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SAEM TEST BANK QUESTIONS WITH COMPLETE SOLUTIONS.
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SAEM TEST BANK QUESTIONS WITH COMPLETESOLUTIONS
"Silent Suicide" is defined as:
A. an act of slowly killing oneself by nonviolent means, such as
starvation or non-compliance with essential medical treatment
B. an attempted suicide
C. suicide involving a number of willing and sometimes not so
willing participants
D. a self-destructive act disguised as an accident
E. recurrent self-destructive acts, such as heavy drinking in the
presence of alcoholic liver disease Correct Answer A. an act of
slowly killing oneself by nonviolent means, such as starvation or
non-compliance with essential medical treatment
The answer is A. "Silent Suicide" is most common in elderly
patients and frequently goes unrecognized. Such patients may
present to the emergency department repeatedly because of non-
compliance with treatment of their medical disorders. "Occult
Suicide" is applied to self-destructive acts disguised as accidents
and should be suspected in those who have "accidental" self-
inflicted gun shot wounds, and in those who "unintentionally"
overdose, or who fall from a height. "Chronic Suicidal
Behavior" consists of recurrent self-destructive acts. "Mass or
Group Suicide" is suicide involving a number of people.
"Parasuicide" is an attempted suicide, which is seen more as a
gesture than a serious act.
19 year old man is brought in to the emergency department by
EMS after being found obtunded in his apartment. No additional
history is available. On arrival, the patient is minimally
,responsive with sonorous respirations and a palpable rapid
pulse. The most appropriate initial diagnostic test would be
A. Arterial blood gas
B. Electrocardiogram
C. Fingerstick glucose
D. Urine drug screen Correct Answer C. Fingerstick glucose
Hypoglycemia is a common and readily treatable cause for
altered mental status. An ABG is unlikely to be diagnostic and
more likely to reflect secondary abnormalities caused by
respiratory depression. While a urine drug screen may show
positives, it cannot quantitate the amount of a substance or the
time period in which the exposure occurred so a positive screen
may not reflect cause and effect. An EKG, while a part of a
toxicology evaluation, is not an appropriate initiate screening
test for an unstable patient until airway and readily reversible
causes have been addressed.
56 year old male presents with sub-sternal chest pain for 4 hours
with worsening shortness of breath for the last 2 hours. The
patient's heart rate is 108 beats per minute, respiratory rate of 24
breaths per minute, and oxygenation saturation of 94% on room
air. On physical examination, the patient appears dyspneic. On
auscultation, he has a harsh II/VI systolic murmur with rales
midway up bilateral lung fields. A bedside echocardiogram is
done which shows papillary muscle rupture. Which valve's
regurgitation is responsible for this patient's shortness of breath?
A. Mitral valve
B. Aortic valve
C. Pulmonic valve
D. Tricuspid valve Correct Answer A. Mitral valve
,60 year old male presents to the emergency department with
chest pain. His monitor strip, shown below, reveals:
[image: unexpected, non-conducted atrial impulses. The R-R
interval and P-R intervals are constant. ]
A. first degree AV block
B. complete heart block
C. second degree AV block Mobitz Type 1
D. second degree AV block Mobitz Type 2 Correct Answer D.
second degree AV block Mobitz Type 2
-- For further reading, see Tintinalli, et al., Emergency
Medicine: A Comprehensive
Study Guide, 5th edition, page 184.
6What does the dotted line in the figure depict?
[image]
Figure used with permission from Hamilton et al, Emergency
Medicine: An approach to clinical problem-solving
A. Placement site for skin clamps.
B. The needle entry angle that optimizes eversion of sutured
skin edges.
C. The approach for subcuticular suture.
D. The injection plane for local anesthesia infiltration.
E. Use of a "finder needle" to mark suture entry points. Correct
Answer B. The needle entry angle that optimizes eversion of
sutured skin edges.
The answer is B. Eversion of the skin edges is maximized by
directing the needle entry as shown in the figure. Injection for
local anesthesia should usually be performed through the
, wound, rather than through intact skin. Use of skin clamps can
damage tissue; in cases where skin stabilization is needed gentle
forceps application is preferred. Subcuticular sutures are placed
deep to the skin.
A "BLS" ambulance differs from an "ALS" ambulance in that
the BLS ambulance:
A. is stocked with different supplies and equipment
B. operates under off-line, as opposed to on-line, medical
control
C. arrives at the patient first
D. is staffed by one EMT crew member (and one driver) rather
than two EMTs
E. is a smaller "van"-type ambulance Correct Answer A. is
stocked with different supplies and equipment
A 10 year old boy presents with high fever and a rash. The rash
started on his wrists and ankles and has spread to his trunk,
palms, and soles. The correct diagnosis is most likely:
A. varicella
B. Rocky Mountain spotted fever
C. tinea
D. Lyme disease
E. scarlet fever Correct Answer B. Rocky Mountain spotted
fever
A 12-day-old term infant presents for evaluation of vomiting
blood-streaked emesis once after feeding. She is well appearing
and well hydrated with normal vital signs and an unremarkable
exam. She is breast-fed. What should the physician do next?
A. Start an H2 blocker for reflux.
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