1 | Page
SAEM Questions and Answers Latest
2026
Management of Large Subungual Hematoma Ans:
Drainage (18-Gauge) or Hot Micro-Cauterization
Reason to Avoid Suction in Ear Foreign Body Removal
Ans: Perforation of Tympanic Membrane
Management of Skin Abscess Ans: Linear Incision for
Non-Face vs. Needle Drainage for Face
Catheter for Bartholin Cyst Ans: Word
Grading of Laryngeal Opening Ans: Cormack-Lehane
Preferred Induction Agent in Reactive Airway Disease for
Dilation Effects Ans: Ketamine
Induction Agent Avoided in Sepsis Due To Adrenal
Suppression Ans: Etomidate
Sudden-Onset Back Pain Worsened by Coughing Soon
After Epidural Anesthesia Ans: Epidural Hematoma
Presentation of Adhesive Arachnoiditis Ans: Progressive
Neuropathy
© 2025 All rights reserved
, 2 | Page
Tom, Dick, and Very Nervous Harry Ans: Anterior to
Posterior of Medial Ankle: Tibialis Posterior, Digitorum
Longus, Vein, Nerve, Hallucis Longus
Absolute Contra-Indication to Crico-Thyrotomy Ans: Age
Under 5
Anesthesia for Suturing D.I.P. of Finger in Patient with
Underlying Vascular Disease Ans: Lidocaine (2%) Without
Epinephrine Around Digital Nerve for Fingers, Toes,
Penis, Nose
Earliest Sign of Lidocaine Toxicity (Over 5 mg/kg) Ans:
Lightheadedness (Also Peri-Oral Numbness, Tinnitus,
Visual and Auditory Disturbances, Shivering, Twitching,
and Generalized Tonic-Clonic Seizures)
(1) Avoid Vertical Mattress Sutures.
(2) Avoid Topical Skin Adhesives (Risk of Dehiscence
from Sweating). Ans: Palm
Glottis Spasm and Chest Wall Rigidity from Sedative
(Rapid High Dose of IV Form) Ans: Fentanyl (Effects Not
Always Reversed by Naloxone)
Management of Long-Lasting L.P. Headache Ans:
Autologous Blood Patch
Timing of Tetanus Prophylaxis Ans: Within First Few
Days (Suture Within First 24 Hours)
Normal C.S.F.-to-Blood Glucose Ratio Ans: 0.6
© 2025 All rights reserved
, 3 | Page
Size of Needle Decompression Needle Ans: 14 Gauge (2nd
Intercostal at Midclavicular Line)
Large Paronychia and Cellulitis Ans: Removal of Affected
Nail Under Digital Block; Start Antibiotics
Signs of Acute Appendicitis Ans: 1. Rovsing: Right Lower
from Left Lower.
2. Psoas: Extension.
3. Obturator: Rotation.
Suggested by Abdominal Pain Preceding Nausea and
Vomiting Ans: Surgery (Small Bowel Obstruction)
Peak of Gastric Acid Secretion at Rest Ans: 2 A.M.
Timing of Presentation of Hypertrophic Pyloric Stenosis
(Non-Bilious) vs. Intussusception (Bilious) Ans: 4 Weeks
vs. 8 Months
Over 95% Sensitive and Specific for Renal Stones Ans:
Helical C.T.
Intermittent Left Lower Quadrant Pain (Afebrile), Loose
Stools (Non-Bloody); Good Follow-Up Ans: Discharge on
High-Fiber Diet (Consider Laxatives and Stool Softeners)
Abdominal Wall Condition in Anti-Coagulated Patient
with Trauma or Coughing Ans: Rectus Sheath Hematoma
(1) Age 30.
© 2025 All rights reserved
, 4 | Page
(2) Prior Abdominal Surgery or Pregnancy.
