
B. Peripheral obliterating arteriophaty
C. Cerebrovascular accident
D. Rheumatoid polyartritis
E. Gout

Answer: B

5. C5 sensitive area includes:
A. Upper part of the shoulders
B. External side of the forearm
C. Posterior side of the arm
D. Internal side of the arm
E. External side of the hip

Answer: A

214


1. Differential diagnostic of the radicular affections is made with:
A. Sacroiliitis (pseudosciatica on alterning sides)
B. Troncular affection of the external sciatic popliteal nerve
C. Obliterative arterial disease of the inferior members
D. Ischemic cardiopathy
E. Acute pancreatitis

Answer: A, B, C

2. Surgery indications in case of lombocruralgia are:
A. Radicular pain with irradiation on the anterior side of the hip and calf
B. Recent motor deficit, inferior or equal with 3 from 5
C. Ponytail syndrome
D. Hyperalgic radiculalgia
E. Sphincters recent disorders linked with radicular affection

Answer: B, C, D, E

3. The following signs and symptoms appear in the carpal tunnel syndrome:
A. Nocturnal acroparesthesia
B. Positive Tinel maneuver
C. Abolished bicipital ROT
D. Thenar atrophy
E. Hypoestesy in the radial nerve area

Answer: A, B, D

4. The surgery indications in carpal tunnel are:
A. Abolished tricipital ROT
B. Muscular atrophy in the thenar bed
C. Denervation signs at electomyogram
D. Paraesthesias in the territory of mediane nerve accentuate by the hand hyperfexion
E. Motor deficit of the thumbs opposer and short abductor

Answer: B, C, E

5. Positive Lasegue sign signifies the affection of the roots:
A. L5
B. S1
C. S2
D. S3
E. S4

Answer: A, B

215

6. The semiology of the L3 radicular affection includes:
A. Hypoestesia on the anterior side of the hip to the knee
B. Hypoestesia on the external side of the hip
C. Motor deficit of the quadriceps and psoas
D. Motor deficit of the medius gluteus
E. Without influation of ROT

Answer: A, C

7. The semiology of C7 radicular affection includes:
A. Hypoestesia on the internal side of the arm and forearm
B. Hypoestesia on the posterior side of the arm and forearm
C. Motor deficit of the extensor muscles of the forearm on the arm
D. Motor deficit of the fingers flexors and interbone flexors
E. Abolished or diminished tricipital ROT

Answer: B, C, E

216

PRESCRIPTION AND MONITORIZING OF CORTICOSTEROID AND
NON-CORTICOSTEROID ANTIINFLAMMATORIES

Simple complement:

1. Coxibs are NSAID that specifically inhibit:
A. Cyclooxygenase 1
B. Cyclooxygenase 2
C. Cyclooxygenase 3
D. Cyclooxygenase 4
E. Cyclooxygenase 5

Answer: B

2. Aspirin has the following effects, except:
A. Antiinflammatory
B. Antiagregrant
C. Antipyretic
D. Analgesic
E. Immunosuppressant

Answer: E

3. NSAID administration presents acute renal insufficiency risk when it is associated with:
A. Antivitamin K
B. ACE inhibitors
C. Lithium
D. Sulphamides
E. Phenytoin

Answer: B

4. The attack dose for prednisone administration in rheumatoid polyarthritis is of:
A. 0,01 mg/kgc/day
B. 0,1 mg/klgc/day
C. 1 mg/kgc/day
D. 10 mg/kgc/day
E. 100 mg/kgc/day

Answer: B

5. In short term therapies with prednisone is lowered with:
A. With 2,5-5 mg/day
B. With 10 mg/day
C. With 0,1 mg/kgc/day
D. With 10% of the anterior dose
E. Progressive decrease is not necessary

Answer: E

217


1. Which are the true statements regarding the way of rectal administration of NSAID?
A. Lower toxicity for the stomach comparing with the oral administration
B. Bigger toxicity for the stomach comparing with the oral administration
C. Identical toxicity for the stomach comparing with the oral administration
D. Risk of hemorrhagic proctitis
E. Risk of hemorrhoids

Answer: C, D

2. The intestinal digestive complications of NSAID are:
A. Intestinal ulcer
B. Colonic polyposis
C. Crises of sigmoid diverticulitis in case of colonic diverticular disease
D. Jejunal polyposis
E. Intestinal abscesses of the inflammatory diseases

Answer: A, C, E

3. The renal complications of NSAID are:
A. Functional renal insufficiency
B. Pyelonephritis
C. Immunoalergic acute interstitial nephritis
D. Minimal glomerular injuries
E. Hyperkaliemia

Answer: A, C, D, E

4. Systematic addition of PPI to nonselective NSAIDs:
A. Age over 65 years old
B. Gastroduodenal ulcer antecedents
C. Intolerances at NSAID antecedents
D. Concomitant therapy with clopidogrel in antiagregant purpose
E. Concomitant therapy with aspirin in antiagregant purpose

Answer: A, B, C, E

5. The steroids treatment is indicated in:
A. Rheumatoid polyarthritis
B. Rheumatic polymyalgia
C. Hortons disease
D. Osteoporosis
E. Cushing disease

Answer: A, B, C

218

6. The side effects of the corticosteroids are:
A. Weight gain by liquid retentions
B. Hypertension
C. Diabetes insipidus
D. Hypopotasemia
E. Cataracts

Answer: A, B, D, E

7. The infiltrations with corticosteroids are indicated in:
A. Septic arthritis
B. Arthrosis
C. Common lumbago
D. Caarpal tunnel syndrome
E. Cataract

Answer: A, B, D, E

8. The infiltrations with corticosteroids are indicated in:
A. Acute microcrystalline arthritis
B. Hemarthrosis
C. Gonarthrosis
D. Coxarthrosis
E. Tendon rupture

Answer: A, B, E

219

ORTOPEDIC SURGERY

FRACTURE OF THE INFERIOR EXTREMITY OF THE RADIUS IN ADULTS

Simple complement:

1. Are extra articular fractures of the inferior extremity of the radius in adult:
A. T fracture
B. Puteau-Colles fracture
C. Cross fracture
D. Gerard-Marchand fracture
E. Diaphyseal Green-stick fracture

Answer: B

2. Are articular fractures of the inferior extremity of the radius in adult, with an exception:
A. Anterior marginal
B. Posterior marginal
C. Cross
D. Presents anterior displacement
E. External cunean

Answer: D

3. Identify the erroneous statement regarding the fractures of the inferior extremity of the radius
in adult from the following:
A. The fracture with anterior diplacement is extra articular
B. External cunean fracture is articular
C. Can be associated with a dislocation of the ulnar head at the level of proximal radio-ulnar
articulation level (Galeazzi fracture)
D. Can be associated with a fracture of the ulnar neck
E. Destot fracture is an articular fracture

Answer: C

4. The positive diagnosis of the fracture of the inferior extremity of the radius in adult assumes
analysis, on the profile radiography, of:
A. Radius glenoid orientation
B. Radio-ulnar index
C. Bistyloid line
D. Bone demineralisation
E. Articular cartilage

Answer: A

220

5. Are true statements regarding the fracture of the inferior extremity of the radius in the adult the
following, with an exception:
A. Pain and functional impotence are elements of positive diagnostic
B. On the face radiography of the fist, the analysis of the radius glenoid orientation, represents a
diagnostic element
C. If the displacement is posterior, appears the deformation of the fist with a silver fork
deformity
D. Radiographies in traction can be realized, under anesthesia
E. The edema represents an element of positive diagnostic

Answer: B

6. In the fracture of the inferior extremity of the radius in adult, postoperative, is made the
diagnostic of the following complications:
A. Compression of the median nerve
B. Vascular lesion
C. Periosteal lesion
D. Fatty embolism
E. Compartment syndrome

Answer: E

7. Regarding the fracture of the inferior extremity of the radius in adult, the following statements
are false, except:
A. Radiography in supination of the forearm offers elements of positive diagnosis
B. Appears extended edema of the forearm
C. T fracture is an articular fracture
D. Anterior marginal fracture is an extra articular fracture
E. Pain and functional impotence are elements of etiologic diagnosis

Answer: C


1. Are articular factures of the inferior extremity of the radius in adult:
A. Anterior marginal
B. Medial marginal
C. Puteau-Colles
D. External cunean
E. Cross

Answer: A, D, E

2. Fracture of the inferior extremity of the radius in adult can be associated with:
A. Fracture of the ulnar styloid
B. Fracture of the ulnar neck
C. Displacement of the ulnar head at the level of distal radio-ulnar articulation
D. Puteau-Colles fracture
E. Green-stick fracture

Answer: A, B, C
221

3. Are elements of positive diagnostic of the fracture of the inferior extremity of the radius in
adult the following, except:
A. Functional impotence
B. Fever
C. Deformation of the fist with a silver fork deformity, if the displacement is anterior
D. Face and profile radiography of the fist
E. Edema

Answer: A, C

4. On the face radiography of the fist, in case of a fracture of the interior extremity of the radius in
adult, the following are analyzed for a positive diagnostic:
A. Radius glenoid orientation
B. Articular interline
C. Bistyloid line
D. Radio-ulnar index
E. Associate periostal reaction

Answer: B, C, D

5. Regarding the fracture of the inferior extremity of the radius in adult, select the false
statements:
A. Compression of the median nerve is part of the category of the initial complications
B. External cunean fracture can be associated with a scapholunate sprain
C. The compartment syndrome is an initial complication
D. Cross fracture is an extra articular fracture
E. On the profile radiography of the fist the radio-ulnar index is analyzed

Answer: C, D, E

6. In case of the fracture of interior extremity of the radius at adults, the following are part of
extra articular fractures, except:
A. Cross fracture
B. Anterior displacement fracture
C. Posterior displacement fracture
D. Puteau-Colles fracture
E. External cunean fracture

Answer: A, E

7. Are postoperative complications of the inferior extremities fractures of the radius in adults:
A. Nail beds compartment syndrome
B. Compression of the median nerve
C. Defect decompensation at the old patient
D. Loss of the autonomy at the old patient
E. Cutaneous opening

Answer: A, D

222

FRACTURE OF THE SUPERIOR EXTREMITY OF THE FEMUR IN ADULTS

Simple complement:
1. Are fractures of the trochanteric massif, except the:
A. Intertrochanteric
B. Subtrochanteric
C. Pertrochanteric
D. Trochanteric-diaphyseal
E. Trochanteric-epiphyseal

Answer: E

2. Indentify the true statement regarding the Garden classification of the real cervical fractures of
the superior extremity of the femur in adult:
A. Garden III: valgus (engaged)
B. Garden II: without displacement (engaged)
C. Garden IV: varus with persistence of a gear of the posterior articulation and horizontalization
of the bone frameworks
D. Garden I: varus with incomplete ruptures

Answer: B

3. The real cervical fractures of the femur:
A. Are extra articular
B. Are intertrochanteric
C. Are horizontalization of the bone framework
D. Do not present necrosis, with possibility of consolidation on vicious position
E. Are subtrochanteric

Answer: B

4. The following statements are true regarding the fractures of the femoral trochanteric massif,
with an exception:
A. Are fractures without risk of necrosis, but with possibility of consolidation in vicious position
B. The pertrochanteric fractures are oblique, from the big to the small trochanter
C. Presents risk of hemarthrosis
D. The intertrochanteric fractures are horizontal, between the two trochanters
E. Are extra articular

Answer: C

5. The following statements regarding the real cervical fractures of the femur in adults are false,
less:
A. Present risk of secondary necrosis of the femoral head
B. Are extra articular
C. Garden II class represents varus with persistence of a posterior articulation gear
D. Garden II class represents varus with complete ruptures of the bone frameworks
E. Do no present risk of necrosis

Answer: A
223

6. The positive diagnosis of the fractures of the superior extremity of the femur in adult is
sustained on the base of the following arguments:
A. Pain and functional impotence, except the disengaged fracture
B. Hip RMI surgery profile
C. Deformation
D. Fever
E. CT hip

Answer: C

7. Indentify the wrong statement regarding the positive diagnostic of the fractures of the superior
extremity of the femur in adult:
A. Functional impotence is a criterion, less for an engaged fracture
B. Serial radiographs are made: face basin + face hip + Arcelin surgery profile hip
C. The pain is a diagnostic criterion
D. Deformation consists of internal twisting, abduction and rotation

Answer: D

8. The differential diagnostic of the fractures of the superior extremity of the femur in adult is
made with:
A. Fracture of the obturator frame
B. Fracture of the inferior ramus of the pubis
C. Femoral diaphyseal fracture
D. Hip displacement
E. Ischium fracture

Answer: A

9. Postoperative complications of the fractures of the superior extremity of the femur in adult are,
except:
A. Infection of the operated area
B. Dehydration
C. Sliding
D. Decubitus injuries
E. Loss of autonomy at the elderly patient

Answer: B


1. Are real the statements regarding the real cervical fractures of the superior extremity of the
femur in adult:
A. Are extra articular fractures
B. Present risk of secondary necrosis of the femoral head
C. Are trochanteric-diaphyseal fractures
D. Present risk of hemartrosis and hypertension
E. Garden II fractures are without displacement

Answer: A, D, E
224

2. Find the false statements regarding the fractures of the femoral trochanteric massif:
A. Are intra articular fractures
B. Can be pertrochanteric fractures
C. Present hemartrosis risk
D. The possibility of vicious consolidation is rarely met
E. Intertrochanteric fractures are horizontal

Answer: A, C, D

3. The following are true, regarding the Garden classification of the femoral real cervical
fractures:
A. Garden II: with displacement (engaged)
B. Garden IV: varus with complete rupture
C. Garden I: valgus (engaged)
D. Garden III: valgus without dislacement
E. Garden classification is applied to the fractures of the trochanteric massif

Answer: B, C

4. Are fractures of the femoral trochanteric massif:
A. Subtrochanteric fractures
B. Trochanteric-diaphyseal fractures
C. Pertrochanteric fractures
D. Intertrochanteric fractures
E. Avulsion fractures

Answer: A, B, C, D

5. Select the true statements regarding the classification of the fractures of the superior extremity
of the femur:
A. The fractures of the trochanteric massif are intraarticular
B. Garden II fracture is an a engaged fracture
C. The avulsion fractures rarely interested the big trochanter
D. The intertrochanteric fractures are oblique, from the big to the small trochanter
E. The real cervical fractures present risk of secondary necrosis of the femoral head

Answer: B, C, E

6. Regarding femoral real cervical fractures, are false statements, less:
A. Are fractures without necrosis
B. Can interest the small trochanter
C. Garden I class signifies valgus with complete ruptures
D. Present risk of hemartrosis and hypertension
E. Are intraarticular fractures

Answer: D, E

225

7. Regarding the diagnostic of the fractures of the superior extremity of the femur in adult, are
true the statements:
A. Appears the pain and functional impotence, except the engaged fracture
B. Are made serial radiographies of face basin + face hip + Arcelin surgery profile hip
C. The differential diagnostic is made with fracture of pubic symphysis
D. The deformation consists of external twisting, abduction and rotation, except the engaged
fracture
E. The reference imagistic investigation is hip RMI

Answer: A, B, D

8. Postoperative complications of the fracture of the femoral superior extremity at adult consist
of:
A. Dehydration
B. Decompensation of the associate affections
C. Sliding
D. Decubitus injuries
E. Infection of the operated zone

Answer: C, D, E

9. There are preoperative complications of the fracture of superior extremity of the femur in adult:
A. Sliding
B. Dehydration
C. Decubitus injuries
D. Loss of authonomy at the old patient
E. Decompensation of the associate affections

Answer: B, E

10. Differential diagnosis of the femoral superior extremity fracture at adult is made, less:
A. With hip congenital dislocation
B. With fracture of the obturator frame
C. With septic necrosis of the femoral head
D. Coxarthrosis
E. Pelvis fracture

Answer: A, C, D, E

226

ACUTE INFECTIONS OF THE SOFT PARTS (ABSCESS, AGNAIL,
PHLEGMON OF THE SHEATH)

Simple complement:

1. The digital phlegmon presents the following characteristics of positive diagnostic:
A. Pulsatile pain
B. Pulpar inflamation
C. Pain at the passive extension of the finger
D. Functional impotence of the affected member
E. Periangular accumulation

Answer: C

2. In the acute infections of the soft parts, biologically, is identified:
A. Coagulation disorders
B. Circulating immune complexes
C. Hyperpotasemia
D. High value of CRP
E. Hypoleukocytosis

Answer: D

3. It is false, regarding the local symptoms in acute infections of the soft parts:
A. In abscess, pain is pulsatile and may cause insomnia
B. The phlegmon represents an infection propagated in an anatomic compartment
C. Fever appears
D. In the digital phlegmon the pain appears only at the active extension of the finger
E. In agnail appears the periangular accumulation

Answer: E

4. It is a favorable factor in apparition of the acute infections of the soft parts:
A. Diabetes
B. Smoking
C. Hepatic insufficiency
D. Hypertension
E. Hypercoagulability

Answer: A

5. Identify the false statement regarding the acute infections of soft parts:
A. Tetanus can appear as complication
B. The radiography can identify gangrenous hydroaeric levels
C. Fever is a general symptom
D. Biological frequently appears CRP dicrease
E. A possible complication is endocarditis

Answer: D

227

6. The therapeutic management in case of arthritis (as urgent situation in the acute infections of
soft parts) assumes:
A. Therapy with antibiotic with large spectrum for 45 days
B. Amputation of the affected segment
C. Cortisol therapy
D. Therapy with antibiotic with large spectrum for 7 days
E. Plaster immobilization

Answer: A

7. The initial treatment in acute infections of the soft parts; in the absence of collection, assumes:
A. Debridement surgery
B. Therapy with penicillin for 10 days
C. Immobilization of the affected member
D. Administration of antifebriles per bone
E. Administration of cephalosporines of third generation

Answer: B


1. Select the false statements about the acute infections of the soft parts, except:
A. In abscess appear fluctuant or retained accumulation
B. Fever is a general symptom
C. Immunodepression may represent a conducting factor
D. Radiographically it is impossible the detection of the gangrenous hydroaeric levels
E. Biologically hyperpotassemia is met

Answer: A, B, C

2. In phlegmon:
A. The pain appear only at the active flexion of the finger
B. Appear the decrease of the fingers volume
C. The pain is elective all over the cover till the proximal glove finger obstruction
D. Infection is propagated in an anatomic compartment
E. The finger is crooked because of the painful tension linked by the liquid from the sheath
coating

Answer: B, C, D, E

3. In urgent situation that implies acute infections of the soft parts:
A. In case of arthritis the therapy with antibiotic must be of maximum 7 days
B. In the second stage of the digital phlegmon is practiced opening in Z of the finger and digital
synectomy
C. Initially, in the absence of the accumulation debridement surgery is practiced
D. Initially, in case of collection, are not necessary the antibiotics after the complete excision, in
absence of the general signs
E. The third level of the digital phlegmon assumes the tendon necrosis

