Free Practice Questions for Épreuves Dématérialisées Nationales (e-EDN)

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Key Facts: Épreuves Dématérialisées Nationales (e-EDN) Exam

14 / 20

Minimum Rang A score required to validate and enter matching

Arrêté du 21 décembre 2021

60%

Weighting of e-EDN in final composite Internat ranking

Décret n° 2021-1156

12 hours

Total test duration (4 computer sessions of 3 hours over 3 days)

CNG e-EDN Regulations

367 Items

National R2C medical syllabus items tested

Collège des Enseignants / CNG

The e-EDN is France's national medical knowledge assessment, delivered in four three-hour digital sessions. Candidates must validate Rang A knowledge at 14/20; the result contributes 60% of residency matching. This 120-question bank is an English-language MCQ study adaptation covering clinical knowledge and LCA methodology.

Sample Épreuves Dématérialisées Nationales (e-EDN) Practice Questions

Try these sample questions to review concepts for the Épreuves Dématérialisées Nationales (e-EDN) exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 120+ question experience with AI tutoring.

1A 62-year-old man collapses in sudden cardiac arrest in the hospital lobby. The medical emergency team arrives with a manual defibrillator, attaches the pads, and observes ventricular fibrillation on the monitor. What is the immediate first-line management according to French resuscitation guidelines (R2C Item 339)?

A.Administer intravenous amiodarone 300 mg bolus before any electrical intervention.

B.Deliver an immediate non-synchronized electrical shock (150–200 J biphasic) followed immediately by 2 minutes of CPR.

C.Administer intravenous adrenaline (epinephrine) 1 mg before attempting defibrillation.

D.Perform endotracheal intubation and verify tube placement before defibrillation.

Explanation: In witnessed cardiac arrest with a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia), immediate unsynchronized defibrillation is the absolute priority. Following shock delivery, chest compressions must be resumed immediately for 2 minutes without pausing for rhythm or pulse checks. Adrenaline and amiodarone are indicated only after subsequent failed shocks (adrenaline after the 3rd shock, amiodarone 300 mg after the 3rd shock).

2A 58-year-old man presents to the emergency department with acute retrosternal crushing chest pain radiating to the left jaw that started 45 minutes ago. An ECG performed within 6 minutes of arrival demonstrates 3 mm ST-segment elevation in leads V1 through V4. The nearest percutaneous coronary intervention (PCI) center is located 25 minutes away. What is the primary reperfusion strategy recommended by national cardiology guidelines (R2C Item 334)?

A.Immediate intravenous fibrinolysis with tenecteplase in the emergency department followed by delayed transfer.

B.Urgent coronary artery bypass graft (CABG) surgery within 24 hours.

C.Immediate transfer for primary percutaneous coronary intervention (PCI) with wire crossing targeted within 90–120 minutes.

D.Conservative medical therapy with dual antiplatelet therapy, heparin, and elective outpatient angiography.

Explanation: According to the Société Française de Cardiologie (SFC) and ESC guidelines for STEMI, primary PCI is the reperfusion therapy of choice if the anticipated delay from STEMI diagnosis to wire crossing is under 120 minutes. With the PCI center 25 minutes away, transfer for emergency coronary angioplasty is the standard of care. Fibrinolysis is indicated only when primary PCI cannot be delivered within 120 minutes of diagnosis.

3A 68-year-old woman with a history of hypertension and ischemic heart disease presents to the ED with severe orthopnea, bilateral crackles extending to the mid-lung fields, jugular venous distension, and peripheral edema. Vital signs show blood pressure 178/96 mmHg, heart rate 104 bpm, and oxygen saturation 87% on room air. What initial pharmacological combination represents the standard French emergency treatment for acute cardiogenic pulmonary edema (R2C Item 232)?

A.Intravenous loop diuretic (furosemide) combined with intravenous vasodilator (isosorbide dinitrate) and supplemental oxygen.

