SAEM EXAM COMPREHENSIVE TEST BANK FINAL EXAM
2026 COMPLETE ACCURATE REAL EXAM QUESTIONS
WITH WELL ELABORATED ANSWERS AND
RATIONALES (100% CORRECT VERIFIED SOLUTIONS)
GUARANTEED PASS A+|BRAND NEW! 2026-2027
"A 46 year old woman presents to the emergency department
complaining of abrupt onset of intermittent severe pain in the left flank
and abdomen that woke her from sleep. She is pacing around the
stretcher and appears extremely uncomfortable. She has never
experienced this type of pain previously and denies fevers or other
symptoms. Renal calculus is suspected. Which of the following is true
regarding the diagnosis of renal calculi in this patient?
A. Urinalysis demonstrating hematuria confirms the diagnosis.
B. KUB detects less than 10% of calculi.
C. Helical CT scan greater than 95% sensitive and specific for renal
calculi.
D. Ultrasound is the study of choice for detecting small ureteral calculi.
E. Intravenous pyelogram (IVP) may be used in patients with renal
insufficiency."
"C. Helical CT scan greater than 95% sensitive and specific for renal
calculi.
The answer is C. Helical CT scan has been shown to be both highly
sensitive and specific in the diagnosis of renal calculi. It is the preferred
modality for evaluation in many centers. Although urinalysis typically
demonstrates hematuria in patients with renal calculi, hematuria is not
specific enough to confirm the diagnosis, and imaging is warranted in
all first-time presenters. KUB detects approximately 60-70% of calculi
(though studies addressing this issue are somewhat methodologically
flawed). Ultrasound is not reliable for detecting small calculi, but is 85-
94% sensitive and 100% specific at demonstrating hydronephrosis. IVP is
contraindicated in patients with renal insufficiency due to the dye load
necessary to perform the study."
,"A 50 year old man presents with 1 day of gradually worsening,
intermittent, left lower quadrant pain associated with loose stools. He
has had no fevers or bloody bowel movements. Similar symptoms in the
past were self-limited. All vital signs lie within normal limits. Physical
examination shows mild tenderness in the left lower quadrant, normal
active bowel sounds and neither masses nor peritoneal signs. His
primary-care physician can see him tomorrow in his clinic. What should
be done next in the E.D.?
A. Discharge home after a single dose of IV antibiotics
B. Discharge home on high-fiber diet, laxatives and stool softeners
C. Gastroenterology consult for endoscopy
D. Admit for observation and serial examinations"
"B. Discharge home on high-fiber diet, laxatives and stool softeners
The answer is B. This patient has classic diverticulosis (saclike
protrusions of colonic mucosa through the muscularis) without signs of
acute diverticulitis (inflammation of diverticula). Usually these patients
can be managed as outpatients with a high-fiber diet and treatments to
decrease intestinal spasm. If the patient develops fever or pain
increases he may need further evaluation to rule out abscess formation.
Diverticulitis is treated with antibiotics, bowel rest and analgesics."
,"You are treating a 25 year old male with the recent diagnosis of
Crohn's disease in the ED. Regarding Crohn's disease, you know that:
A. Lesions are typically contiguous
B. Small bowel involvement is rare
C. Bleeding is common due to superficial bowel wall inflammation
D. There is a small increased risk of colon cancer"
"D. There is a small increased risk of colon cancer
The answer is D. Although Crohn's disease may involve the entire bowel
tract, the rectum is rarely involved. Involved areas are typically non-
contiguous (known as "skip lesions") and the inflammation involves all of
the layers of the bowel wall--resulting in many of the complications of
Crohn's such as abscess and fistula formation, intestinal obstruction,
and perforation. The risk of colon cancer is only slightly elevated above
baseline. In contrast, Ulcerative colitis begins in the rectum and may
spread to the upper parts of the colon but never involves the small
intestine. The ulcerations are contiguous and involve only the colonic
mucosa. The incidence of colon cancer may be increased up to 30
times over baseline."
, "A 53 year old obese woman presents to the emergency department,
accompanied by three of her children, complaining of severe
abdominal pain that began this afternoon after lunch. Physical exam
reveals marked RUQ tenderness. Likely findings on this patient would
include all of the following EXCEPT:
A. positive sonographic Murphy's sign
B. pain in the right scapula
C. leukocytosis with left shift
D. marked inguinal lymphadenopathy
E. aminotransferases and bilirubin within normal limits"
"D. marked inguinal lymphadenopathy
The answer is D. This woman is likely suffering from acute cholecystitis.
Predisposing factors include female gender, obesity, increased age and
increased parity. Inflammation of the gallbladder causes RUQ pain and
sonographic Murphy's sign (inspiratory arrest, due to pain, while the
ultrasound probe is positioned over the gallbladder). Pain may radiate
to the right scapula. Lab studies usually show leukocytosis with or
without a left shift, and aminotransferases and bilirubin are usually
within normal limits."
