├── README.md ├── .gitignore ├── __pycache__ └── prompts.cpython-312.pyc ├── utils ├── config.py ├── parse_video_trascription.py └── prompts.py ├── inference_nebius.py ├── nous-hermes-inference.py ├── async_inference.py ├── async_inference_perplexity.py ├── notebooks ├── .ipynb_checkpoints │ └── inference-checkpoint.ipynb ├── inference.ipynb └── fine-tuning.ipynb ├── async_inference_with_reasoning.py ├── async_inference_with_context.py └── data └── dataset ├── dataset_english_only_clean_final.csv ├── questions.csv └── dataset_english_cleaned.csv /README.md: -------------------------------------------------------------------------------- 1 | Hackaton 2024 Mistral X Alan 2 | -------------------------------------------------------------------------------- /.gitignore: -------------------------------------------------------------------------------- 1 | .env 2 | /venv/ 3 | .venv/ 4 | venv 5 | /data/output 6 | env/ 7 | virtualenv/ 8 | ENV/ 9 | 10 | .DS_Store 11 | __pycache__ -------------------------------------------------------------------------------- /__pycache__/prompts.cpython-312.pyc: -------------------------------------------------------------------------------- https://raw.githubusercontent.com/datapizzaorg-ai-lab/hackaton2024-mistralxalan/HEAD/__pycache__/prompts.cpython-312.pyc -------------------------------------------------------------------------------- /utils/config.py: -------------------------------------------------------------------------------- 1 | models = { 2 | "mistral_large": "mistral-large-latest", 3 | "mistral_large_first_ft": "ft:mistral-large-latest:64a2499b:20241012:bf6d48dc", 4 | "mistral_large_second_ft": "ft:mistral-large-latest:64a2499b:20241013:3d8a5d94", 5 | } 6 | -------------------------------------------------------------------------------- /utils/parse_video_trascription.py: -------------------------------------------------------------------------------- 1 | import json 2 | import re 3 | 4 | 5 | def parse_qa_text(file_path): 6 | with open(file_path, "r", encoding="utf-8") as file: 7 | content = file.read() 8 | 9 | questions = re.split(r"---\n+### \*\*Question \d+\*\*", content)[1:] 10 | parsed_data = [] 11 | 12 | for question in questions: 13 | question_text = re.search(r"(.*?)\n\*\*Questions :\*\*", question, re.DOTALL) 14 | options = re.findall(r"([A-E]\. .*?)\n", question) 15 | correct_answers = re.search(r"\*\*Réponses correctes :\*\* (.*?)\n", question) 16 | explanations = re.findall(r"- ([A-E]) : (.*?)\n", question) 17 | 18 | if question_text and options and correct_answers and explanations: 19 | question_content = ( 20 | question_text.group(1).strip() + "\n\n" + "\n".join(options) 21 | ) 22 | 23 | answer_content = ( 24 | f"Réponses correctes : {correct_answers.group(1)}\n\n" 25 | "Explications :\n" 26 | + "\n".join( 27 | [ 28 | f"{letter} : {explanation}" 29 | for letter, explanation in explanations 30 | ] 31 | ) 32 | ) 33 | 34 | parsed_data.append( 35 | { 36 | "messages": [ 37 | {"role": "user", "content": question_content}, 38 | {"role": "assistant", "content": answer_content}, 39 | ] 40 | } 41 | ) 42 | 43 | return parsed_data 44 | 45 | 46 | def write_json(data, output_file): 47 | with open(output_file, "w", encoding="utf-8") as f: 48 | for item in data: 49 | json.dump(item, f, ensure_ascii=False) 50 | f.write("\n") 51 | 52 | 53 | def main(): 54 | i = 4 55 | filename = f"trascription_{i}" 56 | 57 | parsed_data = parse_qa_text(f"./data/dataset/{filename}.txt") 58 | write_json(parsed_data, f"./data/dataset/{filename}.json") 59 | 60 | print("Parsing complete. Output written to 'output.json'.") 61 | 62 | 63 | if __name__ == "__main__": 64 | main() 65 | -------------------------------------------------------------------------------- /inference_nebius.py: -------------------------------------------------------------------------------- 1 | import datetime 2 | import os 3 | 4 | import pandas as pd 5 | import torch 6 | import transformers 7 | from transformers import AutoModelForCausalLM 8 | 9 | import utils.prompts as prompts 10 | 11 | model_id = "aaditya/OpenBioLLM-Llama3-70B" 12 | model = AutoModelForCausalLM.from_pretrained( 13 | model_id, device_map="auto", torch_dtype=torch.bfloat16 14 | ) 15 | tokenizer = transformers.AutoTokenizer.from_pretrained(model_id, device_map="auto") 16 | device = 0 if torch.cuda.is_available() else -1 17 | pipeline = transformers.pipeline( 18 | "text-generation", 19 | model=model, 20 | tokenizer=tokenizer, 21 | batch_size=8, 22 | device_map="auto", 23 | truncation=True, 24 | ) 25 | questions_file = ( 26 | "./data/dataset/dataset_english_only_clean_final.csv" # path to the questions file 27 | ) 28 | 29 | output_path = "./data/output/" # path to the output file 30 | 31 | df = pd.read_csv(questions_file, sep=",") 32 | 33 | question_prompt = lambda body: (f"{body}\n") 34 | 35 | answers = [] 36 | 37 | list_prompts = [ 38 | question_prompt( 39 | row["question"], 40 | ) 41 | for row_idx, row in df.iterrows() 42 | ] 43 | for p in list_prompts: 44 | messages = [ 45 | { 46 | "role": "system", 47 | "content": prompts.TAGGING_PROMPT, 48 | }, 49 | { 50 | "role": "user", 51 | "content": prompts.TAGGING_USER_PROMPT + p, 52 | }, 53 | ] 54 | 55 | prompt = pipeline.tokenizer.apply_chat_template( 56 | messages, tokenize=False, add_generation_prompt=True 57 | ) 58 | 59 | terminators = [ 60 | pipeline.tokenizer.eos_token_id, 61 | pipeline.tokenizer.convert_tokens_to_ids("<|eot_id|>"), 62 | ] 63 | 64 | outputs = pipeline( 65 | prompt, 66 | max_new_tokens=4096, 67 | eos_token_id=terminators, 68 | do_sample=True, 69 | temperature=0.01, 70 | top_p=0.9, 71 | ) 72 | print(outputs[0]["generated_text"][len(prompt) :]) 73 | answers.append(outputs[0]["generated_text"][len(prompt) :]) 74 | 75 | output_df = pd.DataFrame({"questions": list_prompts, "tag": answers}) 76 | output_df.index.name = "id" 77 | 78 | os.makedirs(output_path, exist_ok=True) 79 | 80 | output_df.to_csv( 81 | f"{output_path}output_verbose_{datetime.datetime.now().strftime('%H:%M:%S')}.csv" 82 | ) 83 | -------------------------------------------------------------------------------- /nous-hermes-inference.py: -------------------------------------------------------------------------------- 1 | import torch 2 | from transformers import AutoTokenizer, AutoModelForCausalLM 3 | from transformers import LlamaTokenizer, MistralForCausalLM 4 | import bitsandbytes 5 | import pandas as pd 6 | import json 7 | import re 8 | 9 | tokenizer = LlamaTokenizer.from_pretrained('NousResearch/Nous-Hermes-2-Mistral-7B-DPO', trust_remote_code=True) 10 | tokenizer.pad_token = tokenizer.eos_token 11 | 12 | model = MistralForCausalLM.from_pretrained( 13 | "NousResearch/Nous-Hermes-2-Mistral-7B-DPO", 14 | torch_dtype=torch.float16, 15 | device_map="auto", 16 | ) 17 | 18 | base = """<|im_start|>system 19 | You are a sentient, superintelligent artificial general intelligence, here to teach and assist me.<|im_end|> 20 | <|im_start|>user 21 | {}<|im_end|> 22 | <|im_start|>assistant""" 23 | 24 | df = pd.read_csv("questions.csv") 25 | 26 | question_prompt = lambda instructions, body, possible_answer_a, possible_answer_b, possible_answer_c, possible_answer_d, possible_answer_e: ( 27 | f"{instructions}\n" 28 | f"{body}\n" 29 | ) 30 | 31 | COT_PROMPT = ( 32 | "Give me the complete medical context i need to answer this question:" 33 | ) 34 | 35 | list_prompts = [ 36 | base.format(question_prompt( 37 | COT_PROMPT, 38 | row["question"], 39 | row["answer_A"], 40 | row["answer_B"], 41 | row["answer_C"], 42 | row["answer_D"], 43 | row["answer_E"], 44 | )) 45 | for row_idx, row in df.iterrows() 46 | ] 47 | 48 | answers = [] 49 | for chat in list_prompts: 50 | # print(chat) 51 | inputs = tokenizer(chat, return_tensors="pt") 52 | input_ids = inputs.input_ids.to("cuda") 53 | attention_mask = inputs.attention_mask.to("cuda") 54 | generated_ids = model.generate(input_ids, attention_mask=attention_mask, max_new_tokens=4096, temperature=0.8, repetition_penalty=1.1, do_sample=True, eos_token_id=tokenizer.eos_token_id) 55 | response = tokenizer.decode(generated_ids[0][input_ids.shape[-1]:], skip_special_tokens=True, clean_up_tokenization_space=True) 56 | #print(response) 57 | #json_string = re.findall( 58 | # r"\{(?:[^{}]|\{(?:[^{}]|\{(?:[^{}]|\{[^{}]*\})*\})*\})*\}", response 59 | #)[0] 60 | #solution = ",".join(json.loads(json_string)["answer"]) 61 | #print(solution) 62 | answers.append(response) 63 | 64 | output_df = pd.DataFrame(answers, columns=["Answer"]) 65 | output_df.index.name = "id" 66 | output_df.to_csv("output_question_context.csv") 67 | -------------------------------------------------------------------------------- /async_inference.py: -------------------------------------------------------------------------------- 1 | import asyncio 2 | import datetime 3 | import json 4 | import os 5 | import re 6 | from asyncio import Semaphore 7 | 8 | import pandas as pd 9 | from dotenv import load_dotenv 10 | from mistralai import Mistral 11 | 12 | from utils.config import models 13 | 14 | MAX_CONCURRENT_CALLS = 20 15 | MAX_TRY_NUMBER = 2 16 | MODEL_ID = "mistral_large_first_ft" 17 | MODEL_NAME = models[MODEL_ID] 18 | 19 | load_dotenv() 20 | 21 | api_key = os.getenv("MISTRAL_API_KEY") 22 | questions_file = "./data/dataset/dataset_english_only_clean_final.csv" 23 | output_path = "./data/output/" 24 | 25 | df = pd.read_csv(questions_file, sep=",") 26 | 27 | question_prompt = lambda body, possible_answer_a, possible_answer_b, possible_answer_c, possible_answer_d, possible_answer_e: ( 28 | f"{body}\n" 29 | f"A: {possible_answer_a}\n" 30 | f"B: {possible_answer_b}\n" 31 | f"C: {possible_answer_c}\n" 32 | f"D: {possible_answer_d}\n" 33 | f"E: {possible_answer_e}\n" 34 | ) 35 | 36 | answers = [] 37 | 38 | 39 | async def process_prompt(client, prompt, semaphore): 40 | async with semaphore: 41 | try: 42 | res = await client.chat.complete_async( 43 | model=MODEL_NAME, 44 | messages=[{"content": prompt, "role": "user"}], 45 | temperature=0.0, 46 | ) 47 | if res is not None: 48 | return prompt, res.choices[0].message.content 49 | except Exception as e: 50 | return prompt, f"Error: {str(e)}" 51 | return prompt, None 52 | 53 | 54 | async def main(prompts=None): 55 | s = Mistral(api_key=os.getenv("MISTRAL_API_KEY", "")) 56 | semaphore = Semaphore(MAX_CONCURRENT_CALLS) 57 | tasks = [process_prompt(s, prompt, semaphore) for prompt in prompts] 58 | results = await asyncio.gather(*tasks) 59 | 60 | for _, result in results: 61 | print(result) 62 | json_strings = re.findall( 63 | r"\{(?:[^{}]|\{(?:[^{}]|\{(?:[^{}]|\{[^{}]*\})*\})*\})*\}", result 64 | ) 65 | if json_strings: 66 | try: 67 | answer_dict = json.loads(json_strings[0]) 68 | answers.append(",".join(answer_dict["answer"])) 69 | except json.JSONDecodeError: 70 | answers.append("Error: Invalid JSON") 71 | else: 72 | answers.append("Error: No valid JSON found") 73 | 74 | 75 | if __name__ == "__main__": 76 | list_prompts = [ 77 | question_prompt( 78 | row["question"], 79 | row["answer_A"], 80 | row["answer_B"], 81 | row["answer_C"], 82 | row["answer_D"], 83 | row["answer_E"], 84 | ) 85 | for _, row in df.iterrows() 86 | ] 87 | asyncio.run(main(prompts=list_prompts)) 88 | 89 | output_df = pd.DataFrame(answers, columns=["Answer"]) 90 | output_df.index.name = "id" 91 | 92 | os.makedirs(output_path, exist_ok=True) 93 | 94 | output_df.to_csv( 95 | f"{output_path}output_verbose_{datetime.datetime.now().strftime('%H:%M:%S')}.csv" 96 | ) 97 | -------------------------------------------------------------------------------- /async_inference_perplexity.py: -------------------------------------------------------------------------------- 1 | import asyncio 2 | import datetime 3 | import json 4 | import os 5 | import re 6 | 7 | import aiohttp 8 | import pandas as pd 9 | from dotenv import load_dotenv 10 | 11 | import utils.prompts as prompts 12 | 13 | load_dotenv() 14 | import pandas as pd 15 | 16 | MODEL_NAME = "llama-3.1-sonar-huge-128k-online" 17 | 18 | questions_file = "./data/dataset/dataset_english_only_clean_final.csv" 19 | 20 | output_path = "./data/output/" 21 | 22 | df = pd.read_csv(questions_file, sep=",") 23 | 24 | question_prompt = lambda body, possible_answer_a, possible_answer_b, possible_answer_c, possible_answer_d, possible_answer_e: ( 25 | f"{body}\n" 26 | f"A: {possible_answer_a}\n" 27 | f"B: {possible_answer_b}\n" 28 | f"C: {possible_answer_c}\n" 29 | f"D: {possible_answer_d}\n" 30 | f"E: {possible_answer_e}\n" 31 | ) 32 | 33 | url = "https://api.perplexity.ai/chat/completions" 34 | answers = [] 35 | 36 | list_prompts = [ 37 | question_prompt( 38 | row["question"], 39 | row["answer_A"], 40 | row["answer_B"], 41 | row["answer_C"], 42 | row["answer_D"], 43 | row["answer_E"], 44 | ) 45 | for _, row in df.iterrows() 46 | ] 47 | 48 | headers = { 49 | "Authorization": f"Bearer {os.getenv('PERPLEXITY_API_KEY')}", 50 | "Content-Type": "application/json", 51 | } 52 | 53 | semaphore = asyncio.Semaphore(15) 54 | 55 | 56 | async def fetch(session, prompt): 57 | payload = { 58 | "model": MODEL_NAME, 59 | "messages": [ 60 | { 61 | "role": "system", 62 | "content": prompts.PIZZA_MODIFIER + prompts.THINK_PROMPT, 63 | }, 64 | {"role": "user", "content": prompt}, 65 | ], 66 | "temperature": 0, 67 | "top_p": 0.9, 68 | "return_citations": True, 69 | "search_domain_filter": ["perplexity.ai"], 70 | "return_images": False, 71 | "return_related_questions": False, 72 | "search_recency_filter": "month", 73 | "top_k": 0, 74 | "stream": False, 75 | "presence_penalty": 0, 76 | "frequency_penalty": 1, 77 | } 78 | async with semaphore: 79 | async with session.post(url, json=payload, headers=headers) as response: 80 | result = await response.json() 81 | message_content = result["choices"][0]["message"]["content"] 82 | json_string = re.findall( 83 | r"\{(?:[^{}]|\{(?:[^{}]|\{(?:[^{}]|\{[^{}]*\})*\})*\})*\}", 84 | message_content, 85 | )[0] 86 | return ",".join(json.loads(json_string)["answer"]) 87 | 88 | 89 | async def main(): 90 | async with aiohttp.ClientSession() as session: 91 | tasks = [fetch(session, prompt) for prompt in list_prompts] 92 | results = await asyncio.gather(*tasks) 93 | return results 94 | 95 | 96 | # Run the async event loop 97 | answers = asyncio.run(main()) 98 | 99 | # Output the results to a DataFrame and save as CSV 100 | output_df = pd.DataFrame(answers, columns=["Answer"]) 101 | output_df.index.name = "id" 102 | 103 | os.makedirs(output_path, exist_ok=True) 104 | 105 | output_df.to_csv( 106 | f"{output_path}output_verbose_{datetime.datetime.now().strftime('%H:%M:%S')}.csv" 107 | ) 108 | -------------------------------------------------------------------------------- /notebooks/.ipynb_checkpoints/inference-checkpoint.ipynb: -------------------------------------------------------------------------------- 1 | { 2 | "cells": [ 3 | { 4 | "cell_type": "code", 5 | "execution_count": 3, 6 | "metadata": {}, 7 | "outputs": [], 8 | "source": [ 9 | "import pandas as pd\n", 10 | "from mistralai import Mistral\n", 11 | "from dotenv import load_dotenv\n", 12 | "import os\n", 13 | "load_dotenv()\n", 14 | "\n", 15 | "api_key = os.getenv(\"MISTRAL_API_KEY\") # your API key\n", 16 | "questions_file = '../data/dataset/questions.csv' # path to the questions file\n", 17 | "\n", 18 | "output_path = '../data/output/' # path to the output file\n", 19 | "\n", 20 | "df = pd.read_csv(questions_file)\n", 21 | "\n", 22 | "question_prompt = lambda body, possible_answer_a, possible_answer_b, possible_answer_c, possible_answer_d, possible_answer_e: (\n", 23 | " \"Answer the following question with the letters of the correct answer. Each question can have multiple answers that are right. \"\n", 24 | " \"Your answer must contain the letter of the answers, separated by commas and without any space. An ideal output is like: 'A,B', for instance.\"\n", 25 | " \"You don't provide any reasoning nor intuition nor explanation of your answer. You merely output the answer as per the instructions you are given.\"\n", 26 | " \"You only output the letters that you are asked to provide, e.g. 'A,B,C' or 'C'. Your answer is always sorted alphabetically. You must not put letters\"\n", 27 | " \"in a different order\"\n", 28 | " f\"{body}\\n\"\n", 29 | " f\"A: {possible_answer_a}\\n\"\n", 30 | " f\"B: {possible_answer_b}\\n\"\n", 31 | " f\"C: {possible_answer_c}\\n\"\n", 32 | " f\"D: {possible_answer_d}\\n\"\n", 33 | " f\"E: {possible_answer_e}\\n\"\n", 34 | ")\n", 35 | "\n", 36 | "answers = []\n", 37 | "client = Mistral(api_key=api_key)\n", 38 | "\n", 39 | "for row_idx, row in df.iterrows():\n", 40 | " prompt = question_prompt(\n", 41 | " row[\"question\"],\n", 42 | " row[\"answer_A\"],\n", 43 | " row[\"answer_B\"],\n", 44 | " row[\"answer_C\"],\n", 45 | " row[\"answer_D\"],\n", 46 | " row[\"answer_E\"]\n", 47 | " )\n", 48 | "\n", 49 | " chat_response = client.chat.complete(\n", 50 | " model = \"mistral-large-latest\",\n", 51 | " messages = [\n", 52 | " {\n", 53 | " \"role\": \"user\",\n", 54 | " \"content\": prompt\n", 55 | " },\n", 56 | " ],\n", 57 | " temperature=0.\n", 58 | " )\n", 59 | " answers.append(\n", 60 | " chat_response.choices[0].message.content\n", 61 | " )\n", 62 | "\n", 63 | "# output format is a 2-columns dataframe with exactly 103 rows\n", 64 | "output_df = pd.DataFrame(answers, columns=[\"Answer\"])\n", 65 | "output_df.index.name = \"id\"\n", 66 | "\n", 67 | "os.makedirs(output_path, exist_ok=True)\n", 68 | "\n", 69 | "output_df.to_csv(f\"{output_path}output.csv\")\n" 70 | ] 71 | } 72 | ], 73 | "metadata": { 74 | "kernelspec": { 75 | "display_name": "mistral-hackathon", 76 | "language": "python", 77 | "name": "python3" 78 | }, 79 | "language_info": { 80 | "codemirror_mode": { 81 | "name": "ipython", 82 | "version": 3 83 | }, 84 | "file_extension": ".py", 85 | "mimetype": "text/x-python", 86 | "name": "python", 87 | "nbconvert_exporter": "python", 88 | "pygments_lexer": "ipython3", 89 | "version": "3.10.15" 90 | } 91 | }, 92 | "nbformat": 4, 93 | "nbformat_minor": 2 94 | } 95 | -------------------------------------------------------------------------------- /async_inference_with_reasoning.py: -------------------------------------------------------------------------------- 1 | import asyncio 2 | import datetime 3 | import json 4 | import os 5 | import re 6 | from asyncio import Semaphore 7 | 8 | import pandas as pd 9 | from dotenv import load_dotenv 10 | from mistralai import Mistral 11 | 12 | import utils.prompts as prompts 13 | from utils.config import models 14 | 15 | MAX_CONCURRENT_CALLS = 20 16 | MAX_TRY_NUMBER = 3 17 | MODEL_ID = "mistral_large_first_ft" 18 | MODEL_NAME = models[MODEL_ID] 19 | 20 | load_dotenv() 21 | 22 | api_key = os.getenv("MISTRAL_API_KEY") 23 | questions_file = "./data/dataset/dataset_english_only_clean_final.csv" 24 | output_path = "./data/output/" 25 | 26 | df = pd.read_csv(questions_file, sep=",") 27 | 28 | question_prompt = lambda body, possible_answer_a, possible_answer_b, possible_answer_c, possible_answer_d, possible_answer_e: ( 29 | f"{body}\n" 30 | f"A: {possible_answer_a}\n" 31 | f"B: {possible_answer_b}\n" 32 | f"C: {possible_answer_c}\n" 33 | f"D: {possible_answer_d}\n" 34 | f"E: {possible_answer_e}\n" 35 | ) 36 | 37 | answers = [] 38 | 39 | check_prompts = [ 40 | "There are lives that depend on your answer; Think carefully, you may as well have given the right answer as you may have been wrong; Write your final answer always following the same format", 41 | "Okay now double-check that the format is right, which is like this: {“answer”: “A,B,D”}", 42 | "You are almost there, just one more step, remember the format! And try to be as accurate as possible with you answers, you can do it!", 43 | ] 44 | 45 | 46 | async def process_prompt(client, prompt, semaphore): 47 | async with semaphore: 48 | history = [] 49 | try: 50 | history.append( 51 | { 52 | "content": prompts.PIZZA_MODIFIER + prompts.THINK_PROMPT, 53 | "role": "system", 54 | } 55 | ) 56 | history.append({"content": prompt, "role": "user"}) 57 | res = await client.chat.complete_async( 58 | model=MODEL_NAME, 59 | messages=history, 60 | temperature=0.0, 61 | ) 62 | if res is not None: 63 | response = res.choices[0].message.content 64 | history.append({"content": response, "role": "assistant"}) 65 | 66 | for index in range(MAX_TRY_NUMBER): 67 | print( 68 | f"Reasoning turn: {index}, {datetime.datetime.now().strftime('%H:%M:%S')}" 69 | ) 70 | history.append({"content": check_prompts[index], "role": "user"}) 71 | 72 | res = await client.chat.complete_async( 73 | model=MODEL_NAME, 74 | messages=history, 75 | temperature=0.0, 76 | ) 77 | 78 | response = res.choices[0].message.content 79 | history.append({"content": response, "role": "assistant"}) 80 | 81 | return ( 82 | prompt, 83 | response, 84 | ) 85 | except Exception as e: 86 | return prompt, f"Error: {str(e)}" 87 | return prompt, None 88 | 89 | 90 | async def main(prompts=None): 91 | s = Mistral(api_key=os.getenv("MISTRAL_API_KEY", "")) 92 | semaphore = Semaphore(MAX_CONCURRENT_CALLS) 93 | tasks = [process_prompt(s, prompt, semaphore) for prompt in prompts] 94 | results = await asyncio.gather(*tasks) 95 | 96 | for _, result in results: 97 | print(result) 98 | json_strings = re.findall( 99 | r"\{(?:[^{}]|\{(?:[^{}]|\{(?:[^{}]|\{[^{}]*\})*\})*\})*\}", result 100 | ) 101 | if json_strings: 102 | try: 103 | answer_dict = json.loads(json_strings[0]) 104 | answers.append(",".join(answer_dict["answer"])) 105 | except json.JSONDecodeError: 106 | answers.append("Error: Invalid JSON") 107 | else: 108 | answers.append("Error: No valid JSON found") 109 | 110 | 111 | if __name__ == "__main__": 112 | list_prompts = [ 113 | question_prompt( 114 | row["question"], 115 | row["answer_A"], 116 | row["answer_B"], 117 | row["answer_C"], 118 | row["answer_D"], 119 | row["answer_E"], 120 | ) 121 | for _, row in df.iterrows() 122 | ] 123 | asyncio.run(main(prompts=list_prompts)) 124 | 125 | output_df = pd.DataFrame(answers, columns=["Answer"]) 126 | output_df.index.name = "id" 127 | 128 | os.makedirs(output_path, exist_ok=True) 129 | 130 | output_df.to_csv( 131 | f"{output_path}output_verbose_{datetime.datetime.now().strftime('%H:%M:%S')}.csv" 132 | ) 133 | -------------------------------------------------------------------------------- /async_inference_with_context.py: -------------------------------------------------------------------------------- 1 | import asyncio 2 | import datetime 3 | import json 4 | import os 5 | import re 6 | from asyncio import Semaphore 7 | 8 | import pandas as pd 9 | from dotenv import load_dotenv 10 | from mistralai import Mistral 11 | 12 | from utils import prompts 13 | from utils.config import models 14 | 15 | MAX_CONCURRENT_CALLS = 20 16 | MAX_TRY_NUMBER = 2 17 | MODEL_ID = "mistral_large_first_ft" 18 | MODEL_NAME = models[MODEL_ID] 19 | 20 | load_dotenv() 21 | 22 | api_key = os.getenv("MISTRAL_API_KEY") 23 | questions_file = "./data/dataset/dataset_english_only_clean_final.csv" 24 | output_path = "./data/output/" 25 | 26 | df = pd.read_csv(questions_file, sep=",") 27 | df_context = pd.read_csv("./data/dataset/context_21:33:00.csv", sep=",") 28 | 29 | question_prompt = lambda body, possible_answer_a, possible_answer_b, possible_answer_c, possible_answer_d, possible_answer_e: ( 30 | f"{body}\n" 31 | f"A: {possible_answer_a}\n" 32 | f"B: {possible_answer_b}\n" 33 | f"C: {possible_answer_c}\n" 34 | f"D: {possible_answer_d}\n" 35 | f"E: {possible_answer_e}\n" 36 | ) 37 | 38 | answers = [] 39 | 40 | check_prompts = [ 41 | "There are lives that depend on your answer; Think carefully, you may as well have given the right answer as you may have been wrong; Write your final answer always following the same format", 42 | "Okay now double-check that the format is right, which is like this: {“answer”: “A,B,D”}", 43 | "You are almost there, just one more step, remember the format! And try to be as accurate as possible with you answers, you can do it!", 44 | ] 45 | 46 | 47 | async def process_prompt(client, prompt, semaphore): 48 | async with semaphore: 49 | history = [] 50 | try: 51 | history.append( 52 | { 53 | "content": prompts.PIZZA_MODIFIER 54 | + prompts.THINK_PROMPT_CONTEXT.format(context=df_context["tag"]) 55 | + prompts.THINK_PROMPT_CONTEXT_FEW_SHOTS, 56 | "role": "system", 57 | } 58 | ) 59 | history.append({"content": prompt, "role": "user"}) 60 | res = await client.chat.complete_async( 61 | model=MODEL_NAME, 62 | messages=history, 63 | temperature=0.0, 64 | ) 65 | if res is not None: 66 | response = res.choices[0].message.content 67 | history.append({"content": response, "role": "assistant"}) 68 | 69 | for index in range(MAX_TRY_NUMBER): 70 | print(f"Try number: {index}") 71 | history.append({"content": check_prompts[index], "role": "user"}) 72 | 73 | res = await client.chat.complete_async( 74 | model=MODEL_NAME, 75 | messages=history, 76 | temperature=0.0, 77 | ) 78 | 79 | response = res.choices[0].message.content 80 | history.append({"content": response, "role": "assistant"}) 81 | 82 | return ( 83 | prompt, 84 | response, 85 | ) 86 | except Exception as e: 87 | return prompt, f"Error: {str(e)}" 88 | return prompt, None 89 | 90 | 91 | async def main(prompts=None): 92 | s = Mistral(api_key=os.getenv("MISTRAL_API_KEY", "")) 93 | semaphore = Semaphore(MAX_CONCURRENT_CALLS) 94 | tasks = [process_prompt(s, prompt, semaphore) for prompt in prompts] 95 | results = await asyncio.gather(*tasks) 96 | 97 | for _, result in results: 98 | json_strings = re.findall( 99 | r"\{(?:[^{}]|\{(?:[^{}]|\{(?:[^{}]|\{[^{}]*\})*\})*\})*\}", result 100 | ) 101 | if json_strings: 102 | try: 103 | answer_dict = json.loads(json_strings[0]) 104 | answers.append(",".join(answer_dict["answer"])) 105 | except json.JSONDecodeError: 106 | answers.append("Error: Invalid JSON") 107 | else: 108 | answers.append("Error: No valid JSON found") 109 | 110 | 111 | if __name__ == "__main__": 112 | list_prompts = [ 113 | question_prompt( 114 | row["question"], 115 | row["answer_A"], 116 | row["answer_B"], 117 | row["answer_C"], 118 | row["answer_D"], 119 | row["answer_E"], 120 | ) 121 | for _, row in df.iterrows() 122 | ] 123 | asyncio.run(main(prompts=list_prompts)) 124 | 125 | output_df = pd.DataFrame(answers, columns=["Answer"]) 126 | output_df.index.name = "id" 127 | 128 | os.makedirs(output_path, exist_ok=True) 129 | 130 | output_df.to_csv( 131 | f"{output_path}output_verbose_{datetime.datetime.now().strftime('%H:%M:%S')}.csv" 132 | ) 133 | -------------------------------------------------------------------------------- /notebooks/inference.ipynb: -------------------------------------------------------------------------------- 1 | { 2 | "cells": [ 3 | { 4 | "cell_type": "code", 5 | "execution_count": 9, 6 | "metadata": {}, 7 | "outputs": [ 8 | { 9 | "name": "stdout", 10 | "output_type": "stream", 11 | "text": [ 12 | "row_idx: 0\n", 13 | "row_idx: 1\n" 14 | ] 15 | } 16 | ], 17 | "source": [ 18 | "import pandas as pd\n", 19 | "from mistralai import Mistral\n", 20 | "from dotenv import load_dotenv\n", 21 | "import os\n", 22 | "load_dotenv()\n", 23 | "\n", 24 | "api_key = os.getenv(\"MISTRAL_API_KEY\") # your API key\n", 25 | "questions_file = '../data/dataset/questions.csv' # path to the questions file\n", 26 | "\n", 27 | "output_path = '../data/output/' # path to the output file\n", 28 | "\n", 29 | "df = pd.read_csv(questions_file)\n", 30 | "\n", 31 | "question_prompt = lambda body, possible_answer_a, possible_answer_b, possible_answer_c, possible_answer_d, possible_answer_e: (\n", 32 | " \"Answer the following question with the letters of the correct answer. Each question can have multiple answers that are right. \"\n", 33 | " \"For each answwer think this way: 'is it true compared to the question provided?'