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ED SAEM test Questions and Answers (Attained Grade A+) Latest Update, RATED A+., Exams of Health sciences

Chaminade UniversityHealth sciences

ED SAEM test Questions and Answers (Attained Grade A+) Latest Update, RATED A+.

Typology: Exams

2023/2024

Available from 06/15/2024

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ED SAEM test Questions and Answers (Attained Grade
A+) Latest Update, RATED A+.
2. where should you also check on exam/be aware of? - correct answers ✅1.
inability to walk 4 steps immediately & in ED + any of the following:
- medial malleolus tenderness
- lateral malleolus tenderness
- navicular tenderensss
- 5th metatarsal tendereness
2. check fibular head tenderness- twisting injury ~ fibular fx
name SIRS criteria (4)
Describe CHEST study findings - correct answers ✅1. Temp < 36 or >38
2. HR >90
3. RR >20 or PaCO2 <32
4. WBC 4,000 > x > 12,000
CHEST study (JAMA): previous SCC (surviving sepsis campaign) studies did
not look at wards; found that SIRS reminders did not affect mortality
1. define sepsis
2. define severe sepsis- criteria?
(SBP, Cr, bili, PLT, INR, lactate)
3. define septic shock - correct answers ✅1. pt who has potential infectious
cause for SIRS syndrome
2. sepsis-induced organ dysfunction. Criteria:
SBP <90 or MAP <70 or SBP decrease >40
Cr >2.0 or urine output <0.5ml/kg/hr
Bili >2
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b
pf1c
pf1d
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Partial preview of the text

Download ED SAEM test Questions and Answers (Attained Grade A+) Latest Update, RATED A+. and more Exams Health sciences in PDF only on Docsity!

A+) Latest Update, RATED A+.

  1. where should you also check on exam/be aware of? - correct answers ✅1. inability to walk 4 steps immediately & in ED + any of the following:
  • medial malleolus tenderness
  • lateral malleolus tenderness
  • navicular tenderensss
  • 5th metatarsal tendereness
  1. check fibular head tenderness- twisting injury ~ fibular fx name SIRS criteria (4) Describe CHEST study findings - correct answers ✅1. Temp < 36 or >
  2. HR >
  3. RR >20 or PaCO2 <
  4. WBC 4,000 > x > 12, CHEST study (JAMA): previous SCC (surviving sepsis campaign) studies did not look at wards; found that SIRS reminders did not affect mortality
  5. define sepsis
  6. define severe sepsis- criteria? (SBP, Cr, bili, PLT, INR, lactate)
  7. define septic shock - correct answers ✅1. pt who has potential infectious cause for SIRS syndrome
  8. sepsis-induced organ dysfunction. Criteria: SBP <90 or MAP <70 or SBP decrease > Cr >2.0 or urine output <0.5ml/kg/hr Bili >

A+) Latest Update, RATED A+.

PLT <100,

INR >1.5 or PTT >60s lactate >2 mmol/L

  1. low BP despite fluid administration
  2. what lab is the ECG of sepsis?
  3. list of labs to get for sepsis?
  4. 3 hour bundle for sepsis?
  5. 6 hour bundle? - correct answers ✅1. lactate
  6. CBC, CMP, PT/INR/PTT, blood Cx x2, UA, CXR
  7. lactate measurement, blood Cx then administration of broad spectrum abx, admin. of 30mL/kg IV crystalloid for hypoTN or lactate >
  8. vasopressors for goal MAP >65, reassess & document volume, repeat lactate if initially > name the AEIOUTIPS of AMS - correct answers ✅A = alcohol E = epilepsy, electrolytes, encephalopathy I = insulin O = opiates & oxygen U = uremia T = trauma & temp I = infection P = poison & psychogenic

A+) Latest Update, RATED A+.

  1. during PEA/asystole
  2. EKG, ABG, serum electrolytes, CXR, US
  3. rapid defibrillation. biphasic: 200. Monophasic: 360
  4. Epi 1mg (1:10,000), vaso 40U, amiodarone 300mg >150mg
  5. what is the leading cause of systolic HF?
  6. Tx for CHF exacerbation?
  7. prognosis at Dx? - correct answers ✅1. myocardial infarction
  8. nitrates are 1st line. IF fluid overloaded, then lasix. If in cardiogenic shock, levophed.
  9. 5 years
  10. classic triad of ruptured AAA
  11. imaging of choice?
  12. continuous abd bruit & palpable thrill?
  13. bloody stool?
  14. Mgmt of AAA? goal MAP? - correct answers ✅1. pain, hypo-TN, pulsatile abd mass
  15. US
  16. aortovenous fistula
  17. aortoenteric fistula
  18. 2 large bore IVs, type/cross, goal MAP 90-100, emergent surgery

A+) Latest Update, RATED A+.

