Emergency Medicine SAEM TEST STUDY
GUIDE 2025/2026 ACCURATE QUESTIONS AND
VERIFIED CORRECT SOLUTIONS WITH
RATIONALES || 100% GUARANTEED PASS
<LATEST VERSION>
1. List ottawa ankle rules
where should you also check on exam/be aware of? - ANSWER ✓ 1.
inability to walk 4 steps immediately & in ED + any of the following:
medial malleolus tenderness
lateral malleolus tenderness
navicular tenderensss
5th metatarsal tendereness
check fibular head tenderness- twisting injury ~ fibular fx
2. Name SIRS criteria (4)
Describe CHEST study findings - ANSWER ✓ 1. Temp < 36 or >38
HR >90
RR >20 or PaCO2 <32
WBC 4,000 > x > 12,000
CHEST study (JAMA): previous SCC (surviving sepsis campaign) studies
did not look at wards; found that SIRS reminders did not affect mortality
3. Define sepsis
define severe sepsis- criteria?
(SBP, Cr, bili, PLT, INR, lactate)
define septic shock - ANSWER ✓ 1. pt who has potential infectious cause
for SIRS syndrome
2. sepsis-induced organ dysfunction. Criteria:
SBP <90 or MAP <70 or SBP decrease >40
Cr >2.0 or urine output <0.5ml/kg/hr
Bili >2
PLT <100,000
, INR >1.5 or PTT >60s
lactate >2 mmol/L
low BP despite fluid administration
4. What lab is the ECG of sepsis?
list of labs to get for sepsis?
3 hour bundle for sepsis?
6 hour bundle? - ANSWER ✓ 1. lactate
2. CBC, CMP, PT/INR/PTT, blood Cx x2, UA, CXR
lactate measurement, blood Cx then administration of broad spectrum abx,
admin. of 30mL/kg IV crystalloid for hypoTN or lactate >4
vasopressors for goal MAP >65, reassess & document volume, repeat lactate
if initially >4
5. Name the AEIOUTIPS of AMS - ANSWER ✓ A = alcohol
E = epilepsy, electrolytes, encephalopathy
I = insulin
= opiates & oxygen
U = uremia
T = trauma & temp
I = infection
P = poison & psychogenic
S = shock, stroke, subarachnoid hemorrhage, space-occupying lesion
6. Name virchow's triad - ANSWER ✓ 1. Hypercoagulability
2. Endothelial damage
3. Abn blood flow
7. DM pt comes in w fever & costoverebral angle tenderness- mgmt?
If pt feels better in 48 hrs- next step? - ANSWER ✓ 1. Tx with IV abx-
Rocephin good choice. IVF.
Switch to po Cipro or TMP/SMX (bactrim)
8. Suspected stroke: time-dependent goals in therapy? FDA recommends tPA
until max time? After how long can thrombolytics no longer be given? Have
to get BP down to __ in order to give? PT/INR values have to be < __ ?
Other CI?
other workup?
If CT neg but suspect subarachnoid hem?
, DDx? - ANSWER ✓ 1. Door to seen by Doc: 10mins. Door to CT in 25
mins. Read by radiologist in 45mins. Door to labs back: 45mins. Door to
needle goal (tPa) < 60min. FDA: up to 3hrs since Sx onset. >4.5 hrs can't
give. BP must be <185/110. INR <1.7, PT <15 sec. Other CI: GI/GU bleed
w/in 3mo. Gluc <50.