B.Oral beta-blocker (bisoprolol) combined with intravenous fluid challenge of 500 mL normal saline.

C.Intravenous calcium gluconate combined with nebulized salbutamol and oral spironolactone.

D.Intravenous digoxin combined with oral amlodipine and fluid loading.

Explanation: Acute cardiogenic pulmonary edema with elevated blood pressure is managed with high-dose intravenous loop diuretics (furosemide) to reduce fluid overload and intravenous nitrates (such as isosorbide dinitrate) to reduce preload and afterload. Supplemental oxygen (or non-invasive ventilation CPAP if hypoxemia persists) is administered concurrently. Fluid loading is strictly contraindicated in volume overload.

4A 24-year-old tall, slender non-smoker presents with sudden-onset right-sided pleuritic chest pain and dyspnea. Physical examination reveals decreased breath sounds, hyperresonance to percussion, and absent tactile fremitus over the right hemithorax. Blood pressure is 124/76 mmHg, heart rate is 82 bpm, and SpO2 is 97% on room air. Chest radiography confirms a 3.5 cm spontaneous primary pneumothorax without mediastinal shift. According to French thoracic society guidelines (R2C Item 206), what is the recommended initial management?

A.Immediate surgical video-assisted thoracoscopic pleurodesis within 2 hours.

B.Emergent needle thoracostomy in the second intercostal space with a large-bore cannula.

C.Oral non-steroidal anti-inflammatory drugs with immediate discharge without pleural intervention.

D.Simple manual needle aspiration (*exsufflation à l'aiguille*) or small-bore chest tube placement.

Explanation: In a well-tolerated, large primary spontaneous pneumothorax (> 2 cm at the hilum or complete lung separation), first-line treatment in France (SPLF guidelines) consists of simple manual needle aspiration (exsufflation à l'aiguille) using a catheter or small-bore drain. If aspiration succeeds and the lung remains expanded on repeat imaging after 4 hours of observation, outpatient follow-up is possible. Emergency needle decompression is reserved for tension pneumothorax with hemodynamic collapse.

5A 45-year-old woman presents with acute onset of right calf swelling, tenderness, and warmth following a 9-hour transatlantic flight 4 days ago. Her modified Wells score for deep vein thrombosis (DVT) is 3 points (high clinical probability). According to national vascular guidelines (R2C Item 226), what is the most appropriate next step in diagnostic management?

A.Measurement of plasma D-dimer levels by quantitative ELISA.

B.Immediate complete venous compression ultrasonography (écho-Doppler veineux) of both lower limbs.

C.Computed tomography pulmonary angiography (CTPA) prior to leg evaluation.

D.Discharge on oral paracetamol and compression stockings without imaging.

Explanation: When the clinical probability of deep vein thrombosis is high (Wells score >= 2), D-dimer testing should not be ordered because a negative result is insufficient to safely rule out thrombosis. The mandatory next diagnostic step is complete compression venous ultrasonography (écho-Doppler) of the lower extremities. D-dimer testing is reserved exclusively for patients with low or intermediate clinical probability where its high negative predictive value can rule out venous thromboembolism without imaging.

6A 22-year-old known asthmatic is brought to the emergency department in severe acute respiratory distress. He is sitting upright, tachypneic at 34 breaths/min, speaking only in single words, with a pulse rate of 128 bpm and SpO2 of 89% on room air. Auscultation reveals widespread bilateral expiratory wheezes. What is the immediate first-line pharmacological treatment (R2C Item 188)?

A.Intravenous theophylline infusion and oral montelukast.

B.Subcutaneous epinephrine 1 mg and intravenous furosemide 80 mg.

C.Nebulized short-acting beta-2 agonist (salbutamol 5 mg) driven by high-flow oxygen, combined with early systemic corticosteroids.

D.Inhaled fluticasone alone via dry powder inhaler.

