Describe the arterial and venous vascularization of the brain. Describe the cortical somatotopy of the primary motor and somatosensory cortices. Describe the mechanisms of regulation of cerebral blood flow. Explain the pathophysiology of ischemic stroke. List the risk factors for ischemic and hemorrhagic stroke. Establish the topographic diagnosis of ischemic and hemorrhagic stroke based on clinical and radiological data. Establish the topographic diagnosis of cerebral venous thrombosis based on clinical and radiological data. Identify the etiologies of ischemic and hemorrhagic stroke according to age. Plan the therapeutic management in the acute phase of ischemic and hemorrhagic stroke. Plan the long-term management and preventive measures for ischemic and hemorrhagic strokes.

Define superficial lymphadenopathy. Recognize through history-taking and physical examination the clinical characteristics of superficial lymphadenopathy. Differentiate through clinical examination between superficial lymphadenopathy and non-nodal swelling in the axillary, cervical, and inguinal regions. Recognize through clinical examination the characteristics that suggest a malignant origin of superficial lymphadenopathy. Prioritize complementary tests based on clinical findings in a patient presenting with superficial lymphadenopathy. Establish the etiological diagnosis of superficial lymphadenopathy through clinical examination and complementary tests.

1. Establish the positive diagnosis of anemia based on anamnestic, clinical, and laboratory data, taking into account the patient’s age, sex, and physiological state.
2. Explain the pathophysiological mechanisms of central or peripheral origin anemia.
3. Describe the metabolism of iron, cobalamins, and folates.
4. Classify anemia based on erythrocyte indices and reticulocyte count.
5. Establish the approach to etiological diagnosis of anemia based on anamnestic, clinical, and laboratory data.
6. Plan the therapeutic management of anemia according to its severity and etiology.
7. Establish a preventive strategy for anemia based on its origin.

1. Enumerate the anatomical variations of the appendix and its anatomical relationships.
2. Explain the etiopathogenic mechanisms of acute appendicitis.
3. Describe the different anatomopathological aspects of acute appendicitis based on their evolving patterns.
4. Gather the clinical and paraclinical elements necessary to establish the positive diagnosis of acute appendicitis in its various clinical forms.
5. Exclude the main differential diagnoses of acute appendicitis in its different clinical forms based on clinical and paraclinical data.
6. Explain the principles of treatment for acute appendicitis and its indications.

1. Describe the different phases of the action potential in nodal tissue and myocardium and its neural regulation.
2. Describe the different stages of realization and the normal appearance of an electrocardiogram.
3. Explain the consequences of tissue and metabolic changes due to anoxia during circulatory arrest.
4. Establish the positive and etiological diagnosis of circulatory arrest. Recognize the different electrocardiographic signs during cardiac arrest.
5. Describe the different elements of the chain of survival.
6. Plan the therapeutic management of cardiac arrest.
7. Describe the procedures for implementing different therapeutic interventions used in the management of cardiac arrest.
8. Describe the mechanism of action and the main pharmacokinetic properties of different medications used in the treatment of cardiac arrest.
9. Plan the management of circulatory arrest in a newborn in the delivery room.

1. Describe the etiopathogenic mechanisms of septic arthritis (SA).
2. Explain the pathophysiological consequences of SA.
3. Gather the clinical and paraclinical evidence in favor of SA in its various clinical forms.
4. Confirm the diagnosis of septic arthritis.
5. Interpret the results of joint aspiration.
6. Assess the local and systemic severity of SA based on clinical and paraclinical findings.
7. Enumerate the sequelae of septic arthritis.
8. List the differential diagnoses of septic arthritis.
9. Plan the therapeutic management of septic arthritis.

1. Describe the etiopathogenic mechanism of allergic asthma.
2. Explain the neural and humoral regulatory mechanisms of bronchomotor activity.
3. Explain the pathophysiological mechanisms of bronchial obstruction in asthma.
4. Define adult, child, and infant asthma.
5. Gather the elements of medical history and physical examination that support the positive diagnosis of asthma based on age.
6. Collect the paraclinical data that support the positive diagnosis of asthma in children and adults.
7. Gather the clinical and paraclinical evidence in favor of allergic etiology in asthma.
8. Recognize, based on clinical and paraclinical evidence, the different etiologies of asthma according to age, excluding allergy.
9. Recognize an asthma attack based on clinical findings.
10. Gather the elements for classifying the severity of an asthma attack.
11. List the main risk factors for a severe acute asthma attack.
12. Gather the clinical and paraclinical evidence in favor of a severe acute asthma attack based on age.
13. List the main differential diagnoses of asthma according to age.
14. Evaluate asthma control according to international recommendations.
15. Describe the mechanism of action and adverse effects of different medication classes used in the treatment of asthma.
16. Plan the treatment of an asthma attack based on its severity in children and adults.
17. Plan the long-term treatment of asthma based on its severity and control in children and adults.
18. Establish the principles of asthma therapeutic education.
19. Indicate the means of prevention for allergic asthma.

1. Define infant bronchiolitis.
2. List the main viruses responsible for infant bronchiolitis.
3. Establish the positive diagnosis of infant bronchiolitis based on the data from the medical history, physical examination, and chest X-ray.
4. Recognize the criteria for hospitalization of an infant with bronchiolitis based on the findings from the clinical examination and complementary tests.
5. Identify the severity criteria of infant bronchiolitis through the medical history, physical examination, and complementary tests.
6. Distinguish bronchiolitis from other causes of acute respiratory distress in infants.
7. Describe the principles of therapeutic management for an infant with bronchiolitis.
8. List the acute complications of infant bronchiolitis.
9. Describe the means of prevention for infant bronchiolitis.