\"\n", 34 | " \"For each question first explain the medical condition and what are the implication, give context, then print the corrects answers.\"\n", 35 | " \"Your answer must contain the letter of the answers, separated by commas and without any space. An ideal output is like: 'A,B', for instance.\"\n", 36 | " \"You output the letters that you are asked to provide, e.g. 'A,B,C' or 'C'. Your answer is always sorted alphabetically. You must not put letters\"\n", 37 | " \"in a different order\"\n", 38 | " f\"{body}\\n\"\n", 39 | " f\"A: {possible_answer_a}\\n\"\n", 40 | " f\"B: {possible_answer_b}\\n\"\n", 41 | " f\"C: {possible_answer_c}\\n\"\n", 42 | " f\"D: {possible_answer_d}\\n\"\n", 43 | " f\"E: {possible_answer_e}\\n\"\n", 44 | ")\n", 45 | "\n", 46 | "answers = []\n", 47 | "client = Mistral(api_key=api_key)\n", 48 | "\n", 49 | "for row_idx, row in df.head(2).iterrows():\n", 50 | " print('row_idx: ',row_idx)\n", 51 | " prompt = question_prompt(\n", 52 | " row[\"question\"],\n", 53 | " row[\"answer_A\"],\n", 54 | " row[\"answer_B\"],\n", 55 | " row[\"answer_C\"],\n", 56 | " row[\"answer_D\"],\n", 57 | " row[\"answer_E\"]\n", 58 | " )\n", 59 | "\n", 60 | " chat_response = client.chat.complete(\n", 61 | " model = \"mistral-large-latest\",\n", 62 | " messages = [\n", 63 | " {\n", 64 | " \"role\": \"user\",\n", 65 | " \"content\": prompt\n", 66 | " },\n", 67 | " ],\n", 68 | " temperature=0.\n", 69 | " )\n", 70 | " answers.append(\n", 71 | " chat_response.choices[0].message.content\n", 72 | " )\n", 73 | "\n", 74 | "# output format is a 2-columns dataframe with exactly 103 rows\n", 75 | "output_df = pd.DataFrame(answers, columns=[\"Answer\"])\n", 76 | "output_df.index.name = \"id\"\n", 77 | "\n", 78 | "os.makedirs(output_path, exist_ok=True)\n", 79 | "\n", 80 | "output_df.to_csv(f\"{output_path}output_verbose.csv\")\n" 81 | ] 82 | }, 83 | { 84 | "cell_type": "code", 85 | "execution_count": 7, 86 | "metadata": {}, 87 | "outputs": [], 88 | "source": [ 89 | "df_output = pd.read_csv(f\"{output_path}output_verbose.csv\")\n", 90 | "\n", 91 | "df_output_verbose = pd.read_csv(f\"{output_path}output_verbose.csv\")" 92 | ] 93 | }, 94 | { 95 | "cell_type": "code", 96 | "execution_count": 8, 97 | "metadata": {}, 98 | "outputs": [ 99 | { 100 | "data": { 101 | "text/html": [ 102 | "
\n", 103 | "\n", 116 | "\n", 117 | " \n", 118 | " \n", 119 | " \n", 120 | " \n", 121 | " \n", 122 | " \n", 123 | " \n", 124 | " \n", 125 | " \n", 126 | " \n", 127 | " \n", 128 | " \n", 129 | " \n", 130 | " \n", 131 | " \n", 132 | " \n", 133 | " \n", 134 | " \n", 135 | " \n", 136 | "
idAnswer
00### Explanation:\\n\\n**Exanthème roséoliforme f...
11### Explication des propositions\\n\\n**A: L’aus...
\n", 137 | "
" 138 | ], 139 | "text/plain": [ 140 | " id Answer\n", 141 | "0 0 ### Explanation:\\n\\n**Exanthème roséoliforme f...\n", 142 | "1 1 ### Explication des propositions\\n\\n**A: L’aus..." 143 | ] 144 | }, 145 | "execution_count": 8, 146 | "metadata": {}, 147 | "output_type": "execute_result" 148 | } 149 | ], 150 | "source": [ 151 | "df_output_verbose.head()" 152 | ] 153 | }, 154 | { 155 | "cell_type": "code", 156 | "execution_count": null, 157 | "metadata": {}, 158 | "outputs": [], 159 | "source": [] 160 | } 161 | ], 162 | "metadata": { 163 | "kernelspec": { 164 | "display_name": "mistral-hackathon", 165 | "language": "python", 166 | "name": "python3" 167 | }, 168 | "language_info": { 169 | "codemirror_mode": { 170 | "name": "ipython", 171 | "version": 3 172 | }, 173 | "file_extension": ".py", 174 | "mimetype": "text/x-python", 175 | "name": "python", 176 | "nbconvert_exporter": "python", 177 | "pygments_lexer": "ipython3", 178 | "version": "3.10.15" 179 | } 180 | }, 181 | "nbformat": 4, 182 | "nbformat_minor": 2 183 | } 184 | -------------------------------------------------------------------------------- /notebooks/fine-tuning.ipynb: -------------------------------------------------------------------------------- 1 | { 2 | "cells": [ 3 | { 4 | "cell_type": "code", 5 | "execution_count": 16, 6 | "metadata": {}, 7 | "outputs": [], 8 | "source": [ 9 | "from mistralai import Mistral\n", 10 | "import os\n", 11 | "import pandas as pd\n", 12 | "import json\n", 13 | "from dotenv import load_dotenv\n", 14 | "\n", 15 | "load_dotenv()\n", 16 | "\n", 17 | "api_key = os.getenv(\"MISTRAL_API_KEY\")\n", 18 | "\n", 19 | "client = Mistral(api_key=api_key)\n", 20 | "\n", 21 | "ultrachat_chunk_train = client.files.upload(file={\n", 22 | " \"file_name\": \"on_video_train.jsonl\",\n", 23 | " \"content\": open(\"on_video_train.jsonl\", \"rb\"),\n", 24 | "})\n", 25 | "ultrachat_chunk_eval = client.files.upload(file={\n", 26 | " \"file_name\": \"on_video_eval.jsonl\",\n", 27 | " \"content\": open(\"on_video_eval.jsonl\", \"rb\"),\n", 28 | "})" 29 | ] 30 | }, 31 | { 32 | "cell_type": "code", 33 | "execution_count": 17, 34 | "metadata": {}, 35 | "outputs": [ 36 | { 37 | "name": "stdout", 38 | "output_type": "stream", 39 | "text": [ 40 | "id='959134cd-9156-491c-9295-46548d57fd2e' object='file' bytes=8272 created_at=1728791677 filename='on_video_eval.jsonl' sample_type='instruct' source='upload' PURPOSE='fine-tune' num_lines=10 id='8ad65426-1c2a-435a-b3a9-0a71d8d68651' object='file' bytes=75007 created_at=1728791677 filename='on_video_train.jsonl' sample_type='instruct' source='upload' PURPOSE='fine-tune' num_lines=97\n" 41 | ] 42 | } 43 | ], 44 | "source": [ 45 | "print(ultrachat_chunk_eval, ultrachat_chunk_train)" 46 | ] 47 | }, 48 | { 49 | "cell_type": "code", 50 | "execution_count": 18, 51 | "metadata": {}, 52 | "outputs": [], 53 | "source": [ 54 | "# create a fine-tuning job\n", 55 | "created_jobs = client.fine_tuning.jobs.create(\n", 56 | " model=\"mistral-large-latest\", \n", 57 | " training_files=[{\"file_id\": ultrachat_chunk_train.id, \"weight\": 1}],\n", 58 | " validation_files=[ultrachat_chunk_eval.id], \n", 59 | " hyperparameters={\n", 60 | " \"training_steps\": 5,\n", 61 | " \"learning_rate\":0.0001\n", 62 | " },\n", 63 | " auto_start=False\n", 64 | ")" 65 | ] 66 | }, 67 | { 68 | "cell_type": "code", 69 | "execution_count": 19, 70 | "metadata": { 71 | "scrolled": true 72 | }, 73 | "outputs": [ 74 | { 75 | "data": { 76 | "text/plain": [ 77 | "JobOut(id='3d8a5d94-d73e-4de7-b3ce-a0546f9bba05', auto_start=False, hyperparameters=TrainingParameters(training_steps=5, learning_rate=0.0001, weight_decay=0.1, warmup_fraction=0.05, epochs=None, fim_ratio=None), model='mistral-large-latest', status='QUEUED', job_type='FT', created_at=1728791692, modified_at=1728791692, training_files=['8ad65426-1c2a-435a-b3a9-0a71d8d68651'], validation_files=['959134cd-9156-491c-9295-46548d57fd2e'], OBJECT='job', fine_tuned_model=None, suffix=None, integrations=[], trained_tokens=None, repositories=[], metadata=JobMetadataOut(expected_duration_seconds=None, cost=0.0, cost_currency=None, train_tokens_per_step=None, train_tokens=None, data_tokens=None, estimated_start_time=None))" 78 | ] 79 | }, 80 | "execution_count": 19, 81 | "metadata": {}, 82 | "output_type": "execute_result" 83 | } 84 | ], 85 | "source": [ 86 | "# start a fine-tuning job\n", 87 | "client.fine_tuning.jobs.start(job_id = created_jobs.id)\n", 88 | "created_jobs" 89 | ] 90 | }, 91 | { 92 | "cell_type": "code", 93 | "execution_count": 20, 94 | "metadata": {}, 95 | "outputs": [ 96 | { 97 | "data": { 98 | "text/plain": [ 99 | "JobOut(id='3d8a5d94-d73e-4de7-b3ce-a0546f9bba05', auto_start=False, hyperparameters=TrainingParameters(training_steps=5, learning_rate=0.0001, weight_decay=0.1, warmup_fraction=0.05, epochs=None, fim_ratio=None), model='mistral-large-latest', status='QUEUED', job_type='FT', created_at=1728791692, modified_at=1728791692, training_files=['8ad65426-1c2a-435a-b3a9-0a71d8d68651'], validation_files=['959134cd-9156-491c-9295-46548d57fd2e'], OBJECT='job', fine_tuned_model=None, suffix=None, integrations=[], trained_tokens=None, repositories=[], metadata=JobMetadataOut(expected_duration_seconds=None, cost=0.0, cost_currency=None, train_tokens_per_step=None, train_tokens=None, data_tokens=None, estimated_start_time=None))" 100 | ] 101 | }, 102 | "execution_count": 20, 103 | "metadata": {}, 104 | "output_type": "execute_result" 105 | } 106 | ], 107 | "source": [ 108 | "created_jobs" 109 | ] 110 | }, 111 | { 112 | "cell_type": "code", 113 | "execution_count": 28, 114 | "metadata": {}, 115 | "outputs": [ 116 | { 117 | "name": "stdout", 118 | "output_type": "stream", 119 | "text": [ 120 | "id='3d8a5d94-d73e-4de7-b3ce-a0546f9bba05' auto_start=False hyperparameters=TrainingParameters(training_steps=5, learning_rate=0.0001, weight_decay=0.1, warmup_fraction=0.05, epochs=69.90133859527492, fim_ratio=None) model='mistral-large-latest' status='SUCCESS' job_type='FT' created_at=1728791692 modified_at=1728792168 training_files=['8ad65426-1c2a-435a-b3a9-0a71d8d68651'] validation_files=['959134cd-9156-491c-9295-46548d57fd2e'] OBJECT='job' fine_tuned_model='ft:mistral-large-latest:64a2499b:20241013:3d8a5d94' suffix=None integrations=[] trained_tokens=1310720 repositories=[] metadata=JobMetadataOut(expected_duration_seconds=365, cost=11.54, cost_currency='EUR', train_tokens_per_step=262144, train_tokens=1310720, data_tokens=18751, estimated_start_time=None) events=[EventOut(name='status-updated', created_at=1728792168, data={'status': 'SUCCESS'}), EventOut(name='status-updated', created_at=1728791703, data={'status': 'RUNNING'}), EventOut(name='status-updated', created_at=1728791699, data={'status': 'QUEUED'}), EventOut(name='status-updated', created_at=1728791693, data={'status': 'VALIDATED'}), EventOut(name='status-updated', created_at=1728791693, data={'status': 'RUNNING'}), EventOut(name='status-updated', created_at=1728791692, data={'status': 'QUEUED'})] checkpoints=[]\n" 121 | ] 122 | } 123 | ], 124 | "source": [ 125 | "# Retrieve a jobs\n", 126 | "retrieved_jobs = client.fine_tuning.jobs.get(job_id = created_jobs.id)\n", 127 | "print(retrieved_jobs)" 128 | ] 129 | }, 130 | { 131 | "cell_type": "code", 132 | "execution_count": 29, 133 | "metadata": {}, 134 | "outputs": [], 135 | "source": [ 136 | "chat_response = client.chat.complete(\n", 137 | " model=retrieved_jobs.fine_tuned_model,\n", 138 | " messages = [{\"role\":'user', \"content\":'What is the best French cheese?'}]\n", 139 | ")" 140 | ] 141 | }, 142 | { 143 | "cell_type": "code", 144 | "execution_count": 30, 145 | "metadata": {}, 146 | "outputs": [ 147 | { 148 | "data": { 149 | "text/plain": [ 150 | "'ft:mistral-large-latest:64a2499b:20241013:3d8a5d94'" 151 | ] 152 | }, 153 | "execution_count": 30, 154 | "metadata": {}, 155 | "output_type": "execute_result" 156 | } 157 | ], 158 | "source": [ 159 | "retrieved_jobs.fine_tuned_model" 160 | ] 161 | }, 162 | { 163 | "cell_type": "code", 164 | "execution_count": 31, 165 | "metadata": {}, 166 | "outputs": [ 167 | { 168 | "data": { 169 | "text/plain": [ 170 | "ChatCompletionResponse(id='650ac712ff354a7887978c65e8110c6e', object='chat.completion', model='ft:mistral-large-latest:64a2499b:20241013:3d8a5d94', usage=UsageInfo(prompt_tokens=10, completion_tokens=314, total_tokens=324), created=1728792308, choices=[ChatCompletionChoice(index=0, message=AssistantMessage(content='Choosing the \"best\" French cheese is subjective, as it depends on personal taste. France is renowned for its wide variety of cheeses, with over 400 different types. Here are a few highly regarded ones:\\n\\n1. **Brie de Meaux**: A soft, creamy cheese made from cow\\'s milk. It\\'s often considered one of the finest cheeses in the world.\\n\\n2. **Camembert de Normandie**: Another soft, creamy cheese made from cow\\'s milk. It has a stronger flavor than Brie.\\n\\n3. **Roquefort**: A sheep milk cheese from the south of France. It\\'s known for its tangy, salty flavor and distinctive veins of blue mold.\\n\\n4. **Comté**: A firm, nutty cheese made from cow\\'s milk in the Jura region. It\\'s often used in fondue and has a complex, rich flavor.\\n\\n5. **Reblochon**: A soft, washed-rind cheese made from cow\\'s milk. It has a nutty taste and is often used in the dish Tartiflette.\\n\\n6. **Époisses de Bourgogne**: A soft, pungent cheese made from cow\\'s milk. It has a strong, somewhat salty flavor.\\n\\nEach of these cheeses has its own unique characteristics, so the \"best\" one depends on your personal preferences.', tool_calls=None, prefix=False, role='assistant'), finish_reason='stop')])" 171 | ] 172 | }, 173 | "execution_count": 31, 174 | "metadata": {}, 175 | "output_type": "execute_result" 176 | } 177 | ], 178 | "source": [ 179 | "chat_response" 180 | ] 181 | }, 182 | { 183 | "cell_type": "code", 184 | "execution_count": null, 185 | "metadata": {}, 186 | "outputs": [], 187 | "source": [] 188 | } 189 | ], 190 | "metadata": { 191 | "kernelspec": { 192 | "display_name": "Python 3 (ipykernel)", 193 | "language": "python", 194 | "name": "python3" 195 | }, 196 | "language_info": { 197 | "codemirror_mode": { 198 | "name": "ipython", 199 | "version": 3 200 | }, 201 | "file_extension": ".py", 202 | "mimetype": "text/x-python", 203 | "name": "python", 204 | "nbconvert_exporter": "python", 205 | "pygments_lexer": "ipython3", 206 | "version": "3.12.4" 207 | } 208 | }, 209 | "nbformat": 4, 210 | "nbformat_minor": 4 211 | } 212 | -------------------------------------------------------------------------------- /utils/prompts.py: -------------------------------------------------------------------------------- 1 | THINK_PROMPT = """ 2 | You are an experienced doctor with 20+ years of experience ready to solve user problems through first-principles thinking and evidence-based reasoning. Your objective is to provide clear, step-by-step solutions by deconstructing queries to their foundational concepts and building answers from the ground up. 3 | 4 | The lives of many people depend on your answer. After carrying out the reasoning, check everything again and look for errors. 5 | 6 | Problem-Solving Steps: 7 | 8 | Understand: Read and comprehend the user's question. 9 | Basics: Identify fundamental concepts involved. 10 | Break Down: Divide the problem into smaller parts. 11 | Analyze: Use facts and data to examine each part. 12 | Build: Assemble insights into a coherent solution. 13 | Edge Cases: Consider and address exceptions. 14 | Communicate: Present the solution clearly. 15 | Verify: Review and reflect on the solution. 16 | 17 | Your answer must contain the letter of the answers, separated by commas and WITHOUT ANY SPACE and IN ALPHABETICAL ORDER. An ideal output is like: 'A,B' DO NOT PRINT 'A, B' for instance. 18 | You output the letters that you are asked to provide, e.g. 'A,B,C' or 'C'. Your answer is always sorted alphabetically. You must not put letters in a different order. 19 | Output the answer as a json at the end of the prompt {"answer": ["A","B","D"]} 20 | 21 | Following, an example of conversation: 22 | 23 | User: 24 | A propos de l'insuffisance cardiaque, quelle(s) est (sont) la (les) proposition(s) vraie(s) ? 25 | A. L'auscultation cardiaque peut mettre en évidence un éclat du b2 au foyer aortique en cas d'hypertension artériellepulmonaire 26 | B. L'auscultation cardiaque peut mettre en évidence un souffle d'insuffisance mitrale liée à la dilatation de l'anneau mitral 27 | C. La turgescence jugulaire constitue un signe périphérique d'insuffisance cardiaque gauche 28 | D. Les œdèmes périphériques sont mous, bleus et douloureux 29 | E. Les râles crépitants ou sous-crépitants sont souvent bilatéraux 30 | 31 | Assistant: ["A","B","E"] 32 | 33 | User: 34 | Quelle(s) est (sont) la (les) réponse(s) vraie(s) concernant la prise en charge des bronchectasies diffuses chez l'adulte (endehors d'un contexte de mucoviscidose) responsables d'épisodes infectieux à répétition ? 35 | A. Drainage bronchique quotidien 36 | B. Corticothérapie systémique 37 | C. Lobectomie pulmonaire 38 | D. Cure d'antibiothérapie trimestrielle systématique 39 | E. Traitement anti-inflammatoire par fluoroquinolone 40 | 41 | Assistant: ["A","D"] 42 | 43 | User: 44 | Une patiente de 58 ans vient aux urgences de votre hôpital pour l'expectoration de deux verres de sang rouge lors d'uneffort de toux. elle n'avait jamais craché de sang. elle est sous aspirine à visée anti-agrégante pour une coronaropathie.son examen clinique est normal ; sa pression artérielle est à 132 /79 mmhg. la fréquence cardiaque est à 80/mn. laradiographie pulmonaire ne montre pas d'anomalie.donnez la ou les réponse(s) juste(s) 45 | A. Vous hospitalisez la patiente 46 | B. Vous mettez en place un remplissage vasculaire 47 | C. Vous prescrivez un agent vasoconstricteur par voie intraveineuse type telipressine 48 | D. Vous prescrivez une tomodensitométrie thoracique injectée avec acquisition au temps artériel après vérificationd'absence de contre-indication 49 | E. Vous rassurez la patiente et lui expliquez qu'il est normal de saigner sous anti-agrégants 50 | 51 | Assistant: ["A","D"] 52 | 53 | User: 54 | Un patient de 55 ans présentant un hyperlymphocytose à 25 g/l sans cytopénie vous est adressé avec un diagnostic deleucémie lymphoide chronique sur l'immunophénotypage lymphocytaire. a l’examen clinique, le patient est en excellent étatgénéral et il existe une polyadénopathie de 1,5 à 2 cm de diamètre dans toutes les aires ganglionnaires. quel examen estnécessaire à ce stade ? (une seule réponse) 55 | A. Aucun 56 | B. Un tep-scanner 57 | C. Une échocardiographie 58 | D. Un myélogramme 59 | E. Une scintigraphie osseuse 60 | 61 | Assistant: B""" 62 | 63 | PERPLEXITY_PROMPT = """Answer could be multiple. Give me as answers ONLY the letters of the answer, don't write anything else, only the letters""" 64 | 65 | 66 | THINK_PROMPT_FRENCH = """" 67 | Vous êtes un modèle de langage AI conçu pour résoudre les problèmes des utilisateurs grâce à une réflexion basée sur les principes fondamentaux et un raisonnement fondé sur des preuves. Votre objectif est de fournir des solutions claires et étape par étape en décomposant les questions jusqu'à leurs concepts fondamentaux et en construisant les réponses à partir de zéro. 68 | 69 | Étapes de résolution de problèmes : 70 | 71 | Comprendre : Lire et comprendre la question de l'utilisateur. 72 | Bases : Identifier les concepts fondamentaux impliqués. 73 | Décomposer : Diviser le problème en parties plus petites. 74 | Analyser : Utiliser des faits et des données pour examiner chaque partie. 75 | Construire : Assembler les idées en une solution cohérente. 76 | Cas particuliers : Considérer et traiter les exceptions. 77 | Communiquer : Présenter la solution clairement. 78 | Vérifier : Revoir et réfléchir à la solution. 79 | Répondez à la question suivante avec les lettres de la bonne réponse. Chaque question peut avoir plusieurs réponses correctes. 80 | Pour chaque réponse, réfléchissez ainsi : 'est-ce vrai par rapport à la question posée ?' 81 | Pour chaque question, expliquez d'abord la condition médicale et ses implications, donnez le contexte, puis imprimez les réponses correctes. 82 | Votre réponse doit contenir la lettre des réponses, séparées par des virgules et SANS ESPACE. Une sortie idéale est comme : 'A,B' NE PAS IMPRIMER 'A, B' par exemple. 83 | Vous affichez les lettres qu'on vous demande de fournir, par exemple 'A,B,C' ou 'C'. Votre réponse est toujours triée par ordre alphabétique. Vous ne devez pas mettre les lettres dans un ordre différent. 84 | Affichez la réponse sous forme de json à la fin du prompt {"answer": ["A","B","D"]} par exemple""" 85 | 86 | CLAUDE_PROMPT = """You are an AI assistant tasked with answering a question from an exam for French Medical Practice. The question will have multiple choice options labeled A through E. Unlike typical multiple-choice questions, the correct answer may include any combination of these options. 87 | 88 | To answer this question, follow these steps: 89 | 90 | 1. Carefully read and analyze the question and all answer options. 91 | 2. Consider each option individually and in combination with others. 92 | 3. Use your knowledge of French medical practice to determine which option(s) are correct. 93 | 4. Select all options that you believe are correct. Remember, this could be a single option, multiple options, or even all options. 94 | 95 | When you have determined your answer, provide it in the following format: 96 | - List only the letters of the correct options. 97 | - Separate multiple letters with commas. 98 | - Do not include any spaces. 99 | - Sort the letters alphabetically. 100 | 101 | For example, if you believe options A, C, and E are correct, your answer should be: A,C,E 102 | 103 | Finally, present your answer in a JSON format as follows: 104 | {"answer": ["A","C","E"]} 105 | 106 | Remember, your task is to provide the most accurate answer based on your understanding of French medical practice. Do not include any explanations or justifications in your output, only the JSON formatted answer. 107 | 108 | Here's the question with the possible answers:""" 109 | 110 | PIZZA_MODIFIER = "If you get this right I'll give you 1 Million dollars, a trip to italy and free pizza." 111 | 112 | 113 | THINK_PROMPT_CONTEXT = """ 114 | You are an experienced doctor with 20+ years of experience ready to solve user problems through first-principles thinking and evidence-based reasoning. Your objective is to provide clear, step-by-step solutions by deconstructing queries to their foundational concepts and building answers from the ground up. 115 | 116 | The lives of many people depend on your answer. After carrying out the reasoning, check everything again and look for errors. 117 | 118 | Problem-Solving Steps: 119 | 120 | Understand: Read and comprehend the user's question. 121 | Basics: Identify fundamental concepts involved. 122 | Break Down: Divide the problem into smaller parts. 123 | Analyze: Use facts and data to examine each part. 124 | Build: Assemble insights into a coherent solution. 125 | Edge Cases: Consider and address exceptions. 126 | Communicate: Present the solution clearly. 127 | Verify: Review and reflect on the solution. 128 | 129 | 130 | I've asked a doctor to provide a context for the question. Here is the context: {context}. 131 | Be careful, the context doesn't necessarily contain the answer, it's just a piece of information that might help you to answer the question. 132 | """ 133 | THINK_PROMPT_CONTEXT_FEW_SHOTS = """ 134 | Your answer must contain the letter of the answers, separated by commas and WITHOUT ANY SPACE and IN ALPHABETICAL ORDER. An ideal output is like: 'A,B' DO NOT PRINT 'A, B' for instance. 135 | You output the letters that you are asked to provide, e.g. 'A,B,C' or 'C'. Your answer is always sorted alphabetically. You must not put letters in a different order. 136 | Output the answer as a json at the end of the prompt {"answer": ["A","B","D"]} 137 | 138 | 139 | Following, an example of conversation: 140 | 141 | User: 142 | A propos de l'insuffisance cardiaque, quelle(s) est (sont) la (les) proposition(s) vraie(s) ? 