SAEM M4 Exam New 2025 Version Best
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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 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.
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.
For several conditions of internal malignancies there may
be associated cutaneous manifestations. The conditions
below all describe common dermatological conditions
associated with malignancy EXCEPT:
,Dermatological anthrax may occur wherever spores come
into contact with the skin. Of the following options, which
statement is FALSE concerning dermatological anthrax:
Answers:
1.Mortality rates are over 20-30% lower than for
pulmonary anthrax.
2.Antibiotics do not affect the course of local disease.
3.Characteristic lesion is a black escar preceded by a
vesiculopapular lesion 1 week prior.
4.Initial diagnosis is usually made by Gram's stain
analysis.
5.The organism most likely to cause dermatological
anthrax is Bacillus anthracis. Correct Answer 4.Initial
diagnosis is usually made by Gram's stain analysis.
In establishing a differential diagnosis of abdominal pain,
which of the following is true?
Answers:
1.The onset of pain prior to the occurrence of nausea and
vomiting is more often suggestive of a surgical etiology.
2.Cervical motion tenderness is a useful physical finding
for differentiating women with or without acute
appendicitis.
3.In patients with sickle cell anemia who present with
abdominal pain and diarrehea, shigellosis should be a top
consideration.
4.Radiation of pain to the scapula is suggestive of acute
hepatitis.
, 5.Diverticultis tends to cause pain in the right upper
quadrant. Correct Answer 1.The onset of pain prior to the
occurrence of nausea and vomiting is more often
suggestive of a surgical etiology.
Of the following pain patterns, which is likely associated
with diagnosis of peptic ulcer disease?
Answers:
1.non-radiating, burning epigastric pain
2.pain that awakens a patient in the middle of the night
3.unrelenting pain over a period of weeks
4.relief of abdominal pain with antacids
5.pain that is worse preceding a meal Correct Answer
3.unrelenting pain over a period of weeks
A 46 year old woman presents to the emergency
department complaining of abrupt onset of intermittent
severe pain in the left flank and abdomen that woke her
from sleep. She is pacing around the stretcher and
appears extremely uncomfortable. She has never
experienced this type of pain previously and denies fevers
or other symptoms. Renal calculus is suspected. Which of
the following is true regarding the diagnosis of renal calculi
in this patient?
Answers:
1.Urnalysis demostrating hematuria confirms the
diagnosis.
2.KUB detects less than 10% of calculi.
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