SAEM EXAM SCRIPT UPDATED COMPLETE
QUESTIONS AND ANSWERS GRADED
APLUS
●● Reason to Avoid Suction in Ear Foreign Body Removal
Answer: Perforation of Tympanic Membrane
●● Management of Skin Abscess
Answer: Linear Incision for Non-Face vs. Needle Drainage for Face
●● Catheter for Bartholin Cyst
Answer: Word
●● Grading of Laryngeal Opening
Answer: Cormack-Lehane
●● Preferred Induction Agent in Reactive Airway Disease for Dilation
Effects
Answer: Ketamine
●● Induction Agent Avoided in Sepsis Due To Adrenal Suppression
Answer: Etomidate
,●● Sudden-Onset Back Pain Worsened by Coughing Soon After
Epidural Anesthesia
Answer: Epidural Hematoma
●● Presentation of Adhesive Arachnoiditis
Answer: Progressive Neuropathy
●● Tom, Dick, and Very Nervous Harry
Answer: Anterior to Posterior of Medial Ankle: Tibialis Posterior,
Digitorum Longus, Vein, Nerve, Hallucis Longus
●● Absolute Contra-Indication to Crico-Thyrotomy
Answer: Age Under 5
●● Anesthesia for Suturing D.I.P. of Finger in Patient with Underlying
Vascular Disease
Answer: Lidocaine (2%) Without Epinephrine Around Digital Nerve for
Fingers, Toes, Penis, Nose
●● Earliest Sign of Lidocaine Toxicity (Over 5 mg/kg)
Answer: Lightheadedness (Also Peri-Oral Numbness, Tinnitus, Visual
and Auditory Disturbances, Shivering, Twitching, and Generalized
Tonic-Clonic Seizures)
,●● (1) Avoid Vertical Mattress Sutures.
(2) Avoid Topical Skin Adhesives (Risk of Dehiscence from Sweating).
Answer: Palm
●● Glottis Spasm and Chest Wall Rigidity from Sedative (Rapid High
Dose of IV Form)
Answer: Fentanyl (Effects Not Always Reversed by Naloxone)
●● Management of Long-Lasting L.P. Headache
Answer: Autologous Blood Patch
●● Timing of Tetanus Prophylaxis
Answer: Within First Few Days (Suture Within First 24 Hours)
●● Normal C.S.F.-to-Blood Glucose Ratio
Answer: 0.6
●● Size of Needle Decompression Needle
Answer: 14 Gauge (2nd Intercostal at Midclavicular Line)
●● Large Paronychia and Cellulitis
, Answer: Removal of Affected Nail Under Digital Block; Start
Antibiotics
●● Signs of Acute Appendicitis
Answer: 1. Rovsing: Right Lower from Left Lower.
2. Psoas: Extension.
3. Obturator: Rotation.
●● Suggested by Abdominal Pain Preceding Nausea and Vomiting
Answer: Surgery (Small Bowel Obstruction)
●● Peak of Gastric Acid Secretion at Rest
Answer: 2 A.M.
●● Timing of Presentation of Hypertrophic Pyloric Stenosis (Non-
Bilious) vs. Intussusception (Bilious)
Answer: 4 Weeks vs. 8 Months
●● Over 95% Sensitive and Specific for Renal Stones
Answer: Helical C.T.
●● Intermittent Left Lower Quadrant Pain (Afebrile), Loose Stools
(Non-Bloody); Good Follow-Up
QUESTIONS AND ANSWERS GRADED
APLUS
●● Reason to Avoid Suction in Ear Foreign Body Removal
Answer: Perforation of Tympanic Membrane
●● Management of Skin Abscess
Answer: Linear Incision for Non-Face vs. Needle Drainage for Face
●● Catheter for Bartholin Cyst
Answer: Word
●● Grading of Laryngeal Opening
Answer: Cormack-Lehane
●● Preferred Induction Agent in Reactive Airway Disease for Dilation
Effects
Answer: Ketamine
●● Induction Agent Avoided in Sepsis Due To Adrenal Suppression
Answer: Etomidate
,●● Sudden-Onset Back Pain Worsened by Coughing Soon After
Epidural Anesthesia
Answer: Epidural Hematoma
●● Presentation of Adhesive Arachnoiditis
Answer: Progressive Neuropathy
●● Tom, Dick, and Very Nervous Harry
Answer: Anterior to Posterior of Medial Ankle: Tibialis Posterior,
Digitorum Longus, Vein, Nerve, Hallucis Longus
●● Absolute Contra-Indication to Crico-Thyrotomy
Answer: Age Under 5
●● Anesthesia for Suturing D.I.P. of Finger in Patient with Underlying
Vascular Disease
Answer: Lidocaine (2%) Without Epinephrine Around Digital Nerve for
Fingers, Toes, Penis, Nose
●● Earliest Sign of Lidocaine Toxicity (Over 5 mg/kg)
Answer: Lightheadedness (Also Peri-Oral Numbness, Tinnitus, Visual
and Auditory Disturbances, Shivering, Twitching, and Generalized
Tonic-Clonic Seizures)
,●● (1) Avoid Vertical Mattress Sutures.
(2) Avoid Topical Skin Adhesives (Risk of Dehiscence from Sweating).
Answer: Palm
●● Glottis Spasm and Chest Wall Rigidity from Sedative (Rapid High
Dose of IV Form)
Answer: Fentanyl (Effects Not Always Reversed by Naloxone)
●● Management of Long-Lasting L.P. Headache
Answer: Autologous Blood Patch
●● Timing of Tetanus Prophylaxis
Answer: Within First Few Days (Suture Within First 24 Hours)
●● Normal C.S.F.-to-Blood Glucose Ratio
Answer: 0.6
●● Size of Needle Decompression Needle
Answer: 14 Gauge (2nd Intercostal at Midclavicular Line)
●● Large Paronychia and Cellulitis
, Answer: Removal of Affected Nail Under Digital Block; Start
Antibiotics
●● Signs of Acute Appendicitis
Answer: 1. Rovsing: Right Lower from Left Lower.
2. Psoas: Extension.
3. Obturator: Rotation.
●● Suggested by Abdominal Pain Preceding Nausea and Vomiting
Answer: Surgery (Small Bowel Obstruction)
●● Peak of Gastric Acid Secretion at Rest
Answer: 2 A.M.
●● Timing of Presentation of Hypertrophic Pyloric Stenosis (Non-
Bilious) vs. Intussusception (Bilious)
Answer: 4 Weeks vs. 8 Months
●● Over 95% Sensitive and Specific for Renal Stones
Answer: Helical C.T.
●● Intermittent Left Lower Quadrant Pain (Afebrile), Loose Stools
(Non-Bloody); Good Follow-Up
