Page 1 of 111
EMERGENCY PHYSICIAN – ABEM (AMERICAN BOARD OF
EMERGENCY MEDICINE) EXAM ACTUAL QUESTIONS
AND DETAILED ANSWERS WITH RATIONALES LATEST
UPDATE THIS YEAR
EMERGENCY PHYSICIAN – ABEM EXAM
HIGH-YIELD SUMMARIZED EXAM COVERAGE (POINT FORM)
1. Airway & Respiratory Emergencies
• Airway assessment (Difficult airway predictors, RSI indications)
• Oxygenation vs ventilation failure
• RSI drugs (etomidate, ketamine, succinylcholine, rocuronium)
• Ventilator settings basics (ARDS, COPD, asthma)
• Status asthmaticus management
• Pneumothorax (tension vs simple)
• Pulmonary embolism diagnosis and treatment
• Respiratory failure causes (Type 1 vs Type 2)
2. Cardiovascular Emergencies
• ACLS algorithms (VF/VT, PEA, asystole)
• Acute coronary syndrome (STEMI/NSTEMI management)
• Aortic dissection recognition
• Heart failure acute pulmonary edema treatment
• Arrhythmias (SVT, AFib, VT)
• Shock types (cardiogenic, distributive, hypovolemic, obstructive)
3. Trauma (ATLS principles)
• Primary survey (ABCDE)
• Hemorrhagic shock management
• FAST exam use
• Traumatic brain injury management
• Spinal precautions
• Chest trauma (tamponade, flail chest)
4. Toxicology
• Opioid overdose (naloxone use)
• Acetaminophen toxicity (N-acetylcysteine)
• TCA overdose (QRS widening treatment)
• Organophosphate poisoning
• Carbon monoxide poisoning
• Alcohol withdrawal management
5. Pediatrics