SAEM FINAL TEST PAPER 2026 QUESTIONS
AND ANSWERS GRADED A PLUS
◉ Stab Wound in 10th Intercostal Space, Absent Breath Sounds;
Dyspnea But Hemodynamically-Stable
Answer: (1) Chest Tube.
(2) Portable X-Ray.
(3) Abdominal C.T.
◉ Decreased Sensation Over Lateral Palm
Answer: Median Nerve Injury from Distal Radius Fracture
◉ Leg Externally-Rotated (And Abducted)
Answer: Femoral Neck Fracture (ER = RE)
◉ Leg Internally-Rotated
Answer: Posterior Hip Dislocation
◉ Popliteal Pain After Impact on Planted Foot; Pale Cold Foot, No
Distal Pulses
Answer: Sedate and Reduce Without X-Rays
,◉ Eikenella
Answer: Aggressive Mouth Flora Requiring Prophylactic Lactam-
Lactamase After Human Bite
◉ Definitively Determines Entry and Exit Points
Answer: Forensic Specialist (Emergency Department Must Describe
Wounds But Never Speculate)
◉ Small Pneumo-Thorax on Chest C.T.; Hemodynamically-Stable
Answer: 100% Oxygen
◉ Flexion and Compression of Vertebral Body, Resulting in Paralysis
and Loss of Pain and Temperature Sensation Below
Answer: Anterior Cord from Anterior Spinal Artery Injury (From
Anterior Flexion)
◉ Severe Burns of Hands (Or Skull) and Heels; Risk of Cardiac Arrest
or Loss of Consciousness
Answer: Deep Burns Distinguish Electrical Injury from Lightning
◉ Hepatitis C Medication With Risk of Depression
Answer: S.S.R.I. Pretreatment for Interferon Alpha
,◉ Psychiatric Risk Associated with Breast Implants
Answer: Suicide
◉ SAD PERSONS
Answer: 1. Male (Caucasian).
2. Age Under 20 or Over 50.
3. Depression.
4. Previous Attempt.
5. Ethanol or Drugs.
6. Rational Thought Loss (Psychosis).
7. Social Support Issues.
8. Organized Plan.
9. No Spouse or Significant Other (1 Point, All Others 2 Points).
10. Sickness or Injury.
◉ Psychiatric Disorder With Greatest Risk of Suicide
Answer: Panic Disorder
◉ Silent vs. Occult Suicide
Answer: Self-Neglect (Starvation) vs. Recurrent Accidents
, ◉ 2 Hours Post-Acetaminophen (Suicide Attempt), Refuses to Drink
Activated Charcoal
Answer: N.G. Tube Avoids Pneumonitis
◉ Contra-Indicated for Hydro-Carbon (Oil) Ingestions
Answer: Gastric Lavage
◉ Belladonna Toxicity
Answer: Stigmine (Anti-Cholinesterase) for Anti-Cholinergic
Poisoning: Hot (Hades), Blind (Bat), Red (Rose), and Mad (Hatter)
◉ 3 Contra-Indications for Activated Charcoal
Answer: 1. Bivalent Metal (Unable to Bind).
2. Unprotected Airway (Aspiration).
3. Caustic Ingestions Awaiting Endoscopy (Black Color).
◉ Mechanism of Q.R.S. Prolongation (And Right Axis Deviation) vs.
Sinus Tachycardia from Tri-Cyclic Anti-Depressant
Answer: Sodium Channel Blockade vs. Anti-Muscarinic
◉ Management of Benzodiazepine Overdose
Answer: Intubate; Risk of Seizures from Flumazenil (Indicated for
Iatrogenic Oversedation)
AND ANSWERS GRADED A PLUS
◉ Stab Wound in 10th Intercostal Space, Absent Breath Sounds;
Dyspnea But Hemodynamically-Stable
Answer: (1) Chest Tube.
(2) Portable X-Ray.
(3) Abdominal C.T.
◉ Decreased Sensation Over Lateral Palm
Answer: Median Nerve Injury from Distal Radius Fracture
◉ Leg Externally-Rotated (And Abducted)
Answer: Femoral Neck Fracture (ER = RE)
◉ Leg Internally-Rotated
Answer: Posterior Hip Dislocation
◉ Popliteal Pain After Impact on Planted Foot; Pale Cold Foot, No
Distal Pulses
Answer: Sedate and Reduce Without X-Rays
,◉ Eikenella
Answer: Aggressive Mouth Flora Requiring Prophylactic Lactam-
Lactamase After Human Bite
◉ Definitively Determines Entry and Exit Points
Answer: Forensic Specialist (Emergency Department Must Describe
Wounds But Never Speculate)
◉ Small Pneumo-Thorax on Chest C.T.; Hemodynamically-Stable
Answer: 100% Oxygen
◉ Flexion and Compression of Vertebral Body, Resulting in Paralysis
and Loss of Pain and Temperature Sensation Below
Answer: Anterior Cord from Anterior Spinal Artery Injury (From
Anterior Flexion)
◉ Severe Burns of Hands (Or Skull) and Heels; Risk of Cardiac Arrest
or Loss of Consciousness
Answer: Deep Burns Distinguish Electrical Injury from Lightning
◉ Hepatitis C Medication With Risk of Depression
Answer: S.S.R.I. Pretreatment for Interferon Alpha
,◉ Psychiatric Risk Associated with Breast Implants
Answer: Suicide
◉ SAD PERSONS
Answer: 1. Male (Caucasian).
2. Age Under 20 or Over 50.
3. Depression.
4. Previous Attempt.
5. Ethanol or Drugs.
6. Rational Thought Loss (Psychosis).
7. Social Support Issues.
8. Organized Plan.
9. No Spouse or Significant Other (1 Point, All Others 2 Points).
10. Sickness or Injury.
◉ Psychiatric Disorder With Greatest Risk of Suicide
Answer: Panic Disorder
◉ Silent vs. Occult Suicide
Answer: Self-Neglect (Starvation) vs. Recurrent Accidents
, ◉ 2 Hours Post-Acetaminophen (Suicide Attempt), Refuses to Drink
Activated Charcoal
Answer: N.G. Tube Avoids Pneumonitis
◉ Contra-Indicated for Hydro-Carbon (Oil) Ingestions
Answer: Gastric Lavage
◉ Belladonna Toxicity
Answer: Stigmine (Anti-Cholinesterase) for Anti-Cholinergic
Poisoning: Hot (Hades), Blind (Bat), Red (Rose), and Mad (Hatter)
◉ 3 Contra-Indications for Activated Charcoal
Answer: 1. Bivalent Metal (Unable to Bind).
2. Unprotected Airway (Aspiration).
3. Caustic Ingestions Awaiting Endoscopy (Black Color).
◉ Mechanism of Q.R.S. Prolongation (And Right Axis Deviation) vs.
Sinus Tachycardia from Tri-Cyclic Anti-Depressant
Answer: Sodium Channel Blockade vs. Anti-Muscarinic
◉ Management of Benzodiazepine Overdose
Answer: Intubate; Risk of Seizures from Flumazenil (Indicated for
Iatrogenic Oversedation)
