SAEM Exam Practice Questions With Answers Latest Updated 2024/2025 Rated A+.

SAEM Exam Practice Questions With Answers Latest Updated 2024/2025 Rated A+. Clostridium perfringens - Answer-Gas gangrene Late onset non-bloody diarrhea (from spores in dirt) Yersinia enterocolitica - Answer-Usually transmitted from pet feces (e.g., puppies), contaminated milk, or pork. Outbreaks are common in day-care centers. Sx can mimic Crohn's or appendicitis - bloody diarrhea, vomiting, cramping RLQ Campylobacter jejuni - Answer-#1 cause of watery or bloody diarrhea in US Usually from travel, PPI, undercooked meat, dairy Fever, abdominal cramp, bloody diarrhea Similar to EIEC infection E coli - Answer-ETEC: watery diarrhea EHEC (O157): bloody diarrhea without fever EIEC: watery > bloody diarrhea Bloody diarrhea with thumb-print sign - Answer-Any sign of bowel ischemia (ischemic bowel >> IBD, volvulus, diverticulitis) #1 cause of upper and lower GI bleed in adults - Answer-Upper: PUD Lower: diverticulosis Majority of diverticulosis bleeding is from __ colon - Answer-R side Indication for surgical removal of ingested foreign body - Answer-Object hasn't moved distally in 24 hour observation Symptomatic Sharp object or batteries CXR findings in aspiration of object - Answer-Hyperinflated opposite lung Atelectasis of affected lung A 22 year old running back is struck from behind by a 300-pound lineman. The blow occurs below the knee as his foot is firmly planted and two other lineman are holding his upper body. He presents to the emergency department with gross anterior dislocation of the tibia on the femur. His foot is cool and palee, and dorsalis pedis and posterior tibial pulses are not detected by Doppler ultrasound. What is the most appropriate management for this patient? - Answer-Immediate reduction (neurovascular compromise) with ortho consult without x-rays Burn rule of 9s - Answer-Head 9% Each arm 9% Chest 9% SAEM Exam Practice Questions With Answers Latest Updated 2024/2025 | Scored A+ Abdomen 9% Each anterior leg 9% Each posterior leg 9% Upper back 9% Lower back 9% Genitals 1% Treatment compartment syndrome - Answer-Emergency escharotomy Human bite microbes - Answer-Eikenella corrodens Expanding intracranial epidural hemorrhage management - Answer-Intubate and consult neurosurgery to take the patient to the OR Depression and IBD - Answer-IBD = higher rate of depression and anxiety A 42 year old male with end stage liver disease due to chronic hepatitis C infection arrives to the emergency department in stable condition after an unsuccessful suicide attempt by bilateral wrist laceration. He reports no history of depression or psychiatric disorder. Aside from his liver disease, for which he takes interferon alpha and ribavirin, he reports that he is in good health and takes no other medications. Which of the following factors increased this patient's risk of new-onset suicidal ideation? - Answer-Depression and/ or suicidal ideation are commonly reported side effects of interferon alpha therapy Which of the following psychiatric disorders is associated with the greatest increased risk of committing suicide? Panic PTSD Schizophrenia Depression - Answer-Panic disorder Silent suicide - Answer-slowly killing oneself by nonviolent means; starvation/noncompliance with essential tx Populations with increased suicide risk - Answer-Old caucasian people Young native american or alaskan natives PUD vs gastritis - Answer-PUD: unrelenting pain for weeks, not better with antacids Liver abscess management - Answer--drainage (not necessarily immediate in ED) -IV antibiotics -look for R effusion and elevation of hemidiaphragm on CXR Proparacaine is a ____ anesthetic (type) - Answer-ester Optic neuritis treatment - Answer-IV steroids (not oral) Nonspecific signs in both preseptal and orbital cellulitis - Answer-Fever Leukocytosis (only orbital has EOM pain or VA impairment) Horner's syndrome symptoms - Answer-Ptosis, miosis, anhydrosis Hyperemia of skin Pseudo-enophthalmos (from lid) NO ophthalmoplegia Delirium definition - Answer-A global inability to relate to the environment and process sensory input Criteria that is NOT enough for inpatient psych admission - Answer-First episode (counts: lack of support, no