Internat Médecine (Côte d'Ivoire) Practice Questions - Concours National d'Internat des Hôpitaux en Médecine (Côte d'Ivoire) Exam - Internat Médecine (Côte d'Ivoire) Practice Questions - Concours National d'Internat des Hôpitaux en Médecine (Côte d'Ivoire) Exam

Question 1

A 28-year-old patient presents with high fever, impaired consciousness, severe pallor, and dark urine. The thick blood film confirms Plasmodium falciparum malaria with a parasite density of 180,000 trophozoites/μL. According to WHO and Côte d'Ivoire national malaria guidelines, what is the first-line emergency antimalarial treatment?

Intravenous artesunate at 2.4 mg/kg at 0, 12, and 24 hours, then once daily Intramuscular artemether at 3.2 mg/kg once daily for 7 days Intravenous quinine gluconate loading dose of 20 mg/kg infused over 4 hours in 5% dextrose Oral artemether-lumefantrine 80/480 mg twice daily with fatty food

Correct Answer:

Intravenous artesunate at 2.4 mg/kg at 0, 12, and 24 hours, then once daily

Question 2

A 35-year-old HIV-positive patient on antiretroviral therapy presents with a 3-week history of productive cough, evening fever, night sweats, and a 5 kg weight loss. Chest radiography shows apical cavitary infiltrates. Which diagnostic test is recommended as the initial rapid molecular assay for tuberculosis and rifampicin resistance detection?

GeneXpert MTB/RIF automated real-time PCR assay on sputum Ziehl-Neelsen microscopic smear examination for acid-fast bacilli Lowenstein-Jensen solid egg-based culture of expectorated sputum Tuberculin skin test (Mantoux reaction with 5 TU of PPD)

Correct Answer:

GeneXpert MTB/RIF automated real-time PCR assay on sputum

Question 3

A 22-year-old university student is admitted with sudden onset of severe headache, photophobia, fever (39.5°C), neck stiffness, and positive Kernig and Brudzinski signs. Lumbar puncture reveals cloudy cerebrospinal fluid (CSF) with 2,500 leukocytes/mm³ (88% neutrophils), protein of 2.8 g/L, and CSF/blood glucose ratio of 0.18. Gram stain demonstrates Gram-negative diplococci. What is the immediate empiric antibiotic and adjunctive management?

Intravenous ceftriaxone 2 g every 12 hours plus intravenous dexamethasone 10 mg started prior to or with the first antibiotic dose Intravenous ampicillin 2 g every 4 hours plus gentamicin 5 mg/kg once daily Intravenous vancomycin 15 mg/kg every 12 hours monotherapy Oral ciprofloxacin 500 mg single dose plus oral rifampicin

Correct Answer:

Intravenous ceftriaxone 2 g every 12 hours plus intravenous dexamethasone 10 mg started prior to or with the first antibiotic dose

Question 4

A 62-year-old hypertensive patient presents to the emergency department with acute respiratory distress, orthopnea, bilateral basal crackles extending to mid-lung fields, jugular venous distension, blood pressure 195/110 mmHg, and oxygen saturation 84% on ambient air. What is the most appropriate initial pharmacological combination?

High-flow oxygen, intravenous furosemide bolus (40–80 mg), and sublingual/intravenous isosorbide dinitrate or nitroglycerin infusion Intravenous digoxin 0.5 mg bolus and oral spironolactone 50 mg Intravenous beta-blocker (labetalol) bolus and aggressive volume loading with normal saline Subcutaneous low-molecular-weight heparin and oral amlodipine 10 mg

Correct Answer:

High-flow oxygen, intravenous furosemide bolus (40–80 mg), and sublingual/intravenous isosorbide dinitrate or nitroglycerin infusion

Question 5

A 54-year-old male with a history of smoking and dyslipidemia presents with crushing substernal chest pain of 90 minutes duration radiating to the left jaw and arm. The 12-lead ECG reveals 3 mm ST-segment elevation in leads V1–V4 with reciprocal ST depression in leads II, III, and aVF. The nearest percutaneous coronary intervention (PCI) center is 4 hours away. What is the correct immediate reperfusion strategy?

Immediate intravenous fibrinolytic therapy (e.g., tenecteplase) within 10 minutes of diagnosis, accompanied by aspirin, clopidogrel, and enoxaparin Transfer for primary PCI regardless of the 4-hour transport delay Conservative medical management with nitrates, beta-blockers, and delayed elective coronary angiography at 48 hours Intravenous unfractionated heparin bolus alone without antiplatelet or fibrinolytic agents

Correct Answer:

Immediate intravenous fibrinolytic therapy (e.g., tenecteplase) within 10 minutes of diagnosis, accompanied by aspirin, clopidogrel, and enoxaparin

Question 1

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Prepare with the Internat Médecine (Côte d'Ivoire) Practice Questions - Concours National d'Internat des Hôpitaux en Médecine (Côte d'Ivoire) Exam practice quiz. This question bank includes 100 questions covering year-old, presents, blood, pain, and severe. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Internat Médecine (Côte d'Ivoire) Practice Questions - Concours National d'Internat des Hôpitaux en Médecine (Côte d'Ivoire) Exam

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Internat Médecine (Côte d'Ivoire) Practice Questions - Concours National d'Internat des Hôpitaux en Médecine (Côte d'Ivoire) Exam

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