SAEM Questions with Complete
Solutions30
A false positive guaiac may be caused by the presence of ___ - ANSWERS-Methylene blue
GI pathogens that cause bloody diarrhea (4) - ANSWERS-Campylobacter
E Coli O157
Yersinia
Salmonella
Clostridium perfringens - ANSWERS-Gas gangrene
Late onset non-bloody diarrhea (from spores in dirt)
Yersinia enterocolitica - ANSWERS-Usually transmitted from pet feces (e.g., puppies),
contaminated milk, or pork. Outbreaks are common in day-care centers.
Sx can mimic Crohn's or appendicitis - bloody diarrhea, vomiting, cramping RLQ
Campylobacter jejuni - ANSWERS-#1 cause of watery or bloody diarrhea in US
Usually from travel, PPI, undercooked meat, dairy
Fever, abdominal cramp, bloody diarrhea
Similar to EIEC infection
E coli - ANSWERS-ETEC: watery diarrhea
,EHEC (O157): bloody diarrhea without fever
EIEC: watery > bloody diarrhea
Bloody diarrhea with thumb-print sign - ANSWERS-Any sign of bowel ischemia (ischemic bowel
>> IBD, volvulus, diverticulitis)
#1 cause of upper and lower GI bleed in adults - ANSWERS-Upper: PUD
Lower: diverticulosis
Majority of diverticulosis bleeding is from __ colon - ANSWERS-R side
Indication for surgical removal of ingested foreign body - ANSWERS-Object hasn't moved distally
in 24 hour observation
Symptomatic
Sharp object or batteries
CXR findings in aspiration of object - ANSWERS-Hyperinflated opposite lung
Atelectasis of affected lung
A 22 year old running back is struck from behind by a 300-pound lineman. The blow occurs
below the knee as his foot is firmly planted and two other lineman are holding his upper body.
He presents to the emergency department with gross anterior dislocation of the tibia on the
femur. His foot is cool and palee, and dorsalis pedis and posterior tibial pulses are not detected
by Doppler ultrasound. What is the most appropriate management for this patient? - ANSWERS-
Immediate reduction (neurovascular compromise) with ortho consult without x-rays
Burn rule of 9s - ANSWERS-Head 9%
Each arm 9%
, Chest 9%
Abdomen 9%
Each anterior leg 9%
Each posterior leg 9%
Upper back 9%
Lower back 9%
Genitals 1%
Treatment compartment syndrome - ANSWERS-Emergency escharotomy
Human bite microbes - ANSWERS-Eikenella corrodens
Expanding intracranial epidural hemorrhage management - ANSWERS-Intubate and consult
neurosurgery to take the patient to the OR
Depression and IBD - ANSWERS-IBD = higher rate of depression and anxiety
A 42 year old male with end stage liver disease due to chronic hepatitis C infection arrives to the
emergency department in stable condition after an unsuccessful suicide attempt by bilateral
wrist laceration. He reports no history of depression or psychiatric disorder. Aside from his liver
disease, for which he takes interferon alpha and ribavirin, he reports that he is in good health
and takes no other medications. Which of the following factors increased this patient's risk of
new-onset suicidal ideation? - ANSWERS-Depression and/ or suicidal ideation are commonly
reported side effects of interferon alpha therapy
Which of the following psychiatric disorders is associated with the greatest increased risk of
committing suicide?
Panic
Solutions30
A false positive guaiac may be caused by the presence of ___ - ANSWERS-Methylene blue
GI pathogens that cause bloody diarrhea (4) - ANSWERS-Campylobacter
E Coli O157
Yersinia
Salmonella
Clostridium perfringens - ANSWERS-Gas gangrene
Late onset non-bloody diarrhea (from spores in dirt)
Yersinia enterocolitica - ANSWERS-Usually transmitted from pet feces (e.g., puppies),
contaminated milk, or pork. Outbreaks are common in day-care centers.
Sx can mimic Crohn's or appendicitis - bloody diarrhea, vomiting, cramping RLQ
Campylobacter jejuni - ANSWERS-#1 cause of watery or bloody diarrhea in US
Usually from travel, PPI, undercooked meat, dairy
Fever, abdominal cramp, bloody diarrhea
Similar to EIEC infection
E coli - ANSWERS-ETEC: watery diarrhea
,EHEC (O157): bloody diarrhea without fever
EIEC: watery > bloody diarrhea
Bloody diarrhea with thumb-print sign - ANSWERS-Any sign of bowel ischemia (ischemic bowel
>> IBD, volvulus, diverticulitis)
#1 cause of upper and lower GI bleed in adults - ANSWERS-Upper: PUD
Lower: diverticulosis
Majority of diverticulosis bleeding is from __ colon - ANSWERS-R side
Indication for surgical removal of ingested foreign body - ANSWERS-Object hasn't moved distally
in 24 hour observation
Symptomatic
Sharp object or batteries
CXR findings in aspiration of object - ANSWERS-Hyperinflated opposite lung
Atelectasis of affected lung
A 22 year old running back is struck from behind by a 300-pound lineman. The blow occurs
below the knee as his foot is firmly planted and two other lineman are holding his upper body.
He presents to the emergency department with gross anterior dislocation of the tibia on the
femur. His foot is cool and palee, and dorsalis pedis and posterior tibial pulses are not detected
by Doppler ultrasound. What is the most appropriate management for this patient? - ANSWERS-
Immediate reduction (neurovascular compromise) with ortho consult without x-rays
Burn rule of 9s - ANSWERS-Head 9%
Each arm 9%
, Chest 9%
Abdomen 9%
Each anterior leg 9%
Each posterior leg 9%
Upper back 9%
Lower back 9%
Genitals 1%
Treatment compartment syndrome - ANSWERS-Emergency escharotomy
Human bite microbes - ANSWERS-Eikenella corrodens
Expanding intracranial epidural hemorrhage management - ANSWERS-Intubate and consult
neurosurgery to take the patient to the OR
Depression and IBD - ANSWERS-IBD = higher rate of depression and anxiety
A 42 year old male with end stage liver disease due to chronic hepatitis C infection arrives to the
emergency department in stable condition after an unsuccessful suicide attempt by bilateral
wrist laceration. He reports no history of depression or psychiatric disorder. Aside from his liver
disease, for which he takes interferon alpha and ribavirin, he reports that he is in good health
and takes no other medications. Which of the following factors increased this patient's risk of
new-onset suicidal ideation? - ANSWERS-Depression and/ or suicidal ideation are commonly
reported side effects of interferon alpha therapy
Which of the following psychiatric disorders is associated with the greatest increased risk of
committing suicide?
Panic