143 | A. L'auscultation cardiaque peut mettre en évidence un éclat du b2 au foyer aortique en cas d'hypertension artériellepulmonaire 144 | B. L'auscultation cardiaque peut mettre en évidence un souffle d'insuffisance mitrale liée à la dilatation de l'anneau mitral 145 | C. La turgescence jugulaire constitue un signe périphérique d'insuffisance cardiaque gauche 146 | D. Les œdèmes périphériques sont mous, bleus et douloureux 147 | E. Les râles crépitants ou sous-crépitants sont souvent bilatéraux 148 | 149 | Assistant: ["A","B","E"] 150 | 151 | User: 152 | Quelle(s) est (sont) la (les) réponse(s) vraie(s) concernant la prise en charge des bronchectasies diffuses chez l'adulte (endehors d'un contexte de mucoviscidose) responsables d'épisodes infectieux à répétition ? 153 | A. Drainage bronchique quotidien 154 | B. Corticothérapie systémique 155 | C. Lobectomie pulmonaire 156 | D. Cure d'antibiothérapie trimestrielle systématique 157 | E. Traitement anti-inflammatoire par fluoroquinolone 158 | 159 | Assistant: ["A","D"] 160 | 161 | User: 162 | Une patiente de 58 ans vient aux urgences de votre hôpital pour l'expectoration de deux verres de sang rouge lors d'uneffort de toux. elle n'avait jamais craché de sang. elle est sous aspirine à visée anti-agrégante pour une coronaropathie.son examen clinique est normal ; sa pression artérielle est à 132 /79 mmhg. la fréquence cardiaque est à 80/mn. laradiographie pulmonaire ne montre pas d'anomalie.donnez la ou les réponse(s) juste(s) 163 | A. Vous hospitalisez la patiente 164 | B. Vous mettez en place un remplissage vasculaire 165 | C. Vous prescrivez un agent vasoconstricteur par voie intraveineuse type telipressine 166 | D. Vous prescrivez une tomodensitométrie thoracique injectée avec acquisition au temps artériel après vérificationd'absence de contre-indication 167 | E. Vous rassurez la patiente et lui expliquez qu'il est normal de saigner sous anti-agrégants 168 | 169 | Assistant: ["A","D"] 170 | 171 | User: 172 | Un patient de 55 ans présentant un hyperlymphocytose à 25 g/l sans cytopénie vous est adressé avec un diagnostic deleucémie lymphoide chronique sur l'immunophénotypage lymphocytaire. a l’examen clinique, le patient est en excellent étatgénéral et il existe une polyadénopathie de 1,5 à 2 cm de diamètre dans toutes les aires ganglionnaires. quel examen estnécessaire à ce stade ? (une seule réponse) 173 | A. Aucun 174 | B. Un tep-scanner 175 | C. Une échocardiographie 176 | D. Un myélogramme 177 | E. Une scintigraphie osseuse 178 | 179 | Assistant: B""" 180 | -------------------------------------------------------------------------------- /data/dataset/dataset_english_only_clean_final.csv: -------------------------------------------------------------------------------- 1 | question,answer_A,answer_B,answer_C,answer_D,answer_E,id 2 | "In the presence of a febrile roseoliform exanthem in a child, the main etiologies are (one or more correct answers):",A sudden rash,An epidemic megaloerythema,A rubella,Infectious mononucleosis,Kawasaki syndrome,0 3 | "Regarding heart failure, which proposition(s) is (are) true?",Cardiac auscultation can reveal an accentuated B2 at the aortic area in cases of pulmonary arterial hypertension.,Cardiac auscultation may reveal a murmur of mitral insufficiency related to the dilation of the mitral annulus.,Jugular venous distention is a peripheral sign of left-sided heart failure.,"Peripheral edema is soft, blue, and painful.",Crackling or sub-crackling rales are often bilateral,1 4 | What is (are) the true answer(s) concerning the management of diffuse bronchiectasis in adults (outside the context of cystic fibrosis) responsible for recurrent infectious episodes?,Daily bronchial drainage,Systemic corticosteroid therapy,Pulmonary lobectomy,Systematic quarterly antibiotic therapy treatment,Anti-inflammatory treatment with fluoroquinolone,2 5 | A 58-year-old female patient comes to the emergency department of your hospital for the expectoration of two glasses of red blood during a coughing effort. She had never coughed up blood before. She is on aspirin for anti-aggregant therapy for coronary artery disease. Her clinical examination is normal; her blood pressure is 132/79 mmHg. The heart rate is 80/min. The chest X-ray shows no abnormalities. Give the correct answer(s).,You are admitting the patient to the hospital,You initiate vascular filling,You prescribe an intravenous vasoconstrictor agent such as terlipressin,You prescribe a contrast-enhanced thoracic computed tomography with acquisition during the arterial phase after verification of the absence of contraindications.,You reassure the patient and explain to her that it is normal to bleed while on antiplatelet agents.,3 6 | "A 55-year-old patient presenting with lymphocytosis at 25 g/l without cytopenia is referred to you with a diagnosis of chronic lymphocytic leukemia based on lymphocyte immunophenotyping. On clinical examination, the patient is in excellent general condition and there is polyadenopathy with diameters of 1.5 to 2 cm in all nodal areas. What examination is necessary at this stage? (only one answer)",None,PET scan,An echocardiography,A myelogram,A bone scintigraphy,4 7 | "A 25-year-old man consults you due to abdominal pain. The examination is normal except for a palpable spleen at the end of inspiration. The blood count shows: leukocytes 14 g/l, neutrophils 8 g/l, myelocytes 1 g/l, metamyelocytes 1 g/l, monocytes 1 g/l, lymphocytes 3 g/l, platelets 510 g/l. You suspect chronic myeloid leukemia. Which biological tests do you prescribe to confirm your diagnostic hypothesis? (one or more possible answers)",Leukocyte immunophenotyping on blood,Search for Jolly bodies in the smear,Search for the bcr-abl transcript,Gumprecht shadow cells examination,Search for a JAK2 mutation,5 8 | Which of the following statements regarding fragility osteopathies is (are) correct?,Primary hyperparathyroidism preferentially affects cortical bone,The treatment of hypothyroidism increases the risk of osteoporotic fracture,Corticosteroid-induced osteoporosis primarily affects the cortical bone,Estrogen deficiency is responsible for osteoclastic hyperactivity,Biphosphonate treatment increases osteoblast activity,6 9 | "A 50-year-old woman arrives at the emergency room for malaise. She has no particular medical history but describes rapidly onset fatigue. The clinical examination is normal except for conjunctival subicterus. The blood count shows hemoglobin 90 g/l, erythrocytes 2.7 t/l, hematocrit 27%, MCV 102 fl, MCHC 33 g/dl, leukocytes 8 g/l, neutrophils 5 g/l, lymphocytes 2.3 g/l, monocytes 0.7 g/l. What biological tests seem relevant to prescribe as a first intention? (One or more possible answers)",C-reactive protein (CRP),Serum iron,Serum protein electrophoresis,Reticulocytes,LDH,7 10 | "Among the following infectious agents, which one(s) is(are) responsible for culture-negative endocarditis?",Mycobacterium tuberculosis,Bartonella,Streptococcus pyogenes,Coxiella burnetii,Tropheryma whipplei,8 11 | "Among the following infectious diseases, which one(s) is(are) notifiable in France?",Rubella,Plague,Tuberculosis,Legionellosis,Invasive pneumococcal disease,9 12 | "In a patient treated for 2 days for proximal pulmonary embolism with unfractionated heparin, the aPTT ratio is 6 and the anti-Xa activity is measured at the peak activity at 1.2 IU/ml, in the absence of bleeding, what measure(s) do you take immediately? (one or more possible answers)",Vitamin K intake,Platelet concentrate transfusion,Protamine infusion,Dose adjustment and cessation,Introduction of VKAs,10 13 | "A 62-year-old man with no medical history presents with a spontaneous deep hematoma of the psoas muscle. The hemogram shows hemoglobin at 90 g/l and platelets at 170 g/l. His hemostasis assessment is as follows: aPTT ratio at 2.1, PT at 78%, and fibrinogen at 3.1 g/l. Mixing the patient's plasma with normal plasma does not correct the aPTT (Rosner index at 28 for a normal < 15). Testing of intrinsic pathway factors reveals factor VIII at 4%. What diagnostic hypothesis(es) do you consider? (one or more possible answers)",Presence of a lupus anticoagulant,A congenital hemophilia,The presence of an anti-factor VIII antibody,Type 1 von Willebrand disease,An acquired hemophilia B,11 14 | "A patient is brought unconscious by firefighters to the emergency room following a road traffic accident. She has multiple trauma for which an emergency brain and thoraco-abdomino-pelvic CT scan is performed. She presents with a splenic fracture requiring surgical intervention. Upon arrival, her husband informs you that she is approximately 8 weeks pregnant. The radiation dose received is 10 mGy. What are the risks associated with the accident and the medical management?",Developmental delay,Cerebral malformation,Abortion,Growth retardation,Retroplacental hematoma,12 15 | "A patient presents to your office for a preconception consultation. She is 32 years old, nulligravida. She has been monitored for a year for well-controlled arterial hypertension under perindopril, one tablet per day. She is using estrogen-progestin contraception which she plans to stop at the end of her pack. She weighs 81 kg and is 1.68 meters tall. She smokes 5 cigarettes per day but would like to quit. What do you plan at the end of the consultation? (one or more correct answers)",Rubella serology,Assistance with smoking cessation using nicotine substitutes,Cervical smear test if the latter is over one year old,Prescription of folates at a dose of 5 mg/day,Discontinuation of treatment with perindopril and switch to another antihypertensive,13 16 | "A 28-year-old woman consults for the palpation of a mass in the upper outer quadrant of the right breast. She is worried because her mother and maternal aunt had breast cancer at 55 and 60 years old, respectively. On clinical examination, you palpate a round and regular 15 mm mass, not adherent to the deep and superficial planes. There is no inflammation or skin retraction observed. No suspicious lymphadenopathy is palpated in the axillary and supraclavicular lymph node areas. What examination(s) should be requested initially?",Breast ultrasound,A chest X-ray,A CA 15-3 assay,A breast MRI,A mammogram,14 17 | "A 38-year-old woman consults 3 months after her third delivery for a request for contraception. She had a cesarean section, whereas her first two deliveries were vaginal. She has just stopped breastfeeding her child because she needs to resume her professional activity. In her medical history, she reports a uterine perforation during the insertion of an intrauterine device 7 years ago, a phlebitis under cast 10 years ago, and a cervical laser treatment 4 years ago for cervical dysplasia related to human papillomavirus infection. She does not smoke but ""vapes"" occasionally. The last cervical cytology, performed at the beginning of pregnancy, was normal. What contraceptive method(s) is(are) possible for this woman?",Levonorgestrel intrauterine device,Copper intrauterine device,Transdermal device releasing norelgestromin and ethinylestradiol,Tubal sterilization by laparoscopy,Subcutaneous device releasing etonogestrel,15 18 | "In the case of suspected intraocular metallic foreign body, which examination(s) do you propose as an emergency?",Orbital CT scan,An MRI,An X-ray of the orbit,Fluorescein angiography,A measurement of intraocular pressure,16 19 | What is the correct statement(s) regarding voluntary termination of pregnancy (abortion) in France?,A woman under guardianship can request an abortion,A woman can request complete anonymity for the performance of an abortion.,The insertion of an intrauterine device is contraindicated in the immediate aftermath of a surgical abortion,Prostaglandins cannot be used in cases of hereditary porphyria,A psychosocial interview must systematically be conducted before performing the abortion,17 20 | A chalazion,Is an infection of an eyelid pilosebaceous follicle,Is a resorption granuloma of a meibomian gland of the eyelids,Treat with corticosteroid ointment,Treated with systemic antibiotics,May require a surgical incision,18 21 | What are the possible etiologies of decreased visual acuity associated with eye redness (several correct answers)?,Acute angle-closure glaucoma attack,Anterior uveitis,Central retinal artery occlusion,Neovascular glaucoma,Retinal vasculitis,19 22 | In cases of myopia (one or more correct answers):,The optical system formed by the eye is too convergent,Distance vision is better than near vision without correction,The light rays focus in front of the retina,A divergent lens can be used for correction,The risk of retinal detachment may be increased,20 23 | "You are managing an 83-year-old patient, well supported, on day 2 of knee arthroplasty. The Redon drains were removed without issue. She presents with a swollen knee, very edematous and inflammatory. The scar is fine, non-inflammatory. What is (are) the correct proposal(s)?",Outpatient care is possible,The electrotherapy techniques practiced by the physiotherapist will aim to reduce the edema.,The prescription for a walking cane could be made by the private physiotherapist after hospital discharge.,Your physical therapy prescription must obligatorily mention the physical therapy techniques to be employed,The adaptation of the home must be carried out after preparing a file with the MDPH (Departmental House for Disabled Persons),21 24 | "You are taking care of a 32-year-old patient, a computer scientist, with a smoking history of 15 pack-years, no medical or surgical history, who was the victim of a road accident resulting in a severe spinal cord injury due to a C5 cervical fracture osteosynthesized via the anterior approach on April 30, 2018. The weaning from mechanical ventilation was difficult, so he underwent a tracheostomy on May 21, 2018, after orotracheal intubation. The weaning was then achieved on May 29. Upon arrival, he is eupneic. He presents a stage 4 pressure sore on the right trochanter, with substance loss down to the bone. The base of the pressure sore is fibrous, and purulent secretions are very abundant without any inflammatory skin signs. What is the correct proposal(s)?",Tracheal stenosis is a complication of prolonged orotracheal intubation.,You prioritize for the treatment of this bedsore a combination of local antiseptics and dry dressings.,The presence of this pressure sore contraindicates sitting in a chair,"The lesion being at the medullary level C6, you would expect anesthesia from the lateral edge of the forearm in anatomical position.",The request for long-term illness can be made by the attending physician,22 25 | You are prescribing a standard articulated knee brace for one of your patients with a knee sprain. Check the correct prescription principle(s) for this type of medical device:,It is prescribed on a regular prescription,It is prescribed on a large appliance form,It is reimbursed at 100% of its purchase price,It can be prescribed by all specialists,It can be prescribed by a physiotherapist,23 26 | "Regarding carpal tunnel syndrome, which proposition(s) is(are) true?",It is most often idiopathic,It is more common during pregnancy,The electromyogram is essential for diagnosis,It may cause a deficit of the long flexor of the thumb,It may cause an abolition of the stylo-radial reflex.,24 27 | "Regarding knee osteoarthritis, which is (are) the correct answer(s)?",Joint aspiration is essential for diagnosis,A genu varum predisposes to medial femorotibial gonarthrosis,Viscosupplementation injections are indicated in flare-ups with effusion.,The surgical indication depends on the extent of joint space narrowing,The effectiveness of corticosteroid infiltrations is limited over time,25 28 | "A 78-year-old former mechanic comes in for consultation due to significant febrile inflammatory low back pain that has appeared over the past 10 days. You suspect a spondylodiscitis and decide to prescribe him a lumbar MRI. This patient has a total hip prosthesis placed 8 years ago and a valve prosthesis for 2 years. He received a coronary stent placement 3 months ago. He presents a glomerular filtration rate of 48 ml/min. During the interview, he reports having received metal fragments in his right eye and right cheek 40 years ago. What contraindicates the use of an injected MRI?",Metallic fragments in the eye,Hip prosthesis,The valve prosthesis,Coronary stent,Renal function,26 29 | "In case of oculomotor nerve (III) paralysis, you may encounter during examination?",A defect in eye elevation,A miosis,Adduction defect of the eye,Exophthalmos,A ptosis,27 30 | "A 62-year-old patient has a medical history of essential hypertension treated with monotherapy for 2 years and active smoking (45 pack-years). For about two weeks, he has been complaining of daily headaches that typically occur in the second part of the night. Initially, they gradually decreased during the morning. For about 3 days, they have been constant. These headaches are described as diffuse and helmet-like, fluctuating in intensity, and are worsened by physical activity. He also complains of a lack of appetite and nausea, both of which have progressively developed. The patient is afebrile. What syndrome do you suggest in light of this picture?",Status migrainosus,Chronic daily headaches,Infectious meningitis syndrome,Intracranial hypertension,Meningeal syndrome associated with subarachnoid hemorrhage,28 31 | "A 59-year-old patient has developed a tremor in the last three fingers of the right hand that those around him have also noticed while walking. He swings the right upper limb less while walking. Upon examination, you note that the tremor disappears with arms outstretched. You observe that passive mobilization of the right elbow is more difficult and that mobilization of the right shoulder is painful. The deep tendon reflexes are normal. This type of tremor is probably aggravated by:",Emotion,Mental calculation,Writing,Movement,Sleep,29 32 | "Among the following propositions, which one(s) apply(ies) to a central neurogenic bladder?",The,Detrusor underactivity,Incontinence,Risk of vesicoureteral reflux,Low intravesical pressures,30 33 | Which of the following foods contain more than 5% carbohydrates?,Contact lenses,Green beans,Meat,Cheese,Fruits,31 34 | "Among the following biological signs, which one(s) guide you towards iatrogenic adrenal insufficiency in a 38-year-old patient with a history of Crohn's disease treated for 5 years with 10 mg/day of prednisone?",Natraemia at 128 mmol/l,Kalemia at 5.8 mmol/l,Fasting blood glucose at 3 mmol/l,Plasma ACTH at 8 a.m. at 585 pg/ml (n: 10 – 20),Urinary free cortisol at 25 µg/24 hours (normal: < 90),32 35 | You see in consultation a 15-day-old newborn who presents with isolated fever at 38.2°C and a preserved general condition.,You reassure the parents about the benign nature of this fever during viral epidemic periods,The flu test is not informative at this age,The urinary strip is not informative at this age.,The performance of a cytobacteriological urine test is systematic,The performance of a lumbar puncture is systematic,33 36 | "In the presence of a tongue lesion, what clinical sign(s) would suggest a malignant origin?",Indurated lesion,Painful lesion,Bleeding upon contact during palpation of the lesion,Submucosal induration,Presence of associated leukoplakia,34 37 | You are intervening at the home of an infant found deceased by their parents a few minutes ago:,You request to be accompanied by the police,You must not sign the death certificate before admission to the hospital.,You are drafting a report to the public prosecutor,You offer the parents to perform an autopsy to investigate the causes of death,The transfer of the body must be to a medico-legal institute,35 38 | You explain to young parents whose child is experiencing a first febrile episode the measure(s) to take during this episode.,Drug treatment is required for any temperature above 39°C,Drinking is necessary every hour as long as the fever persists,Use cool wraps if the child is uncomfortable,The use of ibuprofen is only possible after 3 months,The child should be kept out of group settings during the duration of the fever.,36 39 | "Regarding cervical swellings, what is the exact item(s)?",A thyroglossal duct cyst is mobile with swallowing,A right supraclavicular adenopathy may indicate a genitourinary cancer.,"A superficial, resilient swelling located at the anterior border of the sternocleidomastoid muscle is suggestive of a branchial cyst.",A schwannoma of the brachial plexus is a differential diagnosis of a submandibular lymphadenopathy,A schwannoma of the accessory nerve is a differential diagnosis of spinal adenopathy,37 40 | "Regarding peritonsillar abscess, what are the exact item(s)?",The abscess is located in the lateral pharyngeal space,Trismus may be present,The anterior pillar of the soft palate is enlarged,"In adults, hospitalization is systematic",Abscess drainage is performed either by puncture or by incision under general anesthesia,38 41 | "Regarding benign paroxysmal positional vertigo, what is (are) the exact item(s)?",It lasts less than a minute.,It is consequent to vestibular ischemia,It is treated with vestibular physiotherapy,It is associated with tinnitus,There is a positional triggering factor,39 42 | "A 32-year-old patient presents to the emergency room with asthenia. There are no other abnormalities on clinical examination. Biological tests reveal an increase in transaminases, with AST = 1362 IU (normal <40), ALT = 2348 IU (normal <40). What are the possible cause(s) of this increase in transaminases?",Acute viral hepatitis,Acute alcoholic hepatitis,Drug-induced hepatitis,Autoimmune hepatitis,Cannabis-induced hepatitis,40 43 | "A 62-year-old patient presents with progressively developed hyponatremia. He appears clinically euvolemic. His blood biochemistry results are as follows: Na 125 mmol/l, K 4 mmol/l, chloride 110 mmol/l, HCO3- 25 mmol/l, blood glucose 5 mmol/l, proteins 67 g/l, urea 4 mmol/l, creatinine 78 µmol/l. Urine test results: Na 100 mmol/l, K 25 mmol/l, urea 350 mmol/l, creatinine 8 mmol/l. What are the possible causes of this biological profile? (one or more correct answers)?",Tea and toast syndrome,Furosemide intake,Syndrome of inappropriate antidiuretic hormone secretion,Amlodipine intake,Lithium intake,41 44 | "An 86-year-old patient is hospitalized for hematemesis. He is known to have viral hepatitis B, not monitored. His family describes a bloody vomit equivalent in volume to that of a basin. On examination, he presents with ascites and asterixis. The systolic blood pressure is at 55 mmHg. Among the following elements, which is (are) associated with a poor prognosis?",Age,Volume of hematemesis,Blood pressure,Presence of hepatic encephalopathy,Presence of ascites,42 45 | "A 62-year-old patient presents the following biological results: Na 142 mmol/l, K 5.7 mmol/l, chloride 110 mmol/l, HCO3- 18 mmol/l, proteins 88 g/l, urea 20 mmol/l, creatininemia 170 µmol/l. Which medication(s) can cause this biological profile? (one or more correct answers)",Ibuprofen,Candesartan,Amiloride,Amlodipine,Prednisone,43 46 | "You are managing a 67-year-old female patient in the emergency department whose reason for admission is right calf pain. The interview and clinical examination reveal a progressive cancer undergoing treatment and localized tenderness along the deep venous network on the right. The rest of the examination is unremarkable. You use a simplified clinical prediction model for deep vein thrombosis (DVT) which indicates a 17% probability of DVT. You request a venous Doppler ultrasound of the lower limbs to confirm this suspicion of DVT. Among the following options, which one(s) is (are) correct?",The post-test probability of DVT depends on the sensitivity of the venous Doppler ultrasound.,The pre-test probability of DVT depends on the specificity of the venous Doppler ultrasound.,Post-test probability of DVT depends on the likelihood ratio of the venous Doppler ultrasound.,The post-test probability of DVT depends on the intrinsic performance of venous ultrasound Doppler.,The post-test probability of DVT can be determined graphically using the Fagan nomogram.,44 47 | A 43-year-old patient consults for moderate hyperferritinemia at 2 times normal discovered during a routine examination conducted by occupational medicine. He is asymptomatic. Which element(s) would suggest a metabolic hepatosiderosis?,Elevated transferrin saturation coefficient,Overweight,Hypertriglyceridemia,Graves' disease,History of colon cancer,45 48 | "In the case of sigmoid diverticulitis, a contrast-enhanced abdominopelvic CT scan is performed. It may show (one or more correct answers):",Addition images containing air at the anti-mesenteric border of the colon,A thinning of the colonic wall,An infiltration of fat around a diverticulum,A thickening of the colonic wall,A pylephlebitis,46 49 | In which situation(s) does a patient benefit from an exemption from the copayment (based on social security rates)?,Care for minor children whatever they may be,"Care, whatever it may be, for subjects benefiting from State Medical Assistance (AME)","Care, of any kind, for pregnant women from the 4th month of pregnancy",Performing a mammogram in a 54-year-old woman as part of the national breast cancer screening program,"Additional examinations, outside of the usual care, conducted as part of participation in a randomized trial",47 50 | "A 48-year-old patient has been experiencing