Maladie infectieuse

1(CM)Quels sont les points suivient de l’echec antibiothérapie:

(CM) le choix de l’antibiothérapie tenir compte selon

(CM) Quel sont les 3 signes cliniques plus fréquentés Vue chez les patients présentent de Syndrome Neuro-méningé:

(CS) Une jeunne fille ayant de VIH> 5ans avec CD4 : 45/mm3, et encours de traitement par des TB et ARV (anti-rétroviral débuté 2 semaines après les Anti- TB) avec une bonne réponde aux traitements. Mais au J35, elle se présent : Fièvre, asthénie et toux. Quel l`examen nécessaire pour diagnostiquer PARADOXAL syndrome ?

.(CS) A 19-year-old man has donated blood for the first time. Despite having no risk factors for human immunodeficiency virus (HIV) infection, his blood tests positive for HIV by enzyme immunoassay (EIA). Which of the following statements is correct?

(CS) A 43-year-old man developed a cough shortly after returning from a 1-month hiking trip in Thailand. While there, he was hiking in the Forest. During his trip, he had developed a “flu-like” illness consisting of fever, cough, and muscle pains, which resolved spontaneously. A CXR shows a thin-walled cavity in the right upper lobe, and the sputum reveals fungal elements. Which of the following is the most likely causative organism?

(CS). A24-year-old woman complains of pain in the upper chest every time she eats or drinks anything. She is HIV positive, but currently not on any antiretroviral therapy. Her last CD4 count was 250/mm3. Select the most likely pathogen causing infection.

S).A 44-year-old renal transplant patient develops severe cough and shortness of breath on exertion. On examination, he appears dyspneic, respirations 24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse peri-hilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver (silver staining). Which of the following is the most appropriate next step in management?

(CS).A 19-year-old woman was traveling in a rural Kandal. She returned 3 weeks ago and, over the past few days, has gradually developed lower abdominal pain and diarrhea. Now the symptoms are much worse with 10 stools a day consisting mostly of mucus and blood. She is febrile, the abdomen is tender in left lower quadrant, and the remaining examination is normal. Her stool is mostly comprised of blood and mucus. Which of the following is the most likely causative organism?

(CS) A 43 years-old businesswoman is developing a new enterprise in Phnom Penh. On her most recent trip to Siem reap, she developed diffuse watery diarrhea with severe cramps 1 week after arriving. The illness resolved after about 2 days with no further complications. Which of the following is the most likely causative organism?

(CS) A 22-year-old university student is back travel from Kampong som. Ten days after arriving, she develops symptoms of anorexia, malaise, and abdominal cramps followed by a sudden onset of watery diarrhea. There are no symptoms of fever or chills, and the stools are nonbloody. The most likely pathogen causing infection.

(CS).A31-year-old woman presents with symptoms of vulvar itching and burning made worse by urinating. She has no fever or frequency, but has noticed a recent whitish vaginal discharge. Clinical examination reveals vulvar erythema, edema, and fissures. On speculum examination, there is a white discharge with small white plaques loosely adherent to the vaginal wall. Which of the following treatments is appropriate for her asymptomatic male sexual partner?

(CS). A 24-year-old man is traveling in Southeast Asia. He is eating at local restaurants and from street vendors. He now develops high fevers, anorexia, and frequent passage of small-volume stools containing blood, pus, and mucus. This is associated with severe abdominal cramps and painful straining when having bowel movements. The most likely pathogen causing infection.

(CS) A27-year-old woman is on holiday on the Beach of KAMPOT. She is at a seafood restaurant and has fresh shellfish for dinner. Twenty-four hours later, she and 12 friends in the same group develops symptoms of nausea, vomiting, abdominal cramps, and watery diarrhea. The most likely pathogen causing infection.

(CS)-year-old man presents with diarrhea. He returned 3 weeks ago from a trip to rural Mundulkirie. Over the past few days, he has gradually developed lower abdominal pain and diarrhea. Now the symptoms are much worse with eight stools a day consisting mostly of mucus and blood. He is afebrile, the abdomen is tender in left lower quadrant, and the remaining examination is normal. His stool is mostly comprised of blood and mucus. Which of the following is the most appropriate initial diagnostic test?

