SAEM || 100% Detailed Answers.
Management of Large Subungual Hematoma correct answers Drainage (18-Gauge) or Hot
Micro-Cauterization
Reason to Avoid Suction in Ear Foreign Body Removal correct answers Perforation of Tympanic
Membrane
Management of Skin Abscess correct answers Linear Incision for Non-Face vs. Needle Drainage
for Face
Catheter for Bartholin Cyst correct answers Word
Grading of Laryngeal Opening correct answers Cormack-Lehane
Preferred Induction Agent in Reactive Airway Disease for Dilation Effects correct answers
Ketamine
Induction Agent Avoided in Sepsis Due To Adrenal Suppression correct answers Etomidate
Sudden-Onset Back Pain Worsened by Coughing Soon After Epidural Anesthesia correct
answers Epidural Hematoma
Presentation of Adhesive Arachnoiditis correct answers Progressive Neuropathy
Tom, Dick, and Very Nervous Harry correct answers Anterior to Posterior of Medial Ankle:
Tibialis Posterior, Digitorum Longus, Vein, Nerve, Hallucis Longus
Absolute Contra-Indication to Crico-Thyrotomy correct answers Age Under 5
,Anesthesia for Suturing D.I.P. of Finger in Patient with Underlying Vascular Disease correct
answers Lidocaine (2%) Without Epinephrine Around Digital Nerve for Fingers, Toes, Penis,
Nose
Earliest Sign of Lidocaine Toxicity (Over 5 mg/kg) correct answers 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). correct answers Palm
Glottis Spasm and Chest Wall Rigidity from Sedative (Rapid High Dose of IV Form) correct
answers Fentanyl (Effects Not Always Reversed by Naloxone)
Management of Long-Lasting L.P. Headache correct answers Autologous Blood Patch
Timing of Tetanus Prophylaxis correct answers Within First Few Days (Suture Within First 24
Hours)
Normal C.S.F.-to-Blood Glucose Ratio correct answers 0.6
Size of Needle Decompression Needle correct answers 14 Gauge (2nd Intercostal at
Midclavicular Line)
Large Paronychia and Cellulitis correct answers Removal of Affected Nail Under Digital Block;
Start Antibiotics
Signs of Acute Appendicitis correct answers 1. Rovsing: Right Lower from Left Lower.
2. Psoas: Extension.
3. Obturator: Rotation.
,Suggested by Abdominal Pain Preceding Nausea and Vomiting correct answers Surgery (Small
Bowel Obstruction)
Peak of Gastric Acid Secretion at Rest correct answers 2 A.M.
Timing of Presentation of Hypertrophic Pyloric Stenosis (Non-Bilious) vs. Intussusception
(Bilious) correct answers 4 Weeks vs. 8 Months
Over 95% Sensitive and Specific for Renal Stones correct answers Helical C.T.
Intermittent Left Lower Quadrant Pain (Afebrile), Loose Stools (Non-Bloody); Good Follow-Up
correct answers Discharge on High-Fiber Diet (Consider Laxatives and Stool Softeners)
Abdominal Wall Condition in Anti-Coagulated Patient with Trauma or Coughing correct answers
Rectus Sheath Hematoma
(1) Age 30.
(2) Prior Abdominal Surgery or Pregnancy.
(3) Marathons. correct answers Risk Factors for Cecal (Cross-Country) Volvulus
Possible Chest X-Ray Finding of Hepatic Abscess correct answers Right-Sided Effusion and
Elevated Hemi-Diaphragm
Referred Pain from Ureteral Colic correct answers Inguinal (Ovarian Torsion Does Not Cause
Sacral Pain)
Elderly Patient, Diverticulitis Without Perforation (Without Peritonitis) correct answers I.V.
Fluids (Elderly), Antibiotics, and Bowel Rest (Peritonitis Requires Surgery)
, Proximal vs. Distal Esophageal Perforation correct answers Iatrogenic vs. Spontaneous
Rigidity; Elevated Temperatures, Altered Mental Status, Choreo-Athetosis, Autonomic
Dysfunction (Diaphoresis, Incontinence, Arrhythmia) correct answers Dantrolene (Or
Bromocriptine, Amantadine, Lorazepam) for Neuroleptic Malignant Syndrome
Indicated by Temperature Over 105 correct answers Non-Infectious
Extra-Pyramidal: Involuntary Periodic Movements of Tongue, Lips, or Mouth correct answers
Tardive Dyskinesia
Extra-Pyramidal: Torticollis, Fixed Upper Gaze (Oculogyric Crisis), or Arching of Back
(Opisthotonus) correct answers Benztropine (2mg Cogentin) or Benadryl (25mg) for Dystonia
from Typical Anti-Psychotics
Extra-Pyramidal: Restlessness correct answers Beta-Blocker for Akathisia
E.C.G. Finding of Haloperidol Toxicity correct answers Long Q.T.
