SAEM SET 1 EXAM 2025/2026
QUESTIONS AND ANSWERS 100% PASS
"The chest X-ray in the Figure was taken in an intoxicated patient who is conversant, but an
unreliable historian. The X-ray findings are best described as indicating:
[image]
A. Esophageal foreign body
B. Intratracheal foreign body
C. mediastinitis from esophageal perforation
D. normal chest" - ANS "A. Esophageal foreign body
The answer is A. The film reveals a classic appearance of a round foreign body (in this case, a
pull-top from a beer can) in the esophagus. The foreign body appears to lie outside the tracheal
shadow. There is no sign of mediastinal air (which would be expected with penetrating trauma).
The X-ray reveals no signs of mediastinitis, but the risk of esophageal perforation and ultimate
mediastinitis prompts endoscopic intervention in this patient."
"An 18 year old hockey player is hit in the mouth with a puck, fracturing a maxillary canine
tooth. He brings the severed piece of tooth with him. On physical exam, the tooth is fractured
halfway between the tip and the gumline. The root of the tooth is still firmly intact. The exposed
fracture site has a yellowish tinge without blood. Of the following choices, which is the most
appropriate management for this patient?
A. No specific treatment required
B. Application of calcium hydroxide, placement of aluminum foil, and dental follow-up
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,C. Placement of tooth fragment in saline gauze, outpatient dental follow-up
D. Immediate dental consult to avoid abscess formation
E. Replace fractured piece and place acrylic splint" - ANS "D. Immediate dental consult to
avoid abscess formation
The answer is D. Ellis II dental fracture involves enamel and dentin. The fracture site typically
has a yellowish tinge. Ellis III dental fractures are characterized by exposure of pinkish pulp and
often blood. These fractures require immediate dental consultation to prevent abscess
formation."
"A 22 year old man is punched in the nose during a fight. He presents to the emergency
department with obvious nasal bone deformity. Pressure controls the bleeding. Physical exam
reveals no maxillary bone or orbital rim tenderness, intact vision and extraocular movement.
The oropharynx and mandible are unremarkable. Nasal inspection reveals a swollen,
ecchymotic, tender nasal septum. Which of the following is the most appropriate initial step?
A. Outpatient follow-up with an ENT specialist to surgically correct a deviated septum
B. Plastic surgery consult for immediate reduction of nasal fracture
C. Facial CT scan to rule out more serious facial fractures
D. Incision and drainage of the septal hematoma followed by nasal packing
E. Needle aspiration of the septal hematoma" - ANS "D. Incision and drainage of the septal
hematoma followed by nasal packing"
"A 24 year old woman is playing racquetball and sustains a direct blow from the ball to the right
eye. She presents to the emergency department complaining of eye pain and double vision. On
exam, her right eye does not track properly with upward gaze. This finding suggests which of the
following injuries?
A. Inferior orbital wall fracture
B. Superior orbital rim fracture
C. Ethmoid fracture
D. Zygomatic arch fracture
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, E. Inferior orbital rim fracture" - ANS "A. Inferior orbital wall fracture
The answer is A. The patient most likely has an orbital floor fracture with entrapment."
"A 32 year old man is struck several times in the head with a baseball bat. Upon emergency
medical service arrival, he is mildly confused, vomits once, and complains of a severe headache.
The emergency medical technicians establish two large-bore IVs. Prior to arrival at the
emergency department, he loses consciousness and begins to seize. He is actively seizing when
he is brought into the trauma bay. What should be the first step in the management of this
patient?
A. Administration of phenytoin 1000mg IV
B. Administration of mannitol 50 g IV
C. Rapid sequence intubation using paralytic agent
D. Emergency craniotomy
E. Administration of 2 liters NS bolus" - ANS "C. Rapid sequence intubation using paralytic
agent
The answer is C. The airway should be managed as the first priority in this patient. The other
maneuvers may be helpful but are secondary to securing an airway and providing
oxygenation/ventilation. Airway comes first!"
"A 46 year old man is brought in by EMS after a motor vehicle collision in which he was an
unrestrained driver. Although he has no obvious injury to his head or neck, he complains of
chest pain and appears very short of breath. His vital signs are: T 99.2 F, BP 85/57, HR 123, RR
36, SpO2 95% on non-rebreather. The CXR demonstrates a
tension pneumothorax. Of the following, which is the most appropriate next step in this man's
care?
