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SAEM M4 Exam Questions With Complete Solutions
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SAEM M4 Exam Questions With Complete Solutions
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SAEM M4 Exam Questions With Complete SolutionsA 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? Correct Answer compression fracture of the
posteriolateral aspect of the humeral head (Hill-Sachs
deformity)
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 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 Correct Answer 1.Deferoxamine
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.
,A 22 year old running back is struck from behind by a 300-
pound lineman. The blow occurs below the knee as his foot is
firmly planted and two other linemen are holding his upper
body. He presents to the emergency department with gross
anterior dislocation of the tibia on the femur. His foot is cool
and pale, and dorsalis pedis and posterior tibial pulses are not
detected by Doppler ultrasound. What is the most appropriate
management for this patient?
Answers:
1.Immediate orthopedic consultation without attempts to
manipulate the knee
2.Immediate arteriography to assess for popliteal artery
disruption
3.Immediate reduction in emergency department under
conscious sedation without X-rays
4.Open reduction in OR with exploration of popliteal artery
Correct Answer 3.Immediate reduction in emergency
department under conscious sedation without X-rays
A 23 year old man is stabbed in the anterior neck with a 3-inch
knife during a street fight. At the scene, there is some bleeding,
which is controlled with direct pressure. He presents to the
emergency department breathing comfortably and in no distress.
His pulse is 88, blood pressure 126/76, and oxygen saturation
99% on room air. There is a 1cm laceration 2cm above the right
sternoclavicular junction, lateral to the trachea. There is mild
oozing and no obvious underlying hematoma. There is no
obvious subcutaneous air, and he has clear lung sounds. What is
the most appropriate management for this patient?
, Answers:
1.Immediate operative exploration
2.Local wound exploration and discharge home if no significant
injury identified
3.Local wound exploration and discharge home after 6-hour
observation period
4.Angiography, esophogram, and admission for observation
5.CT scan of the neck and discharge home after 6 hours of
Correct Answer 4.Angiography, esophogram, and admission for
observation
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 Correct Answer 2. cocaine
A 24 year old female gardener presents to the emergency
department with foot pain 30 minutes after working barefoot in
her garden. She saw a scorpion in the area. Which of the
following signs or symptoms are most expected?
Answers:
1.Puncture mark
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