Thérapeutique Méd II

2. គោលបំណងនៃ associations les antibiotiques?

3. 3/ Quelle est la localisation tumorale de neuroblastome ?

3. Parmi les propositions suivantes concernant le bain de dialyse, Choisissez une fausse reponse :

28. La contre indication de SILDENAFIL :

10. Le sphincter anal interne est :

13. Parmi les actions suivantes des laxatifs stimulants, une action est correcte:

28. 4. Les médicaments suivants peuvent provoquer une diarrhée type osmotique. Une affirmation est fausse:

1. Regarding acute pulmonary edema and cardiogenic shock, which of the following statement is the most appropriate?

2. Which of the following physical examination findings suggests acute pulmonary edema?

3. Mrs. X-67 years old with a long history of HTN and diabetes mellitus admits to emergency department with dyspnea at rest preceded by chest pain. Her BP is 70/40mmHg with pulse of 110bpm and SaO2: 88% in room air. Physical examination finds crackles in both lungs with cold skin.ECG shows Q wave with T negative in leads DII, III and avF. Chest X-ray finds alveolar edema with left pleural effusion.Which of the following is the most likely diagnosis?

4. The acute pulmonary edema is suspected, which of the following test is the most appropriate in diagnosis?

1. The most frequent cause of UGI bleeding is:

2. After initial stabilization and resuscitation of the patient, each of the following options should be considered in the management of UGI bleeding except:

3. Endotracheal intubation for airway protection in the management of UGI bleeding should be considered:

4. A 73 year old man presents with several episodes of hematemesis. Examination shows signs of orthostatic hypotension and melen What is the first priority in caring for this patient?

5. An important risk factor for peptic ulcer hemorrhage includes:

6. Which of the following combinations of stigmata of ulcer hemorrhage should be treated with endoscopic hemostasis?

7. For the patient who is now stable after a severe UGI bleed associated with NSAID ingestion, and who is found to be H.pylori positive, what is the most effective management strategy?

8. For the patient with an UGI bleed and endoscopic finding shown gastric ulcer Forrest IIa, the most appropriate management includes:

9. For the patient with an UGI bleed and the endoscopic finding of a clean ulcer, the most appropriate management includes:

10. A sixty-six-year old man presents to the emergency department with a history of one episode of melen Past history includes coronary artery disease, hypertension . He is on one baby aspirin daily. An urgent upper endoscopy is negativ What is the most appropriate next step?

The most frequent cause of UGI bleeding is:

After initial stabilization and resuscitation of the patient, each of the following Options should be considered in the management of UGI bleeding except:

Endotracheal intubation for airway protection in the management of UGI bleeding should be considered:

A 73 year old man presents with several episodes of hematemesis. Examination shows signs of orthostatic hypotension and melena. What is the first priority in caring for this patient?

An important risk factor for peptic ulcer hemorrhage includes:

For the patient who is now stable after a severe UGI bleed associated with NSAID ingestion, and who is found to be H.pylori positive, what is the most effective management strategy?

For the patient with an UGI bleed and the endoscopic finding of a clean ulcer, the most appropriate management includes:

A sixty-six-year old man presents to the emergency department with a history of one episode of melena. Past history includes coronary artery disease, hypertension . He is on one baby aspirin daily. An urgent upper endoscopy is negative. What is the most appropriate next step?

A fifty-eight year old female patient presents to the emergency department with a 24-hour history of several hematemesis. She is found to be hypotensive and anemic. Resuscitative measures are instituted. What is the most appropriate next step?

A fifty-eight year old female patient presents to the emergency department in Calmette hospital with a 24-hour history of several hematochesia. Physical examination show: hypotension, and anemia. Both the upper endoscopy and colonoscopy are not diagnostic. The patient continues to pass clots per rectum. Resuscitation has normalized her vital signs and maintained her Hct at 32%. What is the most effective management strategy?

A 65-year-old woman has a prior history of hospitalization for UGI bleeding from a duodenal ulcer. Which one of the following therapies is not useful for preventing recurrent ulcer hemorrhage?

A 68-year-old healthy woman with a history of duodenal ulcer is placed on low-dose aspirin for coronary prophylaxis. Two weeks later she presents to the emergency room in Calmette hospital with one episode of melena . Physical examination showed : blood pressure and resting heart rate of 90 beats per minute without orthostatic changes. Melena is confirmed on rectal examination. Her admission hematocrit is 36%. She is placed on highdose proton pump inhibitor therapy (omeprazole 40 mg b.i.d.). Due to other complications, endoscopy is not performed until the tenth hospital day, and it shows a small (5 mm) duodenal ulcer with a clean base. Biopsy for CLO test is negative. Which one of the following should be performed now?

An 82-year-old debilitated woman with coronary artery disease and breast cancer presents with hematochezia requiring 4 units of blood. Following colonic preparation, colonoscopy demonstrates fresh blood in the left colon with marked diverticulosis. The right colon is normal and bilious material is seen in the cecal pole. Upon withdrawal of the colonoscope, there was active oozing of blood from the neck of a diverticulum in the distal sigmoid colon. The most appropriate management now is

A 65-year-old presents with iron-deficiency anemia, refractory to iron treatment. No history of overt gastrointestinal bleeding, but fecal occult blood tests were positive on 4 of 5 occasions. A previous EGD showed a large hiatal hernia. Two colonoscopies and a small bowel radiographic series were unremarkable. An endoscopic finding of a repeat EGD is shown ulcerative esophagitis. Which of the following is the most appropriate management of this condition?

A 62-year-old woman with a past medical history of chronic renal insufficiency presents with iron-deficiency anemia and intermittent melena for 2 months requiring multiple blood transfusions. She underwent multiple endoscopic investigations, including EGD, colonoscopy, CT scan of the abdomen and pelvis, and upper gastrointestinal series. No bleeding source was identified. Wireless capsule endoscopy shows multiple vascular abnormalities in the jejunum . Which of the following is the most like diagnosis?

A 68-year-old man presents with intermittent episodes of hematochezia for several months. His stools are normal, but he passes blood clots a few times per week. His past medical history is significant for prostate cancer, for which he received radiation therapy 4 years ago. He denied any weight loss or diarrhea. Physical examination is unremarkable. An endoscopic view of the rectum showed: rectum appears with friability and telangiectasia pale. These findings are limited to the distal rectum. Which of the following is the most likely diagnosis?

Regarding patients with upper GI bleeds which is incorrect?

Which of the following therapies is proven to reduce mortality and morbidity in bleeding peptic ulcers?

Which is not true of bleeding oesophageal varices?

Dans certain cancer, un syndrome de lyse tumorale apparait