Answer: B, D

228

4. About the digital phlegmon are true, except:
A. In the third level amputation is practiced
B. Second level: purulent liquid
C. In the first level is practiced ablation throught the 2 counterincisions from extremities
D. The therapy with antibiotic with large spectrum is part of therapeutic protocol
E. In the third level the sequelae are rare

Answer: A, E

5. Are true statements regarding the acute infections of the soft parts:
A. In the case of the existence of the articular prostesis, a possible complication is the arthrosis
B. Biologic balance includes hyperleucocitosis and the growth of CRP
C. In abscess appears a fluctuant or retained accumulation
D. In arthritis, the therapy with corticosteroids is one of the options in urgence
E. Initial, for prevent the septic extension, the treatment in case of absence of the collection
assumes debridement surgery

Answer: B, D, E

6. About the digital flegmoid, are correct:
A. In the third level is necrotic
B. The pain appears at the passive extension of the finger
C. The pain is pulsatile and causes insomnia
D. In the second level Z is practiced opening and digital synovectomy
E. Infection is spread in an anatomic compartment

Answer: A, B, D, E

229

PEDIATRICS

ACUTE FEVER IN CHILD

Simple complement:

1. Fever is defined as:
A. Peripheral temperature higher than 38 degrees Celsius
B. Central temperature higher than 39 degrees Celsius
C. Central temperature higher than 38 degrees Celsius
D. Peripheral temperature higher than 38,5 degrees Celsius
E. Central temperature higher than 38,5 degrees Celsius

Answer: C

2. Are severity signs that appear in children with fever, except:
A. Marmorate teguments
B. Chill
C. Neurologic disorders
D. Hemodynamic disorders do not appear
E. Tachycardia

Answer: C

3. At children with age under 3 months the most frequent infections are the following, except:
A. Enterococci
B. Streptococcus group A
C. E. coli
D. Listeria monocytogenes
E. Streptococcus group B

Answer: B

4. Are indications of paraclinical examinations in children between 3 and 36 months in case of
fever the following, except:
A. Bad tolerated fever
B. Fever with severity signs
C. Fever without severity signs that lasts more than 24 hours
D. Area with particular risk known uropathy for example
E. Fever without severity signs that lasts more than 48-71 hours

Answer: C

230

5. The signs that appear in meningococcemia are the following except:
A. Purpura
B. Nape stiffness
C. Time of cutaneous recoloring < 3 seconds
D. Toxic aspect of the child
E. Purpural damagies > 2 mm diameter

Answer: C

6. Modifications that appear in meningitis are the following, except:
A. Bulging fontanelle
B. Consciousness disorders
C. Purpura
D. Status epilepticus
E. Nape stiffness

Answer: C

7. In urinary infection the following signs and symptoms appear at children > 3 months, except:
A. Lethargy
C. Irritability
D. Dysuria
E. Vomiting

Answer: B

8. In urinary infection the following signs and symptoms appear at children > 3 months:
A. Lethargy
B. Consciouness disorders
C. Iritability
D. Pollakiuria
E. Cloudy urine

Answer: B

9. In pneumopathies the following appear, except:
A. Tachypnea
B. SaO2 95%
C. Ronflant rales
D. Crepitant rales
E. Cyanosis

Answer: C

231

10. Are signs of the Kawasaki disease, except:
A. Aseptic conjunctivitis
B. Cervical adenopathy
C. Polyrmorphic eruption
D. Exanthem
E. Extremities edema

Answer: D


1. Enumerate the severe signs that appear at children with fever:
A. Marmorate (mottled) teguments
B. Chill
C. Neurologic disorders
D. Hemodynamic disorders do not appear
E. Tachycardia

Answer: A, B, C, E

2. At the child younger than 3 moths the most frequent infections are with:
A. Enterococci
B. Streptococcus group A
C. E. coli
D. Listeria monocytogenes
E. Streptococcus group B

Answer: A, C, D, E

3. Which are the investigations that are made in case of fever at the babies younger than 6 weeks?
A. Hemogram (blood count)
B. Hemoculture (blood culture)
C. Lumbar punction
D. Cerebral CT
E. Urine exam

Answer: A, C, E

4. Management in case of fever at babies under 6 weeks includes:
A. Does not need hospitalisation
B. The triple antibiotherapy with cephalosporine of third generation, amoxicillin and
aminoglycosid
C. Adaptation of the antibiotheraphy at the highlighted germs in culture
D. The triple antibiotherapy with aminoglycosides, amoxicillin and cephalosporine of third
generation
E. Interruption of the antibiotherapy after 48 hours, if the cultures are negative

Answer: C, D, E

232

5. Investigations that should be made at children between 6 weeks and 3 months in case of fever:
A. Blood count
B. Hemocultures
C. NMR
D. Abdominal ecography
E. Lumbar punction

Answer: A, B, E

6. Enumerate the indications of paraclinical examinations at children between 3 and 36 months in
case of fever:
A. Bad tolerated fever
B. Fever with severity signs
C. Fever without severity signs that last more than 24 hours
D. Area with particular risk - known uropathy for example
E. Fever without severity signs that last more than 48-72 hours

Answer: A, B, D, E

7. What are the indications of lumbar punction at febrile child between 3 and 36 months?
A. Is made as routine
B. Bad tolerated fever
C. Presence of the severity signs
D. Presence of the neurological signs
E. It is not practiced at those children

Answer: B, C, D

8. The most frequent causes of fever at the child between 3 months and 36 months are:
A. Urinary infections
B. Meningitis
C. ENT infections
D. Digestive infections
E. Respiratory infections

Answer: C, E

9. About antibiotherapy in case of fever at children between 3 months and 36 months are true:
A. It has indication if the bacterial starting point is evident
B. Aminoglicozides of first intention are administrated
C. Cephalosporins of second generation are administrated
D. Macrolides of first intention are administrated
E. Cephalosporins of third generation are administrated

Answer: C, E

233

10. The signs that appear in meningococcemia are:
A. Purpura
B. Nape stiffness
C. Time of cutaneous recolour < 3 seconds
D. Toxic aspect of the child
E. Purpural damagies > 2 mm diameter

Answer: A, B, D, E

11. Modifications that appear in meningitis are:
A. Unchanged fontanelle
C. Purpura
D. Status epilepticus
E. Nape stiffness

Answer: B, D, E

7. In urinary infection the following signs and symptoms appear at children > 3 months:
A. Lethargy
C. Irritability
D. Pollakiuria
E. Dysuria

Answer: A, C, D, E

13. In urinary infection appear the following signs and symptoms at children > 3 months:
A. Lethargy
B. Vomiting
C. Increased appetite
D. Iritability
E. Dysuria

Answer: A, B, D, E

14. In pneumopathies appear the following:
A. Tachypnea
B. Bradypnea
C. Ronflant rales
D. Crepitant rales
E. Cyanosis

Answer: A, D, E

234

15. In pneumopathies appear the following:
A. Bronchial rales
B. SaO2 > 98%
C. Cyanosis
D. Crepitant rales
E. Tachypnea

Answer: C, D, E

16. Enumerate at least 4 sings from Kawasaki disease:
A. Septic conjunctivitis
B. Cervical adenophaty
C. Polymorphic eruption
D. Enanthem
E. Edema

Answer: B, C, D, E

17. Fever management at the child between 3 and 36 months includes the following measures:
A. Treatment of first intention - Metamizol
B. Paracetamol with NSAID alternance for poorly tolerated fever
C. Warm drinks
D. Cover of the child
E. The treatment is indicated at a temperature over 38,6 degrees Celsius

Answer: B, E

235

ACUTE DIARRHEA AND DEHYDRATION AT BABIES AND CHILDREN

Simple complement:

1. Extracellular dehydration has the following signs, except:
A. Tachycardia
B. Oligoanuria
C. Hypotension
D. Eyeballs hypotonia
E. Cold extremities

Answer: D

2. Extracellular dehydration presents the following signs, except:
A. Marmorated extremities
B. Fever
C. Collapsed veins
D. Elongation time of recolouring
E. Tachycardia

Answer: B

3. Are signs of hypovolemia inside of the extracellular dehydrations, except:
A. Dry mucoses
B. Tachycardia
C. Hypotension
D. Turgescent jugular veins
E. Marmorated teguments

Answer: A

4. Are signs of intracellular dehydration, except:
A. Neurological disorders
B. Dry mucoses
C. Hypotony of the eyeballes
D. Fever
E. Collapsed jugular veins

Answer: E

5. Management dehydration in case of loss less than 5% from the corporal weight:
A. Intravenous rehydratation
B. Volumic expansion
C. Solutions of oral rehydration, in big quantities
D. Rehydratation with nasogastric tube
E. Solutions of oral rehydration, in small quantities

Answer: E

236

6. Are signs of uremic hemolytic syndrome, with an exception:
A. Thrombocytopenic purpura
B. Oligoanuria
C. Polyuria
D. Asthenia
E. Pallor

Answer: C


1. Are signs of intracellular dehydration:
A. Neurologic disorders
B. Marmorated extremities
C. Eyeballs hypotony
D. Fever
E. Collapsed jugular veins

Answer: A, C, D

2. Are signs of intracellular dehydration:
A. Cold extremities
B. Dry mucoses
C. Eyeballs hypotonia
D. Fever
E. Strong thirst

Answer: B, C, D, E

3. Are sings of hypovolemia inside the extracellular dehydration:
A. Dry mocous
B. Tachycardia
C. Hypotension
D. Fever
E. Marmorate teguments

Answer: B, C, E

4. Are signs of hypovolemia inside the extracellular dehydration:
A. Neurologic disorders
B. Tachycardia
C. Hypotension
D. Turgescent jugular veins
E. Eyeballs hypotenia

Answer: A, E

237

5. Are signs of hypovolemia inside the extracellular dehydration:
A. Dry mucoses
B. Tachycardia
C. Hypotension
D. Powerful thirst

Answer: B, C, E

6. The extracellular dehydration by the contraction of the interstitial sector leads to the apparition
to the following signs:
A. Dry skin
B. Powerful thirst
C. Dark circles around the eyes
D. Depression of the fontanelle
Answer: A, C, D

7. Are signs of hypovolemia inside the extracellular dehydration, except:
A. Dark circles around the eyes
B. Tachycardia
C. Turgescent jugular veins
D. Depression of the fontanelle

Answer: B, D, E

8. Dehydration management with more than 10% from the corporal weight is made in this way:
A. Attempt to oral rehydration
B. Rehydration only on nasogastric tube
C. Volumic expansion
D. Intravenous rehydration
E. Solutions of oral rehydration GES 45

Answer: C, D

9. Enumerate hospitalization criteria in case of dehydration:
A. Dehydration > 5%
B. Partial digestive intolerance
C. Age < 3 months
D. Prematurity
E. Pre existing chronical disease

Answer: C, D, E

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10. Enumerate hospitalization criteria in case of dehydration:
A. Dehydration 10%
B. Totally digestive intolerance
C. Dehydration 5% in case of the oral rehydration failure
D. Pre existing chronical disease
E. Age < 6 months

Answer: A, B, C, D

11. The anamnesis for acute diarrhea diagnostic should be specified:
A. Notion of contagiosity
B. Predisposed area
C. Antibiotic treatment
D. Installation mode, evolution
E. No correct answer

Answer: A, B, C, D

12. The clinical examination at the patients with diarrhea includes:
A. Dehydrations signs
B. Uremic hemolytic syndrome signs in infection with E.Coli) 157-H17
C. Denutrition signs in case of acute diarrhea
D. Sepsis signs
E. Oligoanuria

Answer: A, D, E

13. Enumerate signs of hemolytic uremic syndrome:
A. Thrombocytopenic purpura
B. Oligoanuria
C. Polyuria
D. Asthenia
E. Pallor

Answer: A, B, D, E

14. Enumerate viruses that can give acute diarrhea:
A. Adenovirus
B. Rotavirus the least frequent
C. CMV
D. Herpes virus
E. Vibrio cholerae

Answer: A, C

239

15. Enumerate the bacterial causes of acute diarrhea:
A. Shigella
B. Salmonella
C. CMV
D. Clostridium difficile
E. Escherichia coli pathogen

Answer: A, B, D, E

16. Parasite causes of acute diarrhea:
A. Giardia intestinalis
B. Entamoeba hystolityca
C. Vibrio cholera
D. Cryptosporidium hominis
E. Borrelia

Answer: A, B, D

17. Enumerate useful analyses for highlighting severe dehydration status:
A. Urinary electrophoretogram
B. Sanguine electrophoretogram
C. Bicarbonate
D. Complete blood count
E. ESR

Answer: A, B, C

18. Enumerate complementary examinations that can be made in case of septic signs in acute
diarrhea:
A. CRP
B. Hemocultures
C. Pharyngeal exudate
D. Coproculture
E. Hemogram

Answer: A, B, D, E

19. Enumerate the indications for coproculture:
A. Presence of blood in stool
B. Immunocompetence
C. Numerous stools
D. Patients return from an endemic zone
E. It is mandatory at all children with diarrhea

Answer: A, D

240

20. The acute diarrheas treatment is made with:
A. Digestive rest
B. Milk with lactosis
C. Hydrolysic protein of cow milk for the age < 3 month
D. Antibiotherapy adapted in case of proved bacterial diarrhea
E. Antisecretories

Answer: C, D, E

241

VOMITING IN BABY AND CHILD

Simple complement:

1. Medical causes of the vomiting are, except:
A. Acute hepatic insufficiency
B. Hydroelectrolytical disorders
C. Meningitis
D. Meningeal hemorrhage
E. Acute renal insufficiency

Answer: A

2. Surgery causes of acute vomiting are, except:
A. Occlusive syndrome
B. Acute gastroenterocolitis
C. Volvulus
D. Acute intestinal invagination
E. Acute apendicitis

Answer: B

3. Surgery causes of the acute vomiting are, except:
A. Acute intestinal invagination
B. Bundle
C. Acute apendicitis
D. Acute renal insufficiency
E. Strangulated hernia

Answer: D

4. The clinical exam of the child with vomiting includes the following except:
A. Evaluation of an associate infectious focus
B. Abdominal palpation for detecting the surgical causes
C. Evaluation of the digestive and extradigestive signs
D. The existence of dehydration
E. The existence of denutrition

Answer: C

5. There can be infectious medical causes that can lead to the apparition of vomiting in children,
with an exception:
A. ENT focus
B. Pulmonary focus
C. Acute appendicitis
D. Acute gasteroenterocolitis
E. Meningitis

Answer: C

242

6. Neurological causes which determine the apparition of acute vomiting in children, with an
exception:
A. Meningitis
B. Meningeal hemorrhage
C. Intracerebral hematoma
D. Toxics
E. Cranial traumatism

Answer:

7. Regarding the pyloric stenosis the following statements are true, with an exception:
A. Prevails at masculine gender
B. The treatment is surgical
C. Appetite kept
D. Hyperchloremic alkalosis
E. Denutrition state

Answer: D

8. Regarding the pyloric stenosis the following statements are true, with an exception:
A. Abdominal pyloric olive
B. The diagnosis can be confirmed only by abdominal CT
C. Denutrition state
D. Variable dehydration state
E. Projectile vomiting

Answer: B

9. Which is the Domperidone dose indicated in vomiting?
A. 0,10,4 mg/kg/
B. 0,2-0,4 mg/kg/24 h p.o
C. 0,2-0,4 mg at 8 hours p.o.
D. 0,2-0,4 mg/kg/8 hours p.o.
E. 0,2-0,4 mg/kg/8 hours i.v.

Answer: D


1. The case of presence of the vomiting, anamnesis may offer the following informations:
A. Age and the personal and familial record
B. Digestive signs
C. Consequences about the state of the patient
D. Associate infectious focus
E. The character of the vomiting (frequency, aspect)

Answer: A, B, E

243

2. Enumerate the metabolic causes of the apparition of the vomiting:
A. Toxics
B. Diabetes ketoacidosis
C. Aminoacidopathies
D. Gastroesophageal reflux
E. Pyloric stenosis

Answer: A, B, C

3. Enumerate the neurological causes of the apparition of the vomiting:
A. Epilepsy
B. Intracranian hypertension
C. Aminoacidopathies
D. Toxics
E. Hydro-electrolytic disorders

Answer: A, B

4. Enumerate infectious medical causes:
A. Acute apendicitis
B. Acute gastroenterocolitis
C. Pyloric stenosis
D. Meningitis
E. ENT infectious focus

Answer: B, D, E

5. About the pyloric stenosis the following are true, except:
A. Prevails at feminine gender
B. The diagnostic confirmed is of abdominal CT
C. Appears at an interval of 2-8 weeks
D. Vomiting in jet
E. Has progressive aggravation

Answer: A, B

6. About pyloric stenosis the following are true, except:
A. Surgery treatment is of first intention
B. Vomiting appears immediately after lunch
C. Denutrition
D. Dehydration
E. The diagnosis is confirmed by Rx

Answer: A, B, C

244

A. Prevails at masculine gender
B. Vomiting is
C. Vomiting appears remotes between meals
D. The diagnosis is confirmed by the abdominal ecography
E. The appetite decreases

Answer: A, C, D

A. Stop of gaining weight
B. Hypochloremic alcalosis
C. Hyperchloremic acidosis
D. Vomiting in jet
E. Vomiting appears remotes between meals

Answer: A, B, D, E

A. The diagnosis is confirmed by the abdominal ecography
B. Treatment - hydro - electrolytic equilibration
C. Prevails at masculine gender
D. The appetite decreases
E. Pyloric abdominal olive palpation

Answer: A, B, C, E

10. Enumerate the paraclinical investigations that can orient us about the state of the child with
acute vomiting:
A. Electrophoretogram
B. PCR
C. Urea, creatinine
D. PH
E. Thoracic radiograph

Answer: A, C, D

11. Enumerate the paraclinical investigations that can orient us on the status of children with
acute vomiting:
A. Blood sugar
B. Urea, creatinine
C. Abdominal radiography
D. PH
E. Electrophoretogram

Answer: A, B, D, E

245

12. Paraclinical investigations for highlighting an infectious focus are:
A. CRP
B. CBC (Complete blood count)
C. PH
D. Calcemia
E. Hemocultures

Answer: A, B, E

13. Paraclinical investigations for highlighting an infectious focus are:
A. HLG
B. Lumbar puncture
C. Electrophoretogram
D. CRP
E. Urine summary

Answer: A, B, D, E

246

CHILDS ANGINAS AND PHARINGITIS

Simple complement:

1. The rinophyringitis can be defined by:
A. Inflammatory affection of the pharynx and nosal fosses that affects exclusively big children
B. Inflammatory affection of the pharynx and palatine tonsils, very frequent at small children
C. Inflammatory affection of the pharynx and nasal fossae, most frequent of bacterial origin
D. Inflammatory affection of the pharynx and nasal fossae, most frequent of viral origin
E. Inflammatory affection of the palatine tonsils