medication, harm) Which one is least likely associated with organic confusion? DM Hypothyroid Alcoholism COPD - Answer-Hypothyroidism - usually causes depression, very rarely causes myxedema crisis Hypothermia temp + symptoms (mild, moderate, severe) - Answer-Mild (32-35): tachycardia, shivering Moderate (28-32): bradycardia, AMS Severe (<28): vfib, unconscious Lightning strike sequelae - Answer-CV (systole, arrhythmia) Resp arrest Neuro Vascular coagulation GI, ENT BURNS ARE RARE !!!!! Treatment of severe hypothermia - Answer-Severe = <28 C Warm IV fluids Warm humidified air, blankets, BAIR hugger Arrhythmias usually treated AFTER rewarming Scorpion sting management - Answer-Local: local wound care, tetanus prophylaxis, opioids for muscle pain, and benzodiazepines Central (somatic and neuro): antivenom Scorpion sting presentation - Answer-DOES NOT HAVE PUNCTURE WOUND OR LOCAL ERYTHEMA!!!! Severe sensitivity to touch at the site (tap sign), numbness, tingling, anxiety, nausea/vomiting, blurred vision Envenomation: hypersalivation, abnormal roving eye movements, fasciculations, and clonus Cholinergic syndrome: hyperthermia, hypertension, tachycardia and excessive respiratory secretions Viper bite presentation - Answer-Local: bite site edematous and tense, ecchymosis, fluid filled or hemorrhagic bullae, tissue destruction may eventually develop. Systemic: hematologic abnormalities, oral paresthesias, metallic taste, fasciculations, tachycardia, hypotension and anaphylaxis Elapdae bite presentation - Answer-AKA coral snake (red and yellow kill a fellow) Serious systemic toxicity with little findings at the actual site of envenomation due to the venom's lack of cytotoxicity. The neurologic abnormalities may include weakness, numbness, fasciculations, tremor, diplopia, bulbar palsies with slurred speech, dysphagia and respiratory paralysis Snake bite management - Answer-Aggressive supportive care, opioids Discharge after 6-8 hours if no symptoms arise Coral snakes (elapidae): antivenom (unchanged dose per weight), admission for observation Snake bite management if no local reaction, swelling or edema - Answer-Discharge after observation for 6-8 hours TIA likely leads to ____ stroke - Answer-Thrombotic A 36 year old woman presents to the emergency department two hours after the sudden onset of a severe occipital headache and nausea. She has a history of migraine headaches that typically occur in the right frontal area and are associated with an aura. Her temperature is 98.8 degrees Fahrenheit, her neck is supple, and her neurological exam is normal. A non-contrast CT scan of her head is normal. Of the options below, what is the next step in her management? - Answer-LP to rule out subarachnoid hemorrhage Epidural hematomas are least likely in which age group? - Answer-Children < 2 yo Can epidural hematoma present with focal neuro deficits? - Answer-YES! Via herniation Unchecked hematoma expansion leads to elevated intracranial pressure and clinical signs, such as an ipsilateral dilated pupil (due to uncal herniation with compression of the oculomotor nerve) or the Cushing reflex (ie, hypertension, bradycardia, and respiratory depression/irregularity). Such events will culminate in brain herniation and death unless immediate decompression is undertaken. LP lumbar position - Answer-Adult: L2-L3, L3-L4 or L4-L5 interspace Use iliac crest to align = L4 The subarachnoid space extends to the ___ vertebral level. - Answer-S2 Usually LP L2-S1 Lacunar syndrome presentation - Answer-Pure motor hemiparesis Pure sensory stroke Ataxic hemiparesis Sensorimotor stroke Dysarthria-clumsy hand syndrome NO CORTICAL SYMPTOMS Vestibular neuritis presentation - Answer-AKA vestibular neuronitis and labyrinthitis Acute spontaneous, peripheral vestibular ailment, characterized by the rapid onset of severe vertigo Vestibular neuritis vs labyrinthitis - Answer-Auditory function is preserved (vestibular neuritis) vs unilateral hearing loss (labyrinthitis) Labyrinthitis presentation - Answer-Vestibular neuritis (vertigo) + sensorineural hearing loss Vertigo symptomatic treatment - Answer-Antihistamines - meclizine, dimenhydrinate, diphenhydramine Benzodiazepines Antiemetics - ondansetron, prochlorperazine, promethazine, metoclopramide, domperidone