SAEM EXAM QUESTIONS 2024-2025 ACTUAL
EXAM 400 REAL EXAM QUESTIONS MERGED
WITH CORRECT COMPLETE SOLUTIONS ||
ALREADY GRADED A+ || 2026-2027 LATEST
UPDATE!!!
"Regarding the diagnosis of acute appendicitis, all the following are
true EXCEPT:
A. Vital signs are usually abnormal, even early in the course of acute
appendicitis.
B. Rebound is usually elicited only after the appendix has ruptured or
infarcted.
C. Rovsing's sign is pain in the right lower quadrant upon palpation of
the left lower quadrant.
D. The obturator sign is pain upon flexion and internal rotation of the
hip.
,E. The psoas sign is pain upon extension of the hip." - ANSWER-"A.
Vital signs are usually abnormal, even early in the course of acute
appendicitis.
The answer is A. The presentation of acute appendicitis varies
tremendously. Early in its course, vital signs including temperature
may be normal. Once perforation has occurred, the rate of low-grade
fever (<38 C) increases to about 40%. Other variations in presentation
include pain in the right upper quadrant, typically from a retrocecal or
retro iliac appendix."
"Rosving's sign is described as:
A. Tenderness in the right upper quadrant that is worse with
inspiration.
B. Pelvic pain upon flexion of the thigh while the patient is supine.
C. Pelvic pain upon internal and external rotation of the thigh with
the knee flexed.
D. Pain that increases with the release of pressure of palpation.
E. Pain in the right lower quadrant when left lower quadrant is
palpated." - ANSWER-"E. Pain in the right lower quadrant when left
lower quadrant is palpated.
The answer is E. Rosving's sign is pain in the right lower quadrant
when the left lower quadrant is palpated. Rebound tenderness occurs
with the release of pressure. The iliopsoas sign is pain associated with
,thigh flexion. The obturator sign is pain that occurs with thigh
rotation. All of these signs are associated with appendicitis. Murphy's
sign is cessation of inspiration during palpation of the right upper
quadrant and is associated with acute cholecystitis."
"In establishing a differential diagnosis of abdominal pain, which of
the following is true?
A. Radiation of pain to the scapula is suggestive of acute hepatitis.
B. Cervical motion tenderness is a useful physical finding for
differentiating women with or without acute appendicitis.
C. In patients with sickle cell anemia who present with abdominal
pain and diarrhea, shigellosis should be a top consideration.
D. The onset of pain prior to the occurrence of nausea and vomiting is
more often suggestive of a surgical etiology.
E. Diverticulitis tends to cause pain in the right upper quadrant." -
ANSWER-"D. The onset of pain prior to the occurrence of nausea and
vomiting is more often suggestive of a surgical etiology.
The answer is D. Pain prior to nausea and vomiting is often suggestive
of a surgical etiology of the pain, such as small bowel obstruction.
Cervical motion tenderness has been noted in up to 25% of women
with acute appendicitis. Patients with sickle cell anemia are prone to
Salmonella infections. Radiation of pain to the scapula is classically
present in acute cholecystitis. Diverticulitis pain is generally located in
the left lower quadrant."
, "Of the following pain patterns, which is the least likely associated
with diagnosis of peptic ulcer disease?
A. non-radiating, burning epigastric pain
B. pain that awakens a patient in the middle of the night
C. unrelenting pain over a period of weeks
D. relief of abdominal pain with antacids
E. pain that is worse preceding a meal" - ANSWER-"C. unrelenting
pain over a period of weeks
The answer is C. Pain from peptic ulcer disease typically occurs in
periods of exacerbation and remission. Unrelenting pain over weeks
or months should suggest an alternative diagnosis. Pain is classically
described as non-radiating, burning epigastric pain. Some patients
may also complain of chest or back pain. Pain is frequently severe
enough to awaken patients from sleep in early morning hours but is
often not present upon waking in the morning, as gastric acid
secretion peaks around 2 a.m. and nadirs upon awakening."
"A 78 year old female presents to the E.D. with a sensation of left-
lower quadrant abdominal pain, accompanied by some irregular
bowel movements and loss of appetite. Her abdominal CT (two
images) is shown in the Figure. What is the most likely diagnosis?