  1. name 4 causes of mesenteric ischemia & presentation?
  2. which patients should you watch for? Sx?
  3. MC cause? RF?
  4. which has worst prognosis?
  5. which occurs in younger pop?
  6. Imaging used & gold standard?
  7. Tx? For artery thrombus, embolus, veinous thrombosis. - correct answers ✅1. mesenteric artery embolus, thrombus, mesenteric vein thrombosis
  8. elderly- N/V/D, sudden onset diffuse abd pain
  9. Mesenteric a embolus- MR, valvular heart DZ, arrhythmias
  10. Mesenteric artery thrombosis
  11. Mes. vein thrombosis
  12. CTA. Gold standard: angiography
  13. 2 IVs, triple lumen for CVP, Abx. If thrombus: surgery, heparin. Embolus: Sx/Embolectomy. VT: thrombectomy with endarterectomy & lifelong anti- coagulation
  14. Perforated viscus: sensitivity of XR?
  15. test of choice?
  16. labs?
  17. Tx?
  18. mortality? - correct answers ✅1. 30-80% having pt sit upright 10mins incr sens.
  19. CT most sens & spec

A+) Latest Update, RATED A+.

manual detorsion by rotating away from midline 90 degrees while checking doppler (2/3 of cases)

  1. 1st year of life & puberty
    • Prehn's sign, absent cremasteric reflex. PE signs do NOT rule out!!
  3. 6 hours (theoretical)- time is testicle!
  4. 1/3!! 40% with a dead testicle still had a cremasteric reflex!!!
  5. define pulsus paradoxus?
  6. options for steroid administration in asthma exacerbation?
  7. patients @ risk for getting S. pneumonia?
  8. name RF for spontaneous pneumo?
  9. pt has breathing discomfort after bee sting- Tx options? - correct answers ✅1. fall in SBP >10 mmHg during inspiration
  10. IV or oral equally efficacious

  11. 65 yrs old, DM, CAD, splenectomy, SC DZ, malignancy

  12. smoking, thin male
  13. inhaled albuterol, inhaled epi, heliox by face mask, IV cimetidine
  14. which cause of pneumo is ~ bullous myringitis?
  15. describe presentation/complic/mortality of Klebsiella?
  16. which org ~ dorms/prisons?
  17. MC HCAP orgs? - correct answers ✅1. mycoplasma pneumo
  18. MC severe pneumo, empyema, abscess, bacteremia, high mortality, current jelly sputum

A+) Latest Update, RATED A+.

  1. chlamydia pneumo
  2. S pneumo, H infl, Klebsiella
  3. causes of false + on stool guaic?
  4. false -?
  5. Mc causes of lower GI bleed? MC site? 4 MC cause upper GI bleed. DDx?
  6. name infectious causes of bloody diarrhea
  7. indic for blood transfusion? mgmt? - correct answers ✅1. methylene blue, chlorophyll, Br, I, Fe, cupric SO
  8. Antacids, Bile, vitamin C
  9. diverticulosis > CA > rectal, colitis, ischemia, angiodysplasia. L = R side.
  10. PUD. DDX: gastritis, varices, mallory-weiss tear, aortoenteric fistula
  11. Campylobact, E. coli 0157, Salmonella, Yersenia
  12. Hb drop >3 acutely, Hb <9 and actively bleeding, massive bleed (1L). HCT q 6h
  13. name 4 areas of possible hemorrhage?
  14. management of drowning victim?
  15. at what T does shivering stop?
  16. define moderate hypothermia & Sx/VS
  17. define severe hypothermia & mgmt - correct answers ✅1. intraperitoneal space, retroperitoneal space, thorax, GI

A+) Latest Update, RATED A+.

  1. pt drinks windshield wiper fluid- antidote?
  2. pt drinks antifreeze- antidote? - correct answers ✅1. Li, lead, Fe, caustic liquids
  3. dialysis
  4. lorazepam
  5. Anion gap metab. acidosis + respir. akalosis
  6. 150mg. Mgmt: activated charcoal early, measure serum levels @ hour 4--

ORAL N-acetylcysteine

  1. hypo-TN, bradycardia, AMS, respir. depression, miosis. Mimics opioids.
  2. = methanol. Fomepizole
  3. = ethylene glycol = Fomepizole. get Ca Oxalate crystals.
  4. pt coming out of surgery has weird blood discoloration and SOB- dx? pulse ox? Tx?
  5. define shock
  6. name the 4 types
  7. 1st invervention?
  8. BP drops when what % intravascular volume is lost?
  9. best IV method? reasonable fluids? - correct answers ✅1. methemoglobinemia. Pulse ox not helpful bc can't distinguish b/w oxy & methemoglobin. Tx: methylene blue.
  10. inadequate end organ perfusion
  11. hypovolemic, cardiac, distributive, obstructive
  12. supplemental oxygen

A+) Latest Update, RATED A+.