headaches for several weeks, leading to a diagnosis of high blood pressure. The average of his ambulatory blood pressures is 177/92 mmHg. His biological assessment is as follows: Na 142 mmol/L, K 3.4 mmol/L, creatinine 70 µmol/L, calcium 2.5 mmol/L. 24-hour urine output: 1400 ml. Urinary ionogram: Na=180 mmol/L, K=50 mmol/L, proteinuria <0.01 g/L. Based on this assessment, what cause(s) should you consider for this high blood pressure?",Renal artery stenosis,Gitelman syndrome,Primary hyperaldosteronism,Chronic licorice consumption,Pheochromocytoma,48 51 | "Does that tumor marker have relevance in screening, diagnosis, prognosis, and monitoring of the cancer for which it is specific? (1 answer)",Ace,PSA,Alpha-fetoprotein,HCG,CA125,49 52 | "As part of the law of February 2, 2016, known as the ""Claeys-Leonetti"" law, when a patient can no longer express themselves, a treatment that appears unnecessary, disproportionate, or when it has no effect other than the sole artificial maintenance of life, may be suspended following a collegial procedure defined by regulatory means. What elements are provided in this procedure?",A consultation of advance directives if they exist,The opinion of at least one consulting physician,A discussion with the members of the care team present,Information from the on-call director if this procedure takes place over the weekend,The decision must be recorded in the medical record,50 53 | On which means is the evaluation of the qualitative dimension of pain based?,DN4 questionnaire,Doloplus questionnaire,Algoplus scale,Visual analogue scale,Numeric scale,51 54 | By what therapeutic means can neuropathic pain be managed as first-line treatment?,A tricyclic antidepressant,An antiepileptic of the gabapentinoid class,Morphine,Transcutaneous electrical stimulation,Medullary stimulation,52 55 | A 55-year-old patient is being cared for in a palliative care unit for a terminal stage progression of respiratory failure complicating major emphysema. His main complaint is an increase in his dyspnea. How should this dyspnea be managed? (one or more correct answers),Evaluation of the symptom by a visual analogue scale,Adjustment of the oxygen therapy flow to ensure arterial oxygen saturation is greater than 95%,Introduction or increase of an opioid treatment,Comfortable positioning of the patient,Deep and continuous sedation from the outset until death,53 56 | Bariatric surgery such as sleeve gastrectomy may be proposed (one or more correct answers):,In adolescents aged 15 and over if the BMI is greater than 40 kg/m2,"In a 55-year-old patient using a device for sleep apnea, with a BMI ≥ 35 kg/m2",In case of severe eating behavior disorders,If the subject has understood and accepted lifelong post-operative medical and surgical follow-up,If the patient has received clear and complete information about the surgical risks,54 57 | "A 52-year-old patient with no significant medical history presents with arterial hypertension, proteinuria of 2 g/24h, hematuria with 105 red blood cells/ml, and creatininemia at 130 µmol/l. His vesicorenal ultrasound is normal. Here is the report of his renal biopsy: cortical fragment comprising 15 glomeruli of which 4 are sclerotic. The permeable glomeruli show mesangial and endocapillary proliferation. Moderate arteriolosclerosis lesions. Tubular atrophy and interstitial fibrosis lesions on about 20% of the parenchyma. Immunofluorescence shows IgA deposits at +++ in the mesangium and C3 at 1+ in the vessels and glomeruli. What is the possible diagnosis or diagnoses?",Tubulointerstitial nephropathy,Class IV lupus nephritis,Pauci-immune glomerulonephritis,IgA nephropathy,Nephroangiosclerosis,55 58 | What elements guide you towards the occupational origin of allergic contact eczema in a plastic industry worker involved in the manufacturing of pleasure boats (one or more possible answers)?,The symptomatology that improves during vacations,A location of lesions on the backs of the hands and wrists,The presence of several simultaneous cases in the same workshop,A history of atopy in childhood,The presence of lesions on the eyelids,56 59 | "Young general practitioner, you are seeing for the first time a 52-year-old patient who complains of insomnia, anxious ruminations, a loss of vital drive, and withdrawal from family and professional activities. He indicates that his symptoms appeared 6 months ago, following the arrival of a new team leader who continually remarks on his slowness at work and lack of intellectual abilities. He even reports insults directed at him repeatedly when he was alone with his manager. This patient has no notable medical history, except for a reactive depression due to a divorce 10 years ago. The patient is asking you to make a declaration of an occupational disease. What should you indicate on the initial medical certificate?",The existence of a depressive syndrome,The date on which you first noticed the pathology,History of depressive syndrome,The existence of harassment by a colleague,The name of the department head,57 60 | "A 12-year-old patient is admitted to the pediatric emergency department for a meningeal syndrome. He is placed in an examination room by a nursing assistant, and the nurse comes to take his temperature and blood pressure. The intern then comes to examine the child and suspects an invasive meningococcal infection, which will be confirmed by CSF analysis (meningococcus C). The nurse, aged 30, approaches the intern saying she is worried because she is pregnant and asks what she should do as she handled the child without a mask and is not vaccinated against meningococcus. What measure(s) should be proposed to her?",Vaccination with the conjugate vaccine against meningococcus c,Prophylaxis with oral rifampicin for 5 days,Prophylaxis with oral rifampicin for 2 days,Reassure her and inform her that there is no risk of contamination,Prophylaxis with an injection of ceftriaxone,58 61 | What hygiene measures should be taken upon entering the room to care for a patient with pulmonary tuberculosis?,Wearing a long-sleeved gown,Wearing a respiratory protective mask (type FFP2),Wearing a hairnet,Wearing of overshoes,Hand rubbing with an alcohol-based solution,59 62 | What are the mandatory vaccinations for a nurse working in a hospital care unit (one or more possible answers)?,Vaccination against pneumococcus,"Vaccination against diphtheria, tetanus, and poliomyelitis",Vaccination against hepatitis A,Pertussis vaccination,Vaccination against hepatitis B,60 63 | "Regarding acute peritonitis, which proposal(s) do you consider?",Abdominal CT scan is the reference morphological examination for diagnosis,The surgical treatment must include a lavage of the peritoneal cavity.,"The 3 most common causes are appendicitis, peptic ulcer, colonic diverticulum",The evolutionary risk of peritonitis is septic shock,Peritonitis is always related to a digestive perforation,61 64 | "Concerning acute intestinal obstruction, which information is accurate?",A functional obstruction may be caused by an electrolyte imbalance,A peritoneal band can lead to a strangulation obstruction,Strangulation obstruction threatens intestinal viability within a few hours,Abdominal CT scan with contrast injection is the reference examination,Colon cancer is the leading cause of colonic obstruction by blockage,62 65 | Regarding the obstructive syndrome: (one or more correct answers),The cessation of stool passage is a physical sign absent in 30% of cases.,Abdominal pain is always the initial symptom,The site of abdominal pain indicates the site of the obstruction,Repeated and frequent vomiting temporarily relieves abdominal pain in small bowel obstructions.,The cessation of gas is the primary functional sign for diagnosis,63 66 | "Mr. M, a 58-year-old, is referred to you for abnormalities in iron metabolism. In his medical history, only diabetes diagnosed 3 months ago is noted. On clinical examination, the temperature is 37.3 °C. You note hepatomegaly assessed at 5 cm below the right costal margin. His iron metabolism profile is presented below: transferrin saturation coefficient (TSC) at 62%, ferritin at 1200 ng/ml (normal 30 to 300 ng/ml). Among the following options, which cause(s) could explain the abnormalities in the iron metabolism presented in this clinical context?",Inflammatory syndrome,Dysmetabolic hepatic siderosis,Genetic hemochromatosis,Myelodysplasia,Macrophage activation syndrome,64 67 | Upon admission of a polytraumatized patient in severe hemorrhagic shock (one or more correct answers):,A body scan is essential and must be performed urgently,A fast ultrasound performed at the patient's bedside is sufficient to confirm hemoperitoneum.,An emergency laparotomy is indicated to confirm the abdominal origin of the hemorrhagic shock.,"In case of massive hemoperitoneum, the ""damage control"" technique is the reference technique","The ""damage control"" technique aims to control bleeding and simultaneously treat digestive injuries.",65 68 | "A 22-year-old male presents to the emergency department due to asthenia associated with a 39°C fever persisting for 72 hours. He complains of odynophagia and diffuse myalgias. On clinical examination, cervical adenopathies and splenomegaly measuring one finger breadth are found. A blood panel was performed in town and shows the following results: hemoglobin 13.2 g/dl, MCV 89 fl, platelets 120 g/l, leukocytes 10.6 g/l, neutrophils 1.6 g/l, basophils 0.1 g/l, eosinophils 0.4 g/l, lymphocytes 8 g/l, monocytes 0.5 g/l. Blood smear: presence of numerous large lymphocytes with a hyper-basophilic cytoplasm. Among the following complementary examinations, which one(s) seem appropriate to perform initially in this clinical context?",Myelogram,Lymphocyte immunophenotyping,p24 antigenemia,Mini test,Cytomegalovirus (CMV) serology,66 69 | "A patient presents with claudication for a distance evaluated at 400 meters resulting in pain in the right calf. On clinical examination, you note: the absence of edema in the lower limbs, the presence of all peripheral pulses in the left lower limb, while the popliteal pulse is broad and very easy to palpate; on the right, only the femoral pulse is perceived; there are neither sensory nor motor disturbances in the lower limbs. Finally, you find a left iliac bruit. What arterial lesion(s) should you suspect?",Left iliac obliteration,Left iliac stenosis,Left popliteal aneurysm,Right iliac obliteration,Right femoral obliteration,67 70 | "Regarding the murmur in mitral insufficiency, what is (are) the correct statement(s)?",It is systolic ejection murmur,It is most often in a steam jet,It may be associated with a mesodiastolic murmur,It is most often located in the apex-axillary region,It radiates to the carotids,68 71 | "In a clinical trial, the random assignment (randomization) of the treatment being evaluated is intended to:",Constitute comparable groups in light of potential confounding factors,Conclude that there is a difference with a statistical significance level of 5%,Attenuate sampling fluctuations,Maintain the subjects in ignorance of the allocated treatment for the entire duration of the study,Reduce the number of subjects needed,69 72 | Measures of association that can be estimated in a cross-sectional etiological epidemiological study include:,Incidence rate,Odds ratio,Mortality rate,Prevalence,Etiologic fraction,70 73 | "In the list of the following bacterial infections, which one(s) is(are) not usually associated with leukocytosis?",Hepatic abscess with gram-negative bacillus,Acute pyelonephritis,Typhoid fever,Pneumococcal lung infection,Tuberculosis,71 74 | "Among the following parasitic diseases, which one(s) is(are) transmitted through skin contact (walking barefoot, bathing) with water or damp soil?",Amoebiasis,Taeniasis,Hydatidosis (echinococcosis),Strongyloidiasis (threadworm infection),Schistosomiasis (bilharziasis),72 75 | The medical certificate describing injuries secondary to violence: (one or more correct answers),Must mention the psychological impact of violence on the victim,May be handed directly to a judicial police officer if the total incapacity for work exceeds eight days,May be given directly to a third party provided they provide proof of their connection to the victim,Issued to the holder of parental authority if the victim is a minor,Allows the medical assessment of the credibility of the victim's statements,73 76 | "In the absence of a statistically significant difference in the primary endpoint between the two groups of a prospective randomized placebo-controlled trial, it is necessary to consider:",The risk of a type II statistical error (beta),Lack of effect of the treatment,A lack of statistical power,The non-inferiority of the evaluated treatment,The risk of first-type statistical error (alpha),74 77 | "The association at autopsy of a recent, bilateral, and multifocal subdural hematoma and bilateral retinal hemorrhages in a 6-month-old baby without any particular history suggests the diagnosis of: (one or more correct answers)",Sudden infant death syndrome,Shaken baby syndrome,Silverman syndrome,Rupture of cerebral arteriovenous malformation,Accidental cranial trauma,75 78 | "The administrative section of the death certificate, whether in electronic or paper form, is transmitted: (one or more correct answers)",At the town hall of the place of death,At the National Institute of Health and Medical Research (Inserm),To the manager of the funeral home appointed by the family,To the public prosecutor,To the family of the deceased,76 79 | Congenital long QT syndrome is an inherited arrhythmia disorder with autosomal dominant transmission that predisposes to sudden death from childhood and can be subject to preventive management. This pathology is very heterogeneous genetically. What are the correct proposal(s):,The involved genes encode for ion channels,Long QT syndrome is most often associated with a congenital heart defect,The genetic evaluation of this pathology is done by studying the karyotype,The diagnosis in an index case must lead to informing the family members,Molecular predictive diagnosis is not authorized for minors in this situation,77 80 | Drafting a descriptive medical certificate requires the evaluation of ITT in the criminal sense of the term. What is the meaning of this acronym?,Total incapacity for work,Temporary total incapacity,Total temporary incapacity,Total incapacity to work,Total temporary incapacity,78 81 | "You receive in consultation a pregnant woman for the morphological ultrasound at 22 weeks of amenorrhea. Her couple has no family history. Fetal growth is normal. She underwent first-trimester combined screening with a calculated risk of trisomy 21 at 1/10,000. The only particularity is fetal bowel hyperechogenicity. What is(are) the correct proposition(s):",This is a warning sign of cystic fibrosis,This is a warning sign of a viral infection,This sign is frequently observed in fetuses heterozygous for a severe mutation of the CFTR gene,Priority is given to heterozygosity screening in both parents,Priority is given to an amniocentesis to search for cftr gene mutations in the fetus,79 82 | The objectives of the medico-legal management of a victim of sexual violence are: (one or more correct answers),Describe bodily traumatic injuries,Determine whether the person was consenting at the time of the events,Determine if the victim's statements are credible,Implement a multidisciplinary care plan,Take samples for genetic fingerprinting,80 83 | What are the possible therapeutic strategies in asthma and chronic obstructive pulmonary disease (COPD)? (one or more correct answers),Long-term inhaled corticosteroid therapy as a monotherapy in COPD,Continuous inhaled corticosteroid monotherapy in asthma,Long-acting beta-2 agonist in monotherapy for asthma,Inhaled corticosteroid and long-acting inhaled beta-2 agonist combination as maintenance therapy in asthma,Long-acting beta-2 agonist as monotherapy in COPD,81 84 | Cite the potential consequence(s) of a drug interaction with a cytochrome p450 3a4 inducer.,Graft rejection under cyclosporine,Pregnancy under estrogen-progestogen therapy,Ergotism in the presence of ergotamine,Rhabdomyolysis in the presence of certain statins,Failure of antiretroviral treatment,82 85 | You receive the result of a blood ionogram showing a potassium level of 6 mmol/l. What iatrogenic cause(s) can you suggest?,Long-term oral corticosteroid therapy,Angiotensin ii antagonist,Mineralocorticoid receptor inhibitor,Angiotensin-converting enzyme inhibitor,Loop diuretic,83 86 | Concerning drug antidotes:,Protamine sulfate neutralizes the anticoagulant activity of heparin.,Naloxone is a specific antagonist of morphinomimetics.,Prothrombin factors are the antidote for clopidogrel,N-acetylcysteine is the antidote for acetylsalicylic acid,Flumazenil is an antagonist of benzodiazepines and related compounds,84 87 | "A 23-year-old woman is hospitalized in psychiatry for a state of psychomotor excitement evolving for a week, with disinhibition leading to reckless spending and risky sexual behavior. She has not slept for 72 hours but shows no signs of fatigue and is attempting to introduce herself to each of the patients in the ward. If you had to choose a monotherapy, which of these options would seem indicated?",Lithium,Valproic acid,Risperidone,Carbamazepine,Quetiapine,85 88 | Concerning the decision for medical termination of pregnancy (mtp) (one or more correct answers):,Any request for IMG must be reviewed by the multidisciplinary prenatal diagnosis center (CPDPN),There is a list of pathologies for which there is a medical indication for IMG,"The admissibility of the request is based on the demonstration of a ""high probability of a disease of particular severity and incurable at the time of diagnosis",A period of reflection must be offered to the pregnant woman between the diagnosis of the condition and the potential performance of the termination of pregnancy.,An MRI can be performed after consultation with the CPDPN until term,86 89 | "A 31-year-old woman describes the sudden onset, one month ago, of intense fatigue accompanied by profound sadness. She reproaches herself a lot, particularly for being unable to take care of her 2-month-old daughter, is very slowed down, and often wakes up in the middle of the night. At times, she experiences suicidal thoughts. Among the following characteristics, which one(s) may indicate bipolar mood disorder?",Female sex,Postpartum context,Sudden onset,Melancholic features,Suicidal ideation,87 90 | "Among the following signs and symptoms, which one(s) is(are) more frequent in cases of depressive episodes in the elderly compared to young adults?",Somatic complaints,Guilt feeling,Self-deprecation,Suicidal thoughts,Sexual disorders,88 91 | "Among the following signs, which one(s) may be a symptom(s) due to the withdrawal of an opiate substance?",Constipation,Bilateral mydriasis,Hallucinations,Vomiting,Arterial hypertension,89 92 | "When facing a patient with an alcohol use disorder who is opposed to the idea of addiction treatment, what attitude(s) characterize motivational interviewing?",Provide the patient with arguments in favor of change,Let the patient explain what alcohol brings them,Expose the patient to situations at risk of excessive consumption,Identify the patient's personal reasons for change,Emphasize to the patient the risks associated with alcohol consumption,90 93 | A 69-year-old patient presents for an annual visit to his new general practitioner. The clinical examination reveals a pulse of 45 beats per minute. Name the medication(s) likely to be responsible:,Selective beta-blocker,Class III antiarrhythmic,Calcium channel blocker of the dihydropyridine group,Anticholinesterase,Short-acting beta-2 adrenergic agonist bronchodilator for inhalation,91 94 | Regarding Down syndrome (one or more correct answers):,It most often results from a maternal meiotic accident,"When it is associated with a 46,xx,der(14;21),+21 chromosomal formula, it does not require a family investigation.",Its post-natal diagnosis can be quickly confirmed through molecular biology.,The risk of recurrence is close to 1/100 to 1/200 for a couple having had a first affected child,Its risk is reduced by advanced maternal age at the time of conception,92 95 | Regarding the histological lesions of glomerulopathies (one or more correct answers):,The diagnosis of minimal glomerular lesions requires examination by electron microscopy,Focal segmental glomerulosclerosis can be primary in adults,Membranoproliferative glomerulopathy is characterized by double contours of the glomerular basement membrane,Hump-like deposits are present in acute post-infectious glomerulonephritis,Diabetes can lead to glomerulopathy,93 96 | Histological diagnosis of prostate adenocarcinoma on biopsy mapping (one or more accurate responses):,Generally requires six biopsy samples,Can confirm extraprostatic involvement,Requires a biopsy of the seminal vesicles,Specified in its prognosis by the Gleason architectural score,Specified in its prognosis by the proliferation index,94 97 | "During a surgical procedure, a frozen section examination on a tissue sample is requested. The sample must be sent to the pathology laboratory (one or more correct answers):",At + 4°C,At -20°C,Immersed in formalin,Without fixative solution,Accompanied by a consent form,95 98 | "On a liver biopsy, findings supportive of the diagnosis of acute alcoholic hepatitis (one or more correct answers):",An inflammation with neutrophilic polymorphonuclear leukocytes,Ballooned hepatocytes,Councilman bodies.,Cirrhosis,Cholestasis,96 99 | Molecular biology analyses as part of the anatomopathological diagnosis of a tumor (one or more correct answers),Can be performed on tissue samples fixed and embedded in paraffin,Can be performed on unfixed tissue samples frozen at -80°C,Can be performed on liquid-based cytology smears,Morphological control of the tissue sample is required,Require a signed authorization from the patient,97 100 | "Regarding Alzheimer's disease, which statement(s) is(are) correct?",Diagnosis is often late,This is secondary dementia,Behavioral disorders often manifest at the onset of the disease,The Dubois 5-word test allows for diagnosis,It progresses in episodes leading to recurrent hospitalizations,98 101 | "Regarding the aging of organs, which statement(s) is(are) true:",It is marked by a decrease in maximal capacities,It is essentially due to oxidative stress,This is a concept without scientific evidence,It is characterized by a reduction in functional reserve capacity,It allows for assessing the individual's autonomy.,99 102 | "Concerning frailty syndrome, which proposition(s) is(are) correct?",This is a concept without a precise definition,It allows the assessment of the functional reserves of the organs,It is associated with a risk of dependence,It is associated with the risk of pressure ulcers during hospitalization.,It is associated with an increased risk of myocardial infarction,100 103 | "You are taking care of an 85-year-old patient in the emergency department for a head injury under vitamin K antagonist (VKA) prescribed for atrial fibrillation. The INR is 2.9. There is a petechiae on the brain CT scan. Among the following proposals, which one(s) do you retain for your therapeutic management?",Immediate administration of prothrombin complex concentrate,Administration of vitamin K within 4 hours,Routine brain scan in 6 hours,Discontinuation of vitamin K antagonist with bridging to therapeutic dose heparin,Discontinuation of vitamin K antagonist,101 104 | Which criterion/criteria among the following indicate(s) severe malnutrition in the elderly?,Weight loss ≥ 10% in 1 month,Body mass index <18 kg/m2,Weight loss ≥ 15 kg in 6 months,Mini Nutritional Assessment score <17,Plasma albumin level <35 g/l,102 105 | -------------------------------------------------------------------------------- /data/dataset/questions.csv: -------------------------------------------------------------------------------- 1 | id,question,answer_A,answer_B,answer_C,answer_D,answer_E 2 | 0,"Devant un exanthème roséoliforme fébrile de l'enfant, les principales étiologies sont (une ou plusieurs réponsesexactes):",Un exanthème subit,Un mégalérythème épidémique,Une rubéole,Une mononucléose infectieuse,Un syndrome de kawasaki 3 | 1,"A propos de l’insuffisance cardiaque, quelle(s) est (sont) la (les) proposition(s) vraie(s) ?",L’auscultation cardiaque peut mettre en évidence un éclat du b2 au foyer aortique en cas d’hypertension artériellepulmonaire,L’auscultation cardiaque peut mettre en évidence un souffle d’insuffisance mitrale liée à la dilatation de l’anneau mitral,La turgescence jugulaire constitue un signe périphérique d’insuffisance cardiaque gauche,"Les œdèmes périphériques sont mous, bleus et douloureux",Les râles crépitants ou sous-crépitants sont souvent bilatéraux 4 | 2,Quelle(s) est (sont) la (les) réponse(s) vraie(s) concernant la prise en charge des bronchectasies diffuses chez l’adulte (endehors d’un contexte de mucoviscidose) responsables d’épisodes infectieux à répétition ?,Drainage bronchique quotidien,Corticothérapie systémique,Lobectomie pulmonaire,Cure d’antibiothérapie trimestrielle systématique,Traitement anti-inflammatoire par fluoroquinolone 5 | 3,Une patiente de 58 ans vient aux urgences de votre hôpital pour l’expectoration de deux verres de sang rouge lors d’uneffort de toux. elle n’avait jamais craché de sang. elle est sous aspirine à visée anti-agrégante pour une coronaropathie.son examen clinique est normal ; sa pression artérielle est à 132 /79 mmhg. la fréquence cardiaque est à 80/mn. laradiographie pulmonaire ne montre pas d’anomalie.donnez la ou les réponse(s) juste(s),Vous hospitalisez la patiente,Vous mettez en place un remplissage vasculaire,Vous prescrivez un agent vasoconstricteur par voie intraveineuse type telipressine,Vous prescrivez une tomodensitométrie thoracique injectée avec acquisition au temps artériel après vérificationd'absence de contre-indication,Vous rassurez la patiente et lui expliquez qu’il est normal de saigner sous anti-agrégants 6 | 4,"Un patient de 55 ans présentant un hyperlymphocytose à 25 g/l sans cytopénie vous est adressé avec un diagnostic deleucémie lymphoide chronique sur l'immunophénotypage lymphocytaire. a l’examen clinique, le patient est en excellent étatgénéral et il existe une polyadénopathie de 1,5 à 2 cm de diamètre dans toutes les aires ganglionnaires. quel examen estnécessaire à ce stade ? (une seule réponse)",Aucun,Un tep-scanner,Une échocardiographie,Un myélogramme,Une scintigraphie osseuse 7 | 5,"Un homme de 25 ans vous consulte en raison de douleurs abdominales. l'examen est normal en dehors d’une ratepalpable en fin d’inspiration. l’hémogramme montre : leucocytes 14 g/l, pnn 8 g/l, myélocytes 1 g/l, métamyélocytes 1g/l, monocytes 1 g/l, lymphocytes 3 g/l, plaquettes 510 g/l. vous suspectez une leucémie myéloïde chronique. quelsexamens biologiques prescrivez-vous pour confirmer votre hypothèse diagnostique ? (une ou plusieurs réponses possibles)",Immunophénotypage leucocytaire sur sang,Recherche de corps de jolly au frottis,Recherche du transcrit bcr-abl,Recherche d’ombres de gumprecht,Recherche d'une mutation de jak2 8 | 6,"Parmi les affirmations suivantes concernant les ostéopathies fragilisantes, laquelle (lesquelles) est (sont) exacte(s) ?",L’hyperparathyroïdie primitive touche préférentiellement l’os cortical,Le traitement de l’hypothyroïdie augmente le risque de fracture ostéoporotique,L’ostéoporose cortisonique touche principalement l’os cortical,La carence estrogénique est responsable d’une hyperactivité ostéoclastique,Le traitement par biphosphonate augmente l’activité des ostéoblastes 9 | 7,"Une femme de 50 ans arrive aux urgences pour malaise. elle n’a pas d’antécédent particulier mais décrit une fatiguerapidement apparue. l’examen clinique est normal en dehors d’un subictère conjonctival. l’hémogramme montrehémoglobine 90 g/l, hématies 2,7 t/l, hématocrite 27 %, vgm 102 fl, ccmh 33 g/dl, leucocytes 8 g/l, polynucléairesneutrophiles 5 g/l, lymphocytes 2,3 g/l, monocytes 0,7 g/l.quels examens biologiques vous semblent pertinents à prescrire en première intention ?