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Exam (elaborations)

ABEM ABEM Initial Exam

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The American Board of Emergency Medicine (ABEM) Initial Certification Exam is designed for physicians completing residency training in emergency medicine. It tests comprehensive knowledge of emergency care, including resuscitation, toxicology, trauma, pediatrics, cardiology, neurology, critical care, and ethics. The exam has two major components: a multiple-choice written qualifying exam and an oral certification exam. Candidates are usually physicians finishing ACGME-accredited residency programs. Successful certification signifies competence in the independent practice of emergency medicine in the U.S.

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October 9, 2025
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ABEM ABEM Initial Exam
Question 1. Which presentation is most characteristic of sepsis in the

emergency setting?


A) Hypotension, fever, tachycardia, and altered mental status


B) Bradycardia, hypothermia, and hypertension


C) Isolated hypotension without fever or infection signs


D) Chest pain with normal vitals


Answer: A


Explanation: Sepsis typically presents with hypotension, fever,

tachycardia, and altered mental status due to systemic infection causing

distributive shock.




Question 2. Which of the following is the most common cause of acute

appendicitis?


A) Obstruction of the lumen by fecaliths

,ABEM ABEM Initial Exam
B) Bacterial overgrowth


C) Viral infection


D) Autoimmune response


Answer: A


Explanation: Appendicitis is usually caused by luminal obstruction by

fecaliths, leading to inflammation and infection.




Question 3. In a patient with a suspected myocardial infarction, which

initial diagnostic test is most appropriate?


A) Chest X-ray


B) Electrocardiogram (ECG)


C) Cardiac MRI


D) Cardiac catheterization

,ABEM ABEM Initial Exam
Answer: B


Explanation: An ECG is the initial, rapid test to identify ischemic changes

in suspected MI.




Question 4. Which of the following is a key feature of diabetic

ketoacidosis (DKA)?


A) Hyperglycemia, metabolic acidosis, and ketonemia


B) Hypoglycemia and metabolic alkalosis


C) Hyperglycemia without ketosis


D) Elevated insulin levels


Answer: A


Explanation: DKA is characterized by hyperglycemia, anion gap

metabolic acidosis, and elevated ketone levels due to insulin deficiency.

, ABEM ABEM Initial Exam
Question 5. What is the most common cause of upper gastrointestinal

bleeding in the emergency setting?


A) Peptic ulcer disease


B) Esophageal varices


C) Mallory-Weiss tear


D) Gastric carcinoma


Answer: A


Explanation: Peptic ulcers are the most common source of upper GI

bleeding, often due to H. pylori infection or NSAID use.




Question 6. Which airway management technique is preferred in a

patient with suspected cervical spine injury?


A) Conventional orotracheal intubation with manual inline stabilization


B) Nasotracheal intubation without stabilization

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