  1. 14 or 16g catheter- femoral > IJ, subclavian. NS, LR, blood, albumin
  2. options in cardiogenic shock?
  3. Tx spinal cord injury with neurogenic shock?
  4. common organisms that cause sepsis?
  5. possible complications of septic shock?
  6. upper limit of normal body T? - correct answers ✅1. dobutamine, intra- aortic balloon pump
  7. immobilization, high dose steroids, IVF
  8. S. pneumo, E. coli, Psuedomonas, Staph
  9. DIC, ARDS, ATN, high-output CHF
  10. 100.4F or 38C
  11. indications for fibrinolytic therapy in acute MI?
  12. list signs of RV infarction on EKG. best way to Dx?
  13. Pt with CP, and LBBB- Tx?
  14. STEMI in V1-V3, aVL, I is what artery? anatomic region?
  15. STEMI in II, III, aVF, V5, V6 is what artery? anatomic region?
  16. what supplies the SA node?
  17. name leads that are ant/poster/lateral? - correct answers ✅1. 1 mm ST elevation in @ least 2 contiguous leads & <12 hrs
  18. v1 ST elevation, III elevation > II elevation. Dx: EKG with right-sided leads

A+) Latest Update, RATED A+.

  1. define silent suicide
  2. define occult suicide
  3. what is the MC cause of suicide by ingestion? - correct answers ✅1. interferon alpha
  4. panic d/o > MDD > shizophrenia
  5. slowly killing yourself nonviolently- like not taking meds or starvation
  6. self-destructive act disguised as an accident
  7. anti-depressant overdose ~ "mobilization energy"
  8. specific protocol for ASA tox?
  9. protocol for acetaminophen tox (labs, Tx)? When can you give activated charcoal?
  10. briefly explain biochem of acetaminophen tox? - correct answers ✅1. 150 mEq NaHCO3 in 1L D5W: titrate to urine pH 7.5. VBG, ASA, UA q 1-2hr
  11. Labs: 4hr level, BMP, LFTs (AST bumps 1st), U tox, PT/INR, bHcG. N- acetylcysteine IV: 150 mg/kg IV over 1st hour, then 12.5 mg/kg next 4 hrs, then 6.25 mg/kg over 16 hrs. If w/in 1 hr of ingestion: activated charcoal.
  12. aceteminophen->NAPQI (metabolized by glutathione). Depleted in o/d-

NAPQI causes hepatic damage. NAC repletes Glutathione. MC cause for liver transplant give differential for Delirium - correct answers ✅-Withdrawal (alcohol, barbiturates, benzodiazepines) -Acute metabolic disorder (electrolyte imbalance, hepatic or renal failure) -Trauma (head injury, postoperative)

A+) Latest Update, RATED A+.

-CNS pathology (stroke, hemorrhage, tumour, seizure disorder, Parkinson's) -Hypoxia (anemia, cardiac failure, pulmonary embolus) -Deficiencies (vitamin B 12 , folic acid, thiamine) -Endocrinopathies (thyroid, glucose, parathyroid, adrenal) -Acute vascular (shock, vasculitis, hypertensive encephalopathy) -Toxins, substance use, medication (alcohol, anesthetics, anticholinergics, narcotics) -Heavy metals (arsenic, lead, mercury)

  1. what is the protocol for lowering SBP in hypertensive emergency?
  2. what drugs are preferred? dose & max? CI for each?
  3. which BB is safer in pt's with mildly reactive airways? - correct answers ✅1. Decrease SBP by 10-20% in 1st hr. Decrease SBP 10% over next 23 hrs
  4. labetolol (10min onset)- 20mg slow IV push, then double dose q10mins, max 300. CI: asthma, COPD, bradycardia > hydral (20min onset)- 10mg, max
  5. Nitroglycerin arterio-dilates @ hi doses only (great for ACS & pulm edema)
  6. esmolol- (2 min onset, 20 min offset)
  7. define 1st degree burn?
  8. define 2nd degree burn?
  9. define 3rd degree burn?
  10. mgmt of inhalation injury?
  11. temp. injures upper or lower airways more?

A+) Latest Update, RATED A+.