1. Define chronic obstructive pulmonary disease (COPD).
2. Describe the two respiratory mechanical systems.
3. Describe the epidemiological characteristics of COPD in Tunisia.
4. Identify the risk factors for COPD.
5. Describe the different mechanisms of bronchial obstruction in COPD.
6. Describe the disturbances in respiratory mechanics and gas exchange in COPD and emphysema.
7. Gather the clinical and functional elements supporting the positive diagnosis of COPD.
8. Describe the severity of COPD according to the latest international guidelines.
9. List the most common comorbidities in a patient with COPD.
10. Describe the phenotypic profiles associated with COPD.
11. List the acute and chronic complications of COPD.
12. Identify an exacerbation of COPD by assessing its severity signs.
13. Identify spirometric signs to distinguish COPD from asthma.
14. Plan the treatment strategy for exacerbation of COPD.
15. Plan the pharmacological and non-pharmacological management of stable COPD.
16. Indicate the means of preventing COPD.

1. Explain the mechanisms and pathophysiological consequences of burns based on different causative agents and individual factors.
2. Gather the elements that determine the vital and functional prognosis of a severe burn.
3. Organize the initial therapeutic management of recent burns based on the location of the causative agent and the severity.
4. Plan the monitoring of a burn patient.

1. Recognize, based on the topographical anatomy of the mediastinum and pleuropulmonary spaces, the anatomical basis for the locoregional spread of bronchopulmonary cancer.
2. Describe the epidemiological situation of bronchopulmonary cancer worldwide and in Tunisia.
3. List the main factors implicated in the development of primary bronchopulmonary cancers.
4. Identify the main histopathological types of primary bronchopulmonary cancer, specifying their frequency, preferred location, and characteristic progression.
5. Describe the different circumstances under which primary bronchopulmonary cancer is discovered.
6. Gather the anamnestic, clinical, and radiological evidence that raises suspicion of primary bronchopulmonary cancer.
7. Identify the necessary complementary examinations for the positive diagnosis of primary bronchopulmonary cancer.
8. Indicate the clinical and paraclinical examinations necessary for staging and determining the extent of primary bronchopulmonary cancer.
9. Recognize the main differential diagnoses of primary bronchopulmonary cancer based on clinical and radiological evidence.
10. Establish the pretherapeutic assessment of primary bronchopulmonary cancer.
11. Determine the therapeutic indications for primary bronchopulmonary cancer based on histological type, individual factors, and TNM classification.
12. Plan the symptomatic and psychological management of a patient with primary bronchopulmonary cancer.
13. Evaluate the prognosis of primary bronchopulmonary cancer.
14. Describe the means of preventing primary bronchopulmonary cancer.

1. Identify the anatomical relationships of the nasopharynx and its lymphatic drainage pathways.
2. Describe the epidemiological characteristics of nasopharyngeal cancer.
3. Describe the histopathological aspects of nasopharyngeal cancer.
4. Describe the etiological factors of nasopharyngeal cancer.
5. Recognize the clinical signs and symptoms that raise suspicion of nasopharyngeal cancer.
6. Establish the positive diagnosis of nasopharyngeal cancer.
7. Determine the TNM classification of nasopharyngeal cancer based on clinical and paraclinical staging.
8. Gather the clinical and paraclinical factors to assess the prognosis of nasopharyngeal cancer.
9. Specify the therapeutic modalities and their indications in the treatment of nasopharyngeal cancer.
10. Plan the clinical and paraclinical follow-up of a patient treated for nasopharyngeal cancer.

1. Describe the arterial, venous, and lymphatic vascularization of the uterus.
2. Explain the role of oncogenic papillomaviruses in the development of cervical cancer.
3. Describe the anatomopathological characteristics of precancerous lesions and invasive cervical cancer.
4. Describe the modes of spread of cervical cancer.
5. List the risk factors for cervical cancer.
6. Establish the positive diagnosis of cervical cancer based on clinical and paraclinical evidence.
7. Evaluate the prognosis of cervical cancer based on clinical and paraclinical factors.
8. Describe the therapeutic principles for cervical cancer according to the stage of the disease.
9. Describe the post-treatment surveillance modalities for women with cervical cancer.
10. Indicate the primary and secondary prevention measures for cervical cancer.

1. Describe the lymphatic drainage system of the breast.
2. Describe the anatomopathological characteristics of malignant breast tumors.
3. Explain the mode of spread of breast cancer.
4. Identify individuals at risk of developing breast cancer based on the medical history.
5. Gather the clinical and paraclinical elements necessary for diagnosing breast cancer based on the stage of progression.
6. Evaluate the prognosis of breast cancer based on clinical and paraclinical factors.
7. Plan the therapeutic strategy for breast cancer based on the TNM stage and histopronostic factors.
8. Indicate the post-treatment surveillance modalities for breast cancer.
9. Develop a strategy for early detection of breast cancer.
10. Explain the means of breast cancer prevention.