(une ou plusieurs réponsespossibles)",Protéine c réactive (crp),Fer sérique,Electrophorèse des protides sériques,Réticulocytes,Ldh 10 | 8,"Parmi les agents infectieux suivants, le(s)quel(s) est(sont) responsable(s) d’endocardite à hémocultures négatives ?",Mycobacterium tuberculosis,Bartonella,Streptococcus pyogenes,Coxiella burnetii,Tropheryma whipplei 11 | 9,"Parmi les maladies infectieuses suivantes, la(es)quelle(s) est(sont) à déclaration obligatoire en france ?",Rubéole,Peste,Tuberculose,Légionellose,Pneumococcie invasive 12 | 10,"Chez un patient traité depuis 2 jours pour une embolie pulmonaire proximale par héparine non fractionnée, le tca ratio està 6 et l’activité anti-xa est mesurée au pic d’activité à 1,2 ui/ml, en absence de saignement, quelle(s) mesure(s) adoptez-vous immédiatement ? (une ou plusieurs réponses possibles)",Apport de vitamine k,Perfusion de culot concentré plaquettaire,Perfusion de protamine,Arrêt puis adaptation posologique,Introduction des avk 13 | 11,"Un homme de 62 ans sans antécédent médical présente un hématome profond spontané du muscle psoas . la nfsmontre une hémoglobine à 90 g/l et des plaquettes à 170 g/l. son bilan d’hémostase est le suivant : tca ratio à 2,1, tpà 78% et fibrinogène à 3,1g/l. le mélange du plasma du patient avec un plasma normal ne permet pas de corriger le tca(indice de rosner à 28 pour une normale < 15). le dosage des facteurs de la voie endogène révèle un facteur viii à 4%.quelle(s) hypothèse(s) diagnostique(s) retenez-vous ? (une ou plusieurs réponses possibles)",La présence d’un anticoagulant de type lupique,Une hémophilie a constitutionnelle,La présence d’un anticorps anti facteur viii,Une maladie de willebrand de type 1,Une hémophilie b acquise 14 | 12,"Une patiente est amenée inconsciente par les pompiers aux urgences dans les suites d’un accident de la voie publique.elle présente un polytraumatisme pour lequel sont réalisés en urgence un scanner cérébral et thoraco-abdomino-pelvien.elle présente une fracture de rate qui nécessite une intervention chirurgicale. a son arrivée, son mari vous apprend qu'elleest enceinte d’environ 8 semaines d’aménorrhée. la dose d’irradiation reçue est de 10 mgy. quel(s) est(sont) le(s)risque(s) lié(s) à l’accident et à la prise en charge ?",Retard de développement,Malformation cérébrale,Avortement,Retard de croissance,Hématome rétro-placentaire 15 | 13,"Une patiente se présente à votre cabinet pour une consultation préconceptionnelle. elle est âgée de 32 ans, nulligeste. elleest suivie depuis un an pour une hypertension artérielle bien équilibrée sous perindopril, un comprimé par jour. ellebénéficie d’une contraception oestro-progestative qu’elle envisage d’arrêter à la fin de sa plaquette. elle pèse 81 kg pourune taille d’1m68. elle consomme 5 cigarettes par jour mais aimerait arrêter.que prévoyez-vous à l’issue de la consultation ? (une ou plusieurs réponses exactes)",Sérologie de la rubéole,Aide au sevrage tabagique par substituts nicotiniques,Frottis cervico-utérin si ce dernier date de plus de un an,Prescription de folates à la dose de 5 mg/jour,Arrêt du traitement par perindopril et relai par un autre antihypertenseur 16 | 14,"Une femme de 28 ans consulte pour la palpation d’une tuméfaction dans le quadrant supéro-externe du sein droit. elle estinquiète car sa mère et sa tante maternelle ont eu un cancer du sein à 55 et 60 ans respectivement. a l’examen clinique,vous palpez une tuméfaction ronde et régulière de 15 mm, non adhérente aux plans profond et superficiel. il n’y a pasd’inflammation ni de rétraction cutanée en regard. aucune adénopathie suspecte n’est palpée dans les aires ganglionnairesaxillaire et sus-claviculaire.quel(s) examen(s) doit(doivent) être demandé(s) en première intention ?",Une échographie mammaire,Une radiographie pulmonaire,Un dosage du ca 15-3,Une irm mammaire,Une mammographie 17 | 15,"Une femme de 38 ans consulte 3 mois après son troisième accouchement pour une demande de contraception. elle a euune césarienne alors que ses deux premiers accouchements avaient eu lieu par voie vaginale. elle vient d’arrêterl’allaitement de son enfant car elle doit reprendre son activité professionnelle. dans ses antécédents, elle rapporte uneperforation utérine lors de la pose d’un dispositif intra utérin il y a 7 ans, une phlébite sous plâtre il y a 10 ans et untraitement par laser cervical il y a 4 ans pour une dysplasie cervicale liée à une infection à papillomavirus humain. elle nefume pas mais « vapote » de temps en temps. le dernier frottis cervico-utérin, réalisé en début de grossesse, était normal.quel(s) moyen(s) contraceptif(s) est(sont) envisageable(s) pour cette femme ?",Dispositif intra-utérin au lévonorgestrel,Dispositif intra-utérin au cuivre,Dispositif transdermique libérant du norelgestromine et de l’éthinylestradiol,Stérilisation tubaire par coelioscopie,Dispositif sous-cutané libérant de l’étonogestrel 18 | 16,Devant une suspicion de corps étranger intra-oculaire métallique quel(s) examen(s) proposez-vous en urgence ?,Un scanner orbitaire,Une irm,Une radiographie de l’orbite,Une angiographie à la fluorescéine,Une mesure de la pression intra oculaire 19 | 17,Quelle(s) est(sont) la(les) proposition(s) exacte(s) concernant l’interruption volontaire de grossesse (ivg) en france ?,Une femme sous tutelle peut demander une ivg,Une femme peut demander un anonymat complet pour la réalisation d’une ivg,La pose d’un stérilet est contre-indiquée dans les suites immédiates d’une ivg chirurgicale,Les prostaglandines ne peuvent pas être utilisées en cas de porphyrie héréditaire,Un entretien psychosocial doit systématiquement être effectué avant la réalisation de l’ivg 20 | 18,Un chalazion :,Est une infection d’un follicule pilo-sébacé des paupières,Est un granulome de résorption d’une glande de meibomius des paupières,Se traite par des corticostéroïdes en pommade,Se traite par des antibiotiques par voie générale,Peut nécessiter une incision chirurgicale 21 | 19,Quelles sont les étiologies possibles d’une baisse d’acuité visuelle associée à une rougeur oculaire (plusieurs réponsesexactes) ?,Crise de glaucome aigu par fermeture de l’angle,Uvéite antérieure,Occlusion de l’artère centrale de la rétine,Glaucome néovasculaire,Vascularite rétinienne 22 | 20,En cas de myopie (une ou plusieurs réponses exactes) :,Le système optique formé par l’œil est trop convergent,La vision de loin est meilleure que la vision de près sans correction,Les rayons lumineux focalisent en avant de la rétine,Un verre divergent peut être utilisé pour la correction,Le risque de décollement de rétine peut être augmenté 23 | 21,"Vous prenez en charge une patiente de 83 ans, bien entourée, à j2 d’une arthroplastie de genou. les drains de redon ontété retirés sans problème. elle présente un genou augmenté de volume, très œdématié et inflammatoire. la cicatrice estbelle, non inflammatoire. quelle(s) est (sont) la(les) proposition(s) exacte(s) ?",Une prise en charge en ambulatoire est possible,Les techniques d’électrothérapie pratiquées par le kinésithérapeute auront pour objectif de diminuer l’œdème,La prescription de canne anglaise pourrait être faite par le kinésithérapeute libéral après la sortie de l’hôpital,Votre prescription de kinésithérapie devra obligatoirement mentionner les techniques de kinésithérapie à employer,L’adaptation du domicile devra se faire après rédaction d’un dossier auprès de la mdph (maison départementale despersonnes handicapées) 24 | 22,"Vous prenez en charge un patient de 32 ans, informaticien, dont le tabagisme est évalué à 15 paquets/année, sansantécédent médical ou chirurgical, victime d’un accident de la route responsable d’une lésion médullaire sévère par fracturecervicale c5 ostéosynthésée par voie antérieure le 30 avril 2018. le sevrage de la ventilation mécanique ayant été difficile,il a été trachéotomisé le 21 mai 2018 après intubation orotrachéale. le sevrage a ensuite été réalisé le 29 mai. a sonarrivée, il est eupnéique. il présente une escarre du trochanter droit, stade 4 avec une perte de substance jusqu’à l’os. lefond de l’escarre est fibrineux et les sécrétions purulentes sont très abondantes sans signe cutané inflammatoire. quelle(s)est (sont) la(les) proposition(s) exacte(s) ?",La sténose trachéale est une complication de l’intubation orotrachéale prolongée,Vous privilégiez pour le traitement de cette escarre une association antiseptiques locaux et pansements secs.,La présence de cette escarre contre indique la mise au fauteuil,La lésion étant de niveau médullaire c6 vous vous attendez à une anesthésie à partir du bord latéral de l’avant-bras enposition anatomique,La demande d’affection longue durée peut être réalisée par le médecin traitant 25 | 23,Vous prescrivez une orthèse articulée de genou de série à un de vos patients atteint d’une entorse de genou. cochezle(les) principe(s) de prescription(s) juste(s) pour ce type de dispositif médical :,Il est prescrit sur une ordonnance simple,Il est prescrit sur un formulaire grand appareillage,Il est remboursé à 100% de son prix d’achat,Il peut être prescrit par tous les spécialistes,Il peut être prescrit par un kinésithérapeute 26 | 24,"Concernant le syndrome du canal carpien, quelle(s) est( sont) la( les) proposition(s) vraie(s) ?",Il est le plus souvent idiopathique,Il est plus fréquent au cours de la grossesse,L’électromyogramme est indispensable au diagnostic,Il pourra entrainer un déficit du long fléchisseur du pouce,Il pourra entrainer une abolition du réflexe stylo-radial 27 | 25,"Concernant l’arthrose du genou, quelle(s) est(sont) la(les) réponse(s) vraie(s) ?",La ponction articulaire est indispensable au diagnostic,Un genu varum prédispose à la gonarthrose fémoro-tibiale médiale,Les infiltrations par viscosupplémentation sont indiquées dans les poussées avec épanchement,L’indication chirurgicale dépend de l’importance du pincement articulaire,L’efficacité des infiltrations de corticoïdes est limitée dans le temps 28 | 26,"Un ancien garagiste de 78 ans vient consulter pour des lombalgies inflammatoires fébriles importantes apparues depuis 10jours. vous suspectez une spondylodiscite et vous décidez de lui prescrire une irm lombaire. ce patient est porteur d’uneprothèse totale de hanche mise en place il y a 8 ans et d’une prothèse valvulaire depuis 2 ans. il a bénéficié de la posed’un stent coronaire il y a 3 mois. il présente un débit de filtration glomérulaire à 48 ml/ mn. lors de l’interrogatoire, il voussignale qu’il a reçu des éclats métalliques dans l’œil droit et dans la joue droite il y a 40 ans. quelle (s) proposition(s)contre-indique(nt) l’irm injectée ?",Les éclats métalliques dans l’œil,La prothèse de hanche,La prothèse valvulaire,Le stent coronaire,La fonction rénale 29 | 27,"En cas de paralysie du nerf oculo-moteur (iii), vous pouvez rencontrer à l’examen ?",Un défaut d’élévation de l’œil,Un myosis,Un défaut d’adduction de l’œil,Une exophtalmie,Un ptosis 30 | 28,"Un patient de 62 ans a comme antécédents une hypertension artérielle essentielle traitée en monothérapie depuis 2 ans etun tabagisme actif (45 paquets-année). depuis environ deux semaines, il se plaint de céphalées quotidiennes quis’installent volontiers en deuxième partie de nuit. au début, elles s’estompaient progressivement en cours de matinée.depuis environ 3 jours, elles sont constantes. ces céphalées sont décrites comme diffuses en casque, sont fluctuantes enintensité, sont accentuées par l’activité physique. il se plaint également d’une inappétence et de nausées elles aussid’évolution progressive. le patient est apyrétique.quel syndrome évoquez-vous devant ce tableau ?",État de mal migraineux,Céphalées chroniques quotidiennes,Syndrome méningé d’origine infectieuse,Hypertension intracrânienne,Syndrome méningé en lien avec une hémorragie sous-arachnoïdienne 31 | 29,"Un patient de 59 ans a vu apparaître un tremblement des trois derniers doigts de la main droite que son entourage aégalement remarqué à la marche. il balance moins le membre supérieur droit à la marche. a l’examen, vous constatez quele tremblement disparaît les bras tendus. vous percevez que la mobilisation passive du coude droit est plus difficile et quela mobilisation de l’épaule droite est douloureuse. les réflexes ostéo-tendineux sont normaux.ce type de tremblement est probablement aggravé par :",L’émotion,Le calcul mental,L’écriture,Le mouvement,Le sommeil 32 | 30,"Parmi les propositions suivantes, quelle(s) est (sont) celle(s) qui s’applique(nt) à une vessie neurologique centrale ?",Le,Hypoactivité détrusorienne,Incontinence,Risque de reflux urétéro-vésical,Basses pressions intravésicales 33 | 31,"Parmi les aliments suivants, le(s)quel(s) contiennent plus de 5% de glucides ?",Lentilles,Haricots verts,Viande,Fromage,Fruits 34 | 32,"Parmi les signes biologiques suivants, lequel(lesquels) vous oriente(nt) vers une insuffisance surrénale iatrogène chez unpatient de 38 ans aux antécédents de maladie de crohn traitée pendant 5 ans par 10 mg/ jour de prednisone ?",Natrémie à 128 mmol/l,"Kaliémie à 5,8 mmol/l",Glycémie à jeun à 3 mmol/l,Acth plasmatique à 8 heures à 585 pg/ml (n : 10 – 20),Cortisol libre urinaire à 25 µg/24 heures (n: < 90) 35 | 33,"Vous voyez en consultation un nouveau-né de 15 jours qui présente une fièvre isolée à 38,2°c et un état général conservé",Vous rassurez les parents quant à la nature bénigne de cette fièvre en période d’épidémies virales,Le test de grippe n’est pas informatif à cet âge,La bandelette urinaire n’est pas informative à cet âge,La réalisation d’un examen cyto bactériologique des urines est systématique,La réalisation d’une ponction lombaire est systématique 36 | 34,"Devant une lésion de la langue, quel(s) est(sont) le(s) signe(s) clinique(s) qui orientera (orienteront) vers une originemaligne ?",Lésion indurée,Lésion douloureuse,Saignement au contact lors de la palpation de la lésion,Induration sous muqueuse,Présence d’une leucoplasie associée 37 | 35,Vous intervenez au domicile d’un nourrisson trouvé décédé par ses parents il y a quelques minutes :,Vous demandez à être accompagné par la police,Vous ne devez pas signer le certificat de décès avant l’admission à l’hôpital,Vous rédigez un signalement au procureur de la république,Vous proposez aux parents de réaliser une autopsie à la recherche des causes du décès,Le transfert du corps doit se faire vers un institut médico-légal 38 | 36,Vous expliquez à de jeunes parents dont l’enfant présente un premier épisode fébrile la ou lesmesure(s) à prendre pendant cet épisode.,Le traitement médicamenteux s'impose pour toute température supérieure à 39°c,La prise de boisson est nécessaire toutes les heures tant que la fièvre persiste,Il faut utiliser des enveloppements frais si l'enfant est inconfortable,L'utilisation d’ibuprofene n'est possible qu'après 3 mois,Il faut garder l’enfant hors des collectivités pendant la durée de la fièvre 39 | 37,"Concernant les tuméfactions cervicales, quel(s) est(sont) le(s) item(s) exact(s) ?",Un kyste du tractus thyréoglosse est mobile à la déglutition,Une adénopathie sus-claviculaire droite peut être révélatrice d’un cancer génito-urinaire,Une tuméfaction superficielle rénitente localisée au bord antérieur du muscle sternocléidomastoïdien est évocatrice d’unkyste amygdaloïde,Un schwannome du plexus brachial est un diagnostic différentiel d’une adénopathie sous-mandibulaire,Un schwannome du nerf accessoire est un diagnostic différentiel d’une adénopathie spinale 40 | 38,"Concernant le phlegmon péri-amygdalien, quel(s) est(sont) le(s) item(s) exact(s) ?",L’abcès est localisé au niveau de l’espace latéro-pharyngé,Il peut exister un trismus,Le pilier antérieur du voile du palais est élargi,"Chez l’adulte, l’hospitalisation est systématique",Le drainage de l’abcès se fait soit par ponction soit par incision sous anesthésie générale 41 | 39,"Concernant le vertige positionnel paroxystique bénin, quel(s) est(sont) le(s) item(s) exact(s) ?",Il est d’une durée inférieure à une minute,Il est consécutif à une ischémie vestibulaire,Il se traite par de la kinésithérapie vestibulaire,Il est associé à des acouphènes,Il existe un facteur positionnel déclenchant 42 | 40,"Un patient de 32 ans consulte aux urgences pour asthénie. il n’ y a pas d’autre anomalie à l’examen clinique. on constateaux examens biologiques une augmentation des transaminases avec asat=1362 ui (n<40), alat=2348 ui (n<40). quelle(s) est (sont) la (les) cause(s) possible(s) à cette augmentation des transaminases?",Hépatite virale aigue,Hépatite alcoolique aigue,Hépatite médicamenteuse,Hépatite auto-immune,Hépatite liée à la prise de cannabis 43 | 41,"Un patient de 62 ans présente une hyponatrémie d’apparition progressive. il parait euvolémique cliniquement.son bilan biologique sanguin est le suivant : na 125 mmol/l, k 4 mmol/l, chlore 110 mmol/l, hco3- 25 mmol/l, glycémie 5mmol/l, protides 67 g/l, urée 4 mmol/l, créatininémie 78 µmol/l.bilan urinaire : na 100 mmol/l, k 25 mmol/l, urée 350 mmol/l, créatinine 8 mmol/l.quelle(s) est (sont) la (les) cause(s) possible(s) de ce tableau biologique ? (une ou plusieurs bonnes réponses) ?",Tea and toast syndrome,Prise de furosémide,Syndrome de sécrétion inappropriée d’adh,Prise d'amlodipine,Prise de lithium 44 | 42,"Un patient de 86 ans est hospitalisé pour hématémèse. il est connu pour avoir une hépatite virale b, non suivie. sa familledécrit un vomissement sanglant équivalent en volume à celui d'une bassine.a l’examen, il présente une ascite et un asterixis. la pression artérielle systolique est à 55 mmhg. parmi les éléments suivants, le(s)quel(s) est (sont) associé(s) à un mauvais pronostic ?",Age,Volume de l’hématémèse,Pression artérielle,Présence d’une encéphalopathie hépatique,Présence d’une ascite 45 | 43,"Un patient de 62 ans présente le bilan biologique suivant : na 142 mmol/l, k 5,7 mmol/l, chlore 110 mmol/l, hco3- 18mmol/l, protides 88 g/l, urée 20 mmol/l, créatininémie 170 µmol/l. quel(s) médicament(s) peut (peuvent) donner ce tableaubiologique ? (une ou plusieurs bonnes réponses)",Ibuprofène,Candesartan,Amiloride,Amlodipine,Prednisone 46 | 44,"Vous prenez en charge aux urgences une patiente de 67 ans dont le motif d'entrée est une douleur du mollet droit.l'interrogatoire et l'examen clinique retrouvent un cancer évolutif en cours de traitement et une sensibilité localisée le longdu réseau veineux profond à droite. le reste de l'examen est sans particularité.vous utilisez un modèle de prédiction clinique simplifié de thrombose veineuse profonde (tvp) qui indique une probabilitéde tvp de 17%.vous demandez un échodoppler veineux des membres inférieurs pour confirmer cette suscpicion de tvp.parmi les propositions suivantes, laquelle (lesquelles) est (sont) exacte(s) ?",La probabilité post-test de tvp dépend de la sensibilité de l'échodoppler veineux.,La probabilité pré-test de tvp dépend de la spécificité de l'échodoppler veineux.,La probabilité post-test de tvp dépend du rapport de vraisemblance de l'échodoppler veineux.,La probabilité post-test de tvp dépend des performances intrinséques de l'échodoppler veineux.,La probabilité post-test de tvp peut être déterminée graphiquement en utilisant le nomogramme de fagan. 