Explanation: Severe acute asthma exacerbation requires immediate high-dose inhaled short-acting beta-2 agonists (salbutamol 5 mg nebulized with 6–8 L/min O2, often combined with ipratropium bromide) and prompt administration of systemic corticosteroids (oral or IV methylprednisolone 0.5–1 mg/kg) to reduce airway inflammation. Theophylline is obsolete due to high toxicity, and maintenance ICS powder inhalers are ineffective in acute respiratory distress.

7A 74-year-old man with permanent atrial fibrillation and a history of ischemic stroke is evaluated in clinic. His CHA2DS2-VASc score is 4 points and HAS-BLED score is 1. He has normal renal function (eGFR 82 mL/min/1.73 m²). According to French and European cardiology guidelines (R2C Item 236), what is the preferred first-line antithrombotic therapy to prevent thromboembolic stroke?

A.Direct oral anticoagulant (DOAC, e.g., apixaban or rivaroxaban).

B.Aspirin 75 mg daily monotherapy.

C.Dual antiplatelet therapy with aspirin and clopidogrel.

D.Unfractionated heparin continuous intravenous infusion.

Explanation: In non-valvular atrial fibrillation with an elevated CHA2DS2-VASc score (>= 2 in men), direct oral anticoagulants (DOACs: apixaban, rivaroxaban, dabigatran, edoxaban) are recommended as first-line therapy over vitamin K antagonists (VKA) due to superior safety (lower risk of intracranial hemorrhage) and equivalent or superior stroke prevention. Antiplatelet therapy (aspirin or clopidogrel) is ineffective for stroke prevention in AF and is formally discouraged.

8A 52-year-old woman is admitted to the intensive care unit with severe septic shock secondary to acute pyelonephritis. Despite rapid intravenous infusion of 30 mL/kg balanced crystalloids over 2 hours, her mean arterial pressure (MAP) remains 52 mmHg, heart rate is 122 bpm, and serum lactate is 4.6 mmol/L. What is the first-line vasopressor of choice according to the Surviving Sepsis Campaign and French intensive care guidelines (R2C Item 340)?

A.Dopamine infusion at 10–20 mcg/kg/min.

B.Phenylephrine bolus titrated to systolic pressure.

C.Epinephrine (adrenaline) continuous infusion as initial single agent.

D.Norepinephrine (noradrenaline) continuous intravenous infusion titrated to target MAP >= 65 mmHg.

Explanation: Norepinephrine is the uncontested first-line vasopressor in septic shock resistant to fluid resuscitation. It provides potent alpha-1 vasoconstriction with modest beta-1 inotropic support, effectively restoring mean arterial pressure without the severe tachycardia and arrhythmogenic risks associated with dopamine. The target MAP is at least 65 mmHg.

9A 64-year-old woman with a history of breast cancer presents with acute dyspnea, pleuritic chest pain, and hemoptysis. Blood pressure is 128/82 mmHg, heart rate is 108 bpm, and room air SpO2 is 93%. CT pulmonary angiography demonstrates bilateral lobar pulmonary embolism. Echocardiography shows right ventricular enlargement with preserved systolic function, and serum troponin I is elevated at 0.18 ng/mL. Her PESI score classifies her as intermediate-high risk. What is the recommended antithrombotic management (R2C Item 226)?

A.Immediate intravenous systemic thrombolysis with alteplase 100 mg over 2 hours.

B.Therapeutic anticoagulation (e.g., subcutaneous LMWH or direct oral anticoagulant) with continuous hemodynamic monitoring in an intensive or intermediate care unit.

C.Emergency catheter-directed surgical pulmonary embolectomy.

D.Inferior vena cava filter placement without anticoagulation.

Explanation: In intermediate-high risk pulmonary embolism (normotensive, but with both right ventricular dysfunction on echocardiography/CT and elevated cardiac biomarkers), standard management consists of therapeutic anticoagulation (low-molecular-weight heparin or DOAC) and close hemodynamic monitoring in a monitored unit. Systemic thrombolysis is not recommended routinely because bleeding risks outweigh benefits in stable patients; it is reserved for clinical hemodynamic deterioration (refractory hypotension or shock).