1. Identify the risk factors for colorectal cancer.
2. Plan colorectal cancer screening on an individual and community scale based on risk groups.
3. Describe the different modes of extension of colorectal cancer based on the anatomy of the colon and rectum (relationships, vascularization, lymphatic drainage).
4. List the circumstances of discovering colorectal cancer.
5. Establish the positive diagnosis of colorectal cancer.
6. Identify the tests used to determine the staging of colorectal cancer.
7. Plan the therapeutic management of colorectal cancer.
8. Enumerate the prognostic factors of colorectal cancer (clinical, radiological, histological, biological).
9. Describe the methods and strategies for monitoring a patient treated for colorectal cancer.

1. Explain the pathophysiology of migraine.
2. Establish the diagnostic approach (positive, differential, and etiological) for acute primary and secondary headaches.
3. Establish the diagnostic approach (positive, differential, and etiological) for chronic primary and secondary headaches.
4. Identify the diagnosis of an emergency in the presence of headaches.
5. Establish the diagnosis of migraine based on clinical data.
6. Establish the diagnosis of tension-type headache, trigeminal neuralgia, and cluster headache based on clinical data.

1. Explain the pathophysiology of migraine.
2. Establish the diagnostic approach (positive, differential, and etiological) for primary and secondary acute headaches.
3. Establish the diagnostic approach (positive, differential, and etiological) for primary and secondary chronic headaches.
4. Make a diagnosis of an emergency in the presence of headaches.
5. Establish the diagnosis of migraine based on clinical data.
6. Establish the diagnosis of tension-type headache, trigeminal neuralgia, and cluster headache based on clinical data.

1. Define contraception.
2. Describe the different methods of contraception.
3. Explain the pharmacological basis of hormonal contraception.
4. Specify the effectiveness (Pearl index) of different contraceptive methods based on their mode of action.
5. Justify the choice of a contraceptive method based on the clinical and paraclinical assessment of the patient.
6. Provide details on the clinical and laboratory monitoring of a woman using hormonal or mechanical contraception.
7. Specify the means and usage modalities of emergency contraception (morning-after contraception).

1. Define acute dehydration in children.
2. Specify the characteristics of body water composition based on age and hydroelectrolytic regulation.
3. Describe the different mechanisms of dehydration.
4. Establish the positive diagnosis of dehydration based on the data from medical history and physical examination.
5. Evaluate the severity of acute dehydration in children using the WHO scoring system.
6. Establish the management of acute dehydration based on its severity.
7. Explain the preventive measures for dehydration.

1. Établir le diagnostic des troubles de la tolérance glucidique (diabète et prédiabète) selon les dernières recommandations de l’American Diabetes Association (ADA).

2. Indiquer la prévalence actuelle du diabète de type 2 en Tunisie selon les données de l’International Diabètes Fédération (IDF).

3. Identifier dans une population donnée les sujets qui risquent de développer un diabète sucré en précisant les modalités du dépistage.

4. Réunir les arguments anamnestiques, cliniques et paracliniques pour reconnaître les différents types de diabète sucré selon la classification de l’O.M.S.

5. Expliquer l’étiopathogénie et l’histoire naturelle du diabète en fonction de son type (Diabète de type l, Diabète de type 2, Diabète secondaire, Diabète gestationnel).

6. Décrire les conséquences physiopathologiques de l’hyperglycémie.

7. Expliquer les mécanismes physiopathologiques des décompensations hyperglycémiques du diabète.

8. Établir le diagnostic positif et étiologique d’une décompensation hyperglycémique du diabète en évaluant son degré de sévérité.

9. Planifier le traitement et la surveillance d’une décompensation hyperglycémique du diabète.

10. Identifier la gravité et les facteurs impliqués dans la survenue d’une hypoglycémie chez un diabétique.

11. Préciser le degré de sévérité d’une hypoglycémie chez un diabétique. .

12. Planifier la prévention, le traitement et la surveillance d’une hypoglycémie chez un diabétique.

13. Citer les facteurs favorisant la survenue des complications chroniques suivantes chez un diabétique: neuropathie, rétinopathie, néphropathie.

14. Reconnaître à partir des données de l’examen clinique et des examens complémentaires, les complications chroniques (neuropathie, rétinopathie, néphropathie) du diabète à leurs différents stades évolutifs en identifiant celles qui nécessitent une prise en charge thérapeutique urgente.

15. Evaluer le risque cardiovasculaire chez un diabétique selon le type du diabète.

16. Planifier la stratégie de prévention des complications chroniques et de la cardioprotection chez un malade diabétique.

17. Expliquer les mécanismes d’action des médicaments utilisés pour le traitement du diabète.

18. Définir les objectifs thérapeutiques chez un diabétique en fonction du type de diabète et du terrain du patient (âge, grossesse, tares).

19. Justifier le choix d’une stratégie thérapeutique en fonction des objectifs thérapeutiques fixés, du mode d’action des médicaments, de leurs bénéfices prouvés et de leurs risques potentiels.

20. Décrire les modalités de la surveillance du diabète et de son traitement

21. Planifier une grossesse chez une patiente diabétique.

22. Planifier le traitement et la surveillance du diabète pendant la grossesse.

23. Planifier une stratégie d’éducation thérapeutique personnalisée chez un patient diabétique.

24. Planifier la réinsertion socio-professionnelle du diabétique en fonction de son handicap.

25. Décrire les modalités de la prévention primordiale et primaire du diabète de type 2 à l’échelle individuelle et collective.

1. Define chronic diarrhea.
2. Explain the mechanisms of intestinal absorption.
3. Explain the physiopathological mechanisms of chronic diarrhea.
4. Establish a diagnostic approach to guide the etiological diagnosis of chronic diarrhea in children and adults.
5. Evaluate the impact of chronic diarrhea.

