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Emergency Medicine SAEM exam test bank_2023/2024.
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Emergency Medicine SAEM exam test bank_2023/2024. Q&A with rationales
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SAEM Practice Exam Questions with Correct Answers(Latest Update 2023).
Regarding the diagnosis of acute appendicitis, all the following are true
EXCEPT:
A. Vital signs are usually abnormal, even early in the course of acute
appendicitis.
B. Rebound is usually elicited only after the appendix has ruptured or
infarcted.
C. Rovsing's sign is pain in the right lower quadrant upon palpation of the
left lower quadrant.
D. The obturator sign is pain upon flexion and internal rotation of the hip.
E. The psoas sign is pain upon extension of the hip. - correct answers ✅A.
Vital signs are usually abnormal, even early in the course of acute
appendicitis.
The answer is A. The presentation of acute appendicitis varies tremendously.
Early in its course, vital signs including temperature may be normal. Once
perforation has occurred, the rate of low-grade fever (<38 C) increases to
about 40%. Other variations in presentation include pain in the right upper
quadrant, typically from a retrocecal or retroiliac appendix.
Rosving's sign is described as:
,SAEM Practice Exam Questions with Correct Answers
(Latest Update 2023)
A. Tenderness in the right upper quadrant that is worse with inspiration.
B. Pelvic pain upon flexion of the thigh while the patient is supine.
C. Pelvic pain upon internal and external rotation of the thigh with the knee
flexed.
D. Pain that increases with the release of pressure of palpation.
E. Pain in the right lower quadrant when left lower quadrant is palpated. -
correct answers ✅E. Pain in the right lower quadrant when left lower
quadrant is palpated.
The answer is E. Rosving's sign is pain in the right lower quadrant when the
left lower quadrant is palpated. Rebound tenderness occurs with the release
of pressure. The iliopsoas sign is pain associated with thigh flexion. The
obturator sign is pain that occurs with thigh rotation. All of these signs are
associated with appendicitis. Murphy's sign is cessation of inspiration during
palpation of the right upper quadrant and is associated with acute
cholecystitis.
In establishing a differential diagnosis of abdominal pain, which of the
following is true?
A. Radiation of pain to the scapula is suggestive of acute hepatitis.
,SAEM Practice Exam Questions with Correct Answers
(Latest Update 2023)
B. Cervical motion tenderness is a useful physical finding for differentiating
women with or without acute appendicitis.
C. In patients with sickle cell anemia who present with abdominal pain and
diarrhea, shigellosis should be a top consideration.
D. The onset of pain prior to the occurrence of nausea and vomiting is more
often suggestive of a surgical etiology.
E. Diverticulitis tends to cause pain in the right upper quadrant. - correct
answers ✅D. The onset of pain prior to the occurrence of nausea and
vomiting is more often suggestive of a surgical etiology.
The answer is D. Pain prior to nausea and vomiting is often suggestive of a
surgical etiology of the pain, such as small bowel obstruction. Cervical
motion tenderness has been noted in up to 25% of women with acute
appendicitis. Patients with sickle cell anemia are prone to Salmonella
infections. Radiation of pain to the scapula is classically present in acute
choleycystitis. Diverticulitis pain is generally located in the left lower
quadrant.
Of the following pain patterns, which is the least likely associated with
diagnosis of peptic ulcer disease?
A. non-radiating, burning epigastric pain
, SAEM Practice Exam Questions with Correct Answers
(Latest Update 2023)
B. pain that awakens a patient in the middle of the night
C. unrelenting pain over a period of weeks
D. relief of abdominal pain with antacids
E. pain that is worse preceding a meal - correct answers ✅C. unrelenting
pain over a period of weeks
The answer is C. Pain from peptic ulcer disease typically occurs in periods of
exacerbation and remission. Unrelenting pain over weeks or months should
suggest an alternative diagnosis. Pain is classically described as non-
radiating, burning epigastric pain. Some patients may also complain of chest
or back pain. Pain is frequently severe enough to awaken patients from sleep
in early morning hours but is often not present upon waking in the morning,
as gastric acid secretion peaks around 2 a.m. and nadirs upon awakening.
A mother brings her 6 week old boy to the emergency room. She states the
baby has been vomiting everything she's tried to feed him for the past 12
hours. She states that he usually eats readily and completes an entire
feeding, but he is unable to keep anything down. The emesis is non-bloody
and non-bilious, however it is projectile in nature. What is the most likely
condition in this patient?
A. viral gastroenteritis
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