Answer: D

2. The treatment of rinophyringitis is made with the following, except:
A. Always antibiotherapy
B. Antifebrile
C. Local antibiotic and eye wash is not enough in case of isolated purulent conjunctivitis
D. Cleanings of the nasal fossae with physiologic serum does not help
E. Persistent fever more that 2 days does not justify antibiotic administration

Answer: B

3. Angina can be defined as:
A. Inflammatory affection of the palatine tonsils, most often of bacterial origin
B. Inflammatory affection of the pharynx, very frequent at little children
C. Inflammatory affection of the palatine tonsils, most frequent of viral origin, mostly at the age
after 3 years old
D. Inflammatory affection of the pharynx and nasal fosses
E. Inflammatory affection of the palatine tonsils, most frequent of viral origin, mostly in children
under 3 years old

Answer: E

4. The clinical picture of angina includes the following signs and symptoms, except:
A. Fever
B. Odynophagia
C. Can associate sinusitis
D. Cervical adenopathies
E. Reflex otalgia

Answer: C

5. Vesicular anginas are characterized by the following, except:
A. Appear vesicles on eritematous background at the palatine tonsilitis
B. Appear erosions on eritemateous background at the tonsillitis and palatine level
C. Evokes rather viral etiology
D. Evokes mononucleosis with EBV
E. Evokes herpetic angina with HSV type 1

Answer: D

247

6. The treatment of the anginas if TDR test is positive is made with amoxicillin for:
A. 6 weeks
B. 14 days
C. 7 days
D. 6 days
E. 10 days

Answer: D

7. In the treatment of anginas, the children allergical to amoxicillin are administrating:
A. Cephalosporins of first generation
B. Cephalosporins of second or third generation for 2 weeks
C. Cephalosporins of first generation for 4-5 days
D. Cephalosporins of second or third generation for 4-5 days
E. Macrolides of first intention

Answer: D


1. The clinical picture in rhinopharygitis is with:
A. Anterior rhinorrhea
B. Irritative cough, with emphasis in the morning
C. Congestive otitis always appear
D. Posterior rhynorrhea
E. Serous or purulent rhinorrhea

Answer: A, D, E

A. Serous posterior rhinorrhea
B. Irritative cough, with emphasis in the night
C. Congestive otitis
D. Conjunctivitis cannot appear
E. Serous or purulent rhinorrhea

Answer: A, B, C, E

A. Conjunctivitis
B. Fever does not appear
C. Congestive otitis
D. Productive cough
E. Cervical adenopathies

Answer: A, C, E

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4. About rhinopharyngitis the following are true:
A. It is an inflammatory affection of the pharynx and nasal fossae of origin exclusively viral
B. The evolution is spontaneously favorable in less than a week
C. Can complicate with medium otitis
D. Can complicate with pneumonia
E. Can complicate with sinusitis

Answer: B, C, E

5. About rhinopharyngitis the following are true:
A. Is the less frequented infectious pathology in children
B. Has a spontaneously favorable evolution in less than a week
C. Can complicate with sinusitis
D. It is most frequently of viral origin
E. Cannot complicate with medium otitis

Answer: B, C, D

6. The clinical picture in rhinopharyngitis is with:
A. Serous and purulent rhinorrhea that can lead to nasal obstruction
B. Congestive otitis
C. Conjunctivitis
D. Cervical adenopathies cannot appear
E. Productive cough

Answer: A, B, C

7. The treatment of rhinopharyngitis is made with:
A. Cleaning of the nasal with physiologic serum
B. Antipyretics in case of fever
C. Antibiotherapy constantly
D. Systemic antibiotherapy in case of isolated conjunctivitis
E. Antibiotic treatment in case of bacterial complication

Answer: A, B, E

8. The clinical picture of the anginas includes:
A. Unilateral cervical adenopathies
B. Fever, often high
C. Reflexive otalgia
D. Odynophagia
E. Do not appear modifications of the oropharynx

Answer: B, C, D

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9. The clinical picture of the anginas includes:
A. High fever
B. May associate digestive disorders
C. Reflexive otalgia
D. Unilateral cervical adenopathies
E. The fever appear rarely

Answer: A, B, C

10. The following statements about anginas are true:
A. Are inflammatory affections of the tonsils
B. Are often of viral origin
C. Appear most frequently after the age of 6 years
D. Appear most frequently at the age of 3 years
E. Appear most frequently after the age of 3 years

Answer: A, B, D

11. The anginas with streptococcus complicates with:
A. Acute articular rheumatism
B. Retropharhingeal abscess
C. Pyelonephritis
D. Glomerulonephritis
E. Sinusitis

Answer: A, B, D

12. The following statements about pseudomembranous angina are true:
A. Vesicles and erosions on tonsils
B. Thick and adherent fake membrane on tonsils and pedicles
C. Infection can extend to uvula
D. Must suspect a fusospirillary infection
E. Must suspect a herpetic infection

Answer: B, C

13. The following statements about pseudomembranous angina are true:
A. Vesicles and erosions on tonsils
B. Thick and adherent fake membrane on tonsils and pedicles
C. Must suspect a mononucleosis with EBV
D. Suggest a Vincent angina
E. Must suspect diphtheria

Answer: B, C, E

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14. Ulceronecrotic anginas have the following characteristics:
A. Are frequent in children
B. Suggest a herpetic angina
C. Suggest a Vincent angina
D. Are rare in children
E. In case of unilateral ulcerations or agranulocytosis relieves leukemia

Answer: C, D, E

15. Vesicular anginas have the following characteristics:
A. Suggest Vincent angina
B. Evokes a bacterial etiology
C. Evokes a herpangine with Coxsackie B
D. Evokes a herpetic angina with HSV type 1
E. Appear vesicles and erosions on erytematous background on tonsillitis and palatine veil

Answer: D, E

16. Anginas vesicular are characterized by:
A. Appear vesicles on erythematous background at the palatine tonsils level
B. Appear erosions on erythematous background at the palatine tonsils and soft palates level
C. Evokes rather viral etiology
D. Evokes mononucleosis with EBV
E. Evokes herpetic angina with HSV type 1

Answer: A, B, C, E

17. Pseudomembraneous anginas require the following special investigations:
A. Pharyngeal exudate
B. Serology for HVS type 1
C. Serology for EBV
D. Complete blood count
E. Serology for Coxsackie A virus

Answer: A, C, D

251

BRONCHOPULMONARY INFECTIONS AT BABY AND CHILD

Simple complement:

1. Diagnosis of acute bronchiolitis in babies is put on the following, except:
A. Productive cough associated with respiratory distress
B. Baby under 2 years old
C. Crepitant rales that evoke a brocho-alveolitis
D. Appear in winter epidemics, usually viral
E. It is preceded by a rhinopharyngitis phase

Answer: A

2. Differential diagnosis of bronchiolitis is made with the following affections, except:
A. Convulsive cough
B. Cardiomyopathy
C. Pericarditis
D. Congenital cardiopathy
E. Bacterial pulmonary infection

Answer: C

3. The following are included in the severity criteria of bronchiolitis, except:
A. Hypoxemia
B. Hypercapnia
C. Drowsiness
D. Dry coughing fits
E. Superficial polypnea

Answer: D

4. The ambulatory treatment of bronchiolitis consists of:
B. Nasal desobstruction with physiologic serum
C. Always antibiotherapy
D. Fractionation of the meals
E. Amoxillin -clavulinate association

Answer: C

5. Diagnosis of acute bronchitis in children is put on the following, except:
A. Cough
B. Fever
C. Crepitant rales
D. Respiratory destress
E. Bronchial rales

Answer: C

252

6. Indications for making a pulmonary radiography in case of bronchitis are, except:
A. Recurrent pneumonias
B. Inexplicable fever
C. Crepitant, subcrepitant rales
D. Febrile cough, without tachypnea
E. Suspicion of strange body inhalation

Answer: D

7. Pneumonia diagnostic in children is put of the following, except:
A. Polypnea
B. Cough
C. Fever
D. Bronchial rales at auscultation
E. Respiratory insufficiency

Answer: D

8. The dose of Amoxicillin in children smaller than 3 years is:
A. 80-100 mg/kg/day in 2 doses
B. 80-120 mg/kg/day in 3 doses
C. 80-100 mg/kg/day in 3 doses
D. 100-120 mg/kg/day in 3 doses
E. 80-100 mg/kg/day in 3 doses

Answer:

9. The dose of Ceftriaxone in children smaller than 3 years is:
A. 100 mg/kg/day
B. 100 mg/day
C. 50 mg/day
D. 50 mg/kg/day
E. 60-100 mg/kg/day

Answer: D

10. Amoxicillin dose at children over 3 years is:
A. 80-100 mg/kg/day in 3 doses
B. 80-120 mg/kg/day in 2 doses
C. 100-120 mg/kg/day in 3 doses
D. 100-120 mg/kg/day in 2 doses
E. 100-120 mg/kg/day in 3 doses

Answer: E

253

11. The treatment with Amoxicillin for pneumonias in children last:
A. 14 days
B. 5 days
C. 7 days
D. one week
E. 10 days

Answer: E

12. Which is the class of antibiotic administrated at pneumonias in children in case of allergy at
penicillins:
A. Cephalosporins of second generation
B. Macrolides
C. Carbapenems
D. Fluoroquinolones
E. Cephalosporins of third generation

Answer: E


1. The diagnosis of acute bronchiolitis in babies is put on:
A. Productive cough associated with respiratory distress
B. Baby under 2 years old
C. Crepitant rales that evokes a broncho-alveolitis
E. It is preceded by a rhinopharyngitis

Answer: A, C, D, E

2. The diagnosis of acute bronchiolitis in babies is put on:
A. Dry cough associated with respiratory destress
B. Baby under 2 months
C. Crepitant rales that evokes a broncho-alveolitis
E. Dry cough associated with sibilant ralws

Answer: A, B, D, E

3. Differential diagnosis of bronchiolitis is made with:
A. Convulsive cough
B. Cardiomyopathy
C. Pericarditis
D. Congenital cardiopathy
E. Bacterial pulmonary infection

Answer: A, B, D, E

254

4. Convulsive cough is characterized by the following:
A. Dry cough which is continuous
B. Appears at the immunized child
C. Appears to the child who is contaminated
D. Appears in dry coughing fits
E. It is a disease that is made the differential diagnosis of bronchiolitis with

Answer: C, D, E

5. Enumerate severity criteria in bronchiolitis:
A. Hypotonia
B. Drowsiness
C. Dry coughing fits
D. Hypercapnia
E. Bradipnee

Answer: A, B, D

6. Enumerate se verity criteria in acute bronchiolitis:
A. Hypoxemia
B. Superficial polypnea
C. Respiratory exhaustion
D. Hypertonia
E. Feed difficulties

Answer: A, B, C, E

7. Represent hospitalization criteria in case of bronchiolitis:
A. Baby of small age < 6 months
B. Cardiopathy
C. Chronic respiratory pathology
D. Marked polypnea > 60 respirations/min
E. Feed difficulties

Answer: B, C, D, E

A. Drowsiness
B. Toxic aspect
C. Apnea
D. Prematurity < 35 weeks
E. Baby of small age < 3 months

Answer: A, B, C

255

A. Feed difficulty - <1/3 from the usual number of meals/day
B. Polypnea
C. Apnea
D. Respiratory insufficiency
E. Babys age < 6 months

Answer: B, C, D

10. The ambulatory treatment in bronchiolitis consists of:
B. Nasal desobstruction with physiologic serum
C. Always antibiotherapy
D. Fractionation of the meals
E. Association amoxicillin- clavulinate

Answer: A, B, D, E

11. The treatment in hospital of the bronchiolitis consists of:
A. Maintenance of the hydration and correct nutrition 90-100 ml/kg/day
B. Oxygen therapy in case of respiratory insufficiency
C. Dorsal proclive position at 30 degrees
D. Careful supervision of the respiratory frequency
E. Mandatory intravenous hydration

Answer: B, C, D

12. Treatment in hospital of the bronchiolitis consists of:
A. Oxygen therapy in case of respiratory insufficiency
B. Careful supervision of SaO2
C. Supervision of hemodynamic state
D. Intravenous feed if the enteral feed is hardly tolerated
E. Dorsal proclive position at 60 degrees

Answer: A, B, C, D

13. The diagnosis of acute bronchitis at child is put on:
A. Cough
B. Fever
C. Crepitant rales
D. Respiratory destress
E. Bronchial rales

Answer: A, B, D, E

256

14. The indications of making a pulmonary radiography in case of bronchitis are:
A. Recurrent pneumonies
B. Inexplicable fever
C. Crepitant, subcrepitant rales
D. Febrile cough without tachypnea
E. Suspicion of foreign body inhalation

Answer: A, B, C, E

15. The treatment of acute bronchitis in children consists of:
A. Antibiotics in case of fever < 38 degrees Celsius
B. Symptomatic treatment of the fever
C. Nasal desobstruction with physiologic serum
D. Macrolides of first intention
E. Amoxicillin + clavulanic acid

Answer: B, C, E

16. The diagnosis of pneumonia in children is put on:
A. Polypnea
B. Cough
C. Fever
D. Bronchial rales at auscultation
E. Respiratory insufficiency

Answer: A, B, C, E

17. Criteria of severity in case of pneumonia are:
A. Severe infectious syndrome
B. Respiratory insufficiency
C. Age of the child over 1 year
D. Alteration of the general condition
E. Chronical cardiac pathology

Answer: A, B, D, E

18. The clinical picture in pneumonia with Streptoccoc pneumonia is:
A. It is progressive installed
B. Has marked general signs
C. Important fever
D. Associated polymorph eruption
E. May associate medium otitis

Answer: B, C, E

257

19. Pneumonia with Mycoplasma pneumonia presents the following clinical picture:
A. Progressive start
B. Frequently associates the medium otitis
C. Fever of high intensity
D. Polymorph eruption
E. General marked signs

Answer: A, D

20. In pneumonias, thoracic radiographs may highlight:
A. Alveolar pulmonary focus
B. Complications as pleuresy
C. Pahipleuritis
D. Abscess
E. Caverns

Answer: A, B, D

21. The following complementary examinations in pneumonias can be made:
A. Hemoculture in case of bacteriemia suspicion with Mycoplasma pneumonia
B. PCR from nasal infections for mycoplasma detection
C. Hyponatremia in case of infection with pneumococcus
D. Hemogram
E. PCR

Answer: B, C, D, E

22. The treatment of pneumonia in child under 3 years old is made with:
A. Amoxicillin in dose of 100-120 mg/kg/day in 2 doses
B. Cephalosporin of second generation in case of allergy at penicilin
C. Cefotaxime in dose of 50 mg/kg/day
D. Ceftriaxone in dose of 50 mg/kg/day
E. Amoxicillin in dose of 80-100 mg mg/kg/day in 3 doses, for 10 days

Answer: C, D, E

23. The treatment of pneumonia in child under 3 years is made with:
A. Amoxicillin in dose of 100-120 mg/kg/day in 2 doses
B. Cephalosporin of second generation in case of allergy at penicilin
C. Cefotaxime in dose of 50 mg/kg/day
D. Ceftriaxone in dose of 50 mg/kg/day
E. Amoxicillin in dose of 80-90 50 mg/kg/day in 3 doses, for 10 days

Answer: C, D, E

258

24. The diagnosis of pleuropneumopathies is put on:
A. Dulness on percussion
B. The diminish of vesicular murmur
C. Important abdominal pains
D. The thoracic radiography is irrelevant
E. Pulmonary hyper-sonority

Answer: A, B, C

25. The most frequent pleuropneumopathies etiology is given by:
A. Pneumococcus
B. Mycoplasma pneumonia
C. Streptococcus beta hemolytic
D. Staphylococcus
E. Streptococcus A

Answer: A, D, E

259

ASTHMA IN CHILD

Simple complement:

1. Moderate asthma is characterized by the following, except:
A. Paradoxal pulse - absent
B. PEF - 60 - 80
C. PaO2 - > 60 mmHg
D. PaCO2 < 45 mmHg
E. SaO2 90-95 %

Answer: A

2. Mild asthma is characterized by the following, except:
B. PEF > 80 %
C. PaO2 - normal
D. PaCO2 > 45 mmHg
E. SaO2 - > 95 %

Answer: D

3. Mild asthma is characterized by the following, except:
A. Dyspnea on walking
B. Speech - normal
C. Conscious state usually agitation
D. Accessory muscles use - unussual
E. Sibilant rales - moderate

Answer: C

4. Sever asthma is characterized by the following, except:
A. Dyspnea - impossible feed
B. Speech - normal
D. Accessory muscles use - usual
E. Sibilant rales - important

Answer: C

5. The imminence of respiratory arrest is characterized by the following, except:
A. Drowsiness
B. Confusion
C. Thoraco-abdominal asynergy
D. Bradycardia
E. Important sibilant rales

Answer: E

260

6. Severe asthma is characterized by the following, except:
A. Paradoxal pulse - present
B. PEF - < 60
C. PaO2 - < 60 mmHg
D. PaCO2 < 45 mmHg
E. SaO2 - < 90 %

Answer: D

7. Uncontrolled asthma is characterized by the following, except:
A. Diurnal symptoms > 6/week
B. Limitation of the activities
C. Nocturnal symptoms
D. Use of beta 2 agonists - < 2/week
E. MEVS/PEF - law

Answer: D

8. Treatment of asthma attack will not be made with:
A. Oxygen therapy
B. Nebulisations with beta 2 mimetic with short action for 30 min
C. General corticotherapy
D. Anticholinergics
E. May require mechanical ventrilation

Answer: B


1. Mild asthma is characterized by:
A. Dyspnea - on walking
B. Speech isolated phrases
C. Conscious state possible agitation
D. Accessory muscles use - unusual
E. Sibilant rales - absent

Answer: A, C, D

B. PEF - < 80 %
C. PaO2 - normal
D. PaCO2 < 45 mmHg
E. SaO2 90 95%

Answer: A, C, D

261

A. Dyspnea on walking
B. Speech normal
E. Sibilant rales - moderate

Answer: A, B, D, E

A. Paradoxal pulse can be present
B. PEF - > 80 %
C. PaO2 - normal
D. PaCO2 > 45 mmHg
E. SaO2 > 95%

Answer: B, C, E

5. Moderate asthma is characterized by:
A. Paradoxal pulse absent
B. PEF 60- 80
C. PaO2 - > 60 mmHg
D. PaCO2 < 45 mmHg
E. SaO2 90- 95%

Answer: B, C, D, E

6. Moderate asthma is characterized by:
A. Dyspea feeding difficulty
B. Speech - normal
E. Sibilant rales: moderate

Answer: A, C, D

7. Severe asthma is characterized by:
A. Dyspea at rest
B. Speech isolated words
E. Sibilant rales: moderate

Answer: A, B, C

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A. Dyspea impossible feed
B. Speech normal
E. Sibilant rales: important
Answer: A,C,D,E

