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Exam (elaborations)

UPDATED ED SAEM TEST QUESTIONS WITH VERIFIED SOLUTIONS

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UPDATED ED SAEM TEST QUESTIONS WITH VERIFIED SOLUTIONS UPDATED ED SAEM TEST QUESTIONS WITH VERIFIED SOLUTIONS

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  • August 12, 2024
  • 31
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • SAEM
  • SAEM
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ACELEARNERS
UPDATED ED SAEM TEST 2024-2025
QUESTIONS WITH VERIFIED SOLUTIONS
1. list ottawa ankle rules

2. where should you also check on exam/be aware of? - CORRECT ANSWER 1.
inability to walk 4 steps immediately & in ED + any of the following:

- medial malleolus tenderness

- lateral malleolus tenderness

- navicular tenderensss

- 5th metatarsal tendereness

2. check fibular head tenderness- twisting injury ~ fibular fx



name SIRS criteria (4)

Describe CHEST study findings - CORRECT ANSWER 1. Temp < 36 or >38

2. HR >90

3. RR >20 or PaCO2 <32

4. WBC 4,000 > x > 12,000

CHEST study (JAMA): previous SCC (surviving sepsis campaign) studies did not look at
wards; found that SIRS reminders did not affect mortality



1. define sepsis

2. define severe sepsis- criteria?

(SBP, Cr, bili, PLT, INR, lactate)

3. define septic shock - CORRECT ANSWER 1. pt who has potential infectious cause
for SIRS syndrome

2. sepsis-induced organ dysfunction. Criteria:

,UPDATED ED SAEM TEST 2024-2025
QUESTIONS WITH VERIFIED SOLUTIONS
SBP <90 or MAP <70 or SBP decrease >40

Cr >2.0 or urine output <0.5ml/kg/hr

Bili >2

PLT <100,000

INR >1.5 or PTT >60s

lactate >2 mmol/L

3. low BP despite fluid administration



1. what lab is the ECG of sepsis?

2. list of labs to get for sepsis?

3. 3 hour bundle for sepsis?

4. 6 hour bundle? - CORRECT ANSWER 1. lactate

2. CBC, CMP, PT/INR/PTT, blood Cx x2, UA, CXR

3. lactate measurement, blood Cx then administration of broad spectrum abx, admin. of
30mL/kg IV crystalloid for hypoTN or lactate >4

4. vasopressors for goal MAP >65, reassess & document volume, repeat lactate if
initially >4



name the AEIOUTIPS of AMS - CORRECT ANSWER A = alcohol

E = epilepsy, electrolytes, encephalopathy

I = insulin

O = opiates & oxygen

,UPDATED ED SAEM TEST 2024-2025
QUESTIONS WITH VERIFIED SOLUTIONS
U = uremia

T = trauma & temp

I = infection

P = poison & psychogenic

S = shock, stroke, subarachnoid hemorrhage, space-occupying lesion



1. MC cause of asthma exacerbation?

2. Qs to ask pt when they come in?

3. mainstay of therapy? (1st line)

4. if mod/severe, give what?

5. if severe & not improving with albuterol, use what? (4 things)

6. criteria for ICU admission? - CORRECT ANSWER 1. URI

2. previous episodes, prior ED visits, hospitalizations or ICU admissions, steroid use,
past intubations

3. albuterol nebulizer continuous 6-8L/min or via nasal cannula, place on cardiac
monitor/continuous pulse oximetry with goal SpO2 >92%

4. oral/IV steroids

5. IM > SQ epinephrine 0.2mg or terbutaline 0.25 mg. Also ipratropium (anticholinergic)
combined w albuterol = Duonebs. Last line: MgSO4

6. <90% SpO2, FEV1 < 40%



1. how is dosing of drugs administered endotracheally? which drugs?

2. when do you think of H's and T's?

, UPDATED ED SAEM TEST 2024-2025
QUESTIONS WITH VERIFIED SOLUTIONS
3. things to order during ACLS?

4. successful resuscitation dependent on what? Joules on biphasic & monophasic?

5. doses of Epi, vasopressin, amiodarone? - CORRECT ANSWER 1. 2-2.5x the IV
route. Drugs: NAVEL- naloxone, atropine, vasopressin, Epi, Licocaine

2. during PEA/asystole

3. EKG, ABG, serum electrolytes, CXR, US

4. rapid defibrillation. biphasic: 200. Monophasic: 360

5. Epi 1mg (1:10,000), vaso 40U, amiodarone 300mg >150mg



1. what is the leading cause of systolic HF?

2. Tx for CHF exacerbation?

3. prognosis at Dx? - CORRECT ANSWER 1. myocardial infarction

2. nitrates are 1st line. IF fluid overloaded, then lasix. If in cardiogenic shock, levophed.

3. 5 years



1. classic triad of ruptured AAA

2. imaging of choice?

3. continuous abd bruit & palpable thrill?

4. bloody stool?

5. Mgmt of AAA? goal MAP? - CORRECT ANSWER 1. pain, hypo-TN, pulsatile abd
mass

2. US

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