Illicit Drug Causing Vertical Nystagmus correct answers Phencyclidine (PCP)
Controls Agitation Without Respiratory Depression (Negligible Anticholinergic Side Effects)
correct answers Haloperidol (5mg IM q30); B-52 is Benadryl (50 Milligrams), 5 Milligrams of
Haloperidol, and 2 Milligrams of Lorazepam
Risk of Protracted Struggle in Restraints correct answers Metabolic Acidosis
Risk of Flumazenil in Chronic Benzodiazepine User correct answers Withdrawal Seizures
Management of Large Subungual Hematoma correct answers Drainage (18-Gauge) or Hot
Micro-Cauterization
Reason to Avoid Suction in Ear Foreign Body Removal correct answers Perforation of Tympanic
Membrane
Management of Skin Abscess correct answers Linear Incision for Non-Face vs. Needle Drainage
for Face
Catheter for Bartholin Cyst correct answers Word
Grading of Laryngeal Opening correct answers Cormack-Lehane
Preferred Induction Agent in Reactive Airway Disease for Dilation Effects correct answers
Ketamine
Induction Agent Avoided in Sepsis Due To Adrenal Suppression correct answers Etomidate
Sudden-Onset Back Pain Worsened by Coughing Soon After Epidural Anesthesia correct
answers Epidural Hematoma
Presentation of Adhesive Arachnoiditis correct answers Progressive Neuropathy
Tom, Dick, and Very Nervous Harry correct answers Anterior to Posterior of Medial Ankle:
Tibialis Posterior, Digitorum Longus, Vein, Nerve, Hallucis Longus
Absolute Contra-Indication to Crico-Thyrotomy correct answers Age Under 5
,Anesthesia for Suturing D.I.P. of Finger in Patient with Underlying Vascular Disease correct
answers Lidocaine (2%) Without Epinephrine Around Digital Nerve for Fingers, Toes, Penis,
Nose
Earliest Sign of Lidocaine Toxicity (Over 5 mg/kg) correct answers 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). correct answers Palm
Glottis Spasm and Chest Wall Rigidity from Sedative (Rapid High Dose of IV Form) correct
answers Fentanyl (Effects Not Always Reversed by Naloxone)
Management of Long-Lasting L.P. Headache correct answers Autologous Blood Patch
Timing of Tetanus Prophylaxis correct answers Within First Few Days (Suture Within First 24
Hours)
Normal C.S.F.-to-Blood Glucose Ratio correct answers 0.6
Size of Needle Decompression Needle correct answers 14 Gauge (2nd Intercostal at
Midclavicular Line)
Large Paronychia and Cellulitis correct answers Removal of Affected Nail Under Digital Block;
Start Antibiotics
Signs of Acute Appendicitis correct answers 1. Rovsing: Right Lower from Left Lower.
2. Psoas: Extension.
3. Obturator: Rotation.
,Suggested by Abdominal Pain Preceding Nausea and Vomiting correct answers Surgery (Small
Bowel Obstruction)
Peak of Gastric Acid Secretion at Rest correct answers 2 A.M.
Timing of Presentation of Hypertrophic Pyloric Stenosis (Non-Bilious) vs. Intussusception
(Bilious) correct answers 4 Weeks vs. 8 Months
Over 95% Sensitive and Specific for Renal Stones correct answers Helical C.T.
Intermittent Left Lower Quadrant Pain (Afebrile), Loose Stools (Non-Bloody); Good Follow-Up
correct answers Discharge on High-Fiber Diet (Consider Laxatives and Stool Softeners)
Abdominal Wall Condition in Anti-Coagulated Patient with Trauma or Coughing correct answers
Rectus Sheath Hematoma
(1) Age 30.
(2) Prior Abdominal Surgery or Pregnancy.
(3) Marathons. correct answers Risk Factors for Cecal (Cross-Country) Volvulus
Possible Chest X-Ray Finding of Hepatic Abscess correct answers Right-Sided Effusion and
Elevated Hemi-Diaphragm
Referred Pain from Ureteral Colic correct answers Inguinal (Ovarian Torsion Does Not Cause
Sacral Pain)
Elderly Patient, Diverticulitis Without Perforation (Without Peritonitis) correct answers I.V.
Fluids (Elderly), Antibiotics, and Bowel Rest (Peritonitis Requires Surgery)
, Proximal vs. Distal Esophageal Perforation correct answers Iatrogenic vs. Spontaneous
Rigidity; Elevated Temperatures, Altered Mental Status, Choreo-Athetosis, Autonomic
Dysfunction (Diaphoresis, Incontinence, Arrhythmia) correct answers Dantrolene (Or
Bromocriptine, Amantadine, Lorazepam) for Neuroleptic Malignant Syndrome
Indicated by Temperature Over 105 correct answers Non-Infectious
Extra-Pyramidal: Involuntary Periodic Movements of Tongue, Lips, or Mouth correct answers
Tardive Dyskinesia
Extra-Pyramidal: Torticollis, Fixed Upper Gaze (Oculogyric Crisis), or Arching of Back
(Opisthotonus) correct answers Benztropine (2mg Cogentin) or Benadryl (25mg) for Dystonia
from Typical Anti-Psychotics
Extra-Pyramidal: Restlessness correct answers Beta-Blocker for Akathisia
E.C.G. Finding of Haloperidol Toxicity correct answers Long Q.T.
Illicit Drug Causing Vertical Nystagmus correct answers Phencyclidine (PCP)
Controls Agitation Without Respiratory Depression (Negligible Anticholinergic Side Effects)
correct answers Haloperidol (5mg IM q30); B-52 is Benadryl (50 Milligrams), 5 Milligrams of
Haloperidol, and 2 Milligrams of Lorazepam
Risk of Protracted Struggle in Restraints correct answers Metabolic Acidosis
Risk of Flumazenil in Chronic Benzodiazepine User correct answers Withdrawal Seizures