10A 71-year-old man with severe ischemic cardiomyopathy (LVEF 28%, NYHA class III) remains symptomatic despite optimal doses of ramipril 10 mg daily, bisoprolol 10 mg daily, and eplerenone 25 mg daily. His blood pressure is 118/74 mmHg, heart rate is 68 bpm in sinus rhythm, eGFR is 62 mL/min/1.73 m², and serum potassium is 4.4 mmol/L. According to updated French and ESC heart failure guidelines (R2C Item 232), which two pharmacological interventions should be sequentially implemented?

A.Add oral digoxin and switch bisoprolol to carvedilol.

B.Add oral verapamil and increase eplerenone to 100 mg daily.

C.Switch ramipril to sacubitril/valsartan (ARNI) after a 36-hour washout, and initiate an SGLT2 inhibitor (dapagliflozin or empagliflozin).

D.Add isosorbide mononitrate and discontinue bisoprolol.

Explanation: In heart failure with reduced ejection fraction (HFrEF) symptomatic despite triple therapy, guidelines mandate substituting the ACE inhibitor with an Angiotensin Receptor-Neprilysin Inhibitor (sacubitril/valsartan, requiring a 36-hour ACEi washout to prevent angioedema) and initiating an SGLT2 inhibitor (dapagliflozin or empagliflozin). These four pillars (ARNI, beta-blocker, MRA, SGLT2i) provide additive survival benefits.

About the Épreuves Dématérialisées Nationales (e-EDN) Exam

The Épreuves Dématérialisées Nationales (e-EDN) are the standardized national computer-based theoretical examinations administered to all sixth-year medical students in France (DFASM3), established under the Reform of the Second Cycle of Medical Studies (Réforme du 2ème Cycle - R2C) by the Arrêté du 21 décembre 2021. Managed centrally by the Centre National de Gestion (CNG), the e-EDN evaluates competency across 367 nationally defined items divided into Rang A (indispensable common-core knowledge required of any resident, subject to a strict 14/20 pass threshold) and Rang B (discriminating specialist knowledge). Accounting for 60% of the cumulative score that determines residency track and geographic allocation, the e-EDN replaces the former ECNi system, decoupling theoretical knowledge validation from clinical simulation examinations (ECOS, 30%) and longitudinal academic achievement (Parcours, 10%).

Exam sponsor: Centre National de Gestion (CNG) / Ministère de la Santé et de la Prévention. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The e-EDN comprises four computer-based sessions of three hours. The first three sessions each contain 90–110 question units drawn from the national knowledge programme. The fourth comprises two 1h30 LCA units, each with 13–17 questions that receive double weighting. Items distinguish Rang A essential knowledge, subject to a 14/20 validation threshold, from ranking-oriented Rang B knowledge. The e-EDN contributes 60% of the matching score; ECOS contribute 30% and the academic pathway 10%.

Time Limit

12 hours total (4 computer-based sessions of 3 hours over 3 days)

Passing Score

14/20 on Rang A items required to participate in internat matching; e-EDN accounts for 60% of total ranking score

Exam / Certification Fees

No separate public candidate fee is stated in the national examination rules

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

20.83%

Cardiology, Respiratory, Emergency Medicine & Intensive Care

Acute coronary syndromes, heart failure, arrhythmias, pulmonary embolism, respiratory distress, shock states, basic and advanced resuscitation, and clinical toxicology

20.83%

Internal Medicine, Infectious Diseases, Hematology & Pediatrics

Bacterial and viral infections, antimicrobial stewardship, sepsis, systemic autoimmune diseases, cytopenias, hematologic malignancies, neonatal distress, and pediatric development