  1. 4 * [weight kg] * %BSA.
  2. LR- 50% in 1st 8 hrs, remaining 50% next 16hrs
  3. adult: 0.5cc/kg/hr
  4. how can you tell the difference b/w scorpion stings & black widow spider bites?
  5. Sx of scorpion envenomation?
  6. mgmt? Last line? complic? - correct answers ✅1. scorpion stings are painful @ site. black widow bite has localized diaphoresis & possible lymphangitis
  7. pain @ site, numbness, tingling, N/V, blurred vision, hypersalivation, clonus, abn eye movements, cholinergic syndrome
  8. supportive only: ABCs, tetanus ppx, local wound care, opioids for muscle pain, benzos for NMS Sx. Last line: Anascorp (antivenom)- routine use not indicated bc most Sx resolve by 2d; Complic: serum sickness
  9. pt is having a seizure that won't break with mult. doses of lorazepam- next drug of choice?
  10. Tx for non-complicated cellulitis?
  11. Tx for complicated cellulitis (purulent)?
  12. Abscess- workup/TX? DDx? - correct answers ✅1. phenytoin 15mg/kg piggyback
  13. Augmentin 875/125 bid
  14. inpatient IV Clinda q

A+) Latest Update, RATED A+.

  1. If simple, no labs needed! US may help differentiate from cellulitis. Tx: I&D
  • abx! DDx: cellulitis, nec fascitis, hematoma, cyst.
  1. common EKG findings in COPD exacerbation?
  2. rare but specific finding on EKG?
  3. mainstay of Tx?
  4. indications for abx? drug choices?
  5. dispo test?
  6. if still hypoxic despite #3 & 4, next step? - correct answers ✅1. right axis deviation, peaked p waves in II, III, avF, R atrial hypertrophy.
  7. multifocal atrial tachycardia
  8. Duobens MC. Stacked albuterol treatments, ipratropium q4. PO prednisone or IV methylprednisolone.
  9. increased sputum production, change in color sputum, or fever. Levaquin, macrolides, cephalosp, tetracycline
  10. walk around ED with continuous pulse ox
  11. NPPV-->RSI
  12. pt is hemodynamically stable & you suspect ectopic pregnancy- mgmt? Unstable pt?
  13. how can you exclude ectopic? DDx?
  14. level of bHCg should IUP be visualized on transvaginal US? abd US?
  15. US findings suggestive of ectopic
  16. Treatment for confirmed ectopic?

A+) Latest Update, RATED A+.

2. BB

  1. K blockers
  2. CCB Electrical injuries:
  3. which type of circuit is worse- AC or DC?
  4. what are some high resistance tissues of body & consequence?
  5. mechanism of injury from lightning strike? method of death & mgmt in field? - correct answers ✅1. AC 3x worse- causes muscle tetany & pulls source closer
  6. bone, tendon, fat-->more heat = coag. necrosis
  7. TM rupture, dysarhythmias. Death from persistent respiratory arrest: begin respir. support
  8. Define heat exhaustion- electrolytes? LFTs? Hallmarks?
  9. Define heat stroke- hallmarks? LFTs?
  10. Tx of heat stroke? goal T? - correct answers ✅1. volume depletion + hyponatremia/hypochloremia. Hallmarks: T <104, sweating persists, LFTs 1000's
  11. Heat stroke: thermoregulatory mechanisms fail. Sweating absent in 80- 90%, severe CNS derangement, LFTs in 10,000s.
  12. Dunk in icebath! Must reduce T to 102 w/in 10-30mins. 2nd best is ice packs in axilla/groin
  13. child has snake bite but is ASx- mgmt?

A+) Latest Update, RATED A+.

  1. FB ingestion: adults have MC proximal/distal obstr?
  2. FB ingestion: children have MC proximal/distal obstr?
  3. MC location of ingested fb impaction? consult?
  4. other common loc? - correct answers ✅1. Obs for 8 hrs then d/c if ASx
  5. distal
  6. proximal
  7. upper esophagus @ cricopharyngeus mm- otorhinolaryngology consult
  8. level of aortic arch, L main bronchus, GE junction > pylorus, duodenal C loop, ileocecal valve
  9. FB ingestion: size too large to pass?
  10. mgmt if very proximal?
  11. Tx for coin? must differentiated from what & signs on XR? - correct answers ✅1. 6cm long x 2.5 cm wide
  12. laryngoscopy or fiberoptic scope
  13. observe 12-24hrs. Button batteries- halo sign & step off sign
  14. Ingested button battery: golden time period?
  15. Mgmt if past esophagus? (symptomatic, co-ingestion, ASx). If >2cm?
  16. Mgmt if in the esophagus? when can use foley balloon?
  17. MC ingested fb in peds? - correct answers ✅1. perforation in 6hrs!
  18. symptomatic: surgical consult. Co-ingested: remove endoscopically. ASx: expectant w f/u in 24 hrs; repeat films in 48 hrs. If >2cm & still in stomach in 48 hrs->endoscopic removal.