2. EKG, O2 Sat, POC glucose, CBC, BMP, LFTs, PT/PTT, UA, ESR &
BCx if suspect bacterial endocartitis
Stat LP
TIA, intracranial bleed, neoplasm, transient global aphasia, hypoglycemia,
encephalopathy, peripheral neuropathy, MS, seizure d/o
9. What are the top 3 causes of morbidity/mortality in acute chest pain? -
ANSWER ✓ ACS
pulmonary embolism
aortic dissection
10.What is the cardioversion and defibrillation joules? - ANSWER ✓
cardioversion = 50-100 J
defibrillation = 200 J
11.What is the most common EKG finding in a pulmonary embolus? What
should you be on the lookout for? - ANSWER ✓ most common = sinus
tachycardia
12.look for = "S1Q3T3" (large S wave in lead I + Q wave in lead 3 + T wave
inversion in lead 3)
13.What should you worry about if a patient's EKG shows electrical alternans?
What does this look like? - ANSWER ✓ cardiac tamponade! looks like
alternating big and small spikes
14.Describe the basic evolution of the EKG of a patient having a STEMI -
ANSWER ✓ 1-normal
2- T waves become wide and tall
3- ST elevation
4- Q waves and T wave inversion
5- Q waves persist but T wave normalizes
chest pain, weakness, nausea, fatigue
, 15.classic presentation of ___________________ - ANSWER ✓ ACS!
16.pleuritic chest pain, shortness of breath, anxiety
17.classic presentation of ___________________ - ANSWER ✓ pulmonary
embolism
18.a patient with SOB is found on physical exam to have tachycardia, clear
lung sounds, and a swollen leg
19.classic presentation of ___________________ - ANSWER ✓ pulmonary
embolism
20.sudden on set severe chest pain that rips through to the back; unequal blood
pressures on PE
21.classic presentation of ___________________ - ANSWER ✓ aortic
dissection
22.How does cardioversion work? - ANSWER ✓ used to stop tachyarrhythmias
--> the impulse is delivered at the peak of an R wave (prevents going into v
fib)
23.What are 5 indications for cardioversion? - ANSWER ✓ 1. ventricular
tachycardia with a pulse
2. supraventricular tachycardias with hypotension
3. atrial fibrillation
24.atrial flutter
25.AVNRT
26.What are three indications for defibrillation? - ANSWER ✓ ventricular
tachycardia without a pulse
ventricular fibrillation
torsades de pointes without pulse
GUIDE 2025/2026 ACCURATE QUESTIONS AND
VERIFIED CORRECT SOLUTIONS WITH
RATIONALES || 100% GUARANTEED PASS
<LATEST VERSION>
1. List ottawa ankle rules
where should you also check on exam/be aware of? - ANSWER ✓ 1.
inability to walk 4 steps immediately & in ED + any of the following:
medial malleolus tenderness
lateral malleolus tenderness
navicular tenderensss
5th metatarsal tendereness
check fibular head tenderness- twisting injury ~ fibular fx
2. Name SIRS criteria (4)
Describe CHEST study findings - ANSWER ✓ 1. Temp < 36 or >38
HR >90
RR >20 or PaCO2 <32
WBC 4,000 > x > 12,000
CHEST study (JAMA): previous SCC (surviving sepsis campaign) studies
did not look at wards; found that SIRS reminders did not affect mortality
3. Define sepsis
define severe sepsis- criteria?
(SBP, Cr, bili, PLT, INR, lactate)
define septic shock - ANSWER ✓ 1. pt who has potential infectious cause
for SIRS syndrome
2. sepsis-induced organ dysfunction. Criteria:
SBP <90 or MAP <70 or SBP decrease >40
Cr >2.0 or urine output <0.5ml/kg/hr
Bili >2
PLT <100,000
, INR >1.5 or PTT >60s
lactate >2 mmol/L
low BP despite fluid administration
4. What lab is the ECG of sepsis?
list of labs to get for sepsis?
3 hour bundle for sepsis?