47 | 45,Un patient de 43 ans consulte pour une hyperferritinémie modérée à 2 fois la normale découverte surun bilan systématique réalisé par la médecine du travail. il est asymptomatique. quel(s) élément(s) orientera(ont) vers une hépatosidérose métabolique ?,Coefficient de saturation de la transferrine élevé,Surpoids,Hypertriglycéridémie,Maladie de basedow,Antécédent de cancer colique 48 | 46,Devant une diverticulite sigmoïdienne un examen tomodensitométrique abdomino-pelvien injecté estréalisé. il peut montrer (une ou plusieures réponses exactes) :,Des images d’addition contenant de l’air au bord anti-mésentérique du côlon,Un amincissement de la paroi colique,Une infiltration de la graisse autour d’un diverticule,Un épaississement de la paroi colique,Une pyléphlébite 49 | 47,Dans quelle(s) situation(s) un patient bénéficie-t-il d’une exonération du ticket modérateur (sur la base des tarifs sécuritésociale) ?,Les soins aux enfants mineurs quels qu’ils soient,"Les soins, quels qu’ils soient, aux sujets bénéficiaires de l’aide médicale d’etat (ame)","Les soins, quels qu’ils soient, aux femmes enceintes à partir du 4ème mois de grossesse",La réalisation d’une mammographie chez une femme de 54 ans dans le cadre du programme national de dépistage ducancer du sein,"Les examens supplémentaires, hors prise en charge habituelle, réalisés dans le cadre de la participation à un essairandomisé" 50 | 48,"Un patient de 48 ans présente depuis quelques semaines des céphalées qui conduisent à diagnostiquer une hypertensionartérielle. la moyenne de ses pressions artérielles en ambulatoire est à 177/92 mmhg. son bilan biologique est le suivant :na 142 mmol/l, k 3,4 mmol/l, créatininémie 70 µmol/l, calcémie 2,5 mmol/l. diurèse des 24h : 1400 ml. ionogrammeurinaire: na=180 mmol/l, k=50 mmol/l, protéinurie <0,01g/l. au vu de ce bilan, quel(s) est (sont) le(s) cause(s) que vousdevez évoquer pour cette hypertension artérielle ?",Sténose artérielle rénale,Syndrome de gitelman,Hyperaldostéronisme primaire,Consommation chronique de réglisse,Phéochromocytome 51 | 49,"Quel marqueur tumoral a un intérêt à la fois dans le dépistage, le diagnostic, le pronostic et le suivi du cancer dont il estspécifique ? (1 réponse)",Ace,Psa,Alpha fp,Hcg,Ca125 52 | 50,"Dans le cadre de la loi du 2 février 2016 dite loi « claeys-leonetti » lorsque un patient ne peut plus s’exprimer, untraitement qui apparait inutile, disproportionné ou lorsqu’il n’a d’autre effet que le seul maintien artificiel de la vie, peut êtresuspendu à l’issue d’une procédure collégiale définie par voie réglementaire. quel(s) est (sont) la (les) élément(s) prévu(s)dans cette procédure ?",Une consultation des directives anticipées si elles existent,L’avis d’au moins un médecin consultant,Une discussion avec les membres de l’équipe de soins présents,Une information du directeur de garde si cette procédure a lieu le week end,La décision doit être inscrite dans le dossier médical 53 | 51,Sur quel(s) moyen(s) l’évaluation de la dimension qualitative de la douleur s’appuie-t-elle ?,Questionnaire dn4,Questionnaire doloplus,Echelle algoplus,Echelle visuelle analogique,Echelle numérique 54 | 52,Par quel(s) moyen(s) thérapeutique(s) une douleur neuropathique peut elle être prise en charge enpremière intention ?,Un antidépresseur tricyclique,Un antiépileptique de la classe des gabapentinoides,La morphine,La stimulation électrique transcutanée,La stimulation médullaire 55 | 53,Un patient de 55 ans est pris en charge dans une unité de soins palliatifs pour une évolution terminale d’une insuffisancerespiratoire compliquant un emphysème majeur. sa principale plainte est une majoration de sa dyspnée. comment prendreen charge cette dyspnée ? (une ou plusieurs réponse(s) correcte(s)),Évaluation du symptôme par une échelle visuelle analogique,Adaptation du débit de l’oxygénothérapie pour que la saturation artérielle en oxygène soit supérieure à 95 %,Introduction ou majoration d’un traitement opioïde,Installation confortable du patient,Sédation profonde et continue d’emblée jusqu’au décès 56 | 54,Une chirurgie de l'obésité à type de gastrectomie longitudinale peut être proposée (une ou plusieures réponses exactes) :,Chez les adolescents à partir de 15 ans si l'imc est supérieur à 40 kg/m2,"Chez un sujet de 55 ans, appareillé pour apnée du sommeil, ayant un imc ≥ 35 kg/m2",En cas de troubles graves du comportement alimentaire,Si le sujet a compris et accepté le suivi médical et chirurgical post-opératoire à vie,Si le patient a reçu une information claire et complète sur les risques opératoires 57 | 55,"Un patient de 52 ans sans antécédent particulier présente une hypertension artérielle, une protéinurie de 2 g/24h, unehématurie à 105 hématies/ml avec une créatininémie à 130 µmol/l. son échographie vésico-rénale est normale. voici lecompte-rendu de sa biopsie rénale : fragment cortical comprenant 15 glomérules dont 4 glomérules scléreux. lesglomérules perméables présentent une prolifération mésangiale et endocapillaire. lésions d’artériolosclérose modérée.lésions d’atrophie tubulaire et de fibrose interstitielle sur environ 20% du parenchyme. l’immunofluorescence retrouve desdépôts d’iga à +++ dans le mésangium et de c3 à 1+ dans les vaisseaux et les glomérules. quel(s) est (sont) le(s)diagnostic(s) possible(s) ?",Néphropathie tubulo-interstitielle,Néphropathie lupique classe iv,Glomérulonéphrite pauci-immune,Néphropathie à iga,Néphroangiosclérose 58 | 56,Quels sont les éléments qui vous orientent vers l'origine professionnelle d'un eczéma de contact allergique chez un ouvrieren plasturgie travaillant dans la fabrication de bateaux de plaisance (une ou plusieurs réponses possibles) ?,La symptomatologie qui s'améliore pendant les vacances,Une localisation des lésions sur le dos des mains et des poignets,La présence de plusieurs cas simultanés dans le même atelier,Un antécédent d'atopie dans l'enfance,La présence de lésions sur les paupières 59 | 57,"Jeune médecin généraliste, vous recevez pour la première fois un patient de 52 ans qui se plaint d’insomnies, deruminations anxieuses, d’une perte d’élan vital et d’un désinvestissement familial et professionnel. il indique que sessymptômes sont apparus il y a 6 mois, à la suite de l’arrivée d’un nouveau chef d’équipe qui lui fait sans cesse desremarques sur sa lenteur au travail et son manque de capacités intellectuelles. il signale même des injures proféréescontre lui à plusieurs reprises, lorsqu’il était seul avec son chef.ce patient n’a pas d’antécédent médical notable, en dehors d’une dépression réactionnelle à un divorce, il y a 10 ans.le patient vous demande de faire une déclaration de maladie professionnelle.que devez-vous indiquer sur le certificat médical initial ?",L'existence d’un syndrome dépressif,La date à laquelle vous avez constaté la pathologie pour la première fois,L'antécédent de syndrome dépressif,L’existence d’un harcèlement de la part d’un collègue,Le nom du chef de service 60 | 58,"Un patient de 12 ans est admis aux urgences pédiatriques pour un syndrome méningé. il est installé dans une salled'examen par une aide-soignante et l’infirmière vient prendre sa température et sa pression artérielle. l’interne vientensuite examiner l’enfant et suspecte une infection invasive à méningocoque, qui sera confirmée par l’analyse du lcr(méningocoque c).l’infirmière, âgée de 30 ans, vient voir l’interne en lui disant être inquiète car elle est enceinte et elle lui pose laquestion de ce qu’elle doit faire car elle a pris en charge l’enfant sans masque, et n’est pas vaccinée contre leméningocoque.quelle(s) mesure(s) doit (doivent) lui être proposée(s) ?",Une vaccination par le vaccin conjugué contre le méningocoque c,Une prophylaxie par rifampicine per os pendant 5 jours,Une prophylaxie par rifampicine per os pendant 2 jours,La rassurer et lui indiquer qu’il n’y a pas de risque de contamination,Une prophylaxie par une injection de ceftriaxone 61 | 59,Quelles mesures d’hygiène convient-il de prendre à l’entrée dans la chambre pour la prise en charge d’un patient atteintd’une tuberculose pulmonaire ?,Port d’une casaque à manche longue,Port d'un masque de protection respiratoire (type ffp2),Port d'une charlotte,Port de surchaussures,Friction des mains avec une solution hydroalcoolique 62 | 60,Quelles sont les vaccinations obligatoires pour une infirmière travaillant à l’hôpital dans un service de soins (une ouplusieurs réponses possibles) ?,Vaccination contre le pneumocoque,"Vaccination contre la diphtérie, le tétanos et la poliomyélite",Vaccination contre l’hépatite a,Vaccination contre la coqueluche,Vaccination contre l’hépatite b 63 | 61,"Concernant la péritonite aiguë, quelle(s) proposition(s) retenez-vous ?",Le scanner abdominal est l'examen morphologique de référence pour le diagnostic,Le traitement chirurgical doit comporter un lavage de la cavité péritonéale,"Les 3 causes les plus fréquentes sont l'appendicite, l'ulcère gastro-duodénal, le diverticule colique",Le risque évolutif de la péritonite est le choc septique,La péritonite est toujours liée à une perforation digestive 64 | 62,"Concernant l’occlusion intestinale aiguë, quelle(s) est (sont) la (les) information(s) exacte(s) ?",Une occlusion fonctionnelle peut avoir pour cause un trouble hydroélectrolytique,Une bride péritonéale peut entrainer une occlusion par strangulation,L’occlusion par strangulation menace la vitalité de l’intestin en quelques heures,Le scanner abdominal avec injection de produit de contraste est l’examen de référence,Le cancer du côlon est la première cause d’occlusion colique par obstruction 65 | 63,En ce qui concerne le syndrome occlusif : (une ou plusieurs réponses exactes),L'arrêt des matières est un signe physique absent dans 30% des cas,La douleur abdominale est toujours le symptome initial,Le siège de la douleur abdominale signe le siège de l'obstacle,Les vomissements répétés et fréquents soulagent temporairement les douleurs abdominales dans les occlusions del'intestin grêle,L'arrêt des gaz est le signe fonctionnel primordial au diagnostic 66 | 64,"M. m, âgé de 58 ans, vous est adressé pour des anomalies du bilan martial. dans ses antécédents, on note uniquement undiabète diagnostiqué il y a 3 mois.a l’examen clinique, la température est à 37,3 °c. vous notez une hépatomégalie évaluée à 5 cm sous l’auvent costaldroit.son bilan martial vous est présenté ci-dessous :coefficient de saturation de la transferrine (cst) à 62%, ferritine à 1200 ng/ml (normale 30 à 300 mg/ml).parmi les propositions suivantes, laquelle (ou lesquelles) des causes suivantes pourrai(en)t expliquer les anomalies dubilan martial présentées dans ce contexte clinique ?",Syndrome inflammatoire,Hépatosidérose dysmétabolique,Hémochromatose génétique,Myélodysplasie,Syndrome d’activation macrophagique 67 | 65,Lors de l'admission d'un polytraumatisé en état de choc hémorragique sévère (une ou plusieures réponses exactes):,Un bodyscan est indispensable et doit être réalisé en urgence,Une fast écho réalisée au lit du patient suffit à affirmer l'hémopéritoine,Une laparotomie en urgence est indiquée pour affirmer l'origine abdominale du choc hémorragique,"En cas d'hémopéritoine massif la technique de ""damage control"" est la technique de référence","La technique de ""damage control"" a pour but de contrôler le saignement et de traiter dans le même temps les lésionsdigestives" 68 | 66,"M. m., âgé de 22 ans, consulte en urgence en raison d’une asthénie associée à une fièvre à 39°c évoluant depuis 72heures. il se plaint d’une odynophagie et de myalgies diffuses.a l’examen clinique, vous trouvez des adénopathies cervicales et une splénomégalie à un travers de doigt.un bilan sanguin a été réalisé en ville et montre les résultats suivants :hémoglobine 13,2 g/dl, vgm 89 fl, plaquettes 120 g/l, leucocytes 10,6 g/l, polynucléaires neutrophiles 1,6 g/l,basophiles 0,1 g/l, éosinophiles 0,4 g/l, lymphocytes 8 g/l, monocytes 0,5 g/l.frottis sanguin : présence de nombreux lymphocytes de grande taille avec cytoplasme hyper-basophile.parmi les examens complémentaires suivants, lequel (ou lesquels) vous paraissent à réaliser en 1ère intention dans cecontexte clinique ?",Myélogramme,Immunophénotypage lymphocytaire,Antigénémie p24,Mni test,Sérologie du cytomégalovirus (cmv) 69 | 67,"Un patient présente une claudication pour une distance évaluée à 400 mètres et qui se traduit par une douleur au niveau dumollet droit.a l’examen clinique vous notez : l’absence d’œdème des membres inférieurs la présence de tous les pouls périphériques au niveau du membre inférieur gauche le pouls poplité est cependant ample ettrès facile à palper alors qu’à droite seul le pouls fémoral est perçu il n’y a ni trouble sensitif, ni trouble moteur au niveau des membres inférieurs. vous retrouvez enfin un souffle iliaque gauchequelle(s) lésion(s) artérielle(s) devez-vous suspecter ?",Oblitération iliaque gauche,Sténose iliaque gauche,Anévrisme poplité gauche,Oblitération iliaque droite,Oblitération fémorale droite 70 | 68,"A propos du souffle dans l’insuffisance mitrale, quelle(s) est (sont) la(les) proposition(s) exacte(s) ?",Il est mésosystolique éjectionnel,Il est le plus souvent en jet de vapeur,Il peut être associé à un roulement mésodiastolique,Il est le plus souvent de siège apexo-axillaire,Il irradie aux carotides 71 | 69,"Dans un essai clinique, l'attribution aléatoire (randomisation) du traitement évalué est destinée à :",Constituer des groupes comparables à l'aune des facteurs de confusion potentiels,Conclure à une différence avec un seuil de signification statistique de 5%,Atténuer les fluctuations d'échantillonnage,Maintenir les sujets dans l'ignorance du traitement alloué pendant toute la durée d'étude,Réduire le nombre de sujets nécessaire 72 | 70,Les mesures d'association qu'il est possible d'estimer dans une étude épidémiologique étiologique transversale incluent :,Le taux d'incidence,L'odds ratio,Le taux de mortalité,La prévalence,La fraction étiologique 73 | 71,"Dans la liste des infections bactériennes suivantes, quelle(s) est(sont) celle(s) qui n’est(ne sont) habituellement pasassociée(s) à une hyperleucocytose ?",Abcès hépatique à bacille à gram négatif,Pyélonéphrite aiguë,Fièvre typhoïde,Infection pulmonaire à pneumocoque,Tuberculose 74 | 72,"Parmi les parasitoses suivantes, quelle(s) est(sont) celle(s) qui se transmet(tent) par contact cutané (marche pieds nus,baignade) avec l’eau ou le sol humide ?",Amoebose,Téniose,Hydatidose (échinococcose),Strongyloidose (anguillulose),Schistosomoses (bilharzioses) 75 | 73,le certificat médical descriptif de lésions secondaires à des violences : (une ou plusieurs réponses exactes),Doit mentionner le retentissement psychologique des violences sur la victime,Peut être remis directement à un officier de police judiciaire si l’incapacité totale de travail est supérieure à huit jours,Peut être remis directement à un tiers sous réserve qu’il apporte la preuve de son lien avec la victime,Est remis au titulaire de l’autorité parentale si la victime est mineure,Permet de constater sur le plan médical la crédibilité des propos de la victime 76 | 74,"En absence de différence statistiquement significative du critère de jugement principal entre les deux groupes d'un essaicontrôlé randomisé prospectif contre placebo, il faut évoquer :",Le risque d'erreur statistique de deuxième espèce (bêta),L'absence d'effet du traitement,Un défaut de puissance statistique,La non-infériorité du traitement évalué,Le risque d'erreur statistique de première espèce (alpha) 77 | 75,"L’association à l’autopsie d’un hématome sous-dural récent, bilatéral et multi-focal et d’hémorragies rétiniennes bilatéraleschez un bébé de 6 mois sans antécédent particulier évoque le diagnostic de : (une ou plusieurs réponses exactes)",Mort subite du nourrisson,Syndrome du bébé secoué,Syndrome de silverman,Rupture de malformation artério-veineuse cérébrale,Traumatisme crânien accidentel 78 | 76,"Le volet administratif du certificat de décès, par voie électronique ou papier, est transmis : (une ou plusieurs réponsesexactes)",A la mairie du lieu de décès,A l’institut national de la santé et de la recherche médicale (inserm),Au gestionnaire de la chambre funéraire mandaté par la famille,Au procureur de la république,A la famille du défunt 79 | 77,Le syndrome du qt long congénital est un trouble du rythme héréditaire de transmission autosomique dominante quiprédispose à la mort subite dès l'enfance et qui peut faire l'objet d'une prise en charge préventive. cette pathologie est trèshétérogène sur le plan génétique. quelle(s) est (sont) la (les) proposition(s) exacte(s) :,Les gènes impliqués codent pour des canaux ioniques,Le syndrome du qt long est le plus souvent associé à une malformation cardiaque congénitale,L'évaluation génétique de cette pathologie se fait par l'étude du caryotype,Le diagnostic chez un cas index doit mener à une information à la parentèle,Le diagnostic prédictif moléculaire n'est pas autorisée chez l'enfant mineur dans cette situation 80 | 78,La rédaction d'un certificat médical descriptif nécessite l'évaluation de l'itt au sens pénal du terme. quelle est lasignification de cet acronyme ?,L’incapacité totale de travail,L’incapacité totale temporaire,L’incapacité temporaire totale,L’incapacité de travailler totalement,L’incapacité temporaire totale 81 | 79,Vous recevez en consultation une femme enceinte pour l'échographie morphologique de 22 semaines d’aménorrhée. soncouple est sans histoire familiale. la croissance fœtale est normale. elle a bénéficié d'un dépistage combiné du premiertrimestre avec un risque de trisomie 21 calculé à 1/10 000. la seule particularité est une hyperéchogénicité intestinalefœtale. quelle(s) est(sont) le(s) proposition(s) exacte(s) :,Il s'agit d'un signe d'appel de la mucoviscidose,Il s'agit d'un signe d'appel d'une infection virale,Ce signe est fréquemment rencontré chez les fœtus hétérozygotes pour une mutation sévère du gène cftr,On propose en priorité une recherche d'hétérozygotie chez les 2 parents,On propose en priorité une amniocentèse pour recherche de mutations du gène cftr chez le fœtus 82 | 80,Les objectifs de la prise en charge médico-légale d’une victime de violences sexuelles sont : (une ou plusieurs réponsesexactes),Décrire les lésions traumatiques corporelles,Déterminer si la personne était consentante au moment des faits,Déterminer si les déclarations de la victime sont crédibles,Mettre en place une prise en charge multidisciplinaire,Faire des prélèvements pour réalisation d’empreintes génétiques 83 | 81,Quelles sont les stratégies thérapeutiques possibles dans l’asthme et la bronchopneumopathie chronique obstructive(bpco) ? (une ou plusieurs réponses exactes),Corticothérapie inhalée au long cours en monothérapie dans la bpco,Corticothérapie inhalée continue en monothérapie dans l’asthme,Bêta-2 agoniste de longue durée d’action au long cours en monothérapie dans l’asthme,Association de corticoïde inhalé et bêta-2 agoniste de longue durée d’action inhalé en traitement de fond dans l’asthme,Bêta-2 agoniste de longue durée d’action en monothérapie dans la bpco 84 | 82,Citez la(les) conséquence(s) potentielle(s) d’une association médicamenteuse avec un médicament inducteur ducytochrome p450 3a4.,Rejet de greffe sous ciclosporine,Grossesse sous oestroprogestatifs,Ergotisme en présence d'ergotamine,Rhabdomyolyse en présence de certaines statines,Échec d’un traitement antirétroviral 85 | 83,Vous recevez le résultat d’un ionogramme sanguin montrant une kaliémie à 6 mmol/l. quelle(s) cause(s) iatrogène(s)pouvez-vous évoquer ?,Corticothérapie orale au long cours,Antagoniste de l'angiotensine ii,Inhibiteur des récepteurs aux minéralocorticoïdes,Inhibiteur de l'enzyme de conversion,Diurétique de l’anse 86 | 84,À propos des antidotes des médicaments :,Le sulfate de protamine neutralise l'activité anticoagulante de l'héparine,La naloxone est un antagoniste spécifique des morphinomimétiques,Les facteurs prothrombiniques sont l'antidote pour le clopidogrel,La n-acétyl-cystéine est l'antidote de l'acide acétylsalicylique,Le flumazénil est un antagoniste des benzodiazépines et des molécules apparentées 87 | 85,"Une jeune femme de 23 ans est hospitalisée en psychiatrie pour un état d’excitation psychomotrice évoluant depuis unesemaine, avec désinhibition ayant entrainé des dépenses inconsidérées et des conduites sexuelles à risque. elle n’a pasdormi depuis 72h mais ne manifeste aucune fatigue et entreprend de se présenter à chacun des patients du service. sivous deviez opter pour une monothérapie, laquelle ou lesquelles de ces options vous semblerai(en)t indiquée(s) ?",Lithium,Acide valproïque,Risperidone,Carbamazépine,Quétiapine 88 | 86,A propos de la décision d'interruption médicale de grossesse (img) (une ou plusieurs réponses exactes) :,Toute demande d'img doit faire l'objet d'un avis du centre pluridisciplinaire de diagnostic pré-natal (cpdpn),Il existe une liste de pathologies pour lesquelles il y a une indication médicale d'img,"La recevabilité de la demande se fonde sur la démonstration d'une ""forte probabilité d’une affection d'une particulièregravité et incurable au moment du diagnostic""",Un délai de réflexion doit être proposé à la femme enceinte entre le diagnostic de l'affection et la réalisation éventuellede l'img,Une img peut être réalisée après avis du cpdpn jusqu'au terme 89 | 87,"Une jeune femme de 31 ans décrit l’apparition brutale, il y a un mois, d’une fatigue intense accompagnée d’une profondetristesse. elle s’adresse beaucoup de reproches, en particulier de ne pas être capable de s’occuper de sa fille de 2 mois,est très ralentie et se réveille souvent au milieu de la nuit. il lui arrive alors d’avoir des idées suicidaires. parmi lescaractéristiques suivantes, laquelle ou lesquelles peut(peuvent) témoigner d’un trouble bipolaire de l’humeur ?",Le sexe féminin,Contexte de post-partum,Début brutal,Caractéristiques mélancoliques,Idées suicidaires 90 | 88,"Parmi les signes et symptômes suivants, lequel(lesquels) est(sont) plus fréquent(s) en cas d’épisode dépressif chez lesujet âgé par rapport à l’adulte jeune ?",Plaintes somatiques,Sentiment de culpabilité,Autodépréciation,Idées suicidaires,Troubles sexuels 91 | 89,"Parmi les signes suivants, lequel(lesquels) peut(peuvent) être un(des) symptôme(s) dû(s) au sevrage d’une substanceopiacée ?",Constipation,Mydriase bilatérale,Hallucinations,Vomissements,Hypertension artérielle 92 | 90,"Devant un patient présentant un trouble lié à l’usage d’alcool et opposé à l’idée d’une prise en charge addictologique,quelle(s) attitude(s) caractérise(nt) l’entretien motivationnel ?",Donner au patient des arguments en faveur du changement,Laisser le patient expliquer ce que lui apporte l’alcool,Exposer le patient à des situations à risque de consommation excessive,Identifier les motifs personnels de changement chez le patient,Insister auprès du patient sur les risques liés à la consommation d’alcool 93 | 91,Un patient de 69 ans se présente pour une visite annuelle chez son nouveau médecin généraliste. l’examen clinique révèleun pouls à 45 pulsations par minute. citez le(s) médicament(s) susceptible(s) d’être en cause :,Bêtabloquant sélectif,Antiarythmique de classe iii,Inhibiteur calcique du groupe de la dihydropyridine,Anticholinestérasique,Bronchodilatateur bêta-2 mimétique à action rapide et de courte durée par voie inhalée 94 | 92,A propos du syndrome de trisomie 21 (une ou plusieurs réponses exactes):,Il résulte le plus souvent d'un accident méiotique maternel,"Quand il est associé à une formule chromosomique 46,xx,der(14;21),+21, il ne nécessite pas d’enquête familiale",Son diagnostic post-natal peut être affirmé de façon rapide par biologie moléculaire,Son risque de récurrence est proche de 1/100 à 1/200 pour un couple ayant eu un premier enfant atteint,Son risque est diminué par l’âge maternel avancé au moment de la conception 95 | 93,Au sujet des lésions histologiques des glomérulopathies (une ou plusieurs réponses exactes) :,Le diagnostic des lésions glomérulaires minimes nécessite un examen en microscopie électronique,La hyalinose segmentaire et focale peut être primitive chez l’adulte,La glomérulopathie membrano-proliférative est caractérisée par des doubles contours de la membrane basaleglomérulaire,Les dépôts de type « humps » sont présents dans la glomérulonéphrite aiguë post-infectieuse,Le diabète peut donner lieu à une glomérulopathie 96 | 94,Le diagnostic histologique de l’adénocarcinome prostatique sur cartographie biopsique (une ou plusieurs réponsesexactes):,Nécessite en général six prélèvements biopsiques,Peut affirmer une atteinte extra-prostatique,Nécessite une biopsie au niveau des vésicules séminales,Est précisé dans son pronostic par le score architectural de gleason,Est précisé dans son pronostic par l'index de prolifération 97 | 95,"Lors d’une intervention chirurgicale, un examen extemporané sur un prélèvement tissulaire est demandé. le prélèvementdoit être envoyé au laboratoire d’anatomo-pathologie (une ou plusieurs réponses exactes):",À + 4°c,À - 20°c,Immergé dans du formol,Sans liquide fixateur,Accompagné d’une feuille de consentement 98 | 96,"Sur une ponction biopsie hépatique, on retient en faveur du diagnostic d’hépatite alcoolique aigue (une ou plusieursréponses exactes):",Une inflammation à polynucléaires neutrophiles,Des hépatocytes ballonisés,Des corps de councilman,Une cirrhose,Une cholestase 99 | 97,Des analyses de biologie moléculaire dans le cadre du diagnostic anatomopathologique d'une tumeur (une ouplusieurs réponses exactes):,Peuvent être faites sur des prélèvements tissulaires fixés et inclus en paraffine,Peuvent être faites sur des prélèvements tissulaires non fixés congelés à - 80°c,Peuvent être faites sur des frottis cellulaires en milieu liquide,Nécessitent un contrôle morphologique du prélèvement tissulaire,Nécessitent une autorisation signée du patient 100 | 98,"Concernant la maladie d'alzheimer, quelle(s) affirmation(s) est(sont) juste(s) ?",Le diagnostic reste souvent tardif,Il s’agit d’une démence secondaire,Les troubles du comportement se déclarent souvent en début de maladie,Le test des 5 mots de dubois permet de poser le diagnostic,Elle évolue par poussée conduisant à des hospitalisations itératives 101 | 99,"Concernant le vieillissement des organes, quelle(s) est(sont) la(les) propositon(s) juste(s) :",Il est marqué par une diminution des capacités maximales,Il est dû essentiellement au stress oxydant,Il s'agit d'un concept sans preuve scientifique,Il est caractérisé par une réduction des capacités de réserve fonctionnelle,Il permet de juger l’autonomie de l’individu 102 | 100,"Concernant le syndrome de fragilité, quelle(s) proposition(s) est(sont) juste(s) ?",Il s’agit d’un concept sans définition précise,Il permet d'évaluer les réserves fonctionnelles des organes,Il est associé à un risque de dépendance,Il est associé au risque d’escarre pendant l’hospitalisation,Il est associé à une augmentation du risque d’infarctus du myocarde 103 | 101,"Vous prenez en charge aux urgences une patiente de 85 ans pour traumatisme crânien sous antivitamine k (avk) prescritpour une fibrillation atriale. l'inr est à 2,9. il existe une pétéchie sur le scanner cérébral. parmi les propositions suivantes,laquelle(lesquelles) retenez-vous pour votre prise en charge thérapeutique ?",Administration immédiate de concentré de complexes prothrombiniques,Administration de vitamine k dans 4 heures,Scanner cérébral de contrôle systématique dans 6 heures,Arrêt de l’antivitamine k avec relais par héparine à dose curative,Arrêt de l’antivitamine k 104 | 102,Quel(s) critère(s) parmi les suivants témoigne(nt) d’une dénutrition sévère du sujet âgé ?,Perte de poids ≥ 10 % en 1 mois,Index de masse corporelle <18 kg/m2,Perte de poids ≥ 15 kg en 6 mois,Score mini nutritional assessment <17,Taux d’albumine plasmatique <35 g/l 105 | -------------------------------------------------------------------------------- /data/dataset/dataset_english_cleaned.csv: -------------------------------------------------------------------------------- 1 | question;answer_A;answer_B;answer_C;answer_D;answer_E;id 2 | 'In the presence of a febrile roseoliform exanthema in children, the main etiologies are (one or more correct answers):';"""Sudden rash""";'Epidemic megaloerythema';'A rubella';"""Infectious mononucleosis""";'Kawasaki disease';0 3 | Regarding heart failure, which statement(s) is (are) true?;Cardiac auscultation can reveal an accentuated B2 sound at the aortic area in cases of pulmonary arterial hypertension.;Cardiac auscultation can reveal a murmur of mitral regurgitation related to the