EMERGENCY MEDICINE SAEM EXAM TEST
BANK 2023/2024 EXAM SCRIPT 2026
COMPREHENSIVE QUESTIONS WITH
SOLUTIONS GRADED A+
⩥ name SIRS criteria (4)
Describe CHEST study findings> Answer: 1. Temp < 36 or >38
2. HR >90
3. RR >20 or PaCO2 <32
4. WBC 4,000 > x > 12,000
CHEST study (JAMA): previous SCC (surviving sepsis campaign)
studies did not look at wards; found that SIRS reminders did not affect
mortality
⩥ 1. define sepsis
2. define severe sepsis- criteria?
(SBP, Cr, bili, PLT, INR, lactate)
3. define septic shock. Answer: 1. pt who has potential infectious cause
for SIRS syndrome
2. sepsis-induced organ dysfunction. Criteria:
SBP <90 or MAP <70 or SBP decrease >40
Cr >2.0 or urine output <0.5ml/kg/hr
,Bili >2
PLT <100,000
INR >1.5 or PTT >60s
lactate >2 mmol/L
3. low BP despite fluid administration
⩥ 1. what lab is the ECG of sepsis?
2. list of labs to get for sepsis?
3. 3 hour bundle for sepsis?
4. 6 hour bundle? Answer: 1. lactate
2. CBC, CMP, PT/INR/PTT, blood Cx x2, UA, CXR
3. lactate measurement, blood Cx then administration of broad spectrum
abx, admin. of 30mL/kg IV crystalloid for hypoTN or lactate >4
4. vasopressors for goal MAP >65, reassess & document volume, repeat
lactate if initially >4
⩥ name the AEIOUTIPS of AMS. Answer: A = alcohol
E = epilepsy, electrolytes, encephalopathy
I = insulin
O = opiates & oxygen
U = uremia
T = trauma & temp
,I = infection
P = poison & psychogenic
S = shock, stroke, subarachnoid hemorrhage, space-occupying lesion
⩥ 1. MC cause of asthma exacerbation?
2. Qs to ask pt when they come in?
3. mainstay of therapy? (1st line)
4. if mod/severe, give what?
5. if severe & not improving with albuterol, use what? (4 things)
6. criteria for ICU admission? Answer: 1. URI
2. previous episodes, prior ED visits, hospitalizations or ICU
admissions, steroid use, past intubations
3. albuterol nebulizer continuous 6-8L/min or via nasal cannula, place
on cardiac monitor/continuous pulse oximetry with goal SpO2 >92%
4. oral/IV steroids
5. IM > SQ epinephrine 0.2mg or terbutaline 0.25 mg. Also ipratropium
(anticholinergic) combined w albuterol = Duonebs. Last line: MgSO4
6. <90% SpO2, FEV1 < 40%
⩥ 1. how is dosing of drugs administered endotracheally? which drugs?
2. when do you think of H's and T's?
3. things to order during ACLS?
, 4. successful resuscitation dependent on what? Joules on biphasic &
monophasic?
5. doses of Epi, vasopressin, amiodarone? Answer: 1. 2-2.5x the IV
route. Drugs: NAVEL- naloxone, atropine, vasopressin, Epi, Licocaine
2. during PEA/asystole
3. EKG, ABG, serum electrolytes, CXR, US
4. rapid defibrillation. biphasic: 200. Monophasic: 360
5. Epi 1mg (1:10,000), vaso 40U, amiodarone 300mg >150mg
⩥ 1. what is the leading cause of systolic HF?
2. Tx for CHF exacerbation?
3. prognosis at Dx? Answer: 1. myocardial infarction
2. nitrates are 1st line. IF fluid overloaded, then lasix. If in cardiogenic
shock, levophed.
3. 5 years
⩥ 1. classic triad of ruptured AAA
2. imaging of choice?
3. continuous abd bruit & palpable thrill?
4. bloody stool?