1. Establish the positive diagnosis of hemorrhagic shock based on anamnestic, clinical, and paraclinical data.
2. Explain the physiological compensatory mechanisms involved in hemorrhagic shock.
3. Describe the microcirculatory and visceral consequences of hemorrhagic shock.
4. Gather the anamnestic, clinical, and paraclinical elements necessary to establish the etiological diagnosis of hemorrhagic shock.
5. Plan the symptomatic and etiological therapeutic management of hemorrhagic shock.
6. Organize the monitoring of a patient in hemorrhagic shock.

1. Gather the clinical and paraclinical data that point to the etiology of acute non-traumatic chest pain.
2. Indicate appropriate complementary examinations based on the etiological orientation of acute chest pain.
3. Assess for vital distress in a patient presenting with acute chest pain.
4. Gather the clinical and paraclinical evidence that points to cardiac emergencies: aortic dissection, acute coronary syndrome, pulmonary embolism, and acute pericarditis.
5. Gather the clinical and paraclinical evidence that points to a respiratory etiology of acute chest pain: pneumothorax, pneumonia, and pleurisy.
6. Gather the clinical and paraclinical evidence that points to a non-cardiac and non-respiratory etiology of chest pain (parietal, esophageal, neurological).
7. Identify an extra-thoracic cause of acute chest pain (referred abdominal pain, psychogenic pain).

1. State the overall prevalence of dyslipidemias and their contribution to cardiovascular morbidity and mortality.
2. Indicate the frequency of familial hyperlipoproteinemia.
3. Explain the pathophysiological, genetic, and environmental mechanisms of hyperlipoproteinemias.
4. Explain the vascular and extravascular pathophysiological consequences of dyslipidemias.
5. Identify individuals at risk who require screening for hyperlipidemia.
6. Plan the investigation of a lipid abnormality.
7. Interpret the results of a lipid profile.
8. Specify the type of hyperlipoproteinemia and its evolving risk based on clinical and paraclinical data, using Fredrickson’s classification.
9. Gather clinical and paraclinical evidence supporting a secondary hyperlipoproteinemia.
10. Identify the components of metabolic syndrome (according to the updated criteria of the International Diabetes Federation) in a patient with dyslipidemia.
11. Describe the mode of transmission of familial hyperlipoproteinemia for the purpose of genetic counseling.
12. Evaluate the vascular risk in a patient with dyslipidemia.
13. Recognize the vascular and extravascular complications in a patient with dyslipidemia.
14. Prescribe lifestyle and dietary measures based on the type of hyperlipoproteinemia.
15. Explain the mechanism of action of hypolipidemic medications (statins and fibrates).
16. Plan the therapeutic strategy for primary or secondary hyperlipoproteinemia according to the recommendations of the European Society of Cardiology.
17. Plan long-term monitoring for a patient with dyslipidemia.
18. Plan a strategy for primary prevention of cardiovascular diseases (sugar, salt, and lipid consumption, tobacco, physical activity, etc.).

1. Describe the morphological anatomy of the esophagus and its endoscopic correlations.
2. Describe the anatomical elements defining the lower esophageal sphincter.
3. Gather the anamnestic elements characterizing dysphagia (organic or functional).
4. Identify the different etiologies of dysphagia.
5. Plan the investigative strategy for dysphagia based on etiological orientations.

1. Define infective endocarditis.
2. Describe the anatomopathological lesions observed in infective endocarditis and their clinical consequences.
3. Explain the etiopathogenesis of infective endocarditis.
4. Describe the factors that predispose to the occurrence of infective endocarditis.
5. Enumerate the main infectious agents responsible for infective endocarditis based on the predisposing factors and the portal of entry.
6. Plan the necessary complementary examinations for the diagnosis of infective endocarditis.
7. Establish the diagnosis of infective endocarditis based on the data from the clinical and paraclinical examination.
8. Identify the different clinical forms of infective endocarditis according to the pathogen, predisposing factors, and portal of entry.
9. Recognize the complications of infective endocarditis based on the clinical and paraclinical data.
10. Plan the curative and preventive treatment of infective endocarditis.
11. Identify the prognostic factors of infective endocarditis.

1. Define cardiogenic shock.
2. Explain the intrinsic and extrinsic regulation of cardiac output.
3. Explain the mechanisms and pathophysiological consequences of cardiogenic shock.
4. Establish the diagnosis (positive, etiological, and differential) of cardiogenic shock based on the anamnestic, clinical, and paraclinical data.
5. Describe the mechanisms of action of positive inotropes and their hemodynamic effects.
6. Plan the symptomatic and etiological therapeutic management of cardiogenic shock.

1. Define cardiogenic shock.
2. Explain the intrinsic and extrinsic regulation of cardiac output.
3. Explain the mechanisms and pathophysiological consequences of cardiogenic shock.
4. Establish the diagnosis (positive, etiological, and differential) of cardiogenic shock based on the anamnestic, clinical, and paraclinical data.
5. Describe the mechanisms of action of positive inotropes and their hemodynamic effects.
6. Plan the symptomatic and etiological therapeutic management of cardiogenic shock.

1. Define delirium.
2. Establish the positive diagnosis of delirium based on anamnestic and clinical data.
3. Establish the etiological diagnosis of delirium based on anamnestic, clinical, and paraclinical data.
4. Describe the progressive course and complications of delirium.

