SAEM M4 EXAM LATEST
QUESTIONS AND
ANSWERS 2026 - 2027
A 46 year old woman presents to the emergency department
complaining of abrupt onset of intermittent severe pain in the left flank
and abdomen that woke her from sleep. She is pacing around the
stretcher and appears extremely uncomfortable. She has never
experienced this type of pain previously and denies fevers or other
symptoms. Renal calculus is suspected. Which of the following is true
regarding the diagnosis of renal calculi in this patient?
Answers:
1.Urnalysis demostrating hematuria confirms the diagnosis.
2.KUB detects less than 10% of calculi.
3.Ultrasound is the study of choice for detecting small ureteral calculi.
4.Helical CT scan greater than 95% sensitve and specific for renal
calculi.
5.Intravenous pyelogram (IVP) may be used in patients with renal
insufficiency. - ANSWERS-4.Helical CT scan greater than 95% sensitve
and specific for renal calculi.
Regarding esophageal perforation, which of the following is
INCORRECT:
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PAGE
1
, SAEM M4 EXAM LATEST
QUESTIONS AND
ANSWERS 2026 - 2027
Answers:
1.Over 90% of spontaneous esophageal perforations occur in the
proximal esophagus.
2.Esophageal perforation may result from forceful vomiting, coughing,
childbirth or heaving lifting.
3.Over 80% of esophageal are iatrogenic, usually as complications of
upper endoscopy, dilation, or sclerotherapgy.
4.Esophageal perforation has been reported as a complication of
nasogastric tube placement, endotracheal intubation, and
esophagotracheal Combitube intubaton.
5.latrogenic perforations of the esophagus usually occur in the proximal
esophagus or esophagogastric junction. - ANSWERS-1.Over 90% of
spontaneous esophageal perforations occur in the proximal esophagus.
Of the options below, the therapy best for symptomatic 3rd degree heart
block is:
Answers:
1.lidocaine
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PAGE
2
, SAEM M4 EXAM LATEST
QUESTIONS AND
ANSWERS 2026 - 2027
2.transcutaneous pacer
3.atropine
4.oxygen
5.cardioversion - ANSWERS-2.transcutaneous pacer
The best treatment, of the options below, for a patient with second
degree AV block Mobitz Type II is:
Answers:
1.amiodarone
2.epinephrine
3.aspirin
4.transvenous pacing
5.lidocaine - ANSWERS-4. transvenous pacing
A previously healthy 25 year old female arrives at the emergency
department with 3 days of headache, nausea, palpitations, and
diaphoresis. She initially presented 2 days ago to the hospital's walk-in
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PAGE
3
, SAEM M4 EXAM LATEST
QUESTIONS AND
ANSWERS 2026 - 2027
clinic, where her blood pressure was found to be moderately elevated. At
her clinic visit, the initial evaluation for end-organ damage was negative.
In the emergency department, assessment of tests sent from the clinic
visit is noteworthy for a normal TSH, normal head CT scan, and
markedly elevated urine metanephrine levels. If this woman were to
require emergency department therapy for hypertension, which of the
following agents should be AVOIDED:
Answers:
1.alpha-adrenergic receptor blocker
2.beta-adrenergic receptor blocker
3.calcium channel blocker
4.ACE-inhibitor
5.nitroprusside - ANSWERS-2.beta-adrenergic receptor blocker
True or False: gastric distension due to excessive volume or rate of
ventilation impairing ventilatory function is a reason to intubate a
neonate - ANSWERS-False
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PAGE
4
QUESTIONS AND
ANSWERS 2026 - 2027
A 46 year old woman presents to the emergency department
complaining of abrupt onset of intermittent severe pain in the left flank
and abdomen that woke her from sleep. She is pacing around the
stretcher and appears extremely uncomfortable. She has never
experienced this type of pain previously and denies fevers or other
symptoms. Renal calculus is suspected. Which of the following is true
regarding the diagnosis of renal calculi in this patient?
Answers:
1.Urnalysis demostrating hematuria confirms the diagnosis.
2.KUB detects less than 10% of calculi.
3.Ultrasound is the study of choice for detecting small ureteral calculi.
4.Helical CT scan greater than 95% sensitve and specific for renal
calculi.
5.Intravenous pyelogram (IVP) may be used in patients with renal
insufficiency. - ANSWERS-4.Helical CT scan greater than 95% sensitve
and specific for renal calculi.
Regarding esophageal perforation, which of the following is
INCORRECT:
END OF
PAGE
1
, SAEM M4 EXAM LATEST
QUESTIONS AND
ANSWERS 2026 - 2027
Answers:
1.Over 90% of spontaneous esophageal perforations occur in the
proximal esophagus.
2.Esophageal perforation may result from forceful vomiting, coughing,
childbirth or heaving lifting.
3.Over 80% of esophageal are iatrogenic, usually as complications of
upper endoscopy, dilation, or sclerotherapgy.
4.Esophageal perforation has been reported as a complication of
nasogastric tube placement, endotracheal intubation, and
esophagotracheal Combitube intubaton.
5.latrogenic perforations of the esophagus usually occur in the proximal
esophagus or esophagogastric junction. - ANSWERS-1.Over 90% of
spontaneous esophageal perforations occur in the proximal esophagus.
Of the options below, the therapy best for symptomatic 3rd degree heart
block is:
Answers:
1.lidocaine
END OF
PAGE
2
, SAEM M4 EXAM LATEST
QUESTIONS AND
ANSWERS 2026 - 2027
2.transcutaneous pacer
3.atropine
4.oxygen
5.cardioversion - ANSWERS-2.transcutaneous pacer
The best treatment, of the options below, for a patient with second
degree AV block Mobitz Type II is:
Answers:
1.amiodarone
2.epinephrine
3.aspirin
4.transvenous pacing
5.lidocaine - ANSWERS-4. transvenous pacing
A previously healthy 25 year old female arrives at the emergency
department with 3 days of headache, nausea, palpitations, and
diaphoresis. She initially presented 2 days ago to the hospital's walk-in
END OF
PAGE
3
, SAEM M4 EXAM LATEST
QUESTIONS AND
ANSWERS 2026 - 2027
clinic, where her blood pressure was found to be moderately elevated. At
her clinic visit, the initial evaluation for end-organ damage was negative.
In the emergency department, assessment of tests sent from the clinic
visit is noteworthy for a normal TSH, normal head CT scan, and
markedly elevated urine metanephrine levels. If this woman were to
require emergency department therapy for hypertension, which of the
following agents should be AVOIDED:
Answers:
1.alpha-adrenergic receptor blocker
2.beta-adrenergic receptor blocker
3.calcium channel blocker
4.ACE-inhibitor
5.nitroprusside - ANSWERS-2.beta-adrenergic receptor blocker
True or False: gastric distension due to excessive volume or rate of
ventilation impairing ventilatory function is a reason to intubate a
neonate - ANSWERS-False
END OF
PAGE
4