A. Placement of a chest tube followed by a chest xray to determine proper placement
B. Transfusion of 2 units of O-negative packed red blood cells
C. Performance of a chest CT scan to further delineate the pathology
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS 100% PASS
"The chest X-ray in the Figure was taken in an intoxicated patient who is conversant, but an
unreliable historian. The X-ray findings are best described as indicating:
[image]
A. Esophageal foreign body
B. Intratracheal foreign body
C. mediastinitis from esophageal perforation
D. normal chest" - ANS "A. Esophageal foreign body
The answer is A. The film reveals a classic appearance of a round foreign body (in this case, a
pull-top from a beer can) in the esophagus. The foreign body appears to lie outside the tracheal
shadow. There is no sign of mediastinal air (which would be expected with penetrating trauma).
The X-ray reveals no signs of mediastinitis, but the risk of esophageal perforation and ultimate
mediastinitis prompts endoscopic intervention in this patient."
"An 18 year old hockey player is hit in the mouth with a puck, fracturing a maxillary canine
tooth. He brings the severed piece of tooth with him. On physical exam, the tooth is fractured
halfway between the tip and the gumline. The root of the tooth is still firmly intact. The exposed
fracture site has a yellowish tinge without blood. Of the following choices, which is the most
appropriate management for this patient?
A. No specific treatment required
B. Application of calcium hydroxide, placement of aluminum foil, and dental follow-up
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,C. Placement of tooth fragment in saline gauze, outpatient dental follow-up
D. Immediate dental consult to avoid abscess formation
E. Replace fractured piece and place acrylic splint" - ANS "D. Immediate dental consult to
avoid abscess formation
The answer is D. Ellis II dental fracture involves enamel and dentin. The fracture site typically
has a yellowish tinge. Ellis III dental fractures are characterized by exposure of pinkish pulp and
often blood. These fractures require immediate dental consultation to prevent abscess
formation."
"A 22 year old man is punched in the nose during a fight. He presents to the emergency
department with obvious nasal bone deformity. Pressure controls the bleeding. Physical exam
reveals no maxillary bone or orbital rim tenderness, intact vision and extraocular movement.
The oropharynx and mandible are unremarkable. Nasal inspection reveals a swollen,
ecchymotic, tender nasal septum. Which of the following is the most appropriate initial step?
A. Outpatient follow-up with an ENT specialist to surgically correct a deviated septum
B. Plastic surgery consult for immediate reduction of nasal fracture
C. Facial CT scan to rule out more serious facial fractures
D. Incision and drainage of the septal hematoma followed by nasal packing
E. Needle aspiration of the septal hematoma" - ANS "D. Incision and drainage of the septal
hematoma followed by nasal packing"
"A 24 year old woman is playing racquetball and sustains a direct blow from the ball to the right
eye. She presents to the emergency department complaining of eye pain and double vision. On
exam, her right eye does not track properly with upward gaze. This finding suggests which of the
following injuries?
A. Inferior orbital wall fracture
B. Superior orbital rim fracture
C. Ethmoid fracture
D. Zygomatic arch fracture
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, E. Inferior orbital rim fracture" - ANS "A. Inferior orbital wall fracture
The answer is A. The patient most likely has an orbital floor fracture with entrapment."
"A 32 year old man is struck several times in the head with a baseball bat. Upon emergency
medical service arrival, he is mildly confused, vomits once, and complains of a severe headache.
The emergency medical technicians establish two large-bore IVs. Prior to arrival at the
emergency department, he loses consciousness and begins to seize. He is actively seizing when
he is brought into the trauma bay. What should be the first step in the management of this
patient?
A. Administration of phenytoin 1000mg IV
B. Administration of mannitol 50 g IV
C. Rapid sequence intubation using paralytic agent
D. Emergency craniotomy
E. Administration of 2 liters NS bolus" - ANS "C. Rapid sequence intubation using paralytic
agent
The answer is C. The airway should be managed as the first priority in this patient. The other
maneuvers may be helpful but are secondary to securing an airway and providing
oxygenation/ventilation. Airway comes first!"
"A 46 year old man is brought in by EMS after a motor vehicle collision in which he was an
unrestrained driver. Although he has no obvious injury to his head or neck, he complains of
chest pain and appears very short of breath. His vital signs are: T 99.2 F, BP 85/57, HR 123, RR
36, SpO2 95% on non-rebreather. The CXR demonstrates a
tension pneumothorax. Of the following, which is the most appropriate next step in this man's
care?
A. Placement of a chest tube followed by a chest xray to determine proper placement
B. Transfusion of 2 units of O-negative packed red blood cells
C. Performance of a chest CT scan to further delineate the pathology
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
