SAEM Final Exam Review Q's 2026/2027 | Actual Questions and
Answers Latest Updated 2026/2027 (Graded A+)
•
Goal of asthma treatment
i. - ✔✔- relax smooth muscle and decrease inflammation in lower airways
ii. - inhaled B-agonist, inhaled anticholingergic, systemic corticosteroids, and IV mag
iii. - give IV or oral steroid: prednisone, methylprenisolone, or dexamethasone
iv. - avoid inhaled steroids --> outpatient tx only
•
Severity of ARDS
i. - ✔✔- Ratio of arterial partial pressure of oxygen to the fraction of inspired oxygen
ii. - < 100 = severe
iii. - 101-200 = moderate
iv. - 200 - 300 = mild
•
CHF Exacerbation - Medication Management
i. - ✔✔- high dose nitroglycerin ( vasodilate, venodilate)
ii. - IV lasix, but takes hours to have effect
•
Contraindications to BiPAP
- ✔✔facial trauma, vomiting, AMS
•
Epinephrine Dosing - Anaphylaxis
i. - ✔✔- Subcutaneous epinephrine: 0.3 mg 1:1,000
ii. - IV epinephrine: 0.3 mg 1:10,000 (less concentrated)
•
AutoPEEP
i. - ✔✔- Breath stacking
ii. - high peak pressure with bronchoconstriction, difficult time exhaling
iii. - removal from the ventilator for the patient to exhale
•
Initial TV
- ✔✔6-8 mL/kg x ideal body weight
•
Methemoglobinemia
- ✔✔- hypoxia out of proportion that does not respond to supplemental oxygen
, •
Management of ruptured AAA
i. - ✔✔- Transfuse! Blood!!
ii. - Operative Management
iii. - No evidence saying that lowering BP is beneficial
•
Aortic Dissection Management
i. - ✔✔- Anything involving ascending requires surgical management, sometimes
descending can be managed medically
ii. - B-blocker is first line (IV esmolol) because is can lower the SBP/MAP without reflex
tachycardia
iii. - Treating pain is also critical to lower HR
•
Aortic Dissection Diagnosis
i. - ✔✔- Might have a STEMI as a result, this is why CXR required prior to going to the cath
lab
ii. - Upper extremity pulse defect has low sensitivity but should be checked
iii. - D-dimer not helpful
iv. - CT w/ IV contrast or TEE but not if emergent
•
Concern for right ventricular involvment
i. - ✔✔- When ST elevation in lead III higher than lead II
ii. - Elevation in V1 in setting of inferior MI
iii. - Repeat EKG w/ right leads!!
iv. - Nitro contraindicated, give fluids
•
Cocaine induced MI
i. - ✔✔Tx = Benzo
ii. - Same as acute printzmetal → (O2, Heparin, ASA, NTG, CCB, benzo)
iii. - NO Beta blocker bc of vasospasm and risk for further hypotension
•
goal for lowering BP in ED
- ✔✔- 25% in first hour
•
Brugada syndrome
i. - ✔✔-Autosomal dominant disorder most common in Asian males. -ECG pattern of
pseudo-right bundle branch block and ST elevations in V1-V3.
ii. -⬆️risk of ventricular tachyarrhythmias and SCD. Prevent SCD with implantable
cardioverter-defibrillator (ICD).
Answers Latest Updated 2026/2027 (Graded A+)
•
Goal of asthma treatment
i. - ✔✔- relax smooth muscle and decrease inflammation in lower airways
ii. - inhaled B-agonist, inhaled anticholingergic, systemic corticosteroids, and IV mag
iii. - give IV or oral steroid: prednisone, methylprenisolone, or dexamethasone
iv. - avoid inhaled steroids --> outpatient tx only
•
Severity of ARDS
i. - ✔✔- Ratio of arterial partial pressure of oxygen to the fraction of inspired oxygen
ii. - < 100 = severe
iii. - 101-200 = moderate
iv. - 200 - 300 = mild
•
CHF Exacerbation - Medication Management
i. - ✔✔- high dose nitroglycerin ( vasodilate, venodilate)
ii. - IV lasix, but takes hours to have effect
•
Contraindications to BiPAP
- ✔✔facial trauma, vomiting, AMS
•
Epinephrine Dosing - Anaphylaxis
i. - ✔✔- Subcutaneous epinephrine: 0.3 mg 1:1,000
ii. - IV epinephrine: 0.3 mg 1:10,000 (less concentrated)
•
AutoPEEP
i. - ✔✔- Breath stacking
ii. - high peak pressure with bronchoconstriction, difficult time exhaling
iii. - removal from the ventilator for the patient to exhale
•
Initial TV
- ✔✔6-8 mL/kg x ideal body weight
•
Methemoglobinemia
- ✔✔- hypoxia out of proportion that does not respond to supplemental oxygen
, •
Management of ruptured AAA
i. - ✔✔- Transfuse! Blood!!
ii. - Operative Management
iii. - No evidence saying that lowering BP is beneficial
•
Aortic Dissection Management
i. - ✔✔- Anything involving ascending requires surgical management, sometimes
descending can be managed medically
ii. - B-blocker is first line (IV esmolol) because is can lower the SBP/MAP without reflex
tachycardia
iii. - Treating pain is also critical to lower HR
•
Aortic Dissection Diagnosis
i. - ✔✔- Might have a STEMI as a result, this is why CXR required prior to going to the cath
lab
ii. - Upper extremity pulse defect has low sensitivity but should be checked
iii. - D-dimer not helpful
iv. - CT w/ IV contrast or TEE but not if emergent
•
Concern for right ventricular involvment
i. - ✔✔- When ST elevation in lead III higher than lead II
ii. - Elevation in V1 in setting of inferior MI
iii. - Repeat EKG w/ right leads!!
iv. - Nitro contraindicated, give fluids
•
Cocaine induced MI
i. - ✔✔Tx = Benzo
ii. - Same as acute printzmetal → (O2, Heparin, ASA, NTG, CCB, benzo)
iii. - NO Beta blocker bc of vasospasm and risk for further hypotension
•
goal for lowering BP in ED
- ✔✔- 25% in first hour
•
Brugada syndrome
i. - ✔✔-Autosomal dominant disorder most common in Asian males. -ECG pattern of
pseudo-right bundle branch block and ST elevations in V1-V3.
ii. -⬆️risk of ventricular tachyarrhythmias and SCD. Prevent SCD with implantable
cardioverter-defibrillator (ICD).