1. Identify the different stages of severe sepsis based on clinical examination and complementary tests.
2. Explain the pathophysiological mechanisms of severe sepsis.
3. Describe the microcirculatory and macrocirculatory consequences of severe sepsis.
4. Gather anamnestic, clinical, and paraclinical data to establish the etiological diagnosis of severe sepsis.
5. Collect evidence that indicates the community-acquired or nosocomial origin of severe sepsis.
6. Plan the therapeutic management of severe sepsis.
7. Organize the monitoring of a patient with severe sepsis.

1. Describe the topographic anatomy of the leg.
2. Describe the stages of bone healing.
3. Describe the different anatomopathological lesions of an open fracture of the leg.
4. Identify the immediate complications of an open fracture of the leg based on clinical examination findings.
5. Describe the secondary and late complications of open fractures of the leg.
6. Plan the urgent therapeutic management of an open fracture of the leg in adults, based on the type of skin opening according to the Cauchoix and Mechelany classification.
7. Specify the objectives and means of functional rehabilitation based on weight-bearing timelines.

1. Define ectopic pregnancy.
2. List the risk factors for ectopic pregnancy.
3. Describe the different locations and evolutionary patterns of ectopic pregnancy.
4. Gather the clinical and paraclinical elements necessary to diagnose an ectopic pregnancy in its various clinical forms.
5. Discuss the differential diagnoses of ectopic pregnancy.
6. Specify the surgical and medical therapeutic modalities for ectopic pregnancy.
7. Determine the medical and surgical therapeutic indications based on the anatomoclinical aspects of ectopic pregnancy.

1. Define macroscopic hematuria and microscopic hematuria.
2. Differentiate hematuria from abnormal discoloration of urine of another origin.
3. List the clinical and laboratory elements used to assess the impact and severity of hematuria.
4. Suspect the origin of hematuria based on its initial, terminal, or total character during urination.
5. Distinguish between urological and nephrological origins of hematuria based on clinical and laboratory data.
6. Plan radiological and endoscopic investigations in cases of hematuria.
7. Explain the importance of exploring the complement system in cases of hematuria.
8. Enumerate glomerular nephropathies that can be revealed by hematuria.
9. Gather the anamnestic, clinical, and paraclinical evidence necessary to diagnose acute glomerulonephritis in children.
10. Determine the indication for a renal biopsy in the presence of hematuria.
11. Identify the main causes of renal, bladder, and urethro-prostatic hematuria.
12. Plan the emergency management of severe macroscopic hematuria of urological origin.

1. Define upper and lower gastrointestinal bleeding.
2. Describe the arterial vascularization of the stomach and duodenum.
3. Describe the portal system, including porto-caval anastomoses and their clinical correlations.
4. Explain the pathophysiology of gastrointestinal bleeding based on its etiology.
5. Describe the different circumstances in which gastrointestinal bleeding may be discovered.
6. Gather the clinical, paraclinical, and evolutionary severity factors of gastrointestinal bleeding.
7. Establish the etiological diagnosis of gastrointestinal bleeding based on clinical and paraclinical data.
8. Plan the therapeutic management of gastrointestinal bleeding based on its severity and etiology.
9. Explain primary and secondary preventive measures for gastrointestinal bleeding.

1. Define viral hepatitis.
2. Describe the epidemiology, modes of transmission, and risk factors of viral hepatitis in Tunisia and worldwide.
3. Describe the virological characteristics of different hepatitis viruses.
4. Explain the immunopathological mechanisms of viral hepatitis according to the specific virus involved.
5. Make a diagnosis of viral hepatitis based on anamnestic, clinical, and paraclinical data.
6. Interpret the different serological profiles of viral hepatitis.
7. Discuss the clinical and paraclinical monitoring modalities for viral hepatitis based on the stage of disease progression and the specific virus involved.
8. Plan the therapeutic strategy for viral hepatitis based on the stage of disease progression and the specific virus involved.
9. Outline the prophylactic measures for viral hepatitis according to the specific virus involved.

1. Describe the epidemiological characteristics of pulmonary and hepatic hydatidosis in Tunisia and worldwide.
2. Explain the life cycle of the parasite Echinococcus granulosus and the modes of infestation in humans.
3. Describe the anatomopathological features of the hydatid cyst during its different stages of development.
4. Describe the different radioclinical presentations of pulmonary hydatid cyst based on its stages of development and complications.
5. Plan the necessary complementary examinations for the diagnosis and staging of pulmonary hydatid cyst.
6. Discuss the main differential diagnoses based on the stages of development of pulmonary hydatid cyst.
7. Describe the principles and indications of surgical treatment for pulmonary hydatid cyst based on its stage of development.
8. Gather the clinical and paraclinical elements for the positive diagnosis of hepatic hydatid cyst in its different clinical forms.
9. Describe the computed tomography (CT) segmentation of the liver.
10. Specify the role of computed tomography in the exploration of hepatic hydatidosis.
11. Identify the different types of liver hydatid cysts according to Gharbi’s ultrasound classification.
12. Describe the principles of surgical treatment for liver hydatid cyst and its complications.
13. Describe the means of prevention for hydatid cyst.