(CS). A34-year-old man presents with diarrhea 3 weeks after returning from a trip to kg SOM. Over the past few weaks, he has gradually developed severe head ache, and lower abdominal pain and diarrhea. Now the symptoms are much worse with malaise, and a severe head ache, confusion. . He is afebrile, the abdomen is tender in left lower quadrant, and his stools tests show tinea solium. Which offollowing the initial

.(CS). A22-year-old woman HIV+ complains of vulvar itching, burning, and pain when voiding urine. She has no other symptoms of fever, vaginal discharge, or urinary frequency. Physical examination reveals some vulvar ulceration but no vaginal discharge. The ulcers are small 2–3-mm lesions with an erythematous base. Which of the following is the most likely diagnosis?

(CM) A 30-year-old HIV+ begins an anti TB regimen for treatment of pulmonary tuberculosis that includes isoniazid. One month after initiation of therapy, the man visits his primary care physician with complaints of fatigue, anorexia, and nausea. Laboratory tests show: WBC count: 8000/mm3 Hemoglobin: 15.2 g/dL Hematocrit: 49.7% Aspartate aminotransferase: 240 U/L Alanine aminotransferase: 285 U/L Alkaline phosphatase: 405 U/L Which of the following places this patient at increased risk for developing this complication of isoniazid therapy?

(C M).A 25-year-old HIV+ patient known more than 10 years without Anti Retro Viral treatment . On day he develops severe head ache and right hemiplesia. On examination, he appears malaise, head ache and right hemiplesia, BP: 14/8 mm/Hg, pulse 80/min, and his CD4 count 57 cells /mm3 Which of the following is the most appropriate next step in management?

1. Quel est le diagnostic d’un patient avec état dyspnéique fébrile après 48h d’hospitalisation? (QRU) (SBA)

2. Devant un tableau de Pneumonie au cours d’hospitalisation, quel examen clinique faites-vous? (QRU) (SBA)

3. Examen clinique montrait une toux avec des crachats verdâtres avec des crépitants basale droite, quel examen paraclinique demandez-vous pour confirmer le diagnostic ? (QRU) (SBA)

4. La Radio pulmonaire montrait une opacité floue basale droite. Le diagnostic est confirmé pour une Pneumonie nosocomiale, quel est le germe le plus souvent peut responsable dans cette pathologie? (QRU) (SBA)

5. Quel est le traitement proposez-vous pour une Pneumonie nosocomiale (germe indéterminé)? (QRU) (SBA)

6. Définition d’une infection nosocomiale : (QRU) (SBA)

7. Quelle antibiotiques anti-staphylococcique à choisir devant une infection due au Staph Méti-R: (QRU) (SBA)

8. Quelle antibiotique peut-on donner pour une infection dû au group de Pseudomonas : (QRU) (SBA)

9. Quelles sont les infections nosocomiales le plus rencontrée au Cambodge : (QRU) (SBA)

1. Quel est le cause de l’hyper-éosinophilie le plus rencontré au Cambodge: (QRU) (SBA)

11. Devant une hyperéosinophilique, quel examen demander vous en premier intention: (QRU) (SBA)

1. Un patient de 76 ans est hospitalisé dans votre service depuis 5 jours pour baisse de l’état générale. Il présente brutalement une dyspnée. Quels sont les éléments suivants qui vous paraissent des arguments en faveur d’une embolie pulmonaire ? (CM)

Vous examinez durant votre visite un patient fébrile avec une suspicion d’infection du cathéter. Parmi les signes suivants, lequel n’est pas un critère de sévérité ? (CS)

Un patient hospitalisé dans votre unité a été hospitalisé pour sepsis sévère. Des hémocultures ont été réalisées à l’admission. L’examen direct a révélé des bacilles gram positif. Quel(s) germe(s) vous parait responsable(s) d’après ce résultat ? (CM)

Parmi les éléments biologiques suivants, lesquels évoquent un syndrome inflammatoire biologique ? (CM)

Face à un patient hospitalisé confus, quels signes sont en faveur d’une encéphalopathie par carence en vitamine B1 ? (CM)

Face à un malade choqué, quel(s) raisonnement(s) vous parait(ssent) juste(s) ? (CS)

Face à une insuffisance rénale aiguë et un état de choc, quel argument n’est pas en faveur d’une insuffisance surrénalienne aiguë ? (CS)

Parmi les éléments biologiques suivants, lesquels évoquent un syndrome inflammatoire biologique ? (CM)

(CM). Pour la PEC d’un patient en choc septique sur une pneumopathie communautaire grave, vos prescriptions sont :

(CM). Parmi les propositions suivantes concernant la Noradrénaline dans le choc septique, lesquelles sont justes ?