20.83%

Neurology, Psychiatry, Locomotor System & Traumatology

Cerebrovascular accidents, epilepsy, intracranial hypertension, acute delirium, mood disorders, substance abuse, inflammatory and degenerative arthropathies, fractures, and spine trauma

20.83%

Hepato-Gastroenterology, Nephrology, Endocrinology & Oncology

Cirrhosis, upper and lower GI bleeding, acute and chronic kidney injury, electrolyte disorders, diabetes complications, adrenal and pituitary crises, oncologic staging, and palliative care

16.67%

Lecture critique d'article (LCA)

Study design, allocation, bias, effect measures, confidence intervals, diagnostic accuracy, survival analysis, external validity, and transparent reporting

Preparing for the Épreuves Dématérialisées Nationales (e-EDN) Exam

What You Need to Know

Passing score: 14/20 on Rang A items required to participate in internat matching; e-EDN accounts for 60% of total ranking score
Assessment: The e-EDN comprises four computer-based sessions of three hours. The first three sessions each contain 90–110 question units drawn from the national knowledge programme. The fourth comprises two 1h30 LCA units, each with 13–17 questions that receive double weighting. Items distinguish Rang A essential knowledge, subject to a 14/20 validation threshold, from ranking-oriented Rang B knowledge. The e-EDN contributes 60% of the matching score; ECOS contribute 30% and the academic pathway 10%.
Time limit: 12 hours total (4 computer-based sessions of 3 hours over 3 days)
Exam / certification fees: No separate public candidate fee is stated in the national examination rules Official sources

Using Our Practice Resources

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Épreuves Dématérialisées Nationales (e-EDN): Suggested Study Strategy

1Prioritize Rang A items: Master core diagnostic criteria, first-line emergency treatments, and essential red flags to secure the mandatory 14/20 minimum pass mark.

2Review official French College textbooks: Use current Collège des Enseignants editions (Collège de Cardiologie, Pneumologie, Neurologie, etc.) aligned with the official 367 R2C items.

3Train with progressive clinical cases: Practice synthesizing step-by-step diagnostic workflows where subsequent questions reveal new clinical investigations and complications.

4Master critical drug dosages and contraindications: Focus on high-risk medications such as anticoagulants, thrombolytics, intravenous insulin, antiarrhythmics, and broad-spectrum antibiotics.

5Practice clinical literature analysis (LCA): Hone statistical concepts, study designs (RCTs, cohort, case-control), bias identification, and evidence interpretation tested in Session 4.

Frequently Asked Questions

What is the e-EDN examination in French medical education?

The Épreuves Dématérialisées Nationales (e-EDN) is the national theoretical exam taken in October of the 6th year of medicine (DFASM3) in France under the R2C reform. It evaluates theoretical clinical competence across 367 national items and accounts for 60% of the candidate's total ranking for medical residency (internat) allocation.

What is the difference between Rang A and Rang B knowledge?

Rang A covers core fundamental medical knowledge that any generalist physician or starting resident must master; students must achieve at least 14/20 on Rang A items to enter the matching phase. Rang B comprises advanced, in-depth clinical knowledge used to discriminate and rank students for competitive specialty and hospital assignments.

What happens if a candidate scores below 14/20 on Rang A items?

Achieving a score below 14/20 on Rang A knowledge is eliminatory for the residency matching process (procédure d'appariement). Candidates who do not meet this threshold are offered a retake session (session de rattrapage) in the spring to validate their Rang A knowledge before qualifying for internat allocation.

How is the final Internat ranking score calculated under the R2C?

The final ranking is determined by a composite score composed of three parts: the theoretical e-EDN exam (60%), the practical objective structured clinical examinations (ECOS, 30%, which require a minimum validation score of 10/20), and the student's individual academic portfolio (Parcours, 10%).

What is the format and duration of the e-EDN?

The e-EDN consists of four digital sessions of three hours. Sessions 1–3 contain 90–110 question units each. Session 4 is split into two 1h30 LCA units of 13–17 questions each, with double weighting for those questions.