(3) Marathons. Ans: Risk Factors for Cecal (Cross-
Country) Volvulus
Possible Chest X-Ray Finding of Hepatic Abscess Ans:
Right-Sided Effusion and Elevated Hemi-Diaphragm
Referred Pain from Ureteral Colic Ans: Inguinal (Ovarian
Torsion Does Not Cause Sacral Pain)
Elderly Patient, Diverticulitis Without Perforation
(Without Peritonitis) Ans: I.V. Fluids (Elderly), Antibiotics,
and Bowel Rest (Peritonitis Requires Surgery)
Proximal vs. Distal Esophageal Perforation Ans:
Iatrogenic vs. Spontaneous
Rigidity; Elevated Temperatures, Altered Mental Status,
Choreo-Athetosis, Autonomic Dysfunction (Diaphoresis,
Incontinence, Arrhythmia) Ans: Dantrolene (Or
Bromocriptine, Amantadine, Lorazepam) for Neuroleptic
Malignant Syndrome
Indicated by Temperature Over 105 Ans: Non-Infectious
Extra-Pyramidal: Involuntary Periodic Movements of
Tongue, Lips, or Mouth Ans: Tardive Dyskinesia
Extra-Pyramidal: Torticollis, Fixed Upper Gaze (Oculogyric
Crisis), or Arching of Back (Opisthotonus) Ans:
Benztropine (2mg Cogentin) or Benadryl (25mg) for
Dystonia from Typical Anti-Psychotics
© 2025 All rights reserved
SAEM Questions and Answers Latest
2026
Management of Large Subungual Hematoma Ans:
Drainage (18-Gauge) or Hot Micro-Cauterization
Reason to Avoid Suction in Ear Foreign Body Removal
Ans: Perforation of Tympanic Membrane
Management of Skin Abscess Ans: Linear Incision for
Non-Face vs. Needle Drainage for Face
Catheter for Bartholin Cyst Ans: Word
Grading of Laryngeal Opening Ans: Cormack-Lehane
Preferred Induction Agent in Reactive Airway Disease for
Dilation Effects Ans: Ketamine
Induction Agent Avoided in Sepsis Due To Adrenal
Suppression Ans: Etomidate
Sudden-Onset Back Pain Worsened by Coughing Soon
After Epidural Anesthesia Ans: Epidural Hematoma
Presentation of Adhesive Arachnoiditis Ans: Progressive
Neuropathy
© 2025 All rights reserved
, 2 | Page
Tom, Dick, and Very Nervous Harry Ans: Anterior to
Posterior of Medial Ankle: Tibialis Posterior, Digitorum
Longus, Vein, Nerve, Hallucis Longus
Absolute Contra-Indication to Crico-Thyrotomy Ans: Age
Under 5
Anesthesia for Suturing D.I.P. of Finger in Patient with
Underlying Vascular Disease Ans: Lidocaine (2%) Without
Epinephrine Around Digital Nerve for Fingers, Toes,
Penis, Nose
Earliest Sign of Lidocaine Toxicity (Over 5 mg/kg) Ans:
Lightheadedness (Also Peri-Oral Numbness, Tinnitus,
Visual and Auditory Disturbances, Shivering, Twitching,
and Generalized Tonic-Clonic Seizures)
(1) Avoid Vertical Mattress Sutures.
(2) Avoid Topical Skin Adhesives (Risk of Dehiscence
from Sweating). Ans: Palm
Glottis Spasm and Chest Wall Rigidity from Sedative
(Rapid High Dose of IV Form) Ans: Fentanyl (Effects Not
Always Reversed by Naloxone)
Management of Long-Lasting L.P. Headache Ans:
Autologous Blood Patch
Timing of Tetanus Prophylaxis Ans: Within First Few
Days (Suture Within First 24 Hours)
Normal C.S.F.-to-Blood Glucose Ratio Ans: 0.6
© 2025 All rights reserved
, 3 | Page
Size of Needle Decompression Needle Ans: 14 Gauge (2nd
Intercostal at Midclavicular Line)
Large Paronychia and Cellulitis Ans: Removal of Affected
Nail Under Digital Block; Start Antibiotics
Signs of Acute Appendicitis Ans: 1. Rovsing: Right Lower
from Left Lower.
2. Psoas: Extension.
3. Obturator: Rotation.
Suggested by Abdominal Pain Preceding Nausea and
Vomiting Ans: Surgery (Small Bowel Obstruction)
Peak of Gastric Acid Secretion at Rest Ans: 2 A.M.
Timing of Presentation of Hypertrophic Pyloric Stenosis
(Non-Bilious) vs. Intussusception (Bilious) Ans: 4 Weeks
vs. 8 Months
Over 95% Sensitive and Specific for Renal Stones Ans:
Helical C.T.
Intermittent Left Lower Quadrant Pain (Afebrile), Loose
Stools (Non-Bloody); Good Follow-Up Ans: Discharge on
High-Fiber Diet (Consider Laxatives and Stool Softeners)
Abdominal Wall Condition in Anti-Coagulated Patient
with Trauma or Coughing Ans: Rectus Sheath Hematoma
(1) Age 30.
© 2025 All rights reserved
, 4 | Page
(2) Prior Abdominal Surgery or Pregnancy.
(3) Marathons. Ans: Risk Factors for Cecal (Cross-
Country) Volvulus
Possible Chest X-Ray Finding of Hepatic Abscess Ans:
Right-Sided Effusion and Elevated Hemi-Diaphragm
Referred Pain from Ureteral Colic Ans: Inguinal (Ovarian
Torsion Does Not Cause Sacral Pain)
Elderly Patient, Diverticulitis Without Perforation
(Without Peritonitis) Ans: I.V. Fluids (Elderly), Antibiotics,
and Bowel Rest (Peritonitis Requires Surgery)
Proximal vs. Distal Esophageal Perforation Ans:
Iatrogenic vs. Spontaneous
Rigidity; Elevated Temperatures, Altered Mental Status,
Choreo-Athetosis, Autonomic Dysfunction (Diaphoresis,
Incontinence, Arrhythmia) Ans: Dantrolene (Or
Bromocriptine, Amantadine, Lorazepam) for Neuroleptic
Malignant Syndrome
Indicated by Temperature Over 105 Ans: Non-Infectious
Extra-Pyramidal: Involuntary Periodic Movements of
Tongue, Lips, or Mouth Ans: Tardive Dyskinesia
Extra-Pyramidal: Torticollis, Fixed Upper Gaze (Oculogyric
Crisis), or Arching of Back (Opisthotonus) Ans:
Benztropine (2mg Cogentin) or Benadryl (25mg) for
Dystonia from Typical Anti-Psychotics
© 2025 All rights reserved