6 hour bundle? - ANSWER ✓ 1. lactate
2. CBC, CMP, PT/INR/PTT, blood Cx x2, UA, CXR
lactate measurement, blood Cx then administration of broad spectrum abx,
admin. of 30mL/kg IV crystalloid for hypoTN or lactate >4
vasopressors for goal MAP >65, reassess & document volume, repeat lactate
if initially >4
5. Name the AEIOUTIPS of AMS - ANSWER ✓ A = alcohol
E = epilepsy, electrolytes, encephalopathy
I = insulin
= opiates & oxygen
U = uremia
T = trauma & temp
I = infection
P = poison & psychogenic
S = shock, stroke, subarachnoid hemorrhage, space-occupying lesion
6. Name virchow's triad - ANSWER ✓ 1. Hypercoagulability
2. Endothelial damage
3. Abn blood flow
7. DM pt comes in w fever & costoverebral angle tenderness- mgmt?
If pt feels better in 48 hrs- next step? - ANSWER ✓ 1. Tx with IV abx-
Rocephin good choice. IVF.
Switch to po Cipro or TMP/SMX (bactrim)
8. Suspected stroke: time-dependent goals in therapy? FDA recommends tPA
until max time? After how long can thrombolytics no longer be given? Have
to get BP down to __ in order to give? PT/INR values have to be < __ ?
Other CI?
other workup?
If CT neg but suspect subarachnoid hem?
, DDx? - ANSWER ✓ 1. Door to seen by Doc: 10mins. Door to CT in 25
mins. Read by radiologist in 45mins. Door to labs back: 45mins. Door to
needle goal (tPa) < 60min. FDA: up to 3hrs since Sx onset. >4.5 hrs can't
give. BP must be <185/110. INR <1.7, PT <15 sec. Other CI: GI/GU bleed
w/in 3mo. Gluc <50.
2. EKG, O2 Sat, POC glucose, CBC, BMP, LFTs, PT/PTT, UA, ESR &
BCx if suspect bacterial endocartitis
Stat LP
TIA, intracranial bleed, neoplasm, transient global aphasia, hypoglycemia,
encephalopathy, peripheral neuropathy, MS, seizure d/o
9. What are the top 3 causes of morbidity/mortality in acute chest pain? -
ANSWER ✓ ACS
pulmonary embolism
aortic dissection
10.What is the cardioversion and defibrillation joules? - ANSWER ✓
cardioversion = 50-100 J
defibrillation = 200 J
11.What is the most common EKG finding in a pulmonary embolus? What
should you be on the lookout for? - ANSWER ✓ most common = sinus
tachycardia
12.look for = "S1Q3T3" (large S wave in lead I + Q wave in lead 3 + T wave
inversion in lead 3)
13.What should you worry about if a patient's EKG shows electrical alternans?
What does this look like? - ANSWER ✓ cardiac tamponade! looks like
alternating big and small spikes
14.Describe the basic evolution of the EKG of a patient having a STEMI -
ANSWER ✓ 1-normal
2- T waves become wide and tall
3- ST elevation
4- Q waves and T wave inversion
5- Q waves persist but T wave normalizes
chest pain, weakness, nausea, fatigue
, 15.classic presentation of ___________________ - ANSWER ✓ ACS!
16.pleuritic chest pain, shortness of breath, anxiety
17.classic presentation of ___________________ - ANSWER ✓ pulmonary
embolism
18.a patient with SOB is found on physical exam to have tachycardia, clear
lung sounds, and a swollen leg
19.classic presentation of ___________________ - ANSWER ✓ pulmonary
embolism
20.sudden on set severe chest pain that rips through to the back; unequal blood
pressures on PE
21.classic presentation of ___________________ - ANSWER ✓ aortic
dissection
22.How does cardioversion work? - ANSWER ✓ used to stop tachyarrhythmias
--> the impulse is delivered at the peak of an R wave (prevents going into v
fib)
23.What are 5 indications for cardioversion? - ANSWER ✓ 1. ventricular
tachycardia with a pulse
2. supraventricular tachycardias with hypotension
3. atrial fibrillation
24.atrial flutter
25.AVNRT
26.What are three indications for defibrillation? - ANSWER ✓ ventricular
tachycardia without a pulse
ventricular fibrillation
torsades de pointes without pulse
