SAEM M4 Exam saem m4 curriculum 2 Latest Update 2024-2025 500 Questions and 100% Verified Correct Answers Guaranteed A+ A 17 year old boy injured his right shoulder playing football. He tried to arm-tackle a player when his right arm was pulled away from his body and back (abducted and extended). He felt a sudden pain in his shoulder. He presents to the emergency department holding his arm in slight abduction and external rotation by his good arm.He has severe pain with adduction or internal rotation. What is the most common fracture associated with this injury? - CORRECT ANSWER: compression fracture of the posteriolateral aspect of the humeral head (Hill-Sachs deformity)
A 19 year old male presents to the emergency department with allergic-mediated pruritis over large portions of his body. Which of the following is true regarding this condition?
Answers:
1.H2 antagonists such as ranitidine or famotidine have never been shown to provide benefit.
2.Topical antihistamine agents should be encouraged to manage the pruritis.
3.There is no role for therapies such as Domeboro solution (1:10 diluted aluminum sulfate soaks), potassium permanganate baths, and oat-meal baths.
4.Oral doses of antihistamines should be encouraged initially.
5.Second generation antihistamines such astemizole, fexofenadine, and loratadine are more effective but cause increased levels of sedation and should be avoided if possible.
- CORRECT ANSWER: 4.Oral doses of antihistamines should be encouraged initially.
A 2 year old child presents with an overdose of her mother's iron containing multivitamins. What antidote should you consider for iron toxicity?
Answers:
1.Deferoxamine 2.Glucagon 3.Methylene blue
4.Pyridoxine - CORRECT ANSWER: 1.Deferoxamine
A 20 year old college female recently returned from spring break after hiking in the Virginia woods approximately two weeks prior to her presentation to the E.D. One day prior to presentation, she developed fever, chills, and anorexia. In the emergency department, she complains of headache, photophobia, and myalgias. On exam, one notices a disseminated, non-blanching, papular rash. Which of the following statements regarding this condition is FALSE?
Answers:
1.It is caused by the tick borne parasite Rickettsia rickettsii. 1 / 4
2.95% of patients develop symptoms between the period of April 1 and September 30.
3.Characteristically the rash begins on the trunk and spreads to the extremities.
4.A skin biopsy shows a necrotizing vasculitis.
5.If untreated, fatality rates range between 25-50%; however, treatment reduces the rate to 10%. - CORRECT ANSWER: 3.Characteristically the rash begins on the trunk and spreads to the extremities.
A 22 year old running back is struck from behind by a 300-pound lineman. The blow occurs below the knee as his foot is firmly planted and two other linemen are holding his upper body. He presents to the emergency department with gross anterior dislocation of the tibia on the femur. His foot is cool and pale, and dorsalis pedis and posterior tibial pulses are not detected by Doppler ultrasound. What is the most appropriate management for this patient?
Answers:
1.Immediate orthopedic consultation without attempts to manipulate the knee 2.Immediate arteriography to assess for popliteal artery disruption 3.Immediate reduction in emergency department under conscious sedation without X- rays
4.Open reduction in OR with exploration of popliteal artery - CORRECT ANSWER:
3.Immediate reduction in emergency department under conscious sedation without X- rays
A 23 year old man is stabbed in the anterior neck with a 3-inch knife during a street fight. At the scene, there is some bleeding, which is controlled with direct pressure. He presents to the emergency department breathing comfortably and in no distress. His pulse is 88, blood pressure 126/76, and oxygen saturation 99% on room air. There is a 1cm laceration 2cm above the right sternoclavicular junction, lateral to the trachea.There is mild oozing and no obvious underlying hematoma. There is no obvious subcutaneous air, and he has clear lung sounds. What is the most appropriate management for this patient?