5. Mgmt of AAA? goal MAP? Answer: 1. pain, hypo-TN, pulsatile abd
mass
2. US
BANK 2023/2024 EXAM SCRIPT 2026
COMPREHENSIVE QUESTIONS WITH
SOLUTIONS GRADED A+
⩥ name SIRS criteria (4)
Describe CHEST study findings> Answer: 1. Temp < 36 or >38
2. HR >90
3. RR >20 or PaCO2 <32
4. WBC 4,000 > x > 12,000
CHEST study (JAMA): previous SCC (surviving sepsis campaign)
studies did not look at wards; found that SIRS reminders did not affect
mortality
⩥ 1. define sepsis
2. define severe sepsis- criteria?
(SBP, Cr, bili, PLT, INR, lactate)
3. define septic shock. Answer: 1. pt who has potential infectious cause
for SIRS syndrome
2. sepsis-induced organ dysfunction. Criteria:
SBP <90 or MAP <70 or SBP decrease >40
Cr >2.0 or urine output <0.5ml/kg/hr
,Bili >2
PLT <100,000
INR >1.5 or PTT >60s
lactate >2 mmol/L
3. low BP despite fluid administration
⩥ 1. what lab is the ECG of sepsis?
2. list of labs to get for sepsis?
3. 3 hour bundle for sepsis?
4. 6 hour bundle? Answer: 1. lactate
2. CBC, CMP, PT/INR/PTT, blood Cx x2, UA, CXR
3. lactate measurement, blood Cx then administration of broad spectrum
abx, admin. of 30mL/kg IV crystalloid for hypoTN or lactate >4
4. vasopressors for goal MAP >65, reassess & document volume, repeat
lactate if initially >4
⩥ name the AEIOUTIPS of AMS. Answer: A = alcohol
E = epilepsy, electrolytes, encephalopathy
I = insulin
O = opiates & oxygen
U = uremia
T = trauma & temp
,I = infection
P = poison & psychogenic
S = shock, stroke, subarachnoid hemorrhage, space-occupying lesion
⩥ 1. MC cause of asthma exacerbation?
2. Qs to ask pt when they come in?
3. mainstay of therapy? (1st line)
4. if mod/severe, give what?
5. if severe & not improving with albuterol, use what? (4 things)
6. criteria for ICU admission? Answer: 1. URI
2. previous episodes, prior ED visits, hospitalizations or ICU
admissions, steroid use, past intubations
3. albuterol nebulizer continuous 6-8L/min or via nasal cannula, place
on cardiac monitor/continuous pulse oximetry with goal SpO2 >92%
4. oral/IV steroids
5. IM > SQ epinephrine 0.2mg or terbutaline 0.25 mg. Also ipratropium
(anticholinergic) combined w albuterol = Duonebs. Last line: MgSO4
6. <90% SpO2, FEV1 < 40%
⩥ 1. how is dosing of drugs administered endotracheally? which drugs?
2. when do you think of H's and T's?
3. things to order during ACLS?
, 4. successful resuscitation dependent on what? Joules on biphasic &
monophasic?
5. doses of Epi, vasopressin, amiodarone? Answer: 1. 2-2.5x the IV
route. Drugs: NAVEL- naloxone, atropine, vasopressin, Epi, Licocaine
2. during PEA/asystole
3. EKG, ABG, serum electrolytes, CXR, US
4. rapid defibrillation. biphasic: 200. Monophasic: 360
5. Epi 1mg (1:10,000), vaso 40U, amiodarone 300mg >150mg
⩥ 1. what is the leading cause of systolic HF?
2. Tx for CHF exacerbation?
3. prognosis at Dx? Answer: 1. myocardial infarction
2. nitrates are 1st line. IF fluid overloaded, then lasix. If in cardiogenic
shock, levophed.
3. 5 years
⩥ 1. classic triad of ruptured AAA
2. imaging of choice?
3. continuous abd bruit & palpable thrill?
4. bloody stool?
5. Mgmt of AAA? goal MAP? Answer: 1. pain, hypo-TN, pulsatile abd
mass
2. US