dilation of the mitral annulus.;Jugular venous distension is a peripheral sign of left-sided heart failure.;'Peripheral edema is soft, blue, and painful.';The crackles or subcrepitant rales are often bilateral.;1 4 | 'What is/are the correct response(s) regarding the management of diffuse bronchiectasis in adults (excluding a context of cystic fibrosis) responsible for recurrent infectious episodes?';'Daily bronchial drainage';'Systemic corticosteroid therapy';Pulmonary lobectomy;'Systematic quarterly antibiotic therapy treatment';'Anti-inflammatory treatment with fluoroquinolone';2 5 | "'A 58-year-old patient comes to the emergency department of your hospital due to coughing up two glasses of bright red blood during a coughing fit. She had never coughed up blood before. She is on aspirin for its antiplatelet effect due to coronary artery disease. Her clinical examination is normal; her blood pressure is 132/79 mmHg. Her heart rate is 80/min. The chest X-ray does not show any abnormalities. Provide the correct answer(s).'";'You are hospitalizing the patient.';'You initiate vascular fluid resuscitation.';"""You prescribe an intravenous vasoconstrictor agent, such as terlipressin.""";Prescribe an injected chest computed tomography with acquisition during the arterial phase after verifying the absence of contraindications.;Reassure the patient and explain to her that it is normal to bleed while on antiplatelet drugs.;3 6 | A 55-year-old patient with a hyperlymphocytosis of 25 g/l without cytopenia is referred to you with a diagnosis of chronic lymphocytic leukemia based on lymphocyte immunophenotyping. On clinical examination, the patient is in excellent general condition and there is a polyadenopathy of 1.5 to 2 cm in diameter in all lymph node areas. What examination is necessary at this stage? (only one answer);"""None""";A PET scanner;An echocardiogram.;'A myelogram';'A bone scintigraphy';4 7 | 'A 25-year-old man consults you due to abdominal pain. The examination is normal except for a palpable spleen at the end of inspiration. The blood count shows: leukocytes 14 g/l, neutrophils 8 g/l, myelocytes 1 g/l, metamyelocytes 1 g/l, monocytes 1 g/l, lymphocytes 3 g/l, platelets 510 g/l. You suspect chronic myeloid leukemia. What biological tests do you prescribe to confirm your diagnostic hypothesis? (one or more possible answers)';Leukocyte immunophenotyping on blood;"""Search for Jolly bodies in the smear""";'Investigation of the bcr-abl transcript';'Search for Gumprecht shadows';"""Search for a JAK2 mutation""";5 8 | 'Among the following statements regarding fragility-related osteopathies, which one(s) is (are) correct?';'Primary hyperparathyroidism preferentially affects the cortical bone.';'Treatment of hypothyroidism increases the risk of osteoporotic fracture';"""Corticosteroid-induced osteoporosis primarily affects the cortical bone.""";'Estrogen deficiency is responsible for increased osteoclastic activity.';The treatment with bisphosphonates increases the activity of osteoblasts.;6 9 | A 50-year-old woman arrives at the emergency department with malaise. She has no significant medical history but describes fatigue that appeared rapidly. The clinical examination is normal except for conjunctival subicterus. The blood count shows hemoglobin at 90 g/l, red blood cells at 2.7 t/l, hematocrit at 27%, mean corpuscular volume (MCV) at 102 fl, mean corpuscular hemoglobin concentration (MCHC) at 33 g/dl, leukocytes at 8 g/l, neutrophils at 5 g/l, lymphocytes at 2.3 g/l, and monocytes at 0.7 g/l. Which biological tests would be relevant to order as a first step? (one or more possible answers);C-reactive protein (CRP);"""Serum iron""";'Electrophoresis of serum proteins';Reticulocytes;"""LDH"" in English stands for ""Lactate Dehydrogenase.""";7 10 | 'Which of the following infectious agents is/are responsible for culture-negative endocarditis?';"""Mycobacterium tuberculosis""";"""Bartonella""";"""Streptococcus pyogenes""";"""Coxiella burnetii""";Il termine 'Tropheryma whipplei' è il nome scientifico di un batterio e, come tale, non necessita di traduzione in inglese. Mantiene lo stesso nome in entrambe le lingue.;8 11 | """Among the following infectious diseases, which one(s) is(are) notifiable in France?""";"""Rubella""";"""Plague""";"""Tuberculosis""";'Legionellosis';'Invasive pneumococcal disease';9 12 | In a patient treated for 2 days with unfractionated heparin for a proximal pulmonary embolism, the aPTT ratio is 6 and the anti-Xa activity is measured at peak activity at 1.2 IU/ml, in the absence of bleeding, what measure(s) do you take immediately? (one or more possible answers);"""Vitamin K intake""";'Platelet concentrate transfusion';'Protamine infusion';"""Discontinuation followed by dosage adjustment""";Introduction of VKAs (Vitamin K Antagonists);10 13 | A 62-year-old man with no medical history presents with a spontaneous deep hematoma of the psoas muscle. The complete blood count shows hemoglobin at 90 g/L and platelets at 170 g/L. His coagulation profile is as follows: aPTT ratio at 2.1, PT at 78%, and fibrinogen at 3.1 g/L. Mixing the patient's plasma with normal plasma does not correct the aPTT (Rosner index at 28 for a normal < 15). The assay of intrinsic pathway factors reveals factor VIII at 4%. What diagnostic hypothesis/hypotheses do you consider? (One or more possible answers);The presence of a lupus anticoagulant;'A congenital hemophilia';The presence of an anti-factor VIII antibody.;'Type 1 von Willebrand disease';"""Acquired hemophilia B""";11 14 | A patient is brought in unconscious by firefighters to the emergency department following a road traffic accident. She has sustained polytrauma, for which an emergency brain and thoraco-abdomino-pelvic CT scan are performed. She has a splenic fracture that requires surgical intervention. Upon her arrival, her husband informs you that she is approximately 8 weeks pregnant. The radiation dose received is 10 mGy. What are the risks associated with the accident and the management?;"""Developmental delay""";"""Cerebral malformation""";"""Abortion""";'Growth retardation';'Retroplacental hematoma';12 15 | A patient presents to your office for a preconception consultation. She is 32 years old and nulligravida. She has been managed for a year for well-controlled hypertension with perindopril, one tablet per day. She is using combined estrogen-progestin contraception, which she plans to stop at the end of her current pack. She weighs 81 kg and is 1.68 meters tall. She smokes 5 cigarettes per day but would like to quit. What do you plan at the end of the consultation? (one or more correct answers);'Rubella serology';'Assistance in smoking cessation through nicotine replacement therapy';'Cervical smear if the latter is more than one year old';Prescription of folates at a dose of 5 mg/day.;'Discontinuation of treatment with perindopril and transition to another antihypertensive.';13 16 | A 28-year-old woman is seeking consultation for the palpation of a mass in the upper outer quadrant of the right breast. She is worried because her mother and maternal aunt had breast cancer at the ages of 55 and 60, respectively. Upon clinical examination, you palpate a round and regular mass of 15 mm, not adherent to deep or superficial planes. There is no inflammation or skin retraction evident. No suspicious lymphadenopathy is palpated in the axillary and supraclavicular lymph node areas. What examination(s) should be requested first?;"""Breast ultrasound""";'A chest X-ray';"""Measurement of CA 15-3""";A breast MRI;"""A mammography""";14 17 | "A 38-year-old woman consults three months after her third childbirth for a contraception request. She had a cesarean section, while her first two deliveries were vaginal. She has recently stopped breastfeeding her child as she needs to resume her professional activity. In her medical history, she reports a uterine perforation during the insertion of an intrauterine device 7 years ago, a thrombophlebitis under a cast 10 years ago, and cervical laser treatment 4 years ago for cervical dysplasia related to a human papillomavirus infection. She does not smoke but occasionally ""vapes"". The last cervical smear, performed at the beginning of her pregnancy, was normal. What contraceptive method(s) can be considered for this woman?";Levonorgestrel intrauterine device;'Copper intrauterine device';Transdermal device releasing norelgestromin and ethinylestradiol;'Tubal sterilization by laparoscopy';Subcutaneous device releasing etonogestrel;15 18 | In the event of a suspected intraocular metallic foreign body, which examination(s) would you propose urgently?;An orbital scan;"""An MRI""";'An X-ray of the orbit';'Fluorescein angiography';A measurement of intraocular pressure;16 19 | """What are the correct statements regarding voluntary termination of pregnancy (abortion) in France?""";A woman under guardianship can request an abortion.;A woman can request complete anonymity for the performance of an abortion.;The insertion of an intrauterine device (IUD) is contraindicated in the immediate aftermath of a surgical abortion.;'Prostaglandins cannot be used in cases of hereditary porphyria.';A psychosocial consultation must systematically be carried out before performing the termination of pregnancy.;17 20 | A chalazion:;'Is an infection of a pilosebaceous follicle of the eyelids';It is a resorption granuloma of a meibomian gland of the eyelids.;'Treated with corticosteroid ointment';'Treated with systemic antibiotics';'May require a surgical incision';18 21 | What are the possible etiologies of decreased visual acuity associated with ocular redness (multiple correct answers)?;Acute angle-closure glaucoma attack;"""Anterior uveitis""";"""Central Retinal Artery Occlusion""";Neovascular glaucoma;Retinal vasculitis;19 22 | In the case of myopia (one or more correct answers):;The optical system formed by the eye is too convergent.;Distance vision is better than near vision without correction.;'The light rays focus in front of the retina.';A divergent lens can be used for correction.;The risk of retinal detachment may be increased.;20 23 | """You are caring for an 83-year-old patient, well-supported, on day 2 post-knee arthroplasty. The Redon drains were removed without issue. She has a swollen knee, very edematous and inflammatory. The scar is nice, non-inflammatory. What is/are the correct proposition(s)?""";'Outpatient care is possible.';The electrotherapy techniques practiced by the physiotherapist aim to reduce edema.;The prescription for an English cane could be made by the private physiotherapist after discharge from the hospital.;Your physiotherapy prescription must necessarily specify the physiotherapy techniques to be used.;The adaptation of the home should take place after preparing a file with the MDPH (Departmental House for Disabled Persons).;21 24 | You are managing a 32-year-old patient, a computer scientist, whose smoking history is evaluated at 15 pack-years, with no medical or surgical history, who was a victim of a road accident resulting in a severe spinal cord injury due to a C5 cervical fracture treated with anterior osteosynthesis on April 30, 2018. The weaning from mechanical ventilation was difficult, so a tracheostomy was performed on May 21, 2018, after orotracheal intubation. Weaning was then carried out on May 29. Upon arrival, he is eupneic. He has a stage 4 pressure sore on the right trochanter, with a loss of tissue down to the bone. The base of the sore is fibrous, and the purulent secretions are very abundant without signs of cutaneous inflammation. What is/are the correct proposal(s)?;'Tracheal stenosis is a complication of prolonged orotracheal intubation.';You prefer for the treatment of this pressure ulcer a combination of local antiseptics and dry dressings.;The presence of this pressure ulcer contraindicates the use of a wheelchair.;"""With the lesion being at the C6 spinal level, you would expect anesthesia starting from the lateral border of the forearm in the anatomical position.""";The request for long-term care can be made by the attending physician.;22 25 | 'You prescribe a standard articulated knee orthosis to one of your patients suffering from a knee sprain. Check the correct principle(s) of prescription for this type of medical device:';It is prescribed on a regular prescription.;'It is prescribed on a large medical equipment form.';"""He is reimbursed 100% of his purchase price.""";It can be prescribed by all specialists.;'It can be prescribed by a physiotherapist.';23 26 | 'Regarding carpal tunnel syndrome, which statement(s) is (are) true?';'It is most often idiopathic.';"""It is more common during pregnancy.""";The electromyogram is essential for diagnosis.;"""It may lead to a deficit of the flexor pollicis longus.""";It may cause an abolition of the brachioradialis reflex.;24 27 | Regarding knee osteoarthritis, which is(are) the correct answer(s)?;"""Joint aspiration is essential for diagnosis.""";'A genu varum predisposes to medial femorotibial gonarthrosis.';Viscosupplementation injections are indicated during flare-ups with joint effusion.;The surgical indication depends on the severity of the joint space narrowing.;The effectiveness of corticosteroid injections is limited in time.;25 28 | A 78-year-old former mechanic comes in for consultation due to significant febrile inflammatory lower back pain that started 10 days ago. You suspect a spondylodiscitis and decide to prescribe him a lumbar MRI. This patient has a total hip prosthesis that was implanted 8 years ago and a valvular prosthesis placed 2 years ago. He received a coronary stent 3 months ago. He has a glomerular filtration rate of 48 ml/min. During the interview, he reports that he received metallic fragments in his right eye and right cheek 40 years ago. Which consideration(s) contraindicate(s) the use of contrast-enhanced MRI?;"""Metallic fragments in the eye""";'Hip prosthesis';'The prosthetic valve';'The coronary stent';'Renal function';26 29 | In case of oculomotor nerve (III) paralysis, what might you encounter during the examination?;'A defect in eye elevation';'A miosis';A defect in eye adduction;An exophthalmos;A ptosis;27 30 | A 62-year-old patient has a medical history of essential hypertension treated with monotherapy for 2 years and active smoking (45 pack-years). For about two weeks, he has been complaining of daily headaches that tend to settle in the second part of the night. Initially, they gradually subsided during the morning. For about 3 days, they have been constant. These headaches are described as diffuse, helmet-like, and fluctuate in intensity, exacerbated by physical activity. He also complains of a loss of appetite and nausea, both of which have been progressively developing. The patient is afebrile. What syndrome does this presentation suggest to you?;'Status migrainosus';"""Chronic daily headaches""";"""Infectious meningitis syndrome""";'Intracranial hypertension';"""Meningeal syndrome related to a subarachnoid hemorrhage""";28 31 | A 59-year-old patient noticed a tremor in the last three fingers of his right hand that those around him also observed while walking. He swings his right upper limb less while walking. Upon examination, you find that the tremor disappears with arms extended. You observe that passive movement of the right elbow is more difficult and that movement of the right shoulder is painful. The deep tendon reflexes are normal. This type of tremor is likely aggravated by:;The emotion;"Il termine ""Le calcul mental"" si traduce in inglese come ""Mental calculation"". In un contesto medico, può riferirsi all'abilità del cervello di elaborare e risolvere calcoli matematici senza l'uso di strumenti esterni.";The writing;"""The movement""";"Il testo ""Le sommeil"" si traduce in inglese come ""Sleep.""";29 32 | """Among the following propositions, which one(s) apply(ies) to a central neurogenic bladder?""";Il testo francese 'Le' si traduce in inglese come 'The'.;"""Hypoactive detrusor""";Incontinence;'Risk of vesicoureteral reflux';'Low intravesical pressures';30 33 | 'Which of the following foods contain more than 5% carbohydrates?';"""Lenses""";"""Green beans""";Meat'.;Cheese;"""Fruits""";31 34 | 'Among the following biological signs, which one(s) guide(s) you towards an iatrogenic adrenal insufficiency in a 38-year-old patient with a history of Crohn's disease treated for 5 years with 10 mg/day of prednisone?';Sodium level at 128 mmol/l;'Kaliemia at 5.8 mmol/l';'Fasting blood glucose at 3 mmol/L';Plasma ACTH at 8 a.m. at 585 pg/ml (normal range: 10 – 20);Urinary free cortisol at 25 µg/24 hours (normal: < 90);32 35 | You see in consultation a 15-day-old newborn who presents with an isolated fever of 38.2°C and a preserved general condition.;You reassure the parents about the benign nature of this fever during viral epidemic periods.;"""The flu test is not informative at this age.""";"""The urine dipstick is not informative at this age.""";The performance of a urine cytobacteriological examination is systematic.;"""The performance of a lumbar puncture is systematic.""";33 36 | When faced with a lesion on the tongue, what clinical sign(s) would indicate a malignant origin?;'Indurated lesion';'Painful lesion';'Bleeding upon contact during palpation of the lesion';"""Submucosal induration""";'Presence of associated leukoplakia';34 37 | """You are called to the home of an infant found deceased by their parents a few minutes ago:""";You ask to be accompanied by the police.;You must not sign the death certificate before admission to the hospital.;You are drafting a report to the public prosecutor.;You suggest to the parents to conduct an autopsy to determine the causes of death.;The transfer of the body must be made to a medical-legal institute.;35 38 | 'You explain to young parents whose child is experiencing a first febrile episode the measure(s) to be taken during this episode.';The pharmacological treatment is necessary for any temperature exceeding 39°C.;"""Fluid intake is necessary every hour as long as the fever persists.""";'use cool compresses if the child is uncomfortable';"""The use of ibuprofen is only possible after 3 months.""";Keep the child out of group settings for the duration of the fever.;36 39 | Regarding cervical swellings, what is/are the exact item(s)?;A thyroglossal duct cyst is mobile during swallowing.;A right supraclavicular lymphadenopathy may be indicative of a genitourinary cancer.;A superficial, resilient swelling located at the anterior border of the sternocleidomastoid muscle is suggestive of a branchial cyst.;A schwannoma of the brachial plexus is a differential diagnosis for a submandibular lymphadenopathy.;A schwannoma of the accessory nerve is a differential diagnosis for spinal lymphadenopathy.;37 40 | Regarding peritonsillar abscess, what is/are the exact item(s)?;The abscess is located in the parapharyngeal space.;"""There may be trismus""";'The anterior pillar of the soft palate is enlarged.';In adults, hospitalization is systematic.;The drainage of the abscess is performed either by aspiration or by incision under general anesthesia.;38 41 | Regarding benign paroxysmal positional vertigo, what are the exact item(s)?;"""It lasts less than a minute.""";'It is consequent to a vestibular ischemia';It is treated with vestibular physiotherapy.;"""It is associated with tinnitus.""";"""There is a positional triggering factor.""";39 42 | A 32-year-old patient presents to the emergency department with asthenia. There are no other abnormalities on clinical examination. Biological tests reveal an increase in transaminases with AST=1362 IU (normal <40), ALT=2348 IU (normal <40). What are the possible causes for this increase in transaminases?;'Acute viral hepatitis';Acute alcoholic hepatitis;"""Drug-induced hepatitis""";'Autoimmune hepatitis';Cannabis-induced hepatitis;40 43 | A 62-year-old patient presents with progressively developing hyponatremia. Clinically, he appears euvolemic. His blood biochemical profile is as follows: Na 125 mmol/L, K 4 mmol/L, chloride 110 mmol/L, HCO3- 25 mmol/L, glucose 5 mmol/L, proteins 67 g/L, urea 4 mmol/L, creatinine 78 µmol/L. Urinary profile: Na 100 mmol/L, K 25 mmol/L, urea 350 mmol/L, creatinine 8 mmol/L. What are the possible causes of this biochemical profile? (One or more correct answers)?;'Syndrome du thé et des toasts';'Intake of furosemide';Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH);"""Intake of amlodipine""";"""Lithium intake""";41 44 | An 86-year-old patient is hospitalized for hematemesis. He is known to have viral hepatitis B, which is not being monitored. His family describes a bloody vomit equivalent in volume to that of a basin. Upon examination, he presents with ascites and asterixis. The systolic blood pressure is 55 mmHg. Among the following elements, which is/are associated with a poor prognosis?;"La traduzione del termine francese ""Age"" in inglese è ""Age"".";"""Volume of hematemesis""";'Blood pressure';Presence of hepatic encephalopathy;Presence of ascites;42 45 | A 62-year-old patient presents with the following biological profile: Na 142 mmol/l, K 5.7 mmol/l, chloride 110 mmol/l, HCO3- 18 mmol/l, proteins 88 g/l, urea 20 mmol/l, creatinine 170 µmol/l. Which medication(s) could cause this biological profile? (One or more correct answers);'Ibuprofen';"The term ""Candesartan"" is the same in both French and English as it is the generic name of a medication.";"""Amiloride""";"Il termine ""Amlodipine"" è già in inglese. Amlodipine è un farmaco usato principalmente per trattare l'ipertensione e l'angina pectoris.";"Il termine ""Prednisone"" è identico in inglese e in francese, quindi non richiede traduzione.";43 46 | 'In the emergency department, you are treating a 67-year-old female patient whose reason for admission is pain in the right calf. The medical history and clinical examination reveal progressive cancer currently undergoing treatment and localized tenderness along the deep venous network on the right side. The remainder of the examination is unremarkable. You utilize a simplified clinical prediction model for deep vein thrombosis (DVT) which indicates a 17% probability of DVT. You request a venous Doppler ultrasound of the lower limbs to confirm this suspicion of DVT. Among the following options, which one(s) is/are correct?';The post-test probability of DVT depends on the sensitivity of the venous Doppler ultrasound.;The pre-test probability of DVT depends on the specificity of the venous Doppler ultrasound.;The post-test probability of DVT depends on the likelihood ratio of the venous Doppler ultrasound.;The post-test probability of DVT depends on the intrinsic performance of the venous Doppler ultrasound.;The post-test probability of DVT can be determined graphically using Fagan's nomogram.;44 47 | A 43-year-old patient consults for moderate hyperferritinemia at 2 times the normal level, discovered during a routine check-up conducted by occupational medicine. He is asymptomatic. Which element(s) would suggest a metabolic hepatosiderosis?;'Elevated transferrin saturation coefficient';"""Overweight""";Hypertriglyceridemia;Basedow's disease;History of colon cancer;45 48 | """In the case of sigmoid diverticulitis, an injected abdominopelvic computed tomography (CT) scan is performed. It can show (one or more correct answers):""";"""Additive images containing air at the anti-mesenteric border of the colon""";'A thinning of the colonic wall';'An infiltration of fat around a diverticulum';"""Thickening of the colonic wall""";"""The pylophlebitis""";46 49 | """In what situation(s) does a patient benefit from an exemption from the co-payment (based on social security rates)?""";The care of minor children, whatever it may be;The care, whatever it may be, for individuals benefiting from State Medical Assistance (AME);'Care, of any kind, for pregnant women from the 4th month of pregnancy';Performing a mammogram on a 54-year-old woman as part of the national breast cancer screening program.;The additional examinations, outside of the usual care, conducted as part of participation in a randomized trial;47 50 | A 48-year-old patient has been experiencing headaches for a few weeks, leading to a diagnosis of hypertension. The average of his ambulatory blood pressures is 177/92 mmHg. His biological workup is as follows: Na 142 mmol/L, K 3.4 mmol/L, creatinine 70 µmol/L, calcium 2.5 mmol/L. 24-hour urine output: 1400 ml. Urinary ionogram: Na=180 mmol/L, K=50 mmol/L, proteinuria <0.01 g/L. Based on this workup, what cause(s) should you consider for this hypertension?;'Renal artery stenosis';Gitelman syndrome;"""Primary hyperaldosteronism""";Chronic consumption of licorice;"""Pheochromocytoma""";48 51 | Which tumor marker is valuable for screening, diagnosis, prognosis, and monitoring of the cancer for which it is specific? (1 response);"Forse ti riferisci a un contesto specifico in cui ""Ace"" viene utilizzato in francese. Tuttavia, ""Ace"" non è una parola francese; è in realtà una parola inglese usata in vari contesti, tra cui giochi di carte e sport, per indicare l'eccellenza o un colpo vincente. Se hai un contesto medico o un altro uso specifico in mente, ti pregherei di fornire ulteriori dettagli per offrirti una traduzione accurata.";"Il termine ""Psa"" potrebbe riferirsi a ""PSA,"" che in ambito medico sta per ""Antigène Prostatique Spécifique"" in francese, tradotto in inglese come ""Prostate-Specific Antigen.""";"The term ""Alpha fp"" in French refers to ""Alpha-fetoprotein"" in English. Alpha-fetoprotein is a plasma protein that is typically produced by the fetal liver, yolk sac, and gastrointestinal tract. In medical contexts, it is often used as a biomarker in maternal blood screening and in the detection and monitoring of certain types of liver cancer.";"""HCG""";"“CA-125""";49 52 | "'Within the framework of the law of February 2, 2016, known as the ""Claeys-Leonetti law"", when a patient can no longer express themselves, a treatment that appears unnecessary, disproportionate, or when it has no other effect than solely maintaining artificial life, can be suspended following a collegial procedure defined by regulatory means. What element(s) is (are) provided for in this procedure?'";A consultation of advance directives if they exist.;"""The opinion of at least one consulting physician""";A discussion with the members of the care team present.;'Information from the on-call director if this procedure takes place over the weekend';"""The decision must be recorded in the medical record.""";50 53 | """Upon which means does the evaluation of the qualitative dimension of pain rely?""";'DN4 Questionnaire';'Doloplus questionnaire';Algoplus scale;'Visual analogue scale';Numeric scale'.;51 54 | 'By what therapeutic means can neuropathic pain be managed as a first-line treatment?';A tricyclic antidepressant;'An antiepileptic from the gabapentinoid class';The morphine;Transcutaneous electrical stimulation;"""Medullary Stimulation""";52 55 | A 55-year-old patient is being cared for in a palliative care unit for the terminal progression of respiratory failure complicating severe emphysema. His main complaint is an increase in his dyspnea. How should this dyspnea be managed? (one or more correct answer(s));'Evaluation of the symptom using a visual analogue scale';Adaptation of oxygen therapy flow to ensure arterial oxygen saturation is above 95%;"""Introduction or escalation of opioid therapy""";'Comfortable positioning of the patient';"""Deep and continuous sedation from the outset until death""";53 56 | A type of weight loss surgery such as sleeve gastrectomy may be proposed (one or more correct answers):;In adolescents aged 15 and over, if the BMI is greater than 40 kg/m²;In a 55-year-old patient, equipped for sleep apnea, with a BMI ≥ 35 kg/m².;"""In cases of severe eating behavior disorders""";If the subject has understood and accepted the lifelong medical and surgical post-operative follow-up;If the patient has received clear and complete information about the surgical risks;54 57 | A 52-year-old patient with no significant medical history presents with hypertension, proteinuria of 2 g/24h, hematuria at 105 red blood cells/ml, and serum creatinine at 130 µmol/l. His bladder-kidney ultrasound is normal. Here is the report from his kidney biopsy: cortical fragment including 15 glomeruli, 4 of which are sclerotic. The patent glomeruli show mesangial and endocapillary proliferation. Moderate arteriolosclerosis lesions. Tubular atrophy and interstitial fibrosis affecting approximately 20% of the parenchyma. Immunofluorescence reveals IgA deposits at +++ in the mesangium and C3 at 1+ in the vessels and glomeruli. What are the possible diagnosis/diagnoses?;'Tubulointerstitial nephropathy';Class IV lupus nephritis;"""Pauci-immune glomerulonephritis""";IgA nephropathy;'Néphroangiosclérose' si traduce in inglese come 'nephroangiosclerosis'.;55 58 | """What factors indicate the occupational origin of allergic contact dermatitis in a plastics worker involved in the manufacturing of pleasure boats (one or more possible answers)?""";"""The symptomatology that improves during vacations""";A location of the lesions on the back of the hands and wrists.;'The presence of multiple simultaneous cases in the same workshop';'History of atopy in childhood';"""The presence of lesions on the eyelids""";56 59 | Young general practitioner, you are seeing a 52-year-old patient for the first time who complains of insomnia, anxious rumination, a loss of vital drive, and disengagement from family and professional activities. He indicates that his symptoms appeared six months ago, following the arrival of a new team leader who constantly comments on his slowness at work and lack of intellectual abilities. He even reports insults directed at him on several occasions when he was alone with his supervisor. This patient has no notable medical history, except for a reactive depression following a divorce 10 years ago. The patient is asking you to make a declaration of an occupational disease. What should you indicate on the initial medical certificate?;The existence of a depressive syndrome;The date on which you first identified the pathology.;'History of depressive syndrome';The existence of harassment by a colleague;"""The name of the department head""";57 60 | A 12-year-old patient is admitted to the pediatric emergency department for a meningeal syndrome. A nursing assistant settles him in an examination room, and the nurse comes to take his temperature and blood pressure. The intern then examines the child and suspects an invasive meningococcal infection, which will be confirmed by the analysis of the cerebrospinal fluid (meningococcus C). The nurse, who is 30 years old, approaches the intern, expressing concern because she is pregnant and asks what she should do since she attended to the child without a mask and is not vaccinated against meningococcus. What measure(s) should be offered to her?;A vaccination with the conjugate meningococcal vaccine;'Prophylaxis with oral rifampicin for 5 days';"""Prophylaxis with oral rifampicin for 2 days""";'Reassure her and inform her that there is no risk of contamination.';'Prophylaxis with an injection of ceftriaxone';58 61 | What hygiene measures should be taken upon entering the room when caring for a patient with pulmonary tuberculosis?;'Wearing a long-sleeved gown';"""Wearing a respiratory protective mask (FFP2 type)""";"""Wearing a hairnet""";"""Wearing of overshoes""";'Friction of hands with a hydroalcoholic solution';59 62 | What are the mandatory vaccinations for a nurse working in a hospital care unit (one or more answers possible)?;'Pneumococcal vaccination';'Vaccination against diphtheria, tetanus, and poliomyelitis';Vaccination against hepatitis A;Whooping cough vaccination;'Hepatitis B vaccination';60 63 | Regarding acute peritonitis, which proposition(s) do you consider?;The abdominal CT scan is the reference morphological examination for diagnosis.;The surgical treatment must include a lavage of the peritoneal cavity.;The 3 most common causes are appendicitis, gastro-duodenal ulcer, and colonic diverticulum.;The evolutionary risk of peritonitis is septic shock.;Peritonitis is always associated with a gastrointestinal perforation.;61 64 | Regarding acute intestinal obstruction, which information is accurate?;A functional obstruction may be caused by an electrolyte imbalance.;A peritoneal band can lead to an obstruction by strangulation.;'Strangulation obstruction threatens the viability of the intestine within a few hours';The abdominal CT scan with contrast injection is the reference examination.;Colon cancer is the leading cause of colonic obstruction by blockage.;62 65 | 'Regarding the obstructive syndrome: (one or more correct answers)';"""The absence of bowel movements is a physical sign missing in 30% of cases.""";"""Abdominal pain is always the initial symptom.""";"""The location of the abdominal pain indicates the site of the obstruction.""";Repeated and frequent vomiting temporarily relieves abdominal pain in small bowel obstructions.;"""The cessation of gas passage is the primary functional sign for diagnosis.""";63 66 | Mr. M, a 58-year-old patient, has been referred to you for abnormalities in his iron profile. In his medical history, there is only a mention of diabetes diagnosed 3 months ago. During the clinical examination, his temperature is 37.3 °C. You note hepatomegaly estimated at 5 cm below the right costal margin. His iron profile is presented to you below: transferrin saturation coefficient (TSC) at 62%, ferritin at 1200 ng/ml (normal range 30 to 300 ng/ml). Among the following propositions, which of the following causes could explain the abnormalities in the iron profile presented in this clinical context?;'Inflammatory syndrome';'Dysmetabolic hepatosiderosis';'Genetic hemochromatosis';"""Myelodysplasia""";Macrophage activation syndrome;64 67 | 'During the admission of a polytraumatized patient in severe hemorrhagic shock (one or more correct answers):';"""A full-body scan is essential and must be performed urgently.""";A quick bedside ultrasound is sufficient to confirm hemoperitoneum.;An emergency laparotomy is indicated to confirm the abdominal origin of the hemorrhagic shock.;"In the case of massive hemoperitoneum, the ""damage control"" technique is the reference technique.";"The ""damage control"" technique aims to control bleeding and simultaneously treat digestive injuries.";65 68 | Mr. M., a 22-year-old man, presents to the emergency department due to fatigue associated with a fever of 39°C that has been persisting for 72 hours. He complains of odynophagia and diffuse myalgias. On clinical examination, you find cervical lymphadenopathy and splenomegaly measuring a fingerbreadth. A blood workup was conducted externally and shows the following results: hemoglobin 13.2 g/dl, mean corpuscular volume (MCV) 89 fl, platelets 120 g/l, leukocytes 10.6 g/l, neutrophils 1.6 g/l, basophils 0.1 g/l, eosinophils 0.4 g/l, lymphocytes 8 g/l, monocytes 0.5 g/l. Blood smear: presence of numerous large lymphocytes with hyper-basophilic cytoplasm. Among the following additional tests, which one(s) seem appropriate to perform as first-line investigations in this clinical context?;"""Myelogram""";'Lymphocyte immunophenotyping';"""p24 Antigenemia""";Mi dispiace, ma il testo che hai fornito sembra incompleto. Potresti fornire il testo completo o correggerlo?;"""Serology of cytomegalovirus (CMV)""";66 69 | "A patient presents with claudication for a distance evaluated at 400 meters, which manifests as pain in the right calf. Upon clinical examination you note: 70 | 71 | - The absence of edema in the lower limbs 72 | - The presence of all peripheral pulses in the left lower limb 73 | - The popliteal pulse is however full and very easy to palpate 74 | - Whereas on the right, only the femoral pulse is detected 75 | - There are no sensory or motor disturbances in the lower limbs 76 | 77 | Finally, you detect a left iliac bruit. Which arterial lesion(s) should you suspect?";Left iliac occlusion';'Left iliac stenosis';"""Left popliteal aneurysm""";'Right iliac occlusion';'Right femoral occlusion';67 78 | """Regarding the murmur in mitral insufficiency, which proposition(s) is (are) correct?""";'It is a midsystolic ejection murmur.';It is most often in a jet of steam.;It may be associated with a mid-diastolic murmur.;"""It is most often located in the apico-axillary region.""";"""It radiates to the carotids.""";68 79 | In a clinical trial, the random allocation (randomization) of the treatment being evaluated is intended to:;"""Form comparable groups in light of potential confounding factors""";Conclude that there is a difference with a statistical significance threshold of 5%.;'Mitigate sampling fluctuations';"""Maintain the subjects in ignorance of the allocated treatment for the entire duration of the study.""";Reduce the number of subjects required.;69 80 | 'The measures of association that can be estimated in a cross-sectional etiological epidemiological study include:';"""The incidence rate""";"""Odds ratio""";"""The mortality rate""";"""The prevalence""";'The etiological fraction';70 81 | 'Among the following bacterial infections, which one(s) is(are) not usually associated with leukocytosis?';Hepatic abscess with gram-negative bacillus;"""Acute pyelonephritis.""";Typhoid fever;'Pneumococcal lung infection';"""Tuberculosis""";71 82 | Among the following parasitic diseases, which one(s) is(are) transmitted through skin contact (walking barefoot, swimming) with water or moist soil?;Amoebiasis;Taeniasis'.;Hydatidosis (echinococcosis);"""Strongyloidiasis (anguilluliasis)""";Schistosomiasis (bilharziasis);72 83 | The descriptive medical certificate of injuries secondary to violence: (one or more correct answers);Must mention the psychological impact of the violence on the victim.;"""May be directly given to a judicial police officer if the total work incapacity exceeds eight days.""";Can be handed directly to a third party provided they furnish proof of their connection to the victim.;'Is given to the holder of parental authority if the victim is a minor';Allows for assessing the medical credibility of the victim's statements.;73 84 | 'In the absence of a statistically significant difference in the primary outcome measure between the two groups of a prospective, randomized, placebo-controlled trial, one must consider:';The risk of a Type II statistical error (beta);'The absence of treatment effect';'A lack of statistical power';"""The non-inferiority of the evaluated treatment""";The risk of a Type I statistical error (alpha);74 85 | The combination at autopsy of a recent, bilateral, and multifocal subdural hematoma and bilateral retinal hemorrhages in a 6-month-old baby without any particular history suggests the diagnosis of: (one or more correct answers);Sudden Infant Death Syndrome;"""Shaken Baby Syndrome""";Silverman syndrome;Rupture of cerebral arteriovenous malformation;'Accidental cranial trauma';75 86 | 'The administrative section of the death certificate, either electronically or on paper, is transmitted: (one or more correct answers)';"""At the town hall of the place of death""";At the French National Institute of Health and Medical Research (INSERM);To the funeral home manager appointed by the family;"""To the public prosecutor""";"""To the family of the deceased""";76 87 | The congenital long QT syndrome is an inherited arrhythmia disorder with autosomal dominant transmission that predisposes to sudden death from childhood and can be subject to preventive management. This pathology is very heterogeneous at the genetic level. What is (are) the correct proposition(s):;The genes involved encode for ion channels.;Long QT syndrome is most often associated with a congenital heart defect.;The genetic evaluation of this pathology is conducted through karyotype analysis.;The diagnosis in an index case should lead to informing the family members.;"""Molecular predictive diagnosis is not permitted for minors in this situation.""";77 88 | The writing of a descriptive medical certificate requires the evaluation of ITT in the legal sense of the term. What is the meaning of this acronym?;"""Total incapacity for work""";'Temporary total incapacity';"""Total temporary incapacity""";'Total inability to work';"""Temporary total incapacity""";78 89 | You are consulting with a pregnant woman for the 22-week morphological ultrasound. Her partner has no family history. Fetal growth is normal. She underwent a combined first-trimester screening with a calculated risk of Trisomy 21 at 1/10,000. The only notable feature is fetal bowel hyperechogenicity. What is the exact proposition(s):';"""This is a warning sign of cystic fibrosis.""";"""This is a warning sign of a viral infection.""";This sign is frequently encountered in fetuses heterozygous for a severe mutation of the CFTR gene.;'Priority is given to testing for heterozygosity in both parents.';The priority is an amniocentesis to search for mutations in the CFTR gene in the fetus.;79 90 | 'The objectives of the forensic medical management of a victim of sexual violence are: (one or more correct answers)';"""Describe traumatic bodily injuries""";"""Determine if the person was consenting at the time of the events.""";Determine if the victim's statements are credible.;Implement a multidisciplinary care approach.;'Take samples for genetic fingerprinting.';80 91 | What are the possible therapeutic strategies in asthma and chronic obstructive pulmonary disease (COPD)? (one or more correct answers);Long-term inhaled corticosteroid therapy as monotherapy in COPD;Continuous inhaled corticosteroid therapy as monotherapy in asthma;Long-acting beta-2 agonist used as monotherapy in asthma.;Inhaled corticosteroid and long-acting inhaled beta-2 agonist combination as maintenance treatment in asthma.;'Long-acting beta-2 agonist monotherapy in COPD';81 92 | List the potential consequence(s) of a drug interaction with a cytochrome P450 3A4 inducer.;'Graft rejection under cyclosporine';'Pregnancy while on estrogen-progestogen contraceptives';"""Ergotism in the presence of ergotamine""";"""Rhabdomyolysis in the presence of certain statins""";'Treatment failure of antiretroviral therapy';82 93 | You receive the result of a blood electrolyte panel showing a potassium level of 6 mmol/L. What iatrogenic cause(s) can you consider?;'Long-term oral corticosteroid therapy';Angiotensin II antagonist;Mineralocorticoid receptor antagonist;'Angiotensin-converting enzyme inhibitor';'Loop diuretic';83 94 | Regarding the antidotes for medications:;'Protamine sulfate neutralizes the anticoagulant activity of heparin.';Naloxone is a specific antagonist of morphinomimetics.;'Prothrombin factors are the antidote for clopidogrel.';N-acetylcysteine is the antidote for acetylsalicylic acid.;"""Flumazenil is an antagonist of benzodiazepines and related compounds.""";84 95 | A 23-year-old woman is hospitalized in psychiatry for a state of psychomotor agitation that has been ongoing for a week, with disinhibition leading to reckless spending and risky sexual behavior. She has not slept for 72 hours but shows no signs of fatigue and makes efforts to introduce herself to each of the patients in the ward. If you had to choose a monotherapy, which of these options would seem indicated?;"""Lithium""";Valproic acid;"""Risperidone""";"""Carbamazepine""";"""Quetiapine""";85 96 | Regarding the decision of a medical termination of pregnancy (MTP) (one or more correct answers):;Every request for a termination of pregnancy (IMG) must be reviewed by the multidisciplinary prenatal diagnosis center (CPDPN).;"""There is a list of pathologies for which there is a medical indication for termination of pregnancy.""";"The admissibility of the request is based on demonstrating a ""high probability of a particularly severe and incurable condition at the time of diagnosis.""";'A reflection period must be offered to the pregnant woman between the diagnosis of the condition and the eventual performance of the termination of pregnancy (TOP).';An imaging study may be performed after consultation with the perinatal care and diagnostics committee until term.;86 97 | A 31-year-old woman describes the sudden onset, one month ago, of intense fatigue accompanied by deep sadness. She is very self-critical, particularly about not being able to care for her 2-month-old daughter, is very slowed down, and often wakes up in the middle of the night. During these times, she sometimes has suicidal thoughts. Among the following characteristics, which one(s) might indicate a bipolar mood disorder?;"""The female sex""";Postpartum context;Abrupt onset;"""Melancholic features""";"""Suicidal ideation""";87 98 | 'Among the following signs and symptoms, which one(s) is(are) more common in the case of a depressive episode in the elderly compared to young adults?';"""Somatic complaints""";"""Guilt feeling""";"""Self-depreciation""";"""Suicidal ideation""";"""Sexual disorders""";88 99 | Among the following signs, which one(s) can be a symptom(s) due to opioid withdrawal?';"""Constipation""";"""Bilateral mydriasis""";"""Hallucinations""";"""Vomiting""";'Arterial hypertension';89 100 | In front of a patient presenting with alcohol use disorder and opposed to the idea of addiction treatment, which attitude(s) characterize motivational interviewing?;"""Provide the patient with arguments in favor of change""";"""Allow the patient to explain what alcohol brings to them.""";"""Exposing the patient to situations at risk of excessive consumption.""";"""Identify the personal motives for change in the patient""";'Emphasize to the patient the risks associated with alcohol consumption.';90 101 | A 69-year-old patient presents for an annual visit with their new general practitioner. The clinical examination reveals a pulse rate of 45 beats per minute. List the medication(s) that could potentially be responsible:;'Selective beta-blocker';Class III antiarrhythmic;Dihydropyridine calcium channel blocker;Anticholinesterase'.;'Short-acting beta-2 adrenergic agonist bronchodilator administered via inhalation';91 102 | Regarding Down syndrome (one or more correct answers):;"""It most often results from a maternal meiotic accident""";"""When associated with a chromosomal formula 46,xx,der(14;21),+21, it does not require a family investigation.""";"""His postnatal diagnosis can be quickly confirmed through molecular biology.""";"""His risk of recurrence is approximately 1 in 100 to 1 in 200 for a couple who has had a first child affected.""";'Her risk is reduced by advanced maternal age at the time of conception.';92 103 | Concerning the histological lesions of glomerulopathies (one or more correct answers):;The diagnosis of minimal glomerular lesions requires examination by electron microscopy.;'Focal segmental glomerulosclerosis can be primary in adults';Membranoproliferative glomerulopathy is characterized by double contours of the glomerular basement membrane.;"""The 'humps' deposits are present in post-infectious acute glomerulonephritis.""";Diabetes can lead to glomerulopathy.;93 104 | 'The histological diagnosis of prostatic adenocarcinoma in biopsy mapping (one or more correct responses):';"""Generally requires six biopsy samples""";'Can confirm extraprostatic extension';"""Requires a biopsy of the seminal vesicles""";The prognosis is specified by the Gleason architectural score.;It is specified in its prognosis by the proliferation index.;94 105 | During a surgical procedure, a frozen section examination on a tissue sample is requested. The sample must be sent to the pathology laboratory (one or more correct answers):;'At +4°C';'Thermostored at -20°C';"""Immersed in formalin""";'Without fixative solution';Accompanied by a consent form.;95 106 | 'On a liver biopsy sample, the diagnosis of acute alcoholic hepatitis is supported by (one or more correct responses):';'An inflammation with neutrophilic polymorphonuclear leukocytes';'Ballooned hepatocytes';'Councilman bodies';'A cirrhosis';'A cholestasis';96 107 | Molecular biology analyses in the context of the anatomopathological diagnosis of a tumor (one or more correct answers):;'Can be performed on tissue samples that are fixed and embedded in paraffin';"""Can be performed on unfixed tissue samples frozen at -80°C.""";"""Can be performed on liquid-based cytology smears""";"""Require a morphological examination of the tissue sample""";"""Require a signed consent from the patient""";97 108 | Regarding Alzheimer's disease, which statement(s) is(are) correct?;"""The diagnosis is often delayed.""";"""It is a secondary dementia.""";"""Behavioral disorders often manifest at the onset of the disease.""";"""The Dubois 5-word test allows for diagnosis.""";'It progresses in episodes leading to recurrent hospitalizations.';98 109 | Regarding the aging of organs, which statement(s) is(are) correct:;"""It is characterized by a decrease in maximal capacities.""";It is primarily due to oxidative stress.;"""This is a concept without scientific evidence.""";It is characterized by a reduction in functional reserve capacities.;"""It allows for the assessment of the individual's autonomy.""";99 110 | 'Regarding frailty syndrome, which statement(s) is(are) correct?';This is a concept without a precise definition.;'It allows for the assessment of the functional reserves of the organs.';It is associated with a risk of dependence.;"""It is associated with the risk of pressure ulcers during hospitalization.""";It is associated with an increased risk of myocardial infarction.;100 111 | """You are managing an 85-year-old patient in the emergency department for a cranial trauma who is on vitamin K antagonist (VKA) therapy prescribed for atrial fibrillation. The INR is at 2.9. There is a petechial finding on the brain CT scan. Among the following options, which one(s) would you consider for your therapeutic management?""";Immediate administration of prothrombin complex concentrate.;Administration of vitamin K within 4 hours;Systematic follow-up brain scan in 6 hours.;:'Discontinuation of vitamin K antagonist with bridging to therapeutic dose heparin';"""Discontinuation of vitamin K antagonist""";101 112 | """Which of the following criteria indicates severe malnutrition in the elderly?""";'Weight loss ≥ 10% in 1 month';Body mass index <18 kg/m²;"""Weight loss ≥ 15 kg in 6 months""";Mini Nutritional Assessment score <17;Plasma albumin level <35 g/L;102 --------------------------------------------------------------------------------