Answers:
1.Immediate operative exploration 2.Local wound exploration and discharge home if no significant injury identified 3.Local wound exploration and discharge home after 6-hour observation period 4.Angiography, esophogram, and admission for observation
5.CT scan of the neck and discharge home after 6 hours of - CORRECT ANSWER:
4.Angiography, esophogram, and admission for observation
A 23 year old woman is dropped off by her boyfriend after an unknown overdose. You notice that she is has very large pupils and is sweating profusely. Her respiratory rate, blood pressure and heart rate are elevated. Which of the following is the most likely agent to have caused her symptoms?
Answers: 2 / 4
1.Jimson weed 2.Cocaine 3.Heroin
4.Insulin - CORRECT ANSWER: 2. cocaine
A 24 year old female gardener presents to the emergency department with foot pain 30 minutes after working barefoot in her garden. She saw a scorpion in the area. Which of the following signs or symptoms are most expected?
Answers:
1.Puncture mark 2.Local erythema and swelling 3.Pain and paresthesias
4.Cranial nerve abnormalities - CORRECT ANSWER: 3.Pain and paresthesias
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?
Select all that apply 1.Inferior orbital rim fracture 2.Superior orbital rim fracture 3.Inferior orbital wall fracture 4.Ethmoid fracture
5.Zygomatic arch fracture - CORRECT ANSWER: 3.Inferior orbital wall fracture
A 25 year old female presents with fever, productive cough, and shortness of breath.Physical exam reveals T101, RR 24 and SpO2 of 94%. Her left tympanic membrane is inflamed and there are TM bullae. The chest X-ray reveals a large right middle lobe pneumonia. The organism most commonly associated with this type of presentation is:
Answers:
1.Legionella pneumoniae 2.Strep pneumoniae 3.H. influenzae 4.Mycoplasma pneumoniae
5.Moraxella catarrhalis - CORRECT ANSWER: 4.Mycoplasma pneumoniae
A 25 year old male college student with a history of type I diabetes mellitus presents to the emergency department complaining of worsening headache, vomiting, and fever.On exam, he has a temperature of 101.6 F, meningismus, and photophobia. A lumbar puncture is performed and reveals a CSF glucose consistent with bacterial meningitis.What is the normal ratio between CSF and serum glucose?
Answers: 3 / 4
1. 1:1
2. 2:1
3. 0.4:1
4. 0.6:1 - CORRECT ANSWER: 4. 0.6:1
A 25 year old man returns to the ED, 24 hours after being released from the hospital with a new diagnosis of schizophrenia. He has recently started to take haloperidal for his psychotic symptoms. In the ED he is noted to have involuntary contractions of the muscles of the face, a protruding tongue, deviation of the head to one side, and sustained upward deviation of the eyes. Vital signs are stable, and initial labs show no electrolyte or hematological abnormalities. Of the following choices, the preferred
medication for this condition is:
Answers:
1.diphenhydramine 2.lorazepam 3.phenobarbital
4.metoprolol - CORRECT ANSWER: 2.lorazepam
A 27 year old woman is brought into the emergency department by her roommate 30 minutes after ingesting a bottle of aspirin in a suicide attempt. Which of the following acid-base disorders is most likely to be present in this patient?
Answers:
1.Respiratory acidosis due to somnolence causing decreased respiratory drive 2.Respiratory alkalosis due to stimulation of the respiratory center and increased CO2 production 3.Primary respiratory acidosis with compensatory metabolic alkalosis 4.Primary metabolic acidosis with compensatory respiratory alkalosis - CORRECT ANSWER: 2.Respiratory alkalosis due to stimulation of the respiratory center and increased CO2 production
A 28 year old man is shot in the right chest. His vital signs are: T 97.9, HR 120, BP 70/50, RR 12, SPO2 84%. He has significant JVD, his trachea is deviated to the left,
and he has decreased breath sounds on the right. The patient's diagnosis is:
Answers:
1.Hypovolemic shock 2.Tension pneumothorax 3.Cardiac tamponade 4.Lung laceration
5.Spinal cord injury - CORRECT ANSWER: 2.Tension pneumothorax
A 35 year old woman presents complaining of left wrist pain for several months. She works as a waitress and has noticed increasing wrist pain associated with intermittent numbness and tingling of her thumb, index finger and long finger on the left hand. She
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