9. The imminence of respiratory arrest is characterized by:
A. Drowsiness
B. Confusion
C. Thoraco-abdominal asynergy
D. Tachycardia
E. Important sibilant rales

Answer: A, B, C

10. The imminence of respiratory arrest is characterized by:
A. The absence of the paradoxal pulse that suggest respiratory exhaustion:
B. Silentium at auscultation
C. Respiratory frequency > 30/min
D. Usually agitation
E. Confusion

Answer: A, B, E

A. Paradoxal pulse present
B. PEF - < 60%
C. PaO2 - > 60 mmHg
D. PaCO2 < 45 mmHg
E. SaO2 - < 90%

Answer: A, B, E

12. Controlled asthma is characterized by:
A. Diurnal symptoms - 2/week
B. Limitation of the activities - yes
C. Nocturnal symptoms - none
D. Use of beta 2 agonists - normal
E. MEVS/PEF - normal

Answer: A, C, D, E

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13. Partial controlled asthma is characterized by:
A. Diurnal symptoms - 2/week
C. Nocturnal symptoms - yes
D. Use of beta 2 agonists - >2/week
E. MEVS/PEF - normal

Answer: B, C, D

14. Uncontrolled asthma is characterized by:
A. Diurnal symptoms - > 6/week
C. Nocturnal symptoms - yes
D. Use of beta 2 agonists - <2/week
E. MEVS/PEF - low

Answer: A, B, C, E

15. The treatment of asthma crisis will be made with:
A. Oxygen therapy
B. Nebulisations with beta 2 mimetic with short action for 30 min
C. General corticotherapy
D. Anticholinergics
E. May not require mechanical ventrilation

Answer: A, C, D

16. Severe asthma attack is characterized by:
A. PEF < 60% from the therapeutic value
B. Important clinical signs
C. The treatment can last 1-3 hours
D. The good improvement after 1 hour of treatment
E. The treatment is made with beta 2 adrenergics with long action, anticolinergics, general
corticotherapy

Answer: A, B, E

17. Background treatment of the asthma includes:
A. Antileucotriene
B. Corticosteroids
C. Beta blockings
D. Alpha mimetics
E. Beta 2 adrenergics with broad action

Answer: A, B, E

264

EVALUATION AND CARE OF THE TERM NEW-BORNS

Simple complement:

1. Which is the normal weight of a new-born?
A. 2000 g
B. 2500 g
C. 3000 g
D. 5000 g
E. Between 2200 and 2500 g

Answer: C

2. Which is the normal length of a now-born?
A. 70 cm
B. 65 cm
C. 40 cm
D. There is not a normal length
E. 50 cm

Answer: E

3. There are the data that should be known regarding the pregnancy history, with an exception:
A. Maternal HIV serology
B. Maternal HBV serology
C. The result of the prenatal echographies
D. Parity does not matter
E. Mothers Rh

Answer: D

4. Regarding at Apgar 2 points score is accorded for the following, with a single exception:
A. Cardiac frequency over 100 beats per minute (bpm)
B. Respiration - normal
C. Colour cyanosis of the extremities
D. Flexion of the 4 members
E. Reactivity - powerful

Answer: C

5. Concerning the 1 point Apgar score is given for the following, with an exception:
A. Cardiac frequancy under 100 bbm
C. Colour extremities cyanosis
D. Flexion of the inferior members
E. Reactivity - weak

Answer: B

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6. Immediately after birth, the new born will be given, except:
A. Vitamin K
B. Vitamin D
C. Antibiotic ophtalmic eye wash
D. Breast setting
E. The first feeding-bottle in the first hours

Answer: B

7. Most frequent diseases in the first days from birth which have accessible treatment are, with an
exception:
A. Congenital hypothyroidism
B. Suprarrenal congenital hyperplasia
C. Down syndrome
D. Phenylketonuria
E. Mucoviscidosis

Answer: C

8. Prematurity is defined as gestational age under:
A. 28 s
B. 36 s
C. 39 s
D. 37 s
E. 32 s

Answer: D

9. Very big prematurity is, at a gestational age, under
A. 32 s
B. 37 s
C. 35 s
D. 34 s
E. 28 s

Answer:E

10. High prematurity is high at a gestational age:
A. 28-32 s
B. under 37 s
C. under 35 s
D. under 28 s
E. under 27 s

Answer: A

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11. Causes for intrauterine growth retardation can be, with an exception:
A. Mothers age < 20 years old
B. Mothers age > 30 years old
C. Mothers hypertension
D. Anomalies of the placentas position
E. Fetal infections

Answer: B


1. Which are the date that should be known regarding the pregnancy history?
A. Parity
B. ABO blood type
C. Mothers Rh does not matter
D. Medicines administrated in pregnancy
E. Intravaginal presence or absence of streptococcus B

Answer: A, B, D, E

2. Which are the data that should be known regarding the pregnancy history?
A. Maternal HIV serology
B. Maternal HBV serology
C. The result of the prenatal echographies
D. Parity does not matter
E. Mothers Rh

Answer: A, B, C, E

3. What are the data that must be known about birth?
A. The presence of the fetus does not influence the birth
B. The characteristics of the amniotic liquid
C. Duration of the membrane rupture
D. Antibiotic administration during the labor cannot influence the child
E. Fetal cardiac rhythm

Answer: B, C, E

4. Regarding the 2 points Apgar score it is given for:
A. Cardiac frequency under 100 bpm
C. Color - pink
E. Reactivity - powerful

Answer: B, C, E

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5. Regarding the 2 points Apgar score it is given for:
A. Cardiac frequency over 100 bpm
C. Color cyanosis of the extremities
D. Flexion of the four members
E. Reactivity - strong

Answer: A, B, D, E

6. Regarding the 1 point Apgar score it is given for:
A. Cardiac frequency over 100 bpm
B. Respiration - unregulated
D. Flexion of the four members
E. Reactivity - weal

Answer: B, C, E

7. Regarding the 1 point Apgar score it is given for:
A. Cardiac frequency under 100 bpm
B. Normal respiration
E. Reactivity - weak

Answer: A, C, D, E

8. At cardio-vascular exam at birth can be detected:
A. Auscultation of a murmur
B. Pulmonary auscultation FR < 30/min
C. Cutaneous recolouring time normal > 30 s
D. Absence of the respiratory pauses bigger than 10 s
E. Anomalies of the pulses

Answer: A, D, E

9. The management of new-born in the first days consists of:
A. Supervision of the weight curve new-born losses 20% of the initial weight in the first 10
days
B. Verification of the feed quality
C. Detection of the most frequent congenital diseases
D. Clinical examination at discharge from the maternity
E. Early detection of the jaundice

Answer: B, C, D, E

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10. Enumerate the most frequent diseased detected in the first days from birth who has an
accessible treatment:
A. Congenital hypotyroidism
B. Suprarrenal congenital hyperplasia
C. Down syndrome
D. Phenylketonuria
E. Mucoviscidosis

Answer: A, B, D, E

11. About maternal-fetal infection are true:
A. The most frequent germens Staphylococcus, Streptococcus A
B. The bigger risk is in case of premature ruptures of membrane
C. Must be taken into account in case of any inexplicable prematurity
D. The treatment of first intention- double antibiotherapy
E. Detection of the signs of hemodynamic instability

Answer: B, C, E

12. The triple antibiotherapy in case of maternal-fetal infection is made with
A. Cephalosporine of second generation
B. Cephalosporine of third generation
C. Aminoglycoside
D. Macrolide
E. Ampicillin

Answer: B, C, E

13. Enumerate the risks thereupon prematures are subjected:
A. Risk of respiratory distress immaturity of the surfactant before the 32
nd
week
B. Digestive risk - intestinal immaturity
C. Infectious risk - the gestational risk
D. Hemodynamic risk persistence of the arterial duct
E. Major risk of hypothermia

Answer: B, D, E

14. Causes for intrauterine growth retardation may be:
A. Age of the mother < 20 years old
B. Age of the mother > 30 years old
C. Mothers hypertension
D. Abnormal placental position
E. Fetal infections

Answer: A, C, D, E

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15. Causes for intrauterine growth retardation may be:
A. Toxoplasma infections
B. Chromosomal anomalies
C. Unique pregnancy
D. Placental infarction
E. Placental thrombosis

Answer: A, B, D, E

16. Enumerate the main causes of the neonatale respiratory depression:
A. Pulmonary infection
B. Congenital cardiopathy
C. Hyaline membrane disease may appear to all the new-born babies
D. Pneumothorax
E. Inhalation of amniotic fluid

Answer: A, B, D, E

17. Gestational diabetes may lead to:
A. Neonatal hyperglycemias the main risk
B. Prematurity
C. Macrosomia
D. Risk of obstretical injury because of the fetus weight
E. Death of the fetus in uterus

Answer: B, C, D, E

270

INTERNAL MEDICINE

DISSEMINATED ERYTHEMATOUS LUPUS
ANTIPHOSPHOLIPID SYNDROME

1.Referring to systemic lupus, the following statements are true, except for:
A. Systemic disease by excellence
B. Affects mainly women over 45 years old
C. Autoimmunity is improved
D. May be induced by drugs
E. The debut can be sudden

Answer: C

2.The following are LED diagnostic criteria, except for:
A. Malar rash
B. Erosive arthritis
C. Photosensitiveness
D. Pleuritis
E. Pericarditis

Answer: B

3. The hematological affectation in LED is characterized by the following:
A. Normocytic normochromic anemia
B. Leukopenia <5G / L found twice
C. Thrombopenia <150 G / L
D. Lymphopenia <1.8 G / L found twice
E. Autoimmune hemolytic anemia

Answer: E

4. The LED- associated immunological anomalies are the following, except for:
A. Native anti-AND antibody
B. Anti-Ro antibody
C. Anti-Sm antibody
D. Anticardiolipin antibodies
E. Lupus anticoagulant

Answer: B

5. The cutaneous affectation in lupus is characterized by the following:
A. It is monomorphic
B. Associates vasculitis of large vessels
C. Only acute lupus is distinguished
D. The frequency is 60-75%
E. Complement deposits are present only in the skin with lesions

Answer: D
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6.The arthralgias and arthrites in LED are characterized by:
A. The frequency is 10-30%
B. Affect large joints
C. They are chronic forms in general
D. Frequently affect the hip or the shoulder
E. Frequently affect small and medium joints

Answer: E

7. The nervous system affectation in LED is characterized by the following statements, except
for:
A. Migrenous cephalalgia
B. Epilepsy
C. Chorea
D. Myelitis
E. Polyneuritis multiplex

Answer: E

8.The following statements characterize the antiphospholipid antibodies:
A. Lupus anticoagulant
B. Anti-beta-2-glycoprotein 1
C. Anticardiolipins
D. All statements are true
E. None of the statements is true

Answer: D

9. Which of the following statements define an obstetrical event in LED?
A. At least a premature delivery before 36 weeks of pregnancy
B. <3 consecutive miscarriages
C. At least one fetal death before 10 weeks of pregnancy with normal fetus at autopsy
D. Several episodes of deep venous thrombosis
E. New-born morphologically abnormal in relation with a preeclampsia

Answer: C

10.The initial balance in lupus follows the following criteria:
A. Electrophoresis of urinary proteins
B. Reactive C Protein
C. Abdominal echography
D. Chest computer tomography
E. Coomb globular test

Answer: E

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11. Which of the following statements characterizes the LED?
A. It is favored by the administration of progesterone contraceptives
B. It is favored by the consumption of low- estrogen contraceptives
C. It is favored by traumas
D. It is favored by the consumption of high-estrogen contraceptives
E. It is favored by drugs (Ca blockers)

Answer: D

12.Lupus nephropathy is characterized by the following histological abnormalities:
A. Class 6 diffuse fibrosis
B. Class 3 - mesangial injury
C. Class 2 minimal glomerular lesions
D. Class 4 extramembraneous glomerulonephritis
E. Class 5 - focal proliferative lesions

Answer: A

Multiple Complement:

Which of the following statements about skin affectation in LED are true?
A. Any skin lesion should be biopsied
B. Acute and subacute lupus are limited to exclusive skin damage
C. The biopsy shows histological changes only in the healthy tissue
D. The IF examination shows Ig G and IgM deposits
E. The vasculitis in this pathology affects medium vessels

Answer: A, D

2. Hematological affection in LED is characterized by:
A. The cervical polyadenopathy is rare
B. Splenomegaly
C. The leukopenia appears in activity flare-up
D. Thrombocytopenic purpura
E. Autoimmune hemolytic anemia

Answer: B, C, D, E

3. Which of the following statements are part of the ARA haemolitical criteria for LED
diagnosis?
A. Autoimmune hemolytic anemia
B. Thrombopenia <100G / L
C. Lymphopenia <1.5g / L twice constant
D. Abnormal AAN title
E. Leukocytosis> l00g / L

Answer: A, B, C

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4. Which of the following statements are true regarding the LED immunology?
A.AAN are present in 95% of LED
B.AAN are LED specific
C. Anti- DNA are LED specific
D. Anti-ECT present in different collagenoses
E. The antihistones are associated with drug induced lupus

Answer: A, C, D, E

5.The LED balance includes:
A. Chest radiography
B. Cutaneous biopsies only from the affected tissue
C. Brain MRI examination
D. Joint puncture
E. Systematic EKG regardless of symptoms

Answer: A, C, D

6. Which of the following represent immunological ARA criteria?
A. Dissociated syphilis serology
B. Native anti- DNA antibodies
C.Anti-SM antibodies
D. Antithrombin III

Answer: A, B, C, E

7. Which of the following are predictors of LED flare-ups?
A.C5
B.AAN
C.C3-C4-CH-50
D. Anti-DNA
E. Anti-ECT

Answer: C, D

8. The differential diagnosis of lupus is made with scleroderma, taking into account the
following:
A. Severe Raynaud
B.Anti-scl70
C. Arthrites
D. Sjogren
E. Centromer type anti- ECT

Answer: A, B, E

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9. The monitoring of the patient with lupus must take into account the following criteria:
A. Annual ophthalmologic examination under hydroxychloroquine
B.AAN dosage
C. The anti- DNA antibodies are normalized
D. Increase of C3 fractions
E.N ormalization of C4 and CH 50 fractions

Answer: A, C, E

10.The ACR criteria used in the LED diagnosis are represented by:
A. The normal AAN title
B. Erosive arthrities
C.P hotosensitiveness
D. Convulsions
E. Esophageal mucous ulcerations

Answer: C, D

11. Which of the following may represent cutaneous affectation in LED?
A. Alopecia
B. Complement deposits at the dermo-epidermal junction level
C. Present in 60-70% of cases
D. Photosensitiveness
E. Lesions at the level of the healthy skin also

Answer: A, B, D, E

12.Which of the following statements are true about renal affectation in LED:
A. The lesions of classes 2, 3, 4 require immunosuppressive treatment
B.PBR acts as diagnosis in lupus
C. The lesions of classes 4 and 5 justify the immunosuppressive treatment
D. The classical affectation is the pure nephrotic syndrome
E. Ig A deposits in IF

Answer: B, C

13. The affectation of the nervous system in lupus is characterized by:
A. Unsual cephalalgia
B. Brain thrombophlebitis
C. It does not associate epilepsy
D. Polyneurites multiplex
E. Can mimic multiple sclerosis

Answer: A, B, E

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14. During the lupus flare-up, the following immunological parameters may be affected:
A.C3 fractions decrease
B. False positive VDRL serology
C. Anticardiolipins Ig A
D. Possible hereditary deficiency of C4
E. Hypogammaglobulinemia

Answer: A, B, D

15.T he antiphospholipid syndrome can be characterized by:
A. Aortic insufficiency
B. Libman-Sacks endocarditis
C. Cutaneous livedo
D. Central thrombopenia
E. False positive VDRL serology

Answer: B, C, E

16. The pulmonary affectation in LED is characterized by
A. Pulmonary embolism
B. Frequent fibrosis interstitial affectation
C. HTNP
D. Trasudative pleural effusion
E. Exudative pleural effusion

Answer: A, C, E

17. The differential diagnosis of lupus is made by:
A. Wegener Granulomatosis
B. Horton disease
C. Sclerodermia
D. Nodous polyarthritis

Answer: A, C, E

18. The initial balance in lupus includes:
A.AAN
B. Anti-DNA
C. Full blood count
D. Transaminases
E. Proteinuria

Answer: A, B, C

276

ENDOCRINOLOGY-DIABETES- METABOLIC DISEASES

GOITER AND THYROID NODULE. HYPERTHYROIDISM

Simple complement:

1. The wooden consistency to palpation of the thyroid is suggestive for:
A. Endemic goiter
B. Thyroid cancer
C. Multiheteronodular goiter
D. De Quervain thyroiditis
E. Basedow disease

Answer: B

2. The goiter inflammation is called:
A. Struma ovarii
B. Thyroiditis
C. Acute Strumitis
D. Disthyroiditis
E. Schmidt syndrome

Answer: C

3. The freining treatment of the tireotrop axis with levothyroxine:
A. Is the more effective as the goiter is bigger
B. It is a curative treatment for goiter
C. Aims at maintaining the TSH within normal limits
D. Aims at maintaining the TSH at the lower limit of normal values
E. It can be elected for thyroid nodules

Answer: D

4. The key examination in the diagnosis management of echographic suspected thyroid nodules
is:
A. Aspirative puncture with fine needle
B. Thyroid scintigram
C. Dosing of TSH antireceptor antibodies
D. Thyroid radio-iodine-capture
E. FT3 and FT4 dosage

Answer: A

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5.The selective treatment for thyroid nodules is:
A. Alcoholism
B. Radioactive iodine treatment
C. Surgical
D. Suppressive treatment with levothyroxine
E. Clinical and echographic monitoring

Answer: C

6. Which of the following clinical features rises suspicion for malignancy of thyroid nodules?
A. Nodule's soft consistency
B. Dimensions <3 cm
C. Rapid growth in size
D. Mobile nodule over the supra or under-adjacent plans
E. Regular margins to palpation

Answer: C

7. Which of the following examinations confirms the diagnosis of Basedow disease?
A. Decreased TSH + increased FT4
B. Positive anti-thyroid-peroxidase antibodies
C. Positive anti-thyroid-globulin antibodies
D. Increased CRP
E. Positive TSH antireceptor antibodies

Answer: C

8. The initial treatment in most hyperthyroidisms is:
A. Radioactive iodine administration
B. Surgical
C. ATS administration
D. Corticosteroids administration
E. Lugol solution administration

Answer: C

9. The monitoring of the tolerance to ATS treatment of a patient with Graves Basedow disease is
made by:
A. Blood test and TSH
B. Blood test and VSH
C.TSH and FT4
D. Blood test and hepatic balance
E.TSH, FT4 and TSH anti- receptors antibodies