A. ovarian cyst
B. volvulus
EXAM 400 REAL EXAM QUESTIONS MERGED
WITH CORRECT COMPLETE SOLUTIONS ||
ALREADY GRADED A+ || 2026-2027 LATEST
UPDATE!!!
"Regarding the diagnosis of acute appendicitis, all the following are
true EXCEPT:
A. Vital signs are usually abnormal, even early in the course of acute
appendicitis.
B. Rebound is usually elicited only after the appendix has ruptured or
infarcted.
C. Rovsing's sign is pain in the right lower quadrant upon palpation of
the left lower quadrant.
D. The obturator sign is pain upon flexion and internal rotation of the
hip.
,E. The psoas sign is pain upon extension of the hip." - ANSWER-"A.
Vital signs are usually abnormal, even early in the course of acute
appendicitis.
The answer is A. The presentation of acute appendicitis varies
tremendously. Early in its course, vital signs including temperature
may be normal. Once perforation has occurred, the rate of low-grade
fever (<38 C) increases to about 40%. Other variations in presentation
include pain in the right upper quadrant, typically from a retrocecal or
retro iliac appendix."
"Rosving's sign is described as:
A. Tenderness in the right upper quadrant that is worse with
inspiration.
B. Pelvic pain upon flexion of the thigh while the patient is supine.
C. Pelvic pain upon internal and external rotation of the thigh with
the knee flexed.
D. Pain that increases with the release of pressure of palpation.
E. Pain in the right lower quadrant when left lower quadrant is
palpated." - ANSWER-"E. Pain in the right lower quadrant when left
lower quadrant is palpated.
The answer is E. Rosving's sign is pain in the right lower quadrant
when the left lower quadrant is palpated. Rebound tenderness occurs
with the release of pressure. The iliopsoas sign is pain associated with
,thigh flexion. The obturator sign is pain that occurs with thigh
rotation. All of these signs are associated with appendicitis. Murphy's
sign is cessation of inspiration during palpation of the right upper
quadrant and is associated with acute cholecystitis."
"In establishing a differential diagnosis of abdominal pain, which of
the following is true?
A. Radiation of pain to the scapula is suggestive of acute hepatitis.
B. Cervical motion tenderness is a useful physical finding for
differentiating women with or without acute appendicitis.
C. In patients with sickle cell anemia who present with abdominal
pain and diarrhea, shigellosis should be a top consideration.
D. The onset of pain prior to the occurrence of nausea and vomiting is
more often suggestive of a surgical etiology.
E. Diverticulitis tends to cause pain in the right upper quadrant." -
ANSWER-"D. The onset of pain prior to the occurrence of nausea and
vomiting is more often suggestive of a surgical etiology.
The answer is D. Pain prior to nausea and vomiting is often suggestive
of a surgical etiology of the pain, such as small bowel obstruction.
Cervical motion tenderness has been noted in up to 25% of women
with acute appendicitis. Patients with sickle cell anemia are prone to
Salmonella infections. Radiation of pain to the scapula is classically
present in acute cholecystitis. Diverticulitis pain is generally located in
the left lower quadrant."
, "Of the following pain patterns, which is the least likely associated
with diagnosis of peptic ulcer disease?
A. non-radiating, burning epigastric pain
B. pain that awakens a patient in the middle of the night
C. unrelenting pain over a period of weeks
D. relief of abdominal pain with antacids
E. pain that is worse preceding a meal" - ANSWER-"C. unrelenting
pain over a period of weeks
The answer is C. Pain from peptic ulcer disease typically occurs in
periods of exacerbation and remission. Unrelenting pain over weeks
or months should suggest an alternative diagnosis. Pain is classically
described as non-radiating, burning epigastric pain. Some patients
may also complain of chest or back pain. Pain is frequently severe
enough to awaken patients from sleep in early morning hours but is
often not present upon waking in the morning, as gastric acid
secretion peaks around 2 a.m. and nadirs upon awakening."
"A 78 year old female presents to the E.D. with a sensation of left-
lower quadrant abdominal pain, accompanied by some irregular
bowel movements and loss of appetite. Her abdominal CT (two
images) is shown in the Figure. What is the most likely diagnosis?
A. ovarian cyst
B. volvulus
