Emergency Medicine SAEM STUDY QUESTIONS
WITH VERIFIED ANSWERS 22025/2026 Q&A
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1. A 65-year-old male presents with sudden chest pain radiating to his back and
hypotension. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back with hypotension is
classic for aortic dissection. Prompt diagnosis with imaging (CT angiography) is
critical.
2. A patient presents with severe asthma exacerbation not responding to initial
bronchodilator therapy. What is the next best step?
A. IV magnesium sulfate
B. Oral corticosteroids only
C. Antibiotics
D. Intubation immediately
Correct Answer: A. IV magnesium sulfate
Rationale: In severe asthma exacerbations refractory to inhaled beta-agonists, IV
magnesium sulfate is indicated before considering intubation.
3. Which of the following are common signs of sepsis?
A. Fever or hypothermia
B. Tachycardia
,C. Hypotension
D. Bradycardia
Correct Answers: A. Fever or hypothermia, B. Tachycardia, C. Hypotension
Rationale: Sepsis often presents with fever/hypothermia, tachycardia,
hypotension, and signs of organ dysfunction. Bradycardia is less typical.
4. A 28-year-old female presents with shortness of breath and pleuritic chest
pain 3 days postpartum. What is the most likely diagnosis?
A. Pneumonia
B. Pulmonary embolism
C. Pneumothorax
D. Myocardial infarction
Correct Answer: B. Pulmonary embolism
Rationale: Postpartum period is a hypercoagulable state; sudden dyspnea and
pleuritic chest pain are suggestive of pulmonary embolism.
5. Which medications are commonly used in the management of acute STEMI?
A. Aspirin
B. Nitroglycerin
C. Metformin
D. Heparin
Correct Answers: A. Aspirin, B. Nitroglycerin, D. Heparin
Rationale: Aspirin and heparin are anticoagulants to prevent further thrombosis,
nitroglycerin relieves ischemic pain. Metformin is not used acutely.
6. A patient presents with signs of increased intracranial pressure. Which are
appropriate initial interventions?
A. Elevate the head of the bed
B. Mannitol
C. Hyperventilation
,D. Administer IV fluids rapidly
Correct Answers: A. Elevate the head of the bed, B. Mannitol, C. Hyperventilation
Rationale: Elevation, osmotic diuretics, and temporary hyperventilation reduce ICP.
Rapid IV fluids can worsen cerebral edema if not indicated.
7. Which are classic features of anaphylaxis?
A. Urticaria
B. Angioedema
C. Hypotension
D. Bradycardia
Correct Answers: A. Urticaria, B. Angioedema, C. Hypotension
Rationale: Anaphylaxis presents with skin changes, airway edema, and
hypotension. Tachycardia is more typical than bradycardia.
8. Which are indications for urgent surgical intervention in trauma?
A. Penetrating abdominal injury with hypotension
B. Flail chest without hypoxia
C. Tension pneumothorax
D. Open fracture of the femur
Correct Answers: A. Penetrating abdominal injury with hypotension, C. Tension
pneumothorax
Rationale: Hypotension with penetrating injury and tension pneumothorax are life-
threatening surgical emergencies. Flail chest and open fractures require
stabilization but are not immediate surgery.
9. A patient presents with altered mental status, fever, and nuchal rigidity.
Which is the first-line diagnostic test?
A. CT scan of the brain
B. Lumbar puncture
C. EEG
, D. MRI
Correct Answer: B. Lumbar puncture
Rationale: Suspected meningitis requires lumbar puncture for CSF analysis unless
increased ICP is suspected (then CT first).
10. Which are signs of cardiogenic shock?
A. Hypotension
B. Cold extremities
C. Bounding pulses
D. Pulmonary edema
Correct Answers: A. Hypotension, B. Cold extremities, D. Pulmonary edema
Rationale: Cardiogenic shock presents with hypotension, poor perfusion, and
pulmonary congestion. Bounding pulses are not typical.
11. Which are appropriate interventions for hyperkalemia with ECG changes?
A. IV calcium gluconate
B. Insulin with glucose
C. Sodium bicarbonate
D. IV potassium
Correct Answers: A. IV calcium gluconate, B. Insulin with glucose, C. Sodium
bicarbonate
Rationale: Calcium stabilizes cardiac membranes, insulin shifts potassium
intracellularly, bicarbonate can help in acidosis. IV potassium is contraindicated.
12. A 45-year-old male presents after a seizure. What are appropriate next
steps?
