saem m4 curriculum 2 Final
1
Exam 2025/2026 | Society for
Academic Emergency Medicine
M4 Clerkship Final Exam
what is contradinicated for airway mgmt in neck trauma -
100 correct answer as--LMA because can occlude
airway and may also ventilate air thru mucosal defects
when remove foregin bodies - 100 correct answer
as-in the or
injury to neck ndispo - 100 correct answer as-should
be admitted for obs
interoret TBI score - 100 correct answer as-
moderate: 9-13 (mortality under 20% but long term
disability as high as 50%)
severe: 8 and lower (mortality 40%, disaiblity 90%)
people with ead trauma need - 100 correct answer
as-c spine precautions until cleared
, once intubate a low GCS score, be careful - 100
2
correct answer as-do not hyperventialte patient bc low
CO2 leads to vasocosntriction and resultant hypoxemia
what vital avoid in brain ijury? goal? - 100 correct
answer as-hypotension bc resutls in decreased cerebral
perfusion pressure which makes ujury worse
-MAP above 80 is goal
epidural v. subdrual hematoma - 100 correct answer
as-epidural does not cross suture lines
chronic subdural - 100 correct answer as-occur in
those with signfnificnat atropy as a result of minor trauma
cerebral contusions prognosis - 100 correct answer
as--may convert to intracerbral hemorrhage several days
after initial injsry so any new neuro signs neeeds another
ct
diffuse axonal injury results frm? caused by - 100
correct answer as-shearing forces on axonal fibers of
white matter and brain stem
-caused by sudden deceleration
CT of diffuse anxonal injury - 100 correct answer as-.
Initial CT scans may be read as negative, although
classically display punctate hemorrhages along the gray-
, white junction of the cerebral cortex and in deep structures
3
of the brain
signs of basilar skull fractures - 100 correct answer
as--CSF otorrhea or rhinorrhea
-hemotypanum
-deafness
-7thn erve palsy
-racoon and batle sign
skull fracture +overlying lac=_______. need_____ - 100
correct answer as-open. need abx
4 herniation syndromes - 100 correct answer as--
uncal herniation
-central transtentorial herniation
-cerebellotonsillar nernation
-upwards transtentorial herniation
uncal herniation: describe and sx - 100 correct
answer as--when uncus of medial temporal lobe is
displaced inferiorly thru the tentorium
-ispilateral fixed and dialted pupil and c/l motor paralysis
central transtentorial hernation - 100 correct answer
as--occurs from midline lesions of the frontal or temporal
lobes with downward displacement of the parenchyma
through the tentorium.
-sx: b/l pinpoint pulpils, b/l babinski, inc muscle tone
, 4
cerebello tonsillar hernation - 100 correct answer as-
-cerebellar tonsils are displaced through the foramen
magnum,
-resulting in bilateral pinpoint pupils, flaccid paralysis, and
sudden death
upwards transtntorial herniation - 100 correct answer
as-results from posterior fossa lesions, consisting of
conjugate downward gaze with lack of vertical eye
movements and pinpoint pupils.
second impact syndrome - 100 correct answer as--2
concussion in a row can lead to cerebral edema and death
indicaitons of head ct in trauma 4 - 100 correct
answer as--gcs under 15
-neuro deficit
-coaguloapthy
-on anticoags
2 decision tools for head ct - 100 correct answer as--
canadian (83% sensitive, 38% specific). meant to detect
things can itnervene
-new orleans (100% sensitivty, 5% specific). meant to
detect any abnormality
ways to lower icp - 100 correct answer as--raise
head to 30 degree
1
Exam 2025/2026 | Society for
Academic Emergency Medicine
M4 Clerkship Final Exam
what is contradinicated for airway mgmt in neck trauma -
100 correct answer as--LMA because can occlude
airway and may also ventilate air thru mucosal defects
when remove foregin bodies - 100 correct answer
as-in the or
injury to neck ndispo - 100 correct answer as-should
be admitted for obs
interoret TBI score - 100 correct answer as-
moderate: 9-13 (mortality under 20% but long term
disability as high as 50%)
severe: 8 and lower (mortality 40%, disaiblity 90%)
people with ead trauma need - 100 correct answer
as-c spine precautions until cleared
, once intubate a low GCS score, be careful - 100
2
correct answer as-do not hyperventialte patient bc low
CO2 leads to vasocosntriction and resultant hypoxemia
what vital avoid in brain ijury? goal? - 100 correct
answer as-hypotension bc resutls in decreased cerebral
perfusion pressure which makes ujury worse
-MAP above 80 is goal
epidural v. subdrual hematoma - 100 correct answer
as-epidural does not cross suture lines
chronic subdural - 100 correct answer as-occur in
those with signfnificnat atropy as a result of minor trauma
cerebral contusions prognosis - 100 correct answer
as--may convert to intracerbral hemorrhage several days
after initial injsry so any new neuro signs neeeds another
ct
diffuse axonal injury results frm? caused by - 100
correct answer as-shearing forces on axonal fibers of
white matter and brain stem
-caused by sudden deceleration
CT of diffuse anxonal injury - 100 correct answer as-.
Initial CT scans may be read as negative, although
classically display punctate hemorrhages along the gray-
, white junction of the cerebral cortex and in deep structures
3
of the brain
signs of basilar skull fractures - 100 correct answer
as--CSF otorrhea or rhinorrhea
-hemotypanum
-deafness
-7thn erve palsy
-racoon and batle sign
skull fracture +overlying lac=_______. need_____ - 100
correct answer as-open. need abx
4 herniation syndromes - 100 correct answer as--
uncal herniation
-central transtentorial herniation
-cerebellotonsillar nernation
-upwards transtentorial herniation
uncal herniation: describe and sx - 100 correct
answer as--when uncus of medial temporal lobe is
displaced inferiorly thru the tentorium
-ispilateral fixed and dialted pupil and c/l motor paralysis
central transtentorial hernation - 100 correct answer
as--occurs from midline lesions of the frontal or temporal
lobes with downward displacement of the parenchyma
through the tentorium.
-sx: b/l pinpoint pulpils, b/l babinski, inc muscle tone
, 4
cerebello tonsillar hernation - 100 correct answer as-
-cerebellar tonsils are displaced through the foramen
magnum,
-resulting in bilateral pinpoint pupils, flaccid paralysis, and
sudden death
upwards transtntorial herniation - 100 correct answer
as-results from posterior fossa lesions, consisting of
conjugate downward gaze with lack of vertical eye
movements and pinpoint pupils.
second impact syndrome - 100 correct answer as--2
concussion in a row can lead to cerebral edema and death
indicaitons of head ct in trauma 4 - 100 correct
answer as--gcs under 15
-neuro deficit
-coaguloapthy
-on anticoags
2 decision tools for head ct - 100 correct answer as--
canadian (83% sensitive, 38% specific). meant to detect
things can itnervene
-new orleans (100% sensitivty, 5% specific). meant to
detect any abnormality
ways to lower icp - 100 correct answer as--raise
head to 30 degree