Answer: D

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10.The certainty hormonal diagnosis of hypothyroidism is made in the following cases:
A. Increased TSH + low FT4
B. Low TSH + increased FT4
C. Low TSH + normal FT4
D. Increased FT4 + normal FT4
E. Increased TSH + Positive antiTPO antibodies

Answer: A

11.The diagnosis of tireotrope hypophysis insufficiency is stated in the following cases:
A. Increased TSH + low FT4
B. Low TSH + Positive anti-thyroid-globulin antibodies
C. Increased TSH + low FT4
D. Low TSH low + normal FT4
E. Low TSH + low FT4

Answer: E

12.The levothyroxine substitution treatment:
A. Is taken after meals
B. Is monitored by TSH and FT4 dosage
C. The entire dose is administered from the beginning
D. Is administrated in progressively increased doses
E.TSH must be maintained at the lower limit of normal values

Answer: D


1. In which of the following conditions there appears discomfort or pain to the palpation of the
thyroid:
A. Graves Basedow disease
B. Autoimmune chronic thyroiditis
C. Sub-acute and acute thyroidites
D. Ploynodular goiter
E. Hematocele

Answer: C, E

2. The endemic cretinism is characterized by:
A. Reversible mental retard
B. Spastic diplegia
C. Neurological disorders with loss of peripheral sensitivity
D. Mixedem
E. Stature retard

Answer: B, D, E

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3.We can say it is goiter if the echographically measured thyroid volume is:
A.> 15 ml in women
B.> 18 ml in women
C.> 20 ml in men
D.> 18 ml in men
E> 16 ml in adolescents

Answer: B, C, E

4.The complications of the thyroidectomy are:
A. Temporary hypercalcemia
B. Reccurential paralysis
C. Hypertrophic or keloid scar
D. Acute thyrotoxic seizure
E. Hypothyroidism

Answer: B, C, D, E

5. The clinical and echographic features, suggestive for malignant thyroid nodules are:
A. Rapid increase of the nodule's size
B. Dimensions> 3 cm
C. Sub- mandibular adenoapthies
D. Hyperechogenity on the echography
E. Hypervascularization on Doppler echography

Answer: A, B, E

6.In case of a thyroid nodule, which of the following anamnestic arguments pleads for a
malignant cause?
A. The administration of iodine during childhood
B. Family history with thyroidian medular carcinoma
C. Age between 20 and 60 years
D. Male sex
E. Family history with tyroidian autoimmune diseases

Answer: B, D

7.The treatment with radioactive iodine:
A. Represents the selective treatment for thyroid nodules
B. It is not indicated as a first choice in malignant thyroid nodules
C. It is totally contraindicated in cases of Basedow ophthalmopathy
D. It is contraindicated in case of pregnancy
E. It is made when surgery is contraindicated

Answer: B, D, E

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8.The clinical signs of hyperthyroidism are:
A. Sweating
B. Trembling
C. Photo-phobia
D. Depression
E. Tool's sign

Answer: A, B, E

9.The certitude hormonal diagnosis of hyperthyroidism involves making the dosage of:
A.TSH
B. Liver transaminases
C.FT4
D.TSH antireceptor antibodies
E.CRP

Answer: A, C

10.Contraindications in iodine scintigraphy are:
A. Allergy to iodine
B. Pregnancy
C. The malignant thyroid nodule
D. Heart insufficiency
E. Basedow disease

Answer: A, B

11. The diagnosis of De Quervain thyroiditis includes:
A. Low TSH
B. Increased TSH
C. Increased CRP
D. Low CRP
E. Increased FT4

Answer: A, C, E

12.The absence of iodine uptake in scintigraphy (white scintigraphy) occurs in the following
cases:
A. De Quervain thyroiditis
B. Chronic autoimmune thyroiditis
C. Hyperthyroidism by administration of thyroid hormones
D. Postpartum Hyperthyroidism
E. Hyperthyroidism to type II amiodarone

Answer: A, C, D, E

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13. De Quervain Hyperthyroidism can be treated with:
A. NSAID
B.ATS
C. Radioactive iodine
D. Surgery
E. Corticoids

Answer: A, E

14. The therapeutic options for hyperthyroidism are:
A. Synthesis Anti-thyroidians
B. Radioactive iodine
C. NSAID
D. Prednison
E. Surgery

Answer: A, B, E

15. In the type I amiodarone induced hyperthyroidism:
A. The thyroid Doppler echography is normal
B. The treatment is based on the administration of ATS
C. The treatment is with corticosteroids
D. There is a preexisting thyroid pathology
E. The treatment is with NSAID

Answer: B, D

16.Which of the following clinical signs are suggestive for hypothyroidism:
A. Asthenia
B. Feebleness
C. Bradycardia
D. Constipation
E. Dysmenorrhea

Answer: A, B, C, D

17.The association of two of the following conditions represents Schmidt syndrome:
A. Hashimoto thyroiditis
B. Graves- Basedow disease
C. Pituitary insufficiency
D. Autoimmune suprarenal insufficiency
E. Biermer anemia

Answer: A, D

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18.Normal FT4 associated with low TSH can mean:
A. Basedow disease
B.T3 Hyperthyroidism
C. Malignant thyroid nodule
D. Autoimmune chronic thyroiditis with hashitoxicosis
E. Rude hyperthyroidism

Answer: B, E

283

TYPE 1 AND 2 DIABETES IN THE ADULT DIAGNOSIS

Simple complement:

1.Which of the following statements are true?
A. MODY diabetes is a form of type 2 diabetes
B. Type 2 diabetes can have a hereditary component
C. Type 2 diabetes involves autoimmune destruction
D. Patients with type 2 diabetes are frequently normal or subponderal
E. Patients with type 2 diabetes are generally young

Answer: B

2.About type 2 diabetes the following statements are true, except for:
A. It is insulinodependent
B. The most frequent occurs in young people under 35
C. Involves autoimmune destruction in 95% of cases
D. Represents 25% of cases of diabetes;
E. The symptomatology starts quickly

Answer: D

3.In type 1 diabetes the evolution:
A. Involves micro-angiopathic complications, regardless of treatment
B.75% of cases go into remission
C. The post- remission recurrence is not mandatory
D. The negative C peptid involves a difficult glycemic equilibrum
E. The remission phase involves the increase of insulin necessary

Answer: D

4. The following can be associated to type 2 diabetes, except for:
A. Dyslipemia
B. Absolute insulin deficiency
C. HTN
D. Obesity
E. Liver steatosis

Answer: B;

5. The diagnosis of exclusion of type 2 diabetes is made by:
A. Corticosteroid-induced diabetes
B. Haemochromatosis
C. MODY type diabetes
D. Pancreatic neoplasm
E. All the above

Answer: E

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1.The balance in type 2 diabetes includes:
A.FSH
B. Iron and transferrin
C. Glycemia
D.T ransaminases
E.HIV serology

Answer: B, C, D

2. LADA type diabetes includes:
A. Delayed and progressive debute
B. The absence of anti- GAD antibodies
C. Insulinodependence after 5-10 years
D. Quick installation of ketoacidosis
E. Fasting glycemia over 126mg/dl on two separate occasions

Answer: A, C, E

3. The following can be said about MODY type diabetes:
A. It is a type of diabetes that involves a genetic mutation
B. Occurs after the age of 20
C. In MODY 3 diabetes appears the mutation of HNF1
D. There is an important family heredity
E. It is a form of type 2 diabetes

Answer: A, C, D

4.The following appear in the debut of type 1 diabetes:
A. Increase in weight
B. Ployuro- polydipsic syndrome
C. Abdominal pain
D. Cetosis
E. Visual disorders

Answer: B, C, D, E

5. The following statements are false:
A. MODY 3 is transmitted auzomal dominant
B. Type 2 diabetes is pancreatic diabetes
C. The cetoacidosis may be enhanced by acute infections
D. Auto-antibodies appear in type 1 diabetes
E.LADA type diabetes is a form of type 2 diabetes

Answer: B, E

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6. Patients with diabetes:
A. Present a relative or absolute defficiency of insulin
B. They have the fasting glycemia above 106mg/dl in two different determinations
C. 95% have inaugural ketoacidosis
D. May associate hypertension, dyslipidemia, obesity
E. Are older than 35 years
Answer: A, D

286

UROLOGY

BLADDER INFECTIONS IN ADULTS. LEUCOCYTURIA

Simple complement:

1. Referring to urinary infections in adults, the following are true, except for:
A. Affects mostly women
B. In men infections are rare and mostly <50 years
C. In women there are 2 peaks of incidence
D. They appear rarely by hematogenous infection
E. In men they are rare and mostly> 50 years

Answer: B

2.Criteria of complicated acute cystitis are the following, except for:
A. Uropathy
B. Pregnancy
C. Immunodepression
D. Women between 15 and 65 years old
E. Diabetes

Answer: D

3. The following do not represent complications of the acute prostatitis:
A. Acute urine retention
B. Abscess formation
C. Septic shock
D. Prostatodinia
E. Evolution to a chronic form

Answer: D

4. Referring to the chronic prostatitis, we can affirm that the following are true, except for:
A. Represents a chronic infection of the prostate gland, because of the absence or insufficient
treatment of an acute prostatitis
B. Functional urinary signs are present: dysuria, mictional burns, painful ejaculation
C. ECBU is in most of the cases negative
D. Control ECBU is performed 3 months after stopping the treatment
E. Prostatidinias can be very disabling

Answer: D

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5. There are no risk factors for nosocomial urinary tract infections:
A. Bladder probing
B. Age over 50
C. Constipation
D. Female sex
E. Diabetes

Answer: C

6.In case of leukocyturia, unalatered white blood cells appear in:
A. Immunodepression;
B. Bladder tumor
C. Chronic tubulointerstitial nephropathy
D. Vaginal infection
E. Bladder lithiasis

Answer: C


1.There are no favoring factors of urinary tract infections in adults, except for:
A. Pregnancy
B. Diabetes
C. Bilharziasis
D. Antibiotics
E. Intrauterine contraceptive devices

Answer: A, B, C
2.The cytobacteriological examination of urine (CBEU) includes the following:
A. It is made before any antibiotherapy
B. It is performed under 4 hours from the last miction
C. The urine from the beginning of the jet is collected;
D. Involves direct examination, culture and antibiogram
E. Involves immunohistochemical analysis

Answer: A, D

3. From a clinical point of view, we have the following signs in acute cystitis:
A. Urinary functional signs: mictional burns, imperiosity, pollakiuria
B. Unclear odorless urine
C. Sometimes, macroscopic hematuria
D. Fever
E. Pain in the right iliac fossa, imitating appendiceal pathology

Answer: A, C

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4. We speak about simple recurrent acute cystitis when the following are met:
A. <4 episodes per year
B. Systematic ECBU
C. In a patient with diabetes
D. Long treatment with antibiotic adapted to antibiogram
E. History of urinary lithiasis

Answer: B, D

5.There are no risk factors in the acute pyelonephritis, except for:
A. Female sex
B. Sexual relations with postcoital miction
C. Oral contraceptives
D. Bladder- ureteral reflux
E. Miscarriage

Answer: A, D

6. The treatment of a simple acute pyelonephritis is ambulatory, except for:
A. Pregnancy
B. Age between 15-65
C. Vomitting
D. Good clinical tolerance
E. Diabetes

Answer: A, C

7.The treatment of an acute obstructive pyelonephritis involves:
A. Hospitalization
B. Urine draining in emergency by installation of an ureteral probe or carrying out a percutaneous
nephrostomy
C. Obstruction treatment in emergency
D. Double antibiotherapy, parenteral, with a total duration of 10 days
E. Ambulatory treatment

Answer: A, B

8.Referring to the acute prostatitis, the following are true:
A .There are functional urinary signs: dysuria, polakiuria, mictional burns, perineal pain
B. Fever absence
C. ECBU performed, blood cultures, inflammatory balance
D. It is not recommended to perform a pelvic ultrasound postmictional
E. It appears exclusively in the elderly

Answer: A, C

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9. The following modifications of the urinary tract appear during pregnancy, except for:
A. Left ureter compression
B. Urinary tracts peristalsis inhibation
C. Urine acidification
D. Pathological glycosuria
E. The increase of the microbial vulvo-perineal load

Answer: A, C, D

10. The urinary infections occurring during pregnancy have the following care features:
A. Systematic ECBU in case of fever or isolated urinary symptoms
B. The asymptomatic bacteriurias require no treatment
C. After an episode of urinary infection, making a systematic ECBU every 2 months until birth
D. Riphampicine, sulphonamides, quinolones and tetracyclines are contraindicated during
pregnancy
E. Any pyelonephritis should be hospitalized and should receive renal echography

Answer: A, D, E

11. Referring to nosocomial urinary infections, the following are true:
A. For the infections in the Operatory Block, a 30 days delay is stored
B. It is the most common nosocomial infection
C. The germs are in most cases multi-resistant
D. If the surveyed patient has positive ECBU 24 hours after removal of the probe, he/ she should
be treated
E. Diarrhea and diabetes are considered risk factors

Answer: A, B, C, D, E

290

URINARY LITHIASIS

Simple complement:

1. Referring to the urinary lithiasis, the following are true except for:
A. It appears in 5-10% of the general population
B. Sex ratio: 3 men to 1 woman
C. Incidence peak: between 20 and 60 years
D. Frequent recurrences
E. Affects mostly white people

Answer: E

2. In the urinary lithiasis, the clinical diagnosis is on the following, except for:
A. Renal colic
B. Acute renal insufficiency
C. Hematuria
D. Anuria
E. Iradiation to homolateral external genital organs

Answer: B

3. Referring to the treatment of complicated renal colic, the following are not true:
A. Stopping of oral nutrition
B. Ambulatory supervision, then return home with self-monitoring on pain, diuresis, and fever
C. In case of fever, parenteral antibiotherapy
D. Antialgics, antispasmodics
E. Treatment of a possible hyperkalaemia

Answer: B


1.Calcic lithiasis:
A. Has a frequency of 85%
B. The calculus is radiopaque
C. The calculus composition may be represented by calcium oxalate or calcium phosphate
D. Favoring factors: hypercalcemia, hyperuricemia, hyperoxaluria
E. It is the most common

Answer: B, C, E

2. The phospho-amoniaco-magnesium lithiasis:
A. Has a frequency of 15%
B. Calculus are radiopaque
C. Fast increase, often bulky (coraliform);
D. Favoring factors: urinary acid pH (<6), urinary tract infections with urease producing bacteria
E. Presents high risk of pyelonephritis

Answer: A, C
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3. Referring to renal colic, the following are true except for:
A. Acute lumbar pain
B. Irradiation to the genital organs
C. The existence of the antalgic position
D. The absence of functional digestive signs
E. Risk of chronic renal insufficiency

Answer: C, D

4. The following are useful in examining urinary lithiasis:
A. Simple abdominal radiography;
B. Renal echography
C. Intravenous urography
D. Retrograde uretrography
E. Abdominal-pelvic CT without injection (native)

Answer: A, B, C, E

5.In terms of examination of the urinary lithiasis, the following are not true except for:
A. The simple abdominal radiography allows the identification of radiopaque calculus
B. The renal echography indicates the topography of a pelvic calculus migrated
C. The intravenous urography indicates the topography of the calculus
D. Abdominal -pelvic CT without injection does not reveal the transparent millimetric calculus
E. The Uro- CT offers the advantages of abdominal-pelvic CT and UIV

Answer: A, C, E

6.The treatment of the simple renal colic includes:
A.i.v. then orally NSAID
B.i.v. Then orally antialgics
C. Stopping of oral nutrition
D. Urine filtration
E. Hydric restriction during painful periods

Answer: A, B, D, E

7.The following represent indications for ablation of renal calculus
A.> 10 mm
B. Bilateral calculus
C. Calculus on unique kidney
D. Resistant pain to well performed medical treatment
E. Unique calculus

Answer: B, C, D

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8.Referring to the hygienic-dietary rules aimed at preventing recurrent urinary lithiasis, we can
say that:
A. Calcic lithiasis: diuresis diet, fighting against postmictional residue
B. Phospho- amoniaco- magnesium lithiasis: diuresis diet, urinary disinfection
C. Uric lithiasis: diuresis diet, hypourecemiant treatment
D. Cystine lithiasis: diuresis diet, urine alkalinization
E. They are contraindicated in case of diabetes

Answer: B, C, D
9.In case of a nephretic colic, the differential diagnosis is made with:
A. Extrinsic compression: lymphadenopathy, retroperitoneal fibrosis
B. Endoluminal obstacle
C. Acute colecystitis
D. Perforated ulcer
E. Acute appendicitis

Answer: A, B, C

10.Referring to the evolution of the renal lithiasis, the following statements are false:
A. Spontaneous elimination of the calculus
B. Rare recurrence
C. The complications are presented by: acute renal insufficiency, rupture of the excretory
pathway, urinom
D. It does not determine sequelae
E. Predisposition to urinary infections

Answer: B, D

293

NEPHROLOGY

ACUTE RENAL INSUFFICIENCY. ANURIA

Simple complement

1. The acute renal insufficiency involves:
A. Sudden and important decrease of the glomerular filtration
B. Usual calculation of the glomerular filtration ratio (GFR)
C. It is always accompanied by oligoanuria
D. It is not associated with preserved diuresis
E. It is irreversible

Answer: A

2.The clinical severity criteria in acute renal insufficiency:
A. Dangerous hyperkaliemia (EKG manifestations)
B. Uremic encephalopathy
C. Urea> 40 micromoles / 1
D. Metabolic acidosis

Answer: B

3.The following are biological criteria requiring emergency extrarenal purging for IRA:
A. Acute pulmonary edema resistant to medication
B. Hypertensive encephalopathy
C. Uremic encephalopathy
D. Severe metabolic acidosis

Answer: D

4. The abdominal echography is useful in the diagnosis of:
A. Functional IRA
B. Organic IRA
C. Obstructive IRA
D. Acute tubular necrosis
E. Pulmonary fibrosis

Answer: C

5.The anamnesis suggests obstructive IRA by the following, except for:
A. Old patients
B. Lithiasis history
C. Urinary functional signs
D. Exposure to toxic substances
E. Prostatic cancer

Answer: D
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6.The following elements suggest obstructive IRA, except for:
A. Lombar pains
B. HTN
C. Night pollakiuria
D. Microscopic hematuria
E. Prostatic hypertrohpy on rectal touch

Answer: B

7.The examination in obstructive IRA indicates the following, except for:
A. Sometimes poliria
B. Bladder globe
C. Purpura
D: Prostatic hypertrohpy on rectal touch
E. Night pollakiuria

Answer: C

8. The following are causes of urinary tract obstruction, except for:
A. Diuretics
B. Urinary lithiasis
C. Retroperitoneal fibrosis
D. Prostate adenoma
E. Abdominal-pelvic mass