2026 COMPLETE ACCURATE REAL EXAM QUESTIONS
WITH WELL ELABORATED ANSWERS AND
RATIONALES (100% CORRECT VERIFIED SOLUTIONS)
GUARANTEED PASS A+|BRAND NEW! 2026-2027
"A 46 year old woman presents to the emergency department
complaining of abrupt onset of intermittent severe pain in the left flank
and abdomen that woke her from sleep. She is pacing around the
stretcher and appears extremely uncomfortable. She has never
experienced this type of pain previously and denies fevers or other
symptoms. Renal calculus is suspected. Which of the following is true
regarding the diagnosis of renal calculi in this patient?
A. Urinalysis demonstrating hematuria confirms the diagnosis.
B. KUB detects less than 10% of calculi.
C. Helical CT scan greater than 95% sensitive and specific for renal
calculi.
D. Ultrasound is the study of choice for detecting small ureteral calculi.
E. Intravenous pyelogram (IVP) may be used in patients with renal
insufficiency."
"C. Helical CT scan greater than 95% sensitive and specific for renal
calculi.
The answer is C. Helical CT scan has been shown to be both highly
sensitive and specific in the diagnosis of renal calculi. It is the preferred
modality for evaluation in many centers. Although urinalysis typically
demonstrates hematuria in patients with renal calculi, hematuria is not
specific enough to confirm the diagnosis, and imaging is warranted in
all first-time presenters. KUB detects approximately 60-70% of calculi
(though studies addressing this issue are somewhat methodologically
flawed). Ultrasound is not reliable for detecting small calculi, but is 85-
94% sensitive and 100% specific at demonstrating hydronephrosis. IVP is
contraindicated in patients with renal insufficiency due to the dye load
necessary to perform the study."
,"A 50 year old man presents with 1 day of gradually worsening,
intermittent, left lower quadrant pain associated with loose stools. He
has had no fevers or bloody bowel movements. Similar symptoms in the
past were self-limited. All vital signs lie within normal limits. Physical
examination shows mild tenderness in the left lower quadrant, normal
active bowel sounds and neither masses nor peritoneal signs. His
primary-care physician can see him tomorrow in his clinic. What should
be done next in the E.D.?
A. Discharge home after a single dose of IV antibiotics
B. Discharge home on high-fiber diet, laxatives and stool softeners
C. Gastroenterology consult for endoscopy
D. Admit for observation and serial examinations"
"B. Discharge home on high-fiber diet, laxatives and stool softeners
The answer is B. This patient has classic diverticulosis (saclike
protrusions of colonic mucosa through the muscularis) without signs of
acute diverticulitis (inflammation of diverticula). Usually these patients
can be managed as outpatients with a high-fiber diet and treatments to
decrease intestinal spasm. If the patient develops fever or pain
increases he may need further evaluation to rule out abscess formation.
Diverticulitis is treated with antibiotics, bowel rest and analgesics."
,"You are treating a 25 year old male with the recent diagnosis of
Crohn's disease in the ED. Regarding Crohn's disease, you know that:
A. Lesions are typically contiguous
B. Small bowel involvement is rare
C. Bleeding is common due to superficial bowel wall inflammation
D. There is a small increased risk of colon cancer"
"D. There is a small increased risk of colon cancer
The answer is D. Although Crohn's disease may involve the entire bowel
tract, the rectum is rarely involved. Involved areas are typically non-
contiguous (known as "skip lesions") and the inflammation involves all of
the layers of the bowel wall--resulting in many of the complications of
Crohn's such as abscess and fistula formation, intestinal obstruction,
and perforation. The risk of colon cancer is only slightly elevated above
baseline. In contrast, Ulcerative colitis begins in the rectum and may
spread to the upper parts of the colon but never involves the small
intestine. The ulcerations are contiguous and involve only the colonic
mucosa. The incidence of colon cancer may be increased up to 30
times over baseline."
, "A 53 year old obese woman presents to the emergency department,
accompanied by three of her children, complaining of severe
abdominal pain that began this afternoon after lunch. Physical exam
reveals marked RUQ tenderness. Likely findings on this patient would
include all of the following EXCEPT:
A. positive sonographic Murphy's sign
B. pain in the right scapula
C. leukocytosis with left shift
D. marked inguinal lymphadenopathy
E. aminotransferases and bilirubin within normal limits"
"D. marked inguinal lymphadenopathy
The answer is D. This woman is likely suffering from acute cholecystitis.
Predisposing factors include female gender, obesity, increased age and
increased parity. Inflammation of the gallbladder causes RUQ pain and
sonographic Murphy's sign (inspiratory arrest, due to pain, while the
ultrasound probe is positioned over the gallbladder). Pain may radiate
to the right scapula. Lab studies usually show leukocytosis with or
without a left shift, and aminotransferases and bilirubin are usually
within normal limits."
