1 | P a g e SAEM M4 EXAM 2024/200 EXAM QUESTIONS WITH CORRECT DETAILED AND VERIFIED ANSWERS/LATEST UPDATE 2024 -2025 True or False: gastric distension due to excessive volume or rate of ventilation impairing ventilatory function is a reason to intubate a neonate ANSWER False management for nursemaid elbow injury ANSWER apply pressure to the radial head while flexing and supinating elbow A 17 year old boy injured his right shoulder playing football. He tried to arm -
tackle a player when his right arm was pulled away from his body and back (abducted and extended). He felt a sudden pain in his shoulder. He presents to the emergency department holding his arm in slight abduction and external rotation by his good arm. He has severe pain with adduction or internal rot ation. What is the most common fracture associated with this injury? ANSWER compression fracture of the posteriolateral aspect of the humeral head (Hill -Sachs deformity ) What are most common heart rhythms seen in pediatric arrest? ANSWER bradycardia or asystole risk factors for neonatal resuscitation ANSWER prematurity IUGR multiple gestation thick meconium 2 | P a g e In the post-arrest setting, which of the following is the drug of choice in treating hypotension in a child: - >>>epi Low body temperatures in newborns can lead to severe physiologic consequences, which include all EXCEPT: Answers: 1. metabolic acidosis 2. increased oxygen consumption 3. hypoglycemia 4. apnea 5. hyperglycemia ANSWER 3. hypoglycemia In a newborn, bradycardia is most commonly an indicator of: ANSWER hypoxemia All the following are signs of hypoxemia in a newborn, EXCEPT: Answers: 1.cyanosis 2.lethargy 3.tachycardia 4.unresponsive
ness 3 | P a g e 5.bradycardia ANSWER 3. tachycardia A newborn presents to the emergency department a few days after hospital discharge. The infant has been noted to be drooling, choking, and coughing, and the mother reports seeing bubbles at the baby's mouth. Which is the most likely explanation? Answers: 1.osteogenesis imperfecta 2.inborn error of metabolism 3.congenital diaphragmatic hernia 4.foreign body 5.tracheoesophageal fistula ANSWER 5. tracheoesophageal fistula Which of the following pairs of maneuvers are consistent with current recommendations for emergency care for a choking 5 -month -old infant? Answers: 1.back blow then blind finger sweep 2.back blow then chest thrust 3.chest thrust then Heimlich maneuver 4.Heimlich maneuver 4 | P a g e then blind finger sweep 5.Heimlich maneuver then chest thrust ANSWER 2.back blow then chest thrust All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT: Answers: 1. If administering succinylcholine, pretreatment with atropine is always indicated in children under age 10. 2. Lidocaine pretreatment is usually provided to children with head trauma. 3. When deciding which size endotracheal tube to use, one may approximate by using the size of the small finger or nares as a reference. 4. Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to intubation for children under age ten. 5. Uncuffed endotracheal tubes are the preferred devices used in children under 6-8 years of age. - ANSWER 4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to intubation for children under age ten. A 23 year old woman is dropped off by her boyfriend after an unknown overdose. You notice that she is has very large pupils and is sweating profusely. Her respiratory rate, blood pressure and heart rate are elevated. Which of the following is the most likely agent to have caused her symptoms?
tackle a player when his right arm was pulled away from his body and back (abducted and extended). He felt a sudden pain in his shoulder. He presents to the emergency department holding his arm in slight abduction and external rotation by his good arm. He has severe pain with adduction or internal rot ation. What is the most common fracture associated with this injury? ANSWER compression fracture of the posteriolateral aspect of the humeral head (Hill -Sachs deformity ) What are most common heart rhythms seen in pediatric arrest? ANSWER bradycardia or asystole risk factors for neonatal resuscitation ANSWER prematurity IUGR multiple gestation thick meconium 2 | P a g e In the post-arrest setting, which of the following is the drug of choice in treating hypotension in a child: - >>>epi Low body temperatures in newborns can lead to severe physiologic consequences, which include all EXCEPT: Answers: 1. metabolic acidosis 2. increased oxygen consumption 3. hypoglycemia 4. apnea 5. hyperglycemia ANSWER 3. hypoglycemia In a newborn, bradycardia is most commonly an indicator of: ANSWER hypoxemia All the following are signs of hypoxemia in a newborn, EXCEPT: Answers: 1.cyanosis 2.lethargy 3.tachycardia 4.unresponsive
ness 3 | P a g e 5.bradycardia ANSWER 3. tachycardia A newborn presents to the emergency department a few days after hospital discharge. The infant has been noted to be drooling, choking, and coughing, and the mother reports seeing bubbles at the baby's mouth. Which is the most likely explanation? Answers: 1.osteogenesis imperfecta 2.inborn error of metabolism 3.congenital diaphragmatic hernia 4.foreign body 5.tracheoesophageal fistula ANSWER 5. tracheoesophageal fistula Which of the following pairs of maneuvers are consistent with current recommendations for emergency care for a choking 5 -month -old infant? Answers: 1.back blow then blind finger sweep 2.back blow then chest thrust 3.chest thrust then Heimlich maneuver 4.Heimlich maneuver 4 | P a g e then blind finger sweep 5.Heimlich maneuver then chest thrust ANSWER 2.back blow then chest thrust All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT: Answers: 1. If administering succinylcholine, pretreatment with atropine is always indicated in children under age 10. 2. Lidocaine pretreatment is usually provided to children with head trauma. 3. When deciding which size endotracheal tube to use, one may approximate by using the size of the small finger or nares as a reference. 4. Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to intubation for children under age ten. 5. Uncuffed endotracheal tubes are the preferred devices used in children under 6-8 years of age. - ANSWER 4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to intubation for children under age ten. A 23 year old woman is dropped off by her boyfriend after an unknown overdose. You notice that she is has very large pupils and is sweating profusely. Her respiratory rate, blood pressure and heart rate are elevated. Which of the following is the most likely agent to have caused her symptoms?
