SAEM NEWEST EXAM 2026 ACTUAL
EXAM\COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)LATEST
UPDATE 2025 -2026
"A 53 year old obese "D. marked inguinal lymphadenopathy
woman presents to the
emergency department, The answer is D. This woman is likely suffering from
accompanied by three of acute cholecystitis. Predisposing factors include
her children, complaining female gender, obesity, increased age and increased
of severe abdominal pain parity. Inflammation of the gallbladder causes RUQ
that began this afternoon pain and sonographic Murphy's sign (inspiratory
after lunch. Physical exam arrest, due to pain, while the ultrasound probe is
reveals marked RUQ positioned over the gallbladder). Pain may radiate to
tenderness. Likely findings the right scapula. Lab studies usually show
on this patient would leukocytosis with or without a left shift, and
include all of the following aminotransferases and bilirubin are usually within
EXCEPT: normal limits."
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"
,11/23/25, 3:46 PM SAEM EXAM QUESTIONS 2024-2025 ACTUAL EXAM 400 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS W…
"A 25 year old female "A. The most likely explanation for her symptoms is
presents with epigastric gallstone-related pancreatitis.
pain radiating straight
through to the back. The answer is A. The X-ray reveals stones in the
Laboratory tests are gallbladder. These particular stones are not likely the
notable only for markedly cause of pancreatitis, but the demonstration of
elevated amylase and gallstone disease raises the likelihood that the
lipase. An abdominal X-ray patient's pancreatitis is indeed due to gallstones. In
is taken (see Figure). the U.S., the most common etiologies of pancreatitis
Regarding this patient's include gallstones (45%) and alcoholism (35%).
presentation, which of the Alcoholic pancreatitis may occur in young patients as
following is most likely well as in older abusers of alcohol. Many other drugs,
true? infectious agents, and conditions are associated with
[image] the development of pancreatitis. A few examples
A. The most likely include hypertriglyceridemia, trauma, pregnancy,
explanation for her pancreatic carcinoma, atherosclerotic emboli, and
symptoms is gallstone- scorpion bites."
related pancreatitis.
B. She probably has an
ulcer, since the laboratory
results are nonspecific.
C. Alcohol use is only
associated with
pancreatitis in patients
older than this woman,
and who have been
abusing alcohol for years.
D. The abdominal X-ray is
concerning for early
bowel obstruction.
E. The X-ray reveals that
intrathoracic pathology is
likely the cause of the
patient's symptoms."
… 2/83
,11/23/25, 3:46 PM SAEM EXAM QUESTIONS 2024-2025 ACTUAL EXAM 400 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS W…
"A 45 year old woman "D. Cholecystitis
presents with right upper
quadrant pain and fever. The answer is D. Right upper quadrant pain, fever and
The pain is worse after a Murphy's sign suggests cholecystitis. Cholelithiasis
eating. On physical exam presents with similar pain, but is not associated with
she has a Murphy's sign. fever or a Murphy's sign"
The most likely diagnosis
is:
A. Appendicitis
B. Diverticulitis
C. Cholelithiasis
D. Cholecystitis
E. Mesenteric Ischemia"
"When using the "SAD "C. separated, divorced or widowed
PERSONS" scale to
determine suicide risk, The answer is C. Being separated, divorced or widowed is an important but
less significant factor in determining suicide risk and so is assigned 1 point
which factor conveys on the suicide scale. All the others are high-risk factors and are each
the least amount of assigned 2 points on the suicide scale. A score of 6 or more has a sensitivity
points? of 94% and a specificity of 71% compared with formal psychiatric
evaluation to identify the need for hospitalization in patients who present
A. depression immediately after a suicide attempt."
or
hopelessness
B. rational thinking loss
C. separated, divorced
or widowed
D. stated future intent"
… 3/83
, 11/23/25, 3:46 PM SAEM EXAM QUESTIONS 2024-2025 ACTUAL EXAM 400 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS W…
"A 47 year-old male "C. liver disease
presents, confused, to the
ED. He has limited ability The answer is C. The patient's palmar erythema, spider
to give a history. On angiomata, and caput medusa (due to recanalization
physical examination of of the umbilical vein) are all characteristic of hepatic
the skin, it is noted that disease. The figure demonstrates abdominal wall
there are erythematous venous engorgement, as well as ascites (another clue
changes to both palms. to the patient's liver disease)."
Also, the face and arms
are characterized by a
number of superficial,
tortuous arterioles which
fill from the center
outwards. The examination
of the abdomen reveals
violaceous lines radiating
from the umbilicus, and
there are generally
increased venous
markings on the
abdominal wall (see
Figure). What is the most
likely diagnosis?