Nitroprusside vs nitroglycerin - Answer-Nitroprusside is a potent arterial AND venous vasodilator Nitroglycerin is a venodilator at low doses Causes of methemoglobinemia - Answer-Nitrous oxide (NOT nitroglycerin or nitroprusside) Antifreeze Amyl nitrates Dapsone (for PCP prophylaxis) Antimalarials Toxic ingestion treatment - Answer-Activated Charcoal within first hour only Whole Bowel Irrigation (administer PEG to flush) Gastric Lavage is rare and not recommended For which of the following cases (all of which are characterized by an ingestion history known with certainty) is gastric lavage most likely indicated? Ibuprofen Kerosene Metoprolol Amitryptyline - Answer-Amitryptyline (most life threatening) Do NOT use for caustic and hydrocarbon due to risk of aspiration Belladonna poisoning - Answer-Anticholinergic -dry as a bone -hot as a hare -full as a flask -dilation, high HR, high RR Charcoal does not bind _____ - Answer-Metals (such as iron), alcohols or hydrocarbons A 42 year-old woman presents with an overdose of her Xanax (alprazolam) that her family indicates she has been taking for years to help with her anxiety. The bottle indicates that the prescription was filled yesterday with 90 pills and is now empty. The patient is minimally responsive to painful stimuli and does not react when you suction secretions out of her posterior pharynx. What is your next management step? - Answer-Intubation (flumazenil later) Acetaminophen: lethal dose + management - Answer-Acetaminophen level should be checked on ALL overdose patients Lethal dose of APAP is 150mg/kg Toxic level of acetaminophen can be measured on the Rumack nomogram and the toxic plasma level at four hours is 150 Management: repeated doses of activated charcoal >> ORAL antidote N-acetylcysteine (NAC/Mucomyst) based on Rumack nonogram (4 hours in) When to give NAC in acetaminophen overdose - Answer-After 4 hours (acetaminophen levels redrawn at hour 4, indicated if > 150) Clonidine - Answer-alpha 2 agonist, used to treat hypertension > bradycardia, hypotension, small pupil (similar to opioids) Iron overdose presentation + treatment - Answer-Early gastrointestinal (GI) symptoms: 30 minutes to 6 hours after ingestion, elevated anion gap metabolic acidosis 6 hours Latent (or relative stability): 6 to 24 hours after ingestion Treat with deferoxamine Management of caustic drain cleaner ingestion in children - Answer-Endoscopy >> NG or gastrostomy tube Activated charcoal should NOT be given to children who have ingested acidic or alkaline corrosives because charcoal will obstruct the view of the endoscopist and because these small, highly ionized chemicals are poorly absorbed by charcoal Treatment of methemoglobinemia - Answer-IV methylene blue Acid base in aspirin overdose - Answer-Salicylates stimulate the respiratory center directly, resulting in an early fall in the PCO2 and respiratory alkalosis Later causes anion-gap metabolic acidosis due primarily to the accumulation of organic acids, including lactic acid and ketoacids All patients with shock should receive as the first priority: - Answer-Oxygen (before IV fluids) (airway breathing circulation) As compared to adults, children with shock usually: - Answer-Are able to maintain their blood pressure better During hypovolemic shock, hypotension tends to develop after the loss of what percent of blood volume? - Answer-30% The best IV access for volume resuscitation of the hypovolemic patient is: - Answer-16g catheter in the antecubital fossa Acceptable fluids for volume resuscitation - Answer-Crystalloids preferred (saline, LR) Blood Albumin Do NOT use D5W (only for hypoglycemia) A 27 year old man is shot in the right leg. He is unconscious. The wound appears to be pulsatile. The medics report he has lost a lot of blood. His heart rate is 160, and his BP is 70/30. He has received 2 liters of IVF normal saline. The next step in management would be: - Answer-O Rh+ blood Note - he is a man lol, Rh incompatability doesn't matter Neurogenic shock vs spinal shock - Answer-Spinal shock - transient & may occur with neurogenic shock > absence of all neurological activity below the level of injury Neurogenic shock - circulatory abnormalities with bradycardia