Answer: A

9.The treatment in obstructive IRA refers to:
A. Bladder probe for a suprabladder obstacle
B. Nephrostomy for a sub-bladder obstacle
C. Suprapubic catheter for a sub-bladder obstacle
D. Diuretic treatment
E. Hydric pause

Answer: C

10.The treatment in obstructive IRA includes the following, except for:
A. Urinary drainage in emergency
B. Clamping in chronic bladder globe
C. Diuresis compensation
D. Administration of diuretics
E. Prevention of vacuo hemoragy

Answer: D

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1.The renal biopsy puncture (RBP) is indicated in:
A. Acute tubular necrosis
B. It is mandatory in acute interstitial nephropathy
C. Almost always glomerular syndrome
D. Useless in postrenal acute renal sufficiency
E. It is practiced in cases of diagnostic uncertainty

Answer: C, D, E

2.The glomerulonephritis rapidly progressive (GNRP):
A. It is characterized by crescents
B. It is a nephrological emergency
C. It is a urological emergency
D. May have post- infectious causes
E. It is classified according to the presence of deposits

Answer: A, B, D, E

3. Pauci immune vasculitis associated with GNRP:
A. Wegener
B. Sarcoidosis
C. Microscopic polyangiitis
D. Churg Strauss
E. Goodpasture syndrome

Answer: A, C, D

4. The Goodpasture syndrome is characterized by:
A. The presence of antiMGB antibodies
B. Linear deposits of IgG on glomerular basic membranes
C. Granular deposits
D. Absence of deposits
E. Pulmonary-renal syndrome

Answer: A, B, E

5. The following are causes of GNRP with granular deposits:
A. Disseminated acute erythematous lupus
B. Wegener granulomatosis
C. Nephropathy with IgA
D. Cryoglobulinemia
E. Rheumatoid purpura

Answer: A, C, D, E

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6. The GNRP is characterized by:
A. The existence of an extracapilar proliferation
B. May have post- infectious causes
C. It is classified according to the presence of deposits
D. The ANCA vasculites have granular deposits
E. Affects large vessels

Answer: A, B, C

7. The nephritic syndrome is characterized by:
A. It is typical to post- infectious glomerulonephritis
B. The reduction of the serum complement
D. There is a free period of 1-6 weeks between the onset of infection and the renal signs
D. The increase of the serum complement
E.A secondary cause may be the sarcoidosis

Answer: A, B, C

8. The acute renal insufficiency represents:
A. Sudden and significant reduction of glomerular filtration
B. It is associated with increased creatinine
C. Slow progressive reduction of the glomerular filtration
D. The GFR calculation by usual methods cannot be used
E. The diuresis is maintained

Answer: A, B, D, E

9.The renal insufficiency may be accompanied by:
A. Oligoanuria
B. Maintained diuresis
C. Diuresis <500 ml/24h
D. Echographically small kidneys
E. Diuresis cannot be preserved

Answer: A, B, C

10.The clinical severity criteria in the acute renal insufficiency refer to:
A. Uremic encephalopathy
B. Liver encephalopathy
C.EPA resistant to medication
D.K> 6.5 micromoles / 1
E. Severe metabolic acidosis

Answer: A, C

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11. The severity biological criteria in the acute renal insufficiency:
A.BLBT> 4 mg / dl
B.K> 6.5 micromoles / l
C. Severe metabolic acidosis
D. Urea> 40 micromoles / 1

Answer: B, C, D

12.The extrarenal criteria of emergency purging for acute renal insufficiency are:
A. Dangerous hyperkaliemia (K> 6.5 mmol / 1)
B. Uremic encephalopathy
E. Acute pulmonary edema

Answer: A, B, C, E

13.The following suggest an obstructive cause of renal insufficiency:
A. Pyelocaliceal dilatation on renal echography
B. Bladder globe
C. Exposure to toxic substances
D. Renal functional signs
E. Palpable tumoral mass

Answer: A, B, D, E

14.The clinical examination in the obstructive acute renal insufficiency indicates:
A. Variable diuresis
B. Bladder globe
C. Leg edemas
D. Pelvic mass
E. Prostatic hypertrophy

Answer: A, B, D, E

15.The following are causes of acute obstructive renal insufficiency:
A. Retroperitoneal fibrosis
B. NSAID administration
C. Urinary lithiasis
D. Abodmino-pelvic mass
E. Diabetes

Answer: A, C, D

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16.The treatment of obstructive acute renal insufficiency involves:
A. Bladder probe or suprapubic catheter installation for a sub-bladder obstacle
B. Ureterostomy for a suprabladder obstacle
C. Nephrostomy for a suprabladder obstacle
D. Diuretic treatment
E. Hydric restriction

Answer: A, B, C

17.The treatment of obstructive acute renal insufficiency must take into account the prevention
of:
A. Vacuo bladder hemorrhage
B. Obstacle removal syndrome after disobliteration
C. Acute tubular necrosis
D. Renal artery thrombosis
E. Diuresis compensation

Answer: A, B, E

18. The treatment of obstructive acute renal insufficiency involves:
A. Emergency surgical intervention in case of fever
B. Clamping in case of chronic bladder globe
C. Diuresis compensation to prevent the obstacle removal syndrome
D. Anticoagulant administration
E. Administration of hypocalcemics

Answer: A, B, C

19.The drugs involved in the etiology of acute renal functional insufficiency:
A. Rifampicin
B. IEC
C. -lactamines
D. NSAID
E. Cisplatin

Answer: B, D

20. The following are causes of relative hypovolemia and acute renal functional insufficiency:
A. Cirrhosis
B. Nephrotic syndrome
C. Burns
D. Heart insufficiency
E. Digestive fistula

Answer: A, B, D

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21. The following are causes of real hypovolemia and acute renal functional insufficiency:
A. Digestive fistula
B. Diuretics
C. Adrenal insufficiency
D. Cirrhosis
E. Heart insufficiency

Answer: A, B, C

22. The treatment of functional acute renal insufficiency involves:
A. Emergency surgical intervention in case of fever
B. Etiologic treatment
C. Prevention of vacuo bladder hemorrhage
D. The delayed in treatment can lead to acute tubular necrosis
E. The restoration of the hemodynamics in case of shock

Answer: B, D

23. The organic acute renal insufficiency refers to the affectation of:
A. Tubes
B. Glomerulars
C. Interstice
D. It is reversible in most cases
E. Vessels

Answer: A, B, C, E

24. The diagnosis of organic acute renal insufficiency involves:
A. Modified renal echography
B. Normal renal echography
C. Clinical signs related to causal pathology
D. Diluted urine and preserved natriuresis
E. Secondary hyperaldosteronism

Answer: B, C, D, E

25. The acute tubular necrosis is associated with:
A. Hematuria or albuminuria
B. Without HTN, hematuria or albuminuria
C. It is a rare cause of acute renal organic insufficiency
D. It is a common cause of acute renal organic insufficiency
E. Cutaneous rash

Answer: B, D

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26. Acute tubular necrosis (ATN) appears in the context:
A. Extended renal ischemia
B. Toxics intra-tubular obstruction and / or precipitation
C. Sub-bladder obstruction
D. Administration of toxics
E. Extended renal functional insufficiency

Answer: A, B, D, E

27.The following substances may be incriminated in the etiology of NTA:
A. Vancomicin
B. IEC
C. Cisplatin
D. Iodinated contrast substances
E. Phenytoin

Answer: A, C, D

28.NTA may be the result of:
A. Multiple myeloma
B. NSAID administration
C. Acute intravascular hemolysis
D. Shock and extended renal functional insufficiency
E .Administration of quinolones

Answer: A, C, D

29.The following drugs can cause NTA:
A. Metotrexat
B. Rifampicin
C. Aciclovir
D. NSAID
E. Phenytoin

Answer: A, C

30. NTA by intra- tubular precipitation of "toxics" refers to:
A. Muscle enzymes
B. Ureal acid and calcium phosphate
C. Small chain of immunoglobulins
D. Cisplatinp
E. Gamaglobulins

Answer: A, B, C

301

31. The acute interstitial nephropathy (AIN) represents:
A. A cause of acute renal organic insufficiency
B. It is most common by the immune mechanism
C. May appear under the administration of drugs
D. It is the most common cause of acute renal organic insufficiency
E. The diuresis is rarely preserved

Answer: A, B, C

32. The following are true regarding NTA:
A.PBR is mandatory
B. It is necessary to treat the underlying cause
C. Most often its evolution is favorable
D. The mechanism is immuno-allergic
E. It may produce GNRP

Answer: C, D

33. The IAN may present clinically:
A. Diuresis often preserved
B. Skin rash
C. Arthralgias
D. Low blood pressure
E. Fever

Answer: A, B, C, E
34. The drugs incriminated in the etiology of AIN:
A. Cisplatin
B. Allopurinol
C. Rifampicin
D. Quinolones
E. Sulphamides

Answer: B, C, D, E

35. The glomerular causes of acute renal insufficiency are:
A. Impure nephritic syndrome
B. Nephritic syndrome
C. Acute tubular necrosis
D. GNRP
E. AIN

Answer: A, C, D

302

CHRONIC RENAL INSUFFICIENCY

Simple complement:

1. Which of the following is a metabolic complication in chronic renal insufficiency:
A. Hyperkaliemia
B. Gout
D. Hypocalcemia
E. Impotence

Answer: B

2.Which of the following statements is a hydro-electrolytic complication of chronic renal
insufficiency?
A. Hypocalcemia
B. Hyperkalaemia
C. Hyperphosphatemia
D. Hypernatremia
E. Hypokalaemia

Answer: B

3. The kidney has a hormonal role. Which of the following hormones is synthesized by the
kidneys?
A. Somatotropic
B. TSH
C. ACTH
D. Erythropoietin (EPO)
E. ADH

Answer: D

4. The kidney has a role in:
A. EPO synthesis
B. Renin synthesis
C. Vitamin D alpha hydroxylation
D. All statements are true
E. All statements are false

Answer: D

5. Which of these statements is a clinical sign in uremia:
A. Arthralgias
B. Cramps
C. Cephalalgia
D. Anorexia
E. Pyrosis

Answer: B
303

6.Which is the election treatment in chronic renal insufficiency?
A. Hemodialysis
B. Peritoneal dialysis
C. Extrarenal purification
D. Treatment with EPO
E. Renal transplantation

Answer: E

7. The extrarenal purification is started at a GFR of:
A.15 ml / min
B.10 ml / min
C.5 ml / min
D.100 ml / min
E.30 ml / min

Answer: B

8. Which of the following represents a contraindication to peritoneal dialysis?
A. Tracheostomy
B. Acute respiratory insufficiency
C. Cachexy
D. Chronic inflammatory diseases
E. History of Meckel diverticulum

Answer: D

9.The nephro-protection is realized by the proteinuria control:
A. <0.5g/24h
B. <lg / 24h
C.> lg / 24h
D.> 3g / 24h
E <3 g / 24 h

Answer: A

10. Which of the following are clinical endpoints in chronic renal insufficiency?
A. Maintenance of hypocalcaemia
B. Maintenance of hypophosphataemia
C. Maintenance of anemia
D. Maintenance of normal serum calcium levels
E. Maintenance of hypokalemia

Answer: D

304

11. Which of the following statements are true:
A. Stg 1 - 60-90 ml / min
B. Stg 2> 90 ml / min
C. Stg 4 15 - 29 ml / min
D. Stg 5 30-59 ml / min
E. Stg 3 <15 ml / min

Answer: C

12. The therapeutic conduct in stage 3 is:
A. Stg 2 - substitution treatment is started
B. Stg 1 - etiologic diagnosis
C. Stg 3 - correction of progression factors
D. Stg 5 treating the effects of chronic renal insufficiency
E. Stg 4 VHB vaccination

Answer: E

13. Which of the following are absolute indications for the initiation of extra-renal purification
treatment (ERP):
A. Hypokalaemia
B. Hypernatremia
C. Severe respiratory acidosis

Answer: E

14. The blood pressure control is achieved by:
A. IEC
B. Spironolactone
C. Beta inhibitor
D. Calcium inhibitor
E. Nitrates

Answer: A

15.Which of the following are nephro-protective rules:
A. Input of salt> 6g/day
B. Input of salt > 100 mmol / day
C. Input of salt <6g/zi
D. Input of salt 2g/zi
E. Input of salt > 10 g / day

Answer: C

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16. EER in diabetic patients is initiated at a GFR of:
A.> 15ml/min
B. <15 ml / min
C.15 ml / min
D.> 10 ml / min
E. <10 ml / min

Answer: C

17. The registration on the transplantation list is made if:
A. GFR <l0 ml / h
B. Regardless of the age
C. Depending on comorbidities
D. Even if there are surgical contraindications
E. Before starting the EER

Answer: E

18.Which of the following are cardiovascular risk factors:
A. Hypokalaemia
B. Hyperphosphatemia
C. Hypocalcemia
D. Hypercalcemia
E. Hyperkalaemia

Answer: B

19. The hemodialysis requires:
A. Arterial catheter
B. Central venous catheter
C. Arterio-venous fistula
D. Femoral catheter
E. Epidural catheter

Answer: C

20. The peritoneal dialysis:
A. Can be performed on the entire life
B. It is not well tolerated hemodynamically
C. It is performed only in a specialized center
D. There are no contraindications
E. It allows sparing the venous capital

Answer: E

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21. The intake of calcium in chronic renal insufficiency is of:
A.> 1200mg/24h
B.2000 mg/24 h
C.1500 mg/24 h
D. <1200mg/24h
E.1000mg / 24h

Answer: D

22. The nephro-protection is achieved by:
A. Smoking
B. Limited diet of phosphates
D. Reduction of calcium absorption
E. Reduction of potassium absorption

Answer: B

23. In the chronic renal insufficiency, the clinical objectives are:
A. Anemia correction > 12g/dl
B. Avoiding of mixed acidosis
C. Bicarbonate concentration> 23 mmol / 1
D. Maintenance of K <4.5 mmol / 1
E. Loss of weight

Answer: C

24.The following statements are cardiovascular complications, except for:
A. Pericarditis
B. Hypertrophic cardiopathy
C. Accelerated arteriosclerosis
D. Dilatative cardiopathy
E. HTN

Answer: D

25. Which of the following statements is a immunohematological complication:
A. Anemia by iron deficiency
B. Megaloblastic anemia
C. Macrocytic aregenerative anemia
D. Anemia by EPO deficiency
E. Peripheral anemia

Answer: D

307

26. The peripheral neuropathy is a complication:
A. Hormonal
B. Metabolic
C. Neurological
D. Of the bone metabolism
E. Hydro-electrolytic

Answer: C

27.Which of the following represent immuno-hematological consequences?
A. Anemia by iron deficiency
B. Anemia by folate deficiency
C. Anemia by EPO deficiency
D. The decrease in hemorrhage time
E. Anemia by B12 deficiency

Answer: C

28. To what GFR is the chronic renal insufficiency an independent cardiovascular risk factor?
A.60-90
B <60
C.45-59
D <44
E.30-44

Answer: B

29. The uraemic thrombopathy has the following consequences:
A. Increases the INR
B. Increases the PT
C. Increases the hemorrhage time
D. Increases the TCA
E. Reduces the hemorrhage time

Answer: C

30.The following statements are clinical endpoints in IRC, except for:
A. Maintenance of calcemia within the normal limits
B. Provision of a satisfactory nutritional status
C. Maintenance of volemia within normal limits
D. Avoiding of metabolic acidosis
E. Treating of the cardiovascular risk factors

Answer: E

308

31. The decrease of fertility and amenorrhea are consequences of the following cause:
A. Immunologic
B. Neurologic
C. Hormonal
D. Metabolic
E. Lipidic

Answer: C

32. In IRC it is necessary to identify and correct the cardiovascular risk factors, but one of the
following is an independent risk factor:
A. Diabetes
B. Dyslipidemia
C. Obesity
D. Hyperphosphatemia
E. Chronic renal insufficiency

Answer: E

33. The maintenance of a bicarbonate concentration over 23 mmol / 1 is required for:
A. Correcting the metabolic acidosis
B. Avoiding the metabolic acidosis
C. Correcting the metabolic alkalosis
D. Maintaining the kaliemia
E. Avoiding the reduction of diuretics doses

Answer: B

34. The discrete renal insufficiency is characterized by a GFR of:
A.30-59 ml/min/1.73m
2

B.> 90 ml/min/1.73 m
2

C. <15 ml/min/1.73 m
2

D.60-90 ml/min/1.73 m
2

E.15-29 ml/min/1.73 m
2

Answer: D

35. The preterminal renal insufficiency is characterized by a GFR of:
A.60-90 ml/min/1.73 m
2

B.30-59 ml/min/1.73 m
2

C. <15 ml/min/1.73 m
2

D.15-29 ml/min/1.737 m
2

E. > 15 ml/min/1.73 m
2

Answer: C

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36. Among the contraindications for peritoneal dialysis the following are included, except for:
A. History of diverticular sigmoiditis
B. Unsanitary living conditions
C. Chronic respiratory insufficiency
D. Ulcero- hemorrhagic rectocolitis
E. Neoplasm

Answer: E

37. The absolute indications for the initiation of the substitution therapy in IRC are the following,
except for:
A. Uremic pericarditis
B. Hyperkaliemia resistant to medical treatment
C. Slight metabolic acidosis
D. Uremic syndrome

Answer: C


1. Which of the following represents hydroelectrolytic complications in chronic renal
insufficiency:
A. The increase of the uric acid
C. Hypocalcemia
D. Hyperkalaemia
E. Hyperkalaemia

Answer: B, E

2. Which of the following represent hormonal consequences:
A. Impotence
B. Normocytic anemia
C. Amenorrhea
D. Thrombopenia
E. Normochromic anemia

Answer: A, B, C, E

3. The accelerated atherosclerosis is a complication of the chronic renal insufficiency and is
favored by:
A. HTN
B. Hypernatremia
C. Accumulation of toxins
D. Dyslipidemia
E. Hyperphosphatemia

Answer: A, C, D, E

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4. The kidney has a hormonal role in:
A. EPO synthesis
B. Renin synthesis
C. Vitamins synthesis
D. Vitamin D activation
E. Beta- hydroxilation of vitamin D

Answer: A, B, D

5.Care the following are consequences in the phospho-calcium and bone metabolism:
A. Initial hypocalcemia
B. Late hypocalcemia
C. Hyperparatoroidism
E. Hypophosphatemia

Answer: B, C, D

6. Which of the following represent neurological consequences:
A. Central neuropathy
B. Peripheral neuropathy
C. Motive deficiency
D. Tonic- clonic seizures
E. Encephalopathy

Answer: B, E

7. The GFR corresponding to the stages of renal insufficiency are:
A. Stg 2: 60-90 ml / min
B. Stg 1: 100 ml / min
C. Stg 5: <15 ml / min
D. Stg 4: 10-30 ml / min
E. Stg 3: 30-59 ml / min