[image]
A. Rocky Mountain
spotted fever
B. necrotizing fasciitis
C. liver disease
D. lymphangitis
E. hyperthermia"
… 4/83
EXAM\COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)LATEST
UPDATE 2025 -2026
"A 53 year old obese "D. marked inguinal lymphadenopathy
woman presents to the
emergency department, The answer is D. This woman is likely suffering from
accompanied by three of acute cholecystitis. Predisposing factors include
her children, complaining female gender, obesity, increased age and increased
of severe abdominal pain parity. Inflammation of the gallbladder causes RUQ
that began this afternoon pain and sonographic Murphy's sign (inspiratory
after lunch. Physical exam arrest, due to pain, while the ultrasound probe is
reveals marked RUQ positioned over the gallbladder). Pain may radiate to
tenderness. Likely findings the right scapula. Lab studies usually show
on this patient would leukocytosis with or without a left shift, and
include all of the following aminotransferases and bilirubin are usually within
EXCEPT: normal limits."
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"
,11/23/25, 3:46 PM SAEM EXAM QUESTIONS 2024-2025 ACTUAL EXAM 400 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS W…
"A 25 year old female "A. The most likely explanation for her symptoms is
presents with epigastric gallstone-related pancreatitis.
pain radiating straight
through to the back. The answer is A. The X-ray reveals stones in the
Laboratory tests are gallbladder. These particular stones are not likely the
notable only for markedly cause of pancreatitis, but the demonstration of
elevated amylase and gallstone disease raises the likelihood that the
lipase. An abdominal X-ray patient's pancreatitis is indeed due to gallstones. In
is taken (see Figure). the U.S., the most common etiologies of pancreatitis
Regarding this patient's include gallstones (45%) and alcoholism (35%).
presentation, which of the Alcoholic pancreatitis may occur in young patients as
following is most likely well as in older abusers of alcohol. Many other drugs,
true? infectious agents, and conditions are associated with
[image] the development of pancreatitis. A few examples
A. The most likely include hypertriglyceridemia, trauma, pregnancy,
explanation for her pancreatic carcinoma, atherosclerotic emboli, and
symptoms is gallstone- scorpion bites."
related pancreatitis.
B. She probably has an
ulcer, since the laboratory
results are nonspecific.
C. Alcohol use is only
associated with
pancreatitis in patients
older than this woman,
and who have been
abusing alcohol for years.
D. The abdominal X-ray is
concerning for early
bowel obstruction.
E. The X-ray reveals that
intrathoracic pathology is
likely the cause of the
patient's symptoms."
… 2/83
,11/23/25, 3:46 PM SAEM EXAM QUESTIONS 2024-2025 ACTUAL EXAM 400 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS W…
"A 45 year old woman "D. Cholecystitis
presents with right upper
quadrant pain and fever. The answer is D. Right upper quadrant pain, fever and
The pain is worse after a Murphy's sign suggests cholecystitis. Cholelithiasis
eating. On physical exam presents with similar pain, but is not associated with
she has a Murphy's sign. fever or a Murphy's sign"
The most likely diagnosis
is:
A. Appendicitis
B. Diverticulitis
C. Cholelithiasis
D. Cholecystitis
E. Mesenteric Ischemia"
"When using the "SAD "C. separated, divorced or widowed
PERSONS" scale to
determine suicide risk, The answer is C. Being separated, divorced or widowed is an important but
less significant factor in determining suicide risk and so is assigned 1 point
which factor conveys on the suicide scale. All the others are high-risk factors and are each
the least amount of assigned 2 points on the suicide scale. A score of 6 or more has a sensitivity
points? of 94% and a specificity of 71% compared with formal psychiatric
evaluation to identify the need for hospitalization in patients who present
A. depression immediately after a suicide attempt."
or
hopelessness
B. rational thinking loss
C. separated, divorced
or widowed
D. stated future intent"
… 3/83
, 11/23/25, 3:46 PM SAEM EXAM QUESTIONS 2024-2025 ACTUAL EXAM 400 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS W…
"A 47 year-old male "C. liver disease
presents, confused, to the
ED. He has limited ability The answer is C. The patient's palmar erythema, spider
to give a history. On angiomata, and caput medusa (due to recanalization
physical examination of of the umbilical vein) are all characteristic of hepatic
the skin, it is noted that disease. The figure demonstrates abdominal wall
there are erythematous venous engorgement, as well as ascites (another clue
changes to both palms. to the patient's liver disease)."
Also, the face and arms
are characterized by a
number of superficial,
tortuous arterioles which
fill from the center
outwards. The examination
of the abdomen reveals
violaceous lines radiating
from the umbilicus, and
there are generally
increased venous
markings on the
abdominal wall (see
Figure). What is the most
likely diagnosis?
[image]
A. Rocky Mountain
spotted fever
B. necrotizing fasciitis
C. liver disease
D. lymphangitis
E. hyperthermia"
… 4/83
