SAEM Exam with Questions and Solutions

SAEM Exam with Questions and Solutions "A 36 year old male backpacking in the wilderness loses his way in a snowstorm. Temperatures are well below zero degrees and his clothing is inadequate. He is rescued 5 days later and presents to the ED. Rescue crew has already initiated passive rewarming and have removed patient's damp clothing. On arrival, vital signs show pulse of 100 and temperature of 35.5C. On physical exam, you note patient has several toes that are purple with hemorrhagic blisters on his feet. Which of the following is the most appropriate initial management? A. Tetanus prophylaxis B. Administration of morphine C. Immersion in warm water bath D. Debridement of necrotic tissue" ANSWER "C. Immersion in warm water bath The answer is C. Immersion of the affected extremity is the mainstay of treatment for patients with frostbite. Numbness of the affected area is the most common initial symptom and severe pain is frequently encountered after rewarming. Tetanus prophylaxis and debridement is indicated , but is not the most appropriate initial step in the management of patients with frostbite." "All of the following are true regarding the epidemiology of hypothyroidism EXCEPT: A. Hypothyroidism does not occur in infants under six months of age. B. Most cases of hypothyroidism manifest in the winter months. C. Approximately half of myxedema cases are diagnosed after admission to the hospital. D. Hypothyroidism occurs three to ten times more frequently in women than men. E. Peak incidence of hypothyroidism is in the seventh decade." ANSWER "A. Hypothyroidism does not occur in infants under six months of age.