Answer: A, C, E

8.Which of the following clinical signs are part of uremia:
A. Cramps
B. Mialgias
C. Asthenia
D. Itching
E. Anorexia to carbohydrates

Answer: A, C, D

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9. In chronic renal insufficiency, the phosphate intake is achieved by:
A. Milk products
B. Vegetables
C. Eggs
D. Meat
E. Fish

Answer: A, D, E

10. The TA control in IRC is achieved by:
A. Spironolactone
B. Loop diuretics
C. Thiazide diuretics
D. Beta- inhibitors
E. IEC

Answer: B, C, E

11. The K control in IRC is achieved by:
A. KC1 restrictive diet
B. Correction of the metabolic alkalosis
C. Administration of ions exchange resins
D. Insulin
E. Glucose PEV

Answer: A, C

12. Which of the following statements are clinical endpoints in IRC?
C. Maintenance of Ca within normal limits
B. Volemia within normal limits
C. Avoiding metabolic alkalosis
D. Correction of anemia> 10g/dl
E. Maintenance of K <5 mmol /l

Answer: A, B, D

13. The nephro-protection has the following rules:
A. Input of proteins 1g / day
B. Input of salt <6 g / day
C. Proteinuria <0.5g/24h
D. BP <130/80 mmHg
E. Hypophosphatemia

Answer: B, C, D

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14. The substitution therapy is initiated:
A. Normal mode at 10 ml / min
B. GFR <20ml/min
C. GFR 15ml/min
D. GFR 15-29 ml / min
E. GFR <90 ml / min

Answer: A, C

15. The peritoneal dialysis has the following main contraindications:
A. Intestinal inflammatory diseases
B. Acute respiratory insufficiency
C. Disassimilation and hypoalbuminemia
D. Cachexy
E. Surgical and adherent interventions

Answer: B, C, E

16. The main contraindications of peritoneal dialysis are:
A. Obesity
B. Digestive stoma
C. Gastric ulcer
D. Acute respiratory insufficiency
E. Crohn disease

Answer: A, B, E

17. The regular supervision in IRC is done every:
A.1 consultation per month if GFR = l0ml / min
B. Every 2 months if GFR > 10 ml / min
C. Every 6 months if GFR > 30 ml / min
D. Every 3 months if GFR > 30 ml / min
E. Every year if GFR > 30 ml / min

Answer: A, D

18. The registration on the transplantation list is made:
A. If GFR <l0ml / h
B. In the absence of neoplasias
C. In the absence of infections
D. Depending on the age
E. Depending on comorbidities

Answer: B, C

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19. Absolute indications for EER on initiation are:
A. Uremic pericarditis
B. Hypovolemia
C. Severe metabolic acidosis
D. Anemia
E. Refractory hyperkalaemia

Answer: A, C, E

20.Which of the following are immunohematological consequences in IRC:
A. Anemia by B12 deficiency
B. Anemia by folate deficiency
C. Anemia by iron deficiency
D. Anemia by EPO deficiency
E. Increase of the hemorrhage time

Answer: D, E

21.The following are necessary for kidney transplantation:
A. ABO
B. ANA
C. Rh
D. HLA
E. ANCAp

Answer: A, C, D

22. The anti HLA Ac shall be dosed on certain time frames:
A.3 months
B.1 month
C. After transfusions
D. 2 months
E. Never

Answer: A,
23. In order to perform the transplantation it is necessary to explore the external iliac vessels and
the bladder using:
A. Aorto-iliac Doppler
B. Abdominal echography
C. Ascendant urethrocystography
D. Mictional urethrocystography
E. Simple abdominal radiography

Answer: A, C, D

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24. The peritoneal dialysis:
A. Is continuously ambulatory
B. Is performed in a specialized center
C. Is performed at home
D. Is automated
E. Is hemodynamically well tolerated

Answer: A, C, D, E

25. The true statements about hemodialysis are the following:
A. It is performed in a specialized center
B. Is performed at home
C. It involves the installation of a central venous catheter
D. Arterio-venous fistula
E. It involves the installation of an arterial catheter

Answer: A, B, D

26. The following represent nephro- protection rules:
A. Stop smoking
B. Diabetes equilibration
C. Proteinuria> lg / day
D. Proteinuria <0.5 g / day
E. Correction of dyslipidemia

Answer: A, B, D, E

27. Which of the following represent rare clinical signs in uremia:
A. Asthenia
B. Anorexia
C. Uremic pericarditis
D. Cramps
E. Peripheral neuropathy

Answer: C, E

28. Which of the following represent rare clinical signs in uremia:
A. Peripheral neuropathy
B. Anorexia
C. Uremia encephalopathy
D. Itching
E. Uremic pericarditis

Answer: A, C, E

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A. EER is initiated only in the presence of clinical signs
B. The transplantation is performed if GFR> 20 ml / min
C. The hypervolemia is easily controlled
D. Rh and ABO are mandatory
E. The dosing, every 3 months, of anti HLA Ac

Answer: D, E

30. The phospho-calcium balance control is achieved by:
A. Intake of calcium <1000mg/24h
B. Correction of vitamin D deficiency
C. Meat rich diet
D. Administration of phosphate chelators
E. Administration of hydroxylated derivatives 1 vitamin D

Answer: B, D, E

A. The thiazides are administrated with GFR <30ml
B. Loop diuretics GFR> 30ml
C. Proteinuria control with IEC
D. Proteinuria control with ARA
E. The Furosemid is administered with GFR <30ml

Answer: C, D, E

32. In stage 3 of IRC, the therapeutic conduct is characterized by:
A. Etiological diagnosis
B. IRC efficient treatment
C. Correction of the progression factors
D. Maintenance of the venous capital
E. Substitution treatment

Answer: B, C, D

33. In stage 2 of IRC, the therapeutic conduct is characterized by:
A. Search and correction of the progression factors
B. Treatment
C. Anti-VHB vaccination
D. Search and treatment of cardiovascular risk factors
E. Substitution treatment

Answer: A,

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34. The clinical objectives in IRC are the following:
A. Attention to nephrotoxic medication
B. Normal volemia
C. Loss of weight
D. Maintenance of K <5.5 mmol / 1
E. Avoiding metabolic alkalosis

Answer: A, B, D

35.Which of the following statements are markers of kidney damage?
A. Polyuria
B. Dysuria
C. Hematuria
D. Leukocyturia
E. Proteinuria

Answer: C, D, E

36. Which of the following represent metabolic consequences?
A. Hyperkalemia
B. Hyperuricemia
C. Mixed dyslipidemia
D. Metabolic acidosis
E. Hyperkalemia

Answer: B, C

37. The kidney has a role in regulating the volume expansion by?
A. Renin- angiotensin synthesis
B. Pressure natriuresis
C. Electrolytic regulation
D. EPO synthesis
E. Vitamin D activation

Answer: A, B

38. The cardiovascular consequences in IRC are:
A. HTN
B. Dilatative cardiopathy
C. Accelerated arteriosclerosis
D. Pericarditis
E. Hyponatremia

Answer: A, C, D

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39. Which of the following statements are cardiovascular consequences of IRC?
A. Hypertrophic cardiopathy
B. Hydrosodic retention
C. Hypotension
D. Pericarditis
E. Hypokalaemia

Answer: A, B, D

40. The chronic renal insufficiency represents:
A. Acute reduction of GFR
B. It is irreversible
C. GFR <90 ml / min
D. GFR <60 ml / min
E. It is reversible

Answer: B, D

41. Stage 3 of IRC was divided into two substages, what are they?
A.3a GFR 15-29 ml / min
B.3b GFR 30-44 ml / min
C.3a GFR 30-44 ml / min
D.3a GFR 30-44 ml / min
E.3b GFR 30-59 ml / min

Answer: B, D

42. The chronic renal insufficiency is characterized by:
A. Chronic decrease of GFR
B. GFR decrease for at least 3 months
C. Often reversible
D. GFR> 10ml/min
E. GFR <60ml/min

Answer: A, B, E

43.Which of the following statements are false on IRC?
A. stg 1 GFR > 90 ml / min
B. stg 3 GFR = 44-59 ml / min
C. stg 2 GFR = 60-90 ml / min
D. stg 4 GFR = 30-44 ml / min
E. stg 5 GFR <15 ml / min

Answer: B, D

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44. The following represent neurological consequences of IRC, except for:
A. Liver encephalopathy
B. Peripheral neuropathy
C. Uremic encephalopathy
D. Central neuropathy
E. Motive deficiency

Answer: A, D, E

45. The following represent clinical objectives in IRC, except for:
A. Correction of anemia> 11 g / dl
B. Avoiding mixed acidosis
C. Administration of bicarbonate 23 mmol / l
D. Maintenance of K at 5.5 mmol / 1
E. Maintenance of volemia within normal limits

Answer: A, B, C

46. The correction of anemia in IRC is achieved by:
A. Administration of B12
B. Administration of iron
C. Administration of MER
D. Administration of folic acid
E. Administration of PPC

Answer: B, D

47.Which of the following statements are true about anemia in chronic renal insufficiency?
A. Normocytic normochromic anemia
B. Immunohematological consequence
C. Metabolic consequence
D. Macrocytic anemia
E. Hormonal consequence

Answer: A, B, E

48. Which of the following are clinical endpoints in chronic renal insufficiency?
A. Starting the substitution treatment if necessary
B. Correction of anemia
C. Search and treatment of IRC effects
D. Avoiding metabolic acidosis
E. Maintenance of kaliemia at <6 mmol / 1

Answer: B, D

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49. The following clinical signs are common in uremia, except for:
A. Asthenia
B. Cramps
C. Uremic pericarditis
D. Itching
E. Uremic encephalopathy

Answer: C, E

50. The following statements are markers of kidney disease in the IRC, except for:
A. Nitrites present in the urinary sediment
B. Leukocyturia
C. Hematuria
D. Cylindruria
E. Proteinuria

Answer: A, D

51. One of the nephro- protection rules is the correction of cardiovascular factors, which are
represented by:
A. Weight
B. Dyslipidemia
C. Diabetes
E. Hypercalcemia

Answer: A, B, C, D

53. The control of the metabolic acidosis is achieved by:
A. Maintenance of bicarbonate concentration to values of > 23 mmol / 1
B. Administration of Vichy water
C. Increase of diuretics doses
D. Administration of Salvetat water
E. Reduction of diuretics doses

Answer: A, B, C, D

21.Which of the following represent nephro- protection rules?
A. Intake of proteins equivalent to 0.8 -1 g / kg / day
B. Regular medical surveillance (monthly if GFR = 30ml/min)
C. The existence of balanced glycemic values
D. Proteinuria control <lg / 24 h
E. The control of salt intake> l00mmol / day

Answer: A, C

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22. Which of the following consequences are of cardio-vascular origin?
A.HTN
B. Dilatative cardiopathy
C. Pericarditis
D. Accelerated arteriosclerosis
E. Hyperkaliemia

Answer: A, C, D

23. In the performance of nephro- protection by controlling blood pressure and proteinuria, the
following can be used:
A. Sodium deprived diet
B. Thiazide diuretics if GFR <30ml/min
C. Loop diuretics if GFR <30ml/min
D.IEC
E.ARA2

Answer: A, C, D, E

24.Which of the following statements are true?
A. The correction of anemia is achieved by IV administration of EPO
B. The calcium intake will not exceed 1200mg/day
C. The neoplasis is a contraindication for peritoneal dialysis
D. The uremic pericarditis is an absolute indication of EER
E. The medical supervision is recommended every 3 months if GFR > 30 ml / min

Answer: B, D, E

25.Which of the following represent complications of chronic renal insufficiency?
A. Moderated immunity deficiency
B. Hypokalaemia
C. Impotence
D. Mixed dyslipidemia
E. Obesity

Answer: A, C, D

26. The substitution therapy in chronic renal insufficiency is made based on staging. Which of the
following stages are described correctly?
A. stg I-GFR 60-90 ml/min/1.73m
2

B. stg II-severe renal insufficiency
C. stg III- GFR 30-59 ml/min/1.73 m
2

D. stg IV GFR 15-29 ml/min/1.73 m
2

E. stg V- GFR <15 ml/min/1.73 m
2

Answer: C, D, E

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27. The substitution therapy in diabetics is installed at a GFR of 15 ml / min, because:
A. The glucose values are difficult to correct
B. The hydrosodic overload is the frequency
C. No thiazide diuretics may be given
D. No IEC class drugs may be administered
E. It is impossible to control the hydrosodic retention

Answer: B, E

28. The peritoneal dialysis is an ideal substitution therapy in IRC. Which of the following
statements are true:
A. It is hemodynamically well tolerated
B. It allows the sparing of venous capital
C. It can be performed in patients with chronic inflammatory diseases
D. It can be performed even if the patient presents hypoalbuminemia
E. It can be continuously ambulatory or automated

Answer: A, B, E

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HEMATOLOGY-ONCOHEMATOLOGY

ANEMIA

Simple complement:

1. The macrocytic anemia is defined by an MEV of:
A. > _ 80fL
B. 81-90fL
C.> l00fL
D. <l00fL
E. 80 fl

Answer: C

2. The clinical anemic syndrome is characterized by the following, except for:
A. Cutaneous- mucous pallor
B. Degenerative systolic murmur
C. Cephalalgia
D. Asthenia
E. Dyspnea

Answer: B

A. The martial deficiency of is characterized by low ferritin
B. The hemoglobulin in the new- born <14 g / dl
C. The anemia in men Hb <15g/dl
D. The hemolytic anemias are characterized by negative Coombs test
E. Treatment wit Fe p.o l00mg

Answer: A

4. The normocytic aregenerative anemia is represented is the following, except:
A. Bone marrow aplasia
B. Acute leukemia
C. Thyroid dysfunction
D. Melanomas
E. Chronic inflammation

Answer: C

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5. The following are causes of hemolytic anemia, except for:
A. Toxic
B. Paludism
C. G6PD deficiency
D. Drugs
E. Celiac disease

Answer: E

6. In the microcytic anemia, if the ferritin and PCR are normal, the following will be performed:
A. Serum proteins electrophoresis
B. Reticulocytes count
C. Hb electrophoresis
D. Sideraemia
E. Coombs test

Answer: C

7. The treatment for macrocytic anemia is made with:
A. Fe
B. B12 and folate
C. Hydroxiurea
D. Contraceptives
E. Bl and B6

Answer: B

8. The following statements are true, except for:
A. Thalassemia heterozygous PCR - normal
B. Martial deficiency PCR-normal
C. The inflammatory anemia has low ferritin
D. In martial deficiency the ferritin is low
E. Increased PCR anemia

Answer: C


1.The following may be causes of martial deficiency:
A. Psychiatric disorders
B. Digestive disorders
C. Gynecological hemorrhage
D. Alcoholism
E. Celiac disease

Answer: A, B, C, E

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2. The first examinations made in hemolytic anemia are:
A. Indirect Coomb test
B. Blood smear
C. Ferritin
D. PCR
E. Indirect bilirubin

Answer: B, E

3.In colon cancer we can have:
A. Normal ferritin
B. Mixed anemia
C. Macrocytic anemia
D. Increased PCR
E. Martial deficiency

Answer: A, B, D, E

4. The aregenerative macrocytic anemia is found in the following situations:
A. Myeloid hemopathies
B. Acute leukemia
C. Alcoholism
D. Treatment with hydroxyurea
E. IRC

Answer: A, C, D

5. The anemic syndrome is defined by:
A. Vertigo
B. Functional systolic murmur
C. Cyanosis
D. Systolic murmur in the mitral focus
E. Dyspnea

Answer: A, B, E

6. The following will be performed in aregenerative normo/ macrocytic anemia:
A. Reticulocytes count
B. PCR
C. Urinary proteins electrophoresis
D. Myelogram
E. TSH

Answer: A, B, D, E

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7. The treatment of martial deficiency is made with:
A. Fe po 200 mg / day
B. Oral contraceptives
C. Colon tumors surgery
D. Administration of B12
E. Administration of folate

Answer: A, B, C

8. The aregenerativ normocytic anemia is characterized by:
A. All medullar invasions
B. Myelodysplasias
C. Medullar metastases
D. Chronic inlammations
E. Erythroblastopenia

Answer: C, D,
9. The main hemolytic anemias are represented by:
A. Autoimmune anemias
B. Mechanic
C. Paludism
D. Lymphomas
E. Drepanocitosis
Answer: A, B, C, E

10. The following statements are true in microcytic anemia:
A. Deficiency anemia
B. The ferritin is dosed
C. VEM <90 fL
D. Inflammatory anemia
E. The reticulocytes are dosed

Answer: A, B, D

11. Causes of normocytic or macrocytic regenerative anemia are:
A. Gynecological hemorrhage
B. Hemolytic anemia
C. G6PD deficiency
D.IRC
E. Acute hemorrhage

Answer: B, C, E

12. In the deficiency anemia, the 2nd diagnostic strategy is represented by:
A. Sideraemia
B. Upper digestive endoscopy
C. Transferrin
D. Lower digestive endoscopy
E. PCR

Answer: A, C, E
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13. The following statements are true:
A. If there is no clear diagnosis a myelogram is performed
B. Transfusions are performed before giving the diagnosis
C. B12 is administrated in microcytosis
D. The hemograms anomalies indicate systematic myelogram
E. Fe will be administrated regardless of the anemia type

Answer: A, D

14. The hemolysis is confirmed by:
A. Increased haptoglobulin
B. Increased indirect bilirubin
C. Coombe + tests
D. Blood smear
E. Serum proteins electrophoresis

Answer: B, C, D

15. Referring to anemia, the following statements are true, except for:
A. In inflammatory anemia the ferritin is low
B. In thalassemia heterozygous the ferritin is normal
C. In the martial deficiency the PCR is low
D. In the inflammatory anemia the PCR is high
E. In martial deficiency the ferritin is low

Answer: A, C

16. The complications of the treatment with Fe are:
A. Nausea
B. Vomiting
C. Melena
D. Abdominal pain
E. The stools coloring into black

Answer: A, D, E

17. Referring to anemia, the following statements are true, except for:
A. In case of anemias, the diagnostic procedure begins with the MEV value
B. The new- born has a Hb> 16 g / dl
C. The pregnant woman in the II trimester <10.5 g / dl
D. The celiac disease associates B12 absorption deficiency
E. The peripheral anemia is an aregenerativ anemia

Answer: A, D, E

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18. About the macrocytic anemia, the following are true:
A. The fundamental examination begins with the reticulocytes (Rt%)
B. Increased PCR
C.MEV> 100fL
D. Rt %> 150.000/mm3 (regenerative)
E. TSH dosage

Answer: A, C, D, E

19. Alcoholism can determine:
A. Macrocytic anemia
B. Normocytic anemia
C. Aregenerative anemia
D. Vitamin B12 deficiency
E. Microcytic anemia

