SAEM Emergency Medicine Exam | Actual Questions and
Answers Latest Updated 2026/2027 (Graded A+)
•
What are the top 3 causes of morbidity/mortality in acute chest pain?
i. - ✔✔ACS
ii. pulmonary embolism
iii. aortic dissection
•
What is the cardioversion and defibrillation joules?
i. - ✔✔cardioversion = 50-100 J
ii. defibrillation = 200 J
•
What is the most common EKG finding in a pulmonary embolus? What should you be on the lookout
for?
- ✔✔most common = sinus tachycardia
•
look for = "S1Q3T3" (large S wave in lead I + Q wave in lead 3 + T wave inversion in lead 3)
•
What should you worry about if a patient's EKG shows electrical alternans? What does this look like?
- ✔✔cardiac tamponade! looks like alternating big and small spikes
•
Describe the basic evolution of the EKG of a patient having a STEMI
i. - ✔✔1-normal
ii. 2- T waves become wide and tall
iii. 3- ST elevation
iv. 4- Q waves and T wave inversion
v. 5- Q waves persist but T wave normalizes
•
chest pain, weakness, nausea, fatigue
•
classic presentation of ___________________
- ✔✔ACS!
•
pleuritic chest pain, shortness of breath, anxiety
•
classic presentation of ___________________
, - ✔✔pulmonary embolism
•
a patient with SOB is found on physical exam to have tachycardia, clear lung sounds, and a swollen leg
•
classic presentation of ___________________
- ✔✔pulmonary embolism
•
sudden on set severe chest pain that rips through to the back; unequal blood pressures on PE
•
classic presentation of ___________________
- ✔✔aortic dissection
•
How does cardioversion work?
- ✔✔used to stop tachyarrhythmias --> the impulse is delivered at the peak of an R wave
(prevents going into v fib)
•
What are 5 indications for cardioversion?
i. - ✔✔1. ventricular tachycardia with a pulse
ii. 2. supraventricular tachycardias with hypotension
iii. 3. atrial fibrillation
iv. 4. atrial flutter
v. 5. AVNRT
•
What are three indications for defibrillation?
- ✔✔ventricular tachycardia without a pulse
•
ventricular fibrillation
•
torsades de pointes without pulse
•
What are five indications for ICD?
i. - ✔✔1. hx of sudden cardiac death
ii. 2. Brugada syndrome 3. CHF patients with EF < 35% on max medical therapy
iii. 4. long QT syndrome
iv. 5. hypertrophic cardiomyopathy
Answers Latest Updated 2026/2027 (Graded A+)
•
What are the top 3 causes of morbidity/mortality in acute chest pain?
i. - ✔✔ACS
ii. pulmonary embolism
iii. aortic dissection
•
What is the cardioversion and defibrillation joules?
i. - ✔✔cardioversion = 50-100 J
ii. defibrillation = 200 J
•
What is the most common EKG finding in a pulmonary embolus? What should you be on the lookout
for?
- ✔✔most common = sinus tachycardia
•
look for = "S1Q3T3" (large S wave in lead I + Q wave in lead 3 + T wave inversion in lead 3)
•
What should you worry about if a patient's EKG shows electrical alternans? What does this look like?
- ✔✔cardiac tamponade! looks like alternating big and small spikes
•
Describe the basic evolution of the EKG of a patient having a STEMI
i. - ✔✔1-normal
ii. 2- T waves become wide and tall
iii. 3- ST elevation
iv. 4- Q waves and T wave inversion
v. 5- Q waves persist but T wave normalizes
•
chest pain, weakness, nausea, fatigue
•
classic presentation of ___________________
- ✔✔ACS!
•
pleuritic chest pain, shortness of breath, anxiety
•
classic presentation of ___________________
, - ✔✔pulmonary embolism
•
a patient with SOB is found on physical exam to have tachycardia, clear lung sounds, and a swollen leg
•
classic presentation of ___________________
- ✔✔pulmonary embolism
•
sudden on set severe chest pain that rips through to the back; unequal blood pressures on PE
•
classic presentation of ___________________
- ✔✔aortic dissection
•
How does cardioversion work?
- ✔✔used to stop tachyarrhythmias --> the impulse is delivered at the peak of an R wave
(prevents going into v fib)
•
What are 5 indications for cardioversion?
i. - ✔✔1. ventricular tachycardia with a pulse
ii. 2. supraventricular tachycardias with hypotension
iii. 3. atrial fibrillation
iv. 4. atrial flutter
v. 5. AVNRT
•
What are three indications for defibrillation?
- ✔✔ventricular tachycardia without a pulse
•
ventricular fibrillation
•
torsades de pointes without pulse
•
What are five indications for ICD?
i. - ✔✔1. hx of sudden cardiac death
ii. 2. Brugada syndrome 3. CHF patients with EF < 35% on max medical therapy
iii. 4. long QT syndrome
iv. 5. hypertrophic cardiomyopathy