1. Expliquer les mécanismes physiopathologiques induisant une hypercalcémie.

2. Décrire les conséquences physiopathologiques de l’hypercalcémie.

3. Réunir les éléments cliniques et paracliniques en faveur du diagnostic positif d’une hypercalcémie.

4. Réunir les éléments cliniques et paracIiniques permettant d’établir le diagnostic étiologique de l’hypercalcémie.

5. Identifier les manifestations cliniques et biologiques d’une « crise aiguë hypercalcémique » en établissant son degré de gravité.

6. Planifier la prise en charge symptomatique et étiologique d’une hypercalcémie.

1. Explain the physiological mechanisms of neural and hormonal regulation of blood pressure.
2. Explain the pathophysiological mechanisms of arterial hypertension.
3. Identify the risk factors for adult arterial hypertension.
4. Describe the etiopathogenic factors of arterial hypertension.
5. Establish the positive diagnosis of arterial hypertension.
6. Plan the etiological diagnostic approach for arterial hypertension based on the clinical context.
7. Evaluate the impact of arterial hypertension on target organs.
8. Indicate the necessary paraclinical assessment before initiating treatment for arterial hypertension.
9. Assess the overall cardiovascular risk in a hypertensive patient.
10. Plan the initial therapeutic approach for a hypertensive emergency.
11. Describe the mechanisms of action, indications, and adverse effects of different classes of antihypertensive medications.
12. Plan the therapeutic management for a patient with essential arterial hypertension.
13. Plan the monitoring for a patient with essential arterial hypertension.

1. Explain the pathophysiological mechanisms of hyperthyroidism.
2. Explain the metabolic and tissue consequences of hyperthyroidism.
3. Gather the clinical and paraclinical elements necessary for diagnosing hyperthyroidism.
4. Recognize the complicated forms of hyperthyroidism and assess their severity.
5. Establish the etiological diagnosis of hyperthyroidism.
6. Specify the clinical, paraclinical, and evolutionary characteristics of hyperthyroidism based on its etiology and the patient’s characteristics (age, sex, pregnancy, newborn).
7. Specify the modalities and therapeutic indications for hyperthyroidism based on its severity, etiology, and patient characteristics.
8. Plan short-term and long-term monitoring of hyperthyroidism based on the treatment used.

1. Explain the pathophysiological mechanisms of congenital and acquired hypothyroidism.
2. Explain the pathophysiological consequences of hypothyroidism based on the age of onset of the disease.
3. Gather the anamnestic and clinical elements to suspect the positive diagnosis of hypothyroidism based on age (newborn, infant, child, adult).
4. Describe the methods of hormonal functional exploration for hypothyroidism: static and dynamic hormone assays.
5. Describe the complicated forms of hypothyroidism and assess their severity.
6. Distinguish clinically and paraclinically between peripheral hypothyroidism and central hypothyroidism.
7. Gather the anamnestic, clinical, and paraclinical elements to identify the etiology of peripheral hypothyroidism.
8. Recognize the clinical, paraclinical, and evolutionary characteristics of hypothyroidism based on patient characteristics (age, sex, pregnancy).
9. Identify associated conditions in a patient with autoimmune hypothyroidism.
10. Specify the clinical, paraclinical, and evolutionary characteristics of subclinical hypothyroidism.
11. Plan the therapeutic strategy for hypothyroidism based on the peripheral or central level of involvement, severity, etiology, and patient characteristics.
12. Plan the long-term clinical and paraclinical monitoring of treated hypothyroidism.
13. Provide therapeutic education to a patient undergoing treatment for hypothyroidism.
14. Describe the evolutionary patterns of congenital hypothyroidism and indicate prognostic factors.

1. Define jaundice.
2. Describe the anatomy of the intrahepatic and extrahepatic bile ducts and the biliopancreatic junction.
3. Describe the metabolism of bilirubin.
4. Explain the age-related pathophysiological mechanisms of conjugated bilirubin jaundice and unconjugated bilirubin jaundice.
5. Distinguish between conjugated bilirubin jaundice and unconjugated bilirubin jaundice based on the history, physical examination, and laboratory findings.
6. Plan a diagnostic approach, based on age, for a patient with conjugated bilirubin jaundice and unconjugated bilirubin jaundice.

1. Define upper respiratory tract infections (rhinosinusitis, sore throat, laryngitis, otitis).
2. Enumerate the different infectious agents responsible for upper respiratory tract infections, based on age and individual factors.
3. Consider the diagnosis of an upper respiratory tract infection based on the patient’s history and clinical presentation.
4. Specify the role of complementary tests in the diagnosis of upper respiratory tract infections.
5. Identify the different clinical forms of upper respiratory tract infections based on age, individual factors, location, and severity, using clinical and laboratory data.
6. List the potential complications of upper respiratory tract infections.
7. Plan the therapeutic management of different forms of upper respiratory tract infections, considering age, individual factors, location, and severity.

1. Enumerate the main microorganisms responsible for lower respiratory tract infections.
2. Diagnose acute bronchitis based on clinical data.
3. Prescribe the treatment for acute bronchitis.
4. Describe the factors that predispose to the occurrence of community-acquired lower respiratory tract infections.
5. Describe the radioclinical presentations of community-acquired lower respiratory tract infections.
6. Specify the different types of microbiological samples to be taken during community-acquired lower respiratory tract infections and their indications based on the clinical situation.
7. Identify the different clinical forms of community-acquired lower respiratory tract infections based on the patient’s condition, age, severity, and causative organism using clinical and laboratory data.
8. Recognize the potential complications of community-acquired lower respiratory tract infections based on clinical and laboratory findings.
9. List the main differential diagnoses of community-acquired lower respiratory tract infections.
10. Determine the need for hospitalization in a patient with community-acquired lower respiratory tract infection.
11. Plan the therapeutic management of community-acquired lower respiratory tract infections based on the patient’s condition, age, severity, and causative organism.

