Exam (elaborations)
SAEM M4 Exam Solution
- Course
- SAEM M4
- Institution
- University Of California - San Francisco
SAEM M4 Exam Solution
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SAEM M4 Exam SolutionTrue or False: gastric distension due to excessive volume or rate of ventilation impairing ventilatory
function is a reason to intubate a neonate Answer: False
management for nursemaid elbow injury Answer: apply pressure to the radial head while
flexing and supinating elbow
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? Answer: compression fracture of the
posteriolateral aspect of the humeral head (Hill-Sachs deformity)
What are most common heart rhythms seen in pediatric arrest? Answer: bradycardia or
asystole
risk factors for neonatal resuscitation Answer: prematurity
IUGR
multiple gestation
thick meconium
In the post-arrest setting, which of the following is the drug of choice in treating hypotension in a
child: Answer: epi
Low body temperatures in newborns can lead to severe physiologic consequences, which include all
EXCEPT:
,Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia Answer: 3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator of: Answer: hypoxemia
All the following are signs of hypoxemia in a newborn, EXCEPT:
Answers:
1.cyanosis
2.lethargy
3.tachycardia
4.unresponsiveness
5.bradycardia Answer: 3. tachycardia
A newborn presents to the emergency department a few days after hospital discharge. The infant
has been noted to be drooling, choking, and coughing, and the mother reports seeing bubbles at the
baby's mouth. Which is the most likely explanation?
Answers:
1.osteogenesis imperfecta
2.inborn error of metabolism
,3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula Answer: 5. tracheoesophageal fistula
Which of the following pairs of maneuvers are consistent with current recommendations for
emergency care for a choking 5-month-old infant?
Answers:
1.back blow then blind finger sweep
2.back blow then chest thrust
3.chest thrust then Heimlich maneuver
4.Heimlich maneuver then blind finger sweep
5.Heimlich maneuver then chest thrust Answer: 2.back blow then chest thrust
All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT:
Answers:
1.If administering succinylcholine, pretreatment with atropine is always indicated in children under
age 10.
2.Lidocaine pretreatment is usually provided to children with head trauma.
3.When deciding which size endotracheal tube to use, one may approximate by using the size of the
small finger or nares as a reference.
4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to
intubation for children under age ten.
5.Uncuffed endotracheal tubes are the preferred devices used in children under 6-8 years of age.
Answer: 4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed
prior to intubation for children under age ten.
, 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:
1.Jimson weed
2.Cocaine
3.Heroin
4.Insulin Answer: 2. cocaine
A mother brings in her 4 year old child who was happily eating "blackberries" from weeds in the
garden and is now acting strangely. She has identified them as Belladonna from a quick internet
search. Which physical examination finding might you also expect to find in this child?
Answers:
1.Diaphoresis
2.Flushed skin
3.Miosis
4.Urinary incontinence Answer: 2. flushed skin
For which of the following cases is activated charcoal therapy most appropriate?
Answers:
1.Acetaminophen overdose
2.Drain cleaner ingestion
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