A. Check blood glucose
B. Administer antibiotics
C. Evaluate electrolytes
D. Assess for head trauma
WITH VERIFIED ANSWERS 22025/2026 Q&A
|INSTANT DOWNLOAD PDF
1. A 65-year-old male presents with sudden chest pain radiating to his back and
hypotension. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back with hypotension is
classic for aortic dissection. Prompt diagnosis with imaging (CT angiography) is
critical.
2. A patient presents with severe asthma exacerbation not responding to initial
bronchodilator therapy. What is the next best step?
A. IV magnesium sulfate
B. Oral corticosteroids only
C. Antibiotics
D. Intubation immediately
Correct Answer: A. IV magnesium sulfate
Rationale: In severe asthma exacerbations refractory to inhaled beta-agonists, IV
magnesium sulfate is indicated before considering intubation.
3. Which of the following are common signs of sepsis?
A. Fever or hypothermia
B. Tachycardia
,C. Hypotension
D. Bradycardia
Correct Answers: A. Fever or hypothermia, B. Tachycardia, C. Hypotension
Rationale: Sepsis often presents with fever/hypothermia, tachycardia,
hypotension, and signs of organ dysfunction. Bradycardia is less typical.
4. A 28-year-old female presents with shortness of breath and pleuritic chest
pain 3 days postpartum. What is the most likely diagnosis?
A. Pneumonia
B. Pulmonary embolism
C. Pneumothorax
D. Myocardial infarction
Correct Answer: B. Pulmonary embolism
Rationale: Postpartum period is a hypercoagulable state; sudden dyspnea and
pleuritic chest pain are suggestive of pulmonary embolism.
5. Which medications are commonly used in the management of acute STEMI?
A. Aspirin
B. Nitroglycerin
C. Metformin
D. Heparin
Correct Answers: A. Aspirin, B. Nitroglycerin, D. Heparin
Rationale: Aspirin and heparin are anticoagulants to prevent further thrombosis,
nitroglycerin relieves ischemic pain. Metformin is not used acutely.
6. A patient presents with signs of increased intracranial pressure. Which are
appropriate initial interventions?
A. Elevate the head of the bed
B. Mannitol
C. Hyperventilation
,D. Administer IV fluids rapidly
Correct Answers: A. Elevate the head of the bed, B. Mannitol, C. Hyperventilation
Rationale: Elevation, osmotic diuretics, and temporary hyperventilation reduce ICP.
Rapid IV fluids can worsen cerebral edema if not indicated.
7. Which are classic features of anaphylaxis?
A. Urticaria
B. Angioedema
C. Hypotension
D. Bradycardia
Correct Answers: A. Urticaria, B. Angioedema, C. Hypotension
Rationale: Anaphylaxis presents with skin changes, airway edema, and
hypotension. Tachycardia is more typical than bradycardia.
8. Which are indications for urgent surgical intervention in trauma?
A. Penetrating abdominal injury with hypotension
B. Flail chest without hypoxia
C. Tension pneumothorax
D. Open fracture of the femur
Correct Answers: A. Penetrating abdominal injury with hypotension, C. Tension
pneumothorax
Rationale: Hypotension with penetrating injury and tension pneumothorax are life-
threatening surgical emergencies. Flail chest and open fractures require
stabilization but are not immediate surgery.
9. A patient presents with altered mental status, fever, and nuchal rigidity.
Which is the first-line diagnostic test?
A. CT scan of the brain
B. Lumbar puncture
C. EEG
, D. MRI
Correct Answer: B. Lumbar puncture
Rationale: Suspected meningitis requires lumbar puncture for CSF analysis unless
increased ICP is suspected (then CT first).
10. Which are signs of cardiogenic shock?
A. Hypotension
B. Cold extremities
C. Bounding pulses
D. Pulmonary edema
Correct Answers: A. Hypotension, B. Cold extremities, D. Pulmonary edema
Rationale: Cardiogenic shock presents with hypotension, poor perfusion, and
pulmonary congestion. Bounding pulses are not typical.
11. Which are appropriate interventions for hyperkalemia with ECG changes?
A. IV calcium gluconate
B. Insulin with glucose
C. Sodium bicarbonate
D. IV potassium
Correct Answers: A. IV calcium gluconate, B. Insulin with glucose, C. Sodium
bicarbonate
Rationale: Calcium stabilizes cardiac membranes, insulin shifts potassium
intracellularly, bicarbonate can help in acidosis. IV potassium is contraindicated.
12. A 45-year-old male presents after a seizure. What are appropriate next
steps?
A. Check blood glucose
B. Administer antibiotics
C. Evaluate electrolytes
D. Assess for head trauma