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1. Enumerate the main sexually transmitted infections in Tunisia.
2. List the main infectious agents responsible for sexually transmitted infections.
3. Describe the epidemiology of sexually transmitted infections in Tunisia.
4. Identify the modes of transmission of the main sexually transmitted infections.
5. Describe the pathophysiology of HIV infection.
6. Discuss the etiology of a sexually transmitted infection based on the data from the medical history and physical examination.
7. Identify the complementary tests that can help in diagnosing a sexually transmitted infection.
8. Make a positive diagnosis of a sexually transmitted infection based on clinical and paraclinical data.
9. Describe the progression and complications of sexually transmitted infections.
10. Plan the curative treatment of a sexually transmitted infection based on its etiology.
11. Establish a strategy for the prevention of sexually transmitted infections.

1. Describe the pathophysiological mechanisms of urinary tract infections.
2. Specify the different infectious agents responsible for urinary tract infections according to age and individual characteristics, as well as their antibiotic susceptibility profile.
3. Identify the predisposing factors for urinary tract infections in children and adults based on clinical examination and complementary tests.
4. Establish a positive diagnosis of a urinary tract infection based on clinical and paraclinical data, taking into account the patient’s age.
5. Identify the different clinical forms of urinary tract infections based on clinical and paraclinical data.
6. Plan the necessary complementary examinations for the management of a urinary tract infection based on its location and individual characteristics.
7. Interpret the results of urine cytobacteriological examination in relation to clinical data.
8. Identify the acute and chronic complications of urinary tract infections based on clinical and paraclinical data.
9. Plan radiological investigations for etiological purposes in the case of a urinary tract infection episode or recurrence.
10. Plan the curative and preventive treatment for a patient presenting with a urinary tract infection.
11. Enumerate the clinical and paraclinical monitoring criteria for urinary tract infections after treatment.
12. Justify the use of different antibiotics in the treatment of urinary tract infections based on their pharmacokinetic and/or pharmacodynamic characteristics.
13. Describe the adverse effects of antibiotics used in the treatment of urinary tract infections.
14. Establish a clinical and paraclinical surveillance approach for a patient being treated for a urinary tract infection.

1. Describe the pathophysiological mechanisms of urinary tract infections.
2. Specify the different infectious agents responsible for urinary tract infections according to age and individual characteristics, and their antibiotic susceptibility profile.
3. Identify from clinical examination and complementary tests the factors that predispose to urinary tract infections in children and adults.
4. Establish a positive diagnosis of a urinary tract infection based on clinical and paraclinical data, taking into account the age of the patient.
5. Identify the different clinical forms of urinary tract infections based on clinical and paraclinical data.
6. Plan the necessary complementary tests for the management of a urinary tract infection according to the location and individual characteristics.
7. Interpret the results of cytobacteriological examination of urine based on clinical data.
8. Identify acute and chronic complications of urinary tract infections based on clinical and paraclinical data.
9. Plan radiological investigations for etiological purposes following an episode of urinary tract infection and in case of recurrence.
10. Plan the curative and preventive treatment for a patient presenting with a urinary tract infection.
11. List the clinical and paraclinical arguments for monitoring urinary tract infections after treatment.
12. Justify the indication of different antibiotics used in the treatment of urinary tract infections based on their pharmacokinetic and/or pharmacodynamic characteristics.
13. Describe the adverse effects of antibiotics used in the treatment of urinary tract infections.
14. Establish a clinical and paraclinical surveillance approach for a patient treated for a urinary tract infection.

1. Explain the acute and chronic pathophysiological mechanisms of acute adrenal insufficiency.
2. Specify the enzymatic blocks in steroidogenesis that can lead to adrenal insufficiency.
3. Explain the metabolic and functional consequences of acute adrenal insufficiency.
4. Establish a positive diagnosis of acute adrenal insufficiency based on clinical and paraclinical data.
5. Gather the clinical and paraclinical elements indicating the severity of acute adrenal insufficiency.
6. Gather the clinical and paraclinical elements supporting the central or peripheral origin of acute adrenal insufficiency, specifying its etiology.
7. Plan the emergency management of acute adrenal insufficiency.
8. Plan the etiological exploration process in a patient who has experienced acute adrenal insufficiency.
9. Indicate the therapeutic and educational preventive measures for acute decompensation in a patient with adrenal insufficiency.
10. Indicate the preventive measures to avoid the occurrence of acute adrenal insufficiency in a patient being treated with corticosteroids.

Carbon Monoxide Poisoning.

1. Describe the role of hemoglobin in the transport of respiratory gases.
2. Describe the chain of formation of carbon monoxide (CO).
3. Explain the pathophysiological mechanisms of CO toxicity.
4. Describe the circumstances of carbon monoxide poisoning.
5. Establish the diagnosis of carbon monoxide poisoning based on anamnestic, clinical, and paraclinical data.
6. Plan the therapeutic management of carbon monoxide poisoning according to the condition and severity.
7. Specify the complications and sequelae of carbon monoxide poisoning.

Organophosphate Poisoning.