Answer: A, C, D

20. The systematic myelogram is made in case of:
A. Circulating blasts
B. Normal ferritin
C. Thrombopenia
D. Neutropenia
E. Increased PCR

Answer: A, C,
21. The normocytic aregenerative anemia is characterized by:
A.MEV 81-99fL
B. MEV > 100fL
C. Bone marrow aplasia
D. Increased PCR
E. Acute IR

Answer: A, C, D

22. The macrocytic aregenerative anemia is characterized by:
A. Hyposideraemia
B. Increased PCR
C. Hypotransferinemia
D. B12 deficiency
E. Folate deficiency

Answer: D, E

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31. In the diagnosis of anemia, the upper gastrointestinal endoscopy is required in the following
situations:
A. In men
B. In women without an obvious cause
C. When there is a digestive symptomatology
D. In case of menorrhagias
E. In case of celiac diseases

F. Answer: A, B, C, E

32. Inn thalassemia heterozygous we meet the following:
A. Normal ferritin
B. Increased ferritin
C. Normal PCR
D. Protein electrophoresis
E. Increased PCR

F. Answer: A, C, D

329

ANOMALIES OF HEMOSTASIS AND COAGULATION

1. The following coagulation factors are dependent on vitamin K, except for:
A.II
B.VII
C.V
D.IX
E.X

Answer: C

2. PT explores the activity of the following factors, except for:
A.I
B.II
C.VII
D.IX
E.X

Answer: D

3. TCA provides details about:
A. The intrinsic path
B Primary hemostasis
C. The extrinsic path
D. The common path
E. Factor VII

Answer: A

4.PT provides details about:
A. The intrinsic path
B. The extrinsic path
C. Primary hemostasis
D. Factor IX
E. Factor XI

Answer: B

5. PFA has a role in:
A. Primary hemostasis
B. The common path
C. The intrinsic path
D. The extrinsic path
E. Primary hemostasis

Answer: E

330

6. Under what conditions is PT low and TCA normal?
A. Deficiency of IX
B. Low Factor VIII;
C. Lupus anticoagulant
D. Vitamin K deficiency
E. Heparin treatment

Answer: D

7. Normal PT and extended TCA characterize the following diseases, except for:
A. Von Willebrand disease
B. B hemophilia B
C. Liver insufficiency
D. Deficiency of factor XII
E. Classical (A) hemophilia

Answer: C

8.CIVD is characterized by the following, except for:
A. Low TCA
B. Low PT
C. Low fibrinogen
D. Thrombopenia
E. Increased D-dimers

Answer: A

9. The Von Willebrand disease is characterized by:
A. Low T
B. Low TCA
C. Normal PT
D. Increased PT
E. Increased TCA

Answer: C

10. The deficiency of vitamin K is caused by the following:
A. Food deficiencies
B. Malabsorption
C. Cholestasis
D. All of the above

Answer: D

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1. By the TCA, the activity of the following factors is explored:
A. II
B. VII
C. I
D. IX
E. XIII

Answer: A, C, D, E

2. PT explores the following:
A. The common path
B. The secondary hemostasis
E. The primary hemostasis

Answer: B, D

3.PT explores the activity of the following factors:
A.II
B.VII
L IX
D.X
E.XI

Answer: A, B, D

14.The following disease are causes of normal PT and extended TCA:
A.CIVD
B. Von Willebrand disease
C. Deficiency of factor II
D. Low factor VII
E. Deficiency of factor IX

Answer: B, D

15. If PT is normal, TCA is normal, the thrombocytes have normal values and the patient is
hemorrhage, the paraclinical exploration will follow:
A. PFA
B. D-dimers
C. Factor XIII dosage
D. Factor IX dosage
E. Factor X dosage

Answer: A, C

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16.Care the following factors are dependent on vitamin K?
A.II
B.VII
C.VII
D.IX
E.X

Answer: A, B, D, E

17. The fibrinogen explores:
A. Primary hemostasis
B. The common path
E. Secondary hemostasis

Answer: B, E

18. Low PT and normal TCA appear in the following affections:
A. Deficiency of factor VII
B. Deficiency of factor XI
C. Food deficiencies
D. Cholestasis
E. Malabsorption

Answer: A, C, D, E

19. Low PT and normal TCA do not appear in the following conditions:
A. Haemophilia B
B. Deficiency of factor VII
C. Deficiency of factor IX
D. Deficiency of factor XIII
E. Deficiency of factor XI

Answer: A, C, D, E

20. Von Willebrand disease is characterized by:
A. Normal TCA
B. Extended TCA
C. Low Von Willebrand factor
D. Extended PFA
E. Often low factor VIII

Answer: B, C, D, E

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21. In patients with factor VII deficiency who were not given vitamin K, the following
investigations can be performed:
A. Factor VII dosage
B. Administration of vitamin K
C. No dosage of factor VII
D. Factor II dosage
E. Factor V dosage

Answer: B, C

22. Which of the following are common causes of low PT and extended TCA?
A. Deficiency of factor VII
B. Hepatic insufficiency
C. CIVD
D. Deficiency of factor IX
E. Administration of vitamin K

Answer: B, C, E

23.What factors are dosed with normal PT and extended TCA?
A. Factor VII
B. Factor VII
C. Factor IX
D. Factor X

Answer: B, C, E

24.Which of the following statements are true for factor XIII?
A. Explores PT
B. Interferes in the secondary hemostasis
C. It is a clot consolidation factor
D. Interfers in the intrinsic path
E. Explores the TCA

Answer: A, C, E

25. Lupus anticoagulant is characterized by the following:
A. Extended reptilase time
B. Depends on vitamin K
C. Extended PT
D. Contributes in clot consolidation
E. It is altered during heparin treatment

Answer: A, C

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26. The following statements are true about hemostasis:
A. PFA has a role in secondary hemostasis
B. TCA has a role in secondary hemostasis
C. The fibrinogen has a role in secondary hemostasis and common path
D. PT has a role in the intrinsic path
E. Thrombocytes have a role in the intrinsic path

Answer: B, C, E

335

ONCOLOGY

ACUTE LEUKEMIAS

Simple complement:

1. The diagnostis and prognosis of acute leukemia (AL) is based on the following statements,
except for:
A. Molecular study
B. Cytogenetic study
C. Morphological examination of blasts only from the bone marrow
D. Immunophenotyping
E. Morphological examination of blood blasts

Answer: C

2. The marrow insufficiency in acute leukemias occurs except for:
A. Anemia
B. Neutropenia
C. E.N.T. infections
E. Without sepsis

Answer: E

3. The blast proliferation in the clinical diagnosis of AL, may cause, except for:
A. Brain localizations
B. Testicular localizations
C. Splenomegalia
D. Digestive localizations
E. Adenopathies

Answer: D

4. The blast hyperleukocytosis occurs in the following situations, except for:
A. Almost constant fever
B. Cerebro- meningeal hemorrhage
C. The associated coagulopathy is frequent
D. Respiratory distress may appear
E. Without any neurological phenomena occurring

Answer: E

336

5. The medullar examination by myelogram and osteo- medullar biopsy show the following
elements, except for:
A. Marrow rich in cells
B. Marrow rich in megakaryocytes
C. The marrow contains at least 20% blasts
D. The marrow is low in megakaryocytes
E. It can sometimes contain 100% blasts

Answer: B

6. The group of favorable prognosis in acute leukemias, according to cytogenetics, is
characterized by the following, except for:
A. Includes t (8; 21), t (15, 17) and inv (16) or t (16; 16)
B. 20% of cases between 15-60 years
C. The recovery seems to exceed 2/3 of cases, approximately 75% in case of LAP
D. The survival ratio at 5 years is of 40%
E. In young patients, it is characterized by high rates of complete response (> 85%)

Answer: D

7. The group of unfavorable prognosis in acute leukemias, according to cytogenetics, is
characterized by the following, except for:
A. 30% of cases between 15-60 years
B. Complex karyotypes (3 associated abnormalities or more)
C. Monosomics 5 or 7
D. Anomalies of 3q
E. Anomalies in 18p

Answer: E

8.Other tests for the diagnosis of acute leukemia are, except for:
A. Search of CID
B. Hyperkalemia
C. Hyperuricemia
D. Hypocalcemia
E. Hypercalcamia

Answer: E

Multiple complement

1. The acute leukemias represent:
A. A heterogeneous group of clonal malignant proliferations of the hematopoietic stem cells
B. Progenitor cells
C. Marrow progenitors of blood cells
D. Present maturation blockage in an immature stage
E. No tumor syndrome occurs in AL

Answer: A, B, C, D

337

2. The diagnosis and prognosis of AL is based on:
A. Morphological examination of blood blasts
B. Morphological examination of bone marrow blasts
C. Immunophenotyping
D. Molecular study
E. Without cytogenetic study

Answer: A, B, C, D

3. The 3 major subtypes of acute leukemias are:
A. Novo acute leukemia
B. Secondary acute leukemia
C. Chemo / radiotherapy induced acute leukemia
D. Acute iatrogenic leukemia
E. Acute ethanol leukemia

Answer: A, B, C

4. The blast proliferation in the clinical diagnosis of AL, can lead to the appearance:
A. Without adenopathies
B. Without splenomegalia
C. Hepato- splenomegalia
D. Gum localizations
E. Testicular localizations

Answer: C, D, E

5. The blast hyperleukocytosis is characterized by:
A. There are no clinical signs unless it is major> 100000
B. The leukostasis syndrome appears
C. The clinical signs are neurological
D. No respiratory signs
E. No fever occurs

Answer: A, B, C

6. The AL can also be manifested clinically as follows:
A. Hemorrhage syndrome by consumption coagulopathy
B. Central thrombopenia
C. Blast lysis triggered by chemotherapy
D. Fibrinolysis may occur
E. No fibrinolysis occurring in AL

Answer: A, B, C, D

338

7. The consumption coagulopathy (CID) in acute leukemias:
A. May or may not be accompanied by fibrinolysis
B. It is more common in cases of LAM3
C. It is more frequent in monocyte LAM
D. It does not affect the nervous system
E. It is more frequent in hyperleukocyte LAM under the treatments action

Answer: A, B, C, E

8. The consumption coagulopathy (CID) in acute leukemias, appears in the following situations,
except for:
A. In any type of AL
B. LAM3
C. Monocyte LAM
D. hyperleukocyte LAM under the treatment action
E. Only in case of LAM3

Answer: A, E

9. The full blood count, in AL:
A. Is normal
B. Significant thrombopenia appears
C. Leukopenia
D. Hyperleukocytosis
E. Non-regenerative anemia

Answer: B, C, D, E

l0. The immunophenotyping in acute leukemias:
A. Is indispensable
B. Identifies CD surface antigens, cluster of differentiation
C. It makes the distinction between LAL and LAM
D. There are cases of biphenotyping AL
E. There are no differences LAM and LAL

Answer: A, B, C, D

11. The cytogenetics in acute leukemias:
A. Allows the characterization of molecular alterations of AL
B. Shows translocations
C. Depending on cytogenetic, there are 3 groups of prognostic indicated for acute leukemias
D. It makes the distinction between LAL and LAM
E. Identifies CD surface antigens, cluster of differentiation

Answer: A, B, C

339

12. The group of favorable prognosis in acute leukemia, according to cytogenetics:
A. 40% of cases
B. Includes t (8; 21), t (15, 17) and inv (16) or t (16; 16)
C. In young patients it is characterized by high rates of complete response (> 85%)
D. The survival ratio is of 10% in 5 years
E. The recovery seems to exceed 2/3 of cases

Answer: B, C, E

13. The group of unfavorable prognosis in acute leukemia, according to cytogenetics, is
characterized as follows:
A. Monosomics 5 or 7
B. Deletion of 5q
C. Anomalies of 7q
D. Abnormalities in 11q, t (6,9); t (9,22)
E. Anomalies in 17p

Answer : A, B, D, E

14. The group of intermediary prognosis in acute leukemia, according to cytogenetics, is
characterized as follows:
A. Normal karyotypes
B. The survival ratio in 5 years is of 40%
C. 30% of cases between 15-60 years
D. The survival ratio is of 10% in 5 years
E. 20% of cases between 15-60 years

Answer: A, B

15. The molecular biology in acute leukemias:
A. The indication of gene amplification
B. The indication by PCR of diverse transcriptions
C. The transcriptions are according to cytogenetic anomalies
D. The transcriptions may have a therapeutic role
E. The transcriptions have no prognostic role

Answer: A, B, C, D

16. Other tests for the diagnosis of acute leukemias are:
A. Hemostasis balance
B. Metabolic balance
C. Lombar puncture
D. Pleural puncture
E. Bronchic aspiration

Answer : A, B, C

340

CHRONIC LYMPHOID LEUKEMIAS

Simple complement :

1. The clinical diagnosis has the following characteristics, except for :
A. Adenopathy
B. Splenomegalia
C. Anemia
D. Thrombopenia
E. Herpes zoster

Answer: E

2. The immunophenotype of B lymphocytes is characterized by, except for:
A. Expresses hard chain, often IgM
B. Two light type chains, kappa or lambda
C. B differentiation markers
D. CD5 marker
E. CD19 marker

Answer: B

3. The differential diagnosis of chronic lymphoid leukemias is made with the following
pathologies, except for:
A. Coat lymphoma
B. Waldenstrom disease
C. Malignant lympohomas
D. Viral infections
E. Bacterial infections

Answer : C

Multiple complement :

1. The chronic lymphoid leukemia is defined by :
A. Monoclonal proliferation
B. Medullar infiltration
C. Blood infiltration
D. B phenotyping or sometimes T phenotyping
E. Without ganglion infiltration

Answer: A, B, C, D

2. The monoclonality of the lymphocyte population in chronic lymphoid leukemias:
A. It is stated for B type proliferations
B. The presence of an increased intensity monoclonal Ig at the lymphocytes surface
C. In most cases, of IgM type
D. The chronic lymphoid leukemia remains an incurable disease for most of the patients
E. The presence of a reduced intensity monoclonal Ig at the lymphocytes surface

Answer: A, C, D, E
341

3. The monoclonality of the lymphocyte population in chronic lymphoid leukemias is included in
the following correct statements, except for:
A. The presence of a reduced intensity monoclonal Ig at the lymphocytes surface
B. In most cases, of IgG type
C. It is stated for B type proliferations
D. The chronic lymphoid leukemia remains an incurable disease for most of the patients
E. Discovered in time, this disease can be treated

Answer: C, E

4. The Binet classification in chronic lymphoid leukemias:
A. Stage A less than three ganglion areas affected
B. Stage B more than three ganglion areas affected
C. Stage C anemia and/ or thrombopenia
D. Stage A 6-year survival
E. Stage C 4-year survival

Answer: A, B, C, E

5. The clinical diagnosis has the following characteristics:
A. Patients under 50
B. Without infectious complications
C. Tumor syndrome
D. Hyperlymphocytosis
E. Without medullar insufficiency

Answer: C, D

6. The full blood count in chronic lymphoid leukemias chows:
A. Anemia
B. Thrombopenia
C. Autoimmune thrombopenia
D. B differentiation marker
E. CD5 marker

Answer: A, B, C

7. The differential diagnosis in chronic lymphoid leukemias is made with the following
pathologies:
A. Reactive hyperlymphocytosis
B. Coat lymphoma
C. Tricoleukocytes leukemia
D. Waldenstrom disease
E. Malignant lymphomas

Answer : A, B, C, D

342

MALIGNANT LYMPHOMAS

Simple complement :

1. The following statements about Burkitt Lymphoma are true, except for :
A. It appears in children and young adults
B. High risk of lysis, in case of a large tumor mass
C. The tumor lysis syndrome is characterized by a significant release of intracellular products in
the patients circulation
D. It usually appears in older patients
E. It may lead to the apparition of an acute renal insufficiency risk

Answer: D

2. The extension balance of aggressive lymphomas in the adult includes, except for:
A. Upper digestive endoscopy
B. Thorax- abdominal- pelvic CT, PET/ CT
C. Biological explorations
D. It does not need serological determinations
E. ECG and echocardiography before the administration of the antracyclin

Answer: D


1. The following statements are true about the malignant lymphomas in adults:
A. Heterogenous group of malignant lymphoid proliferations
B. Made of 2 subgroups
C. Some of them represent a therapeutic emergency Hodgkin disease
D. The 2 subgroups are: Hodgkin disease and non- Hodgkin lymphomas
E. Burkitt lymphoma is a therapeutic emergency

Answer: A, B, D, E

2. The circumstances to discover a malignant lymphoma are:
A. Tumor syndrome
B. Alteration of the general condition
C. Lower vena cava syndrome
D. Occlusive syndrome
E. Without adenopathies

Answer: A, B, D

3. The following are true about sampling of ganglion biopsy:
A. It must be appropriately performed
B. It must be sufficiently large
C. With intact tissue, which is not necrosed
D. It must allow a precise classification
E. The biopsy tissue, if it is sufficient, may also be necrosed

Answer: A, B, C, D
343

4. The laboratory techniques used in the diagnosis of malignant lymphomas are:
A. Histological
B. Cytological
C. Refrigeration
D. Cytogenic
E. Without marking technique

Answer: A, B, C, D

4. Referring to phenotyping, the following are true:
A. One single identity is sufficient to identify certain genetic anomalies
B. In Burkitt aggressive lymphomas, the genetic anomaly is c-myc
C. In coat lymphomas, the anomaly is t (11; 14)
D. The Ann Arbor classification allows the prediction of the patients prognosis
E. Two identities are sufficient to identify certain genetic anomalies

Answer: B, C, D, E

5. The main forms of malignant lymphomas may be classified as follows:
A. B lymphomas with small cells
B. Burkitt lymphomas in old patients
C. Hodgkin lymphoma
D. Burkitt lymphoma
E. B lymphomas with large cells

Answer: C, D, E

6. B lymphomas with large cells:
A. Represent a heterogenous group of NHL (non Hodgkin lymphoma)
B. Represent 1/3 of NHL
C. Represent 1/2 of NHL
D. The most frequent are the ganglion affectations
E. Among the extraganglion affectations there may be those in the ENT and digestive area

Answer: A, B, D, E

7. The extension balance of aggressive lymphomas in the adult includes:
A. Clinical
B. Histological
C. It does not need any radiological controls
D. HIV, HBV, HCV, HTLV-1 serology
E. Pre- transfusion balance

Answer: A, B, D, E

344

8. Referring to the Ann-Arbor classification in malignant lymphomas, the following statements
are true:
A. Stage I only one territory affected and only one visceral affection
B. Stage I only one territory affected
C. Stage II at least two ganglion territories affected on the same side of the diaphragm
D. Stage III supra- and sub- diaphragmatic affection
E. Stage IV hepatic, pulmonary or medullar visceral affection

Answer: B, C, D, E

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