1 | P a g e SAEM M4 FINAL EXAM NEWEST 2024 -2025 ACTUAL EXAM COMPLETE 120 QUESTIONS AND CORRECT DETAILED ANSWERS ( VERIFIED ANSWERS ) |ALREADY GRADED A+ 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 - ANSWER - 1.Deferoxamine Severe lead toxicity can commonly result in which of the following clinical symptoms Answers: 1.Constipation 2.Dermatitis 2 | P a g e 3.Memory loss 4.Stocking glove peripheral neuropathy - ANSWER - 3.Memory loss 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 - ANSWER - 2.Respiratory alkalosis due to stimulation of the respiratory center and increased CO2 production The most common cause of intrinsic lower gastrointestinal (GI) bleeding in an adult is: Answers: 3 | P a g e 1.Cancer 2.Diverticulosis 3.Inflammatory bowel disease 4.Polyps - ANSWER - 2.Diverticulosis Which of the following bacteria does NOT produce bloody diarrhea? Answers: 1.Campylobacter enteritis 2.Clostridium perfringens 3.Escherichia coli 0157 4.Yersinia enterocolitica - ANSWER - 2.Clostridium perfringens With respect to laboratory findings in diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic coma (HHNC), all of the following guidelines are generally true EXCEPT: Answers: 1.Patients with HHNC typically have blood glucose > 700 mg/dL, whereas patients with DKA have blood glucose > 350 mg/dL. 4 | P a g e 2.Serum ketones are present in patients with DKA but not usually in patients with HHNC. 3.Serum bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC. 4.Serum osmolality in patients with HHNC is typically > 350 mOsm/L. 5.BUN is elevated more in patients with HHNC (>50 mg/dL) than in patients with DKA (25 -50 mg/dL). - ANSWER - 3.Serum bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC. Regarding the treatment of hyperosmolar hypertonic nonketotic coma (HHNC) and its associated symptoms, which of the following is correct: Answers: 1.Half of the fluid deficit should be corrected over the first hour and the remainder over the following 8 hours. 2.Since patients are not acidotic, close monitoring of glucose is not necessary. 3.Hyperosmolarity should be corrected within the first few hours in the emergency department. 4.Phenytoin (Dilantin) is often ineffective for seizures associated with HHNC.
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