8. Explain the pathophysiological mechanism of organophosphate poisoning.
9. Describe the circumstances of acute or chronic intoxication by organophosphates.
10. Establish the diagnosis of acute or chronic organophosphate poisoning based on anamnestic, clinical, and paraclinical data.
11. Plan the therapeutic management of acute organophosphate poisoning.
12. Specify the clinical and paraclinical surveillance parameters for acute organophosphate poisoning.
13. Recognize the immediate, medium-term, and long-term complications of acute and chronic organophosphate poisoning.
14. Establish the modalities for the prevention of acute and chronic organophosphate poisoning.

Psychotropic Poisoning.

15. Classify psychotropics based on their pharmacodynamic properties.
16. Establish the diagnosis of acute psychotropic poisoning based on anamnestic, clinical, and paraclinical data.
17. Specify the clinical and paraclinical severity criteria for acute psychotropic poisoning.
18. Plan the symptomatic and specific therapeutic management of acute psychotropic poisoning.

1. Describe the arterial vascularization of the limbs.
2. Explain the etiopathogenic mechanisms leading to acute limb ischemia (ALI).
3. Explain the pathophysiological consequences of arterial flow interruption in a limb.
4. Describe the mechanisms and pathophysiological consequences of reperfusion syndrome.
5. Recognize the clinical and laboratory signs of severity in ALI.
6. Establish the diagnosis of ALI based on clinical and paraclinical data.
7. Gather the clinical and paraclinical elements to specify the etiology of ALI.
8. Evaluate the prognosis of ALI based on clinical and paraclinical data.
9. Plan an urgent therapeutic management of ALI.
10. Specify the preventive measures and principles of education for a patient with arterial disease.

1. Explain the mechanisms of lithogenesis, specifying the risk factors for urinary lithiasis.
2. Describe the different physicochemical types of urinary lithiasis, specifying their properties.
3. Describe the clinical forms of urinary lithiasis.
4. Make a positive diagnosis of urinary lithiasis based on anamnestic, clinical, and paraclinical data.
5. Describe the mechanical and infectious impact of urinary lithiasis on the urinary system.
6. Evaluate the organic and functional repercussions of urinary lithiasis based on clinical and paraclinical data.
7. Gather the biological and radiological evidence for the etiological diagnosis of urinary lithiasis.
8. Describe the medical and surgical therapeutic methods for urinary lithiasis and their indications.
9. List the follow-up elements for a patient with urinary lithiasis.
10. Explain the measures to be prescribed for preventing lithiasis recurrence.

1. Describe the etiopathogenesis and the pathophysiological consequences of venous thromboembolism (VTE).
2. List the risk factors for VTE.
3. Suggest, based on the data from the medical history and physical examination, the diagnosis of deep vein thrombosis and pulmonary embolism.
4. Prioritize the prescription of paraclinical examinations for VTE based on the patient’s condition and signs of severity in order to confirm the diagnosis.
5. Establish the etiological diagnosis of VTE based on the data from the medical history, physical examination, and paraclinical examinations.
6. Describe the clinical forms (symptomatic, topographical, and according to the patient’s condition) of VTE.
7. Describe the short-term, medium-term, and long-term complications of VTE.
8. List the differential diagnoses of deep vein thrombosis in the lower extremities.
9. Plan the curative treatment, preventive measures, and surveillance of VTE.
10. Describe the main drug interactions of anticoagulants.

1. Describe the pathophysiological mechanisms of acute meningitis.
2. Describe the main infectious agents responsible for acute meningitis according to age and predisposing factors.
3. Recognize, based on the anamnestic and clinical data, the suggestive signs of meningitis according to age.
4. Identify the contraindications and precautions to be taken before performing a lumbar puncture in a patient with febrile meningeal syndrome.
5. Interpret the results of a lumbar puncture in cases of acute meningitis.
6. Identify the severity criteria of meningitis based on the clinical and paraclinical data.
7. Establish the etiological diagnosis of acute meningitis based on the anamnestic, clinical, and paraclinical data according to age.
8. Plan the curative and preventive treatment for acute meningitis according to age.
9. Determine the elements of clinical and paraclinical monitoring for acute meningitis.
10. Describe the clinical course of acute meningitis.

1. Define metrorrhagia.
2. Identify the signs of severity in metrorrhagia.
3. State the initial emergency measures for severe metrorrhagia.
4. Explain the mechanisms of functional metrorrhagia.
5. Establish the etiological diagnoses of metrorrhagia based on clinical and paraclinical data in non-pregnant individuals.
6. Outline the approach to the etiological diagnosis of metrorrhagia during pregnancy, labor, and the postpartum period.

Please note that medical terms and translations may vary, and it’s always best to consult professional medical resources for accurate and up-to-date information.

1. Define acute intestinal obstruction.
2. Explain the etiopathogenic mechanisms and anatomopathological consequences of acute intestinal obstructions.
3. Explain the physiopathological consequences of acute intestinal obstruction.
4. Establish the positive diagnosis of acute intestinal obstruction based on clinical examination and abdominal X-ray without preparation.
5. Recognize the signs of severity of acute intestinal obstruction based on clinical examination, paraclinical examinations, and the patient’s condition.
6. Gather the clinical and paraclinical elements to identify the level, mechanism, and etiology of acute intestinal obstruction.
7. Plan the therapeutic management of acute intestinal obstruction based on its severity, mechanism, level, cause, and the patient’s condition.

Please note that medical terms and translations may vary, and it’s always best to consult professional medical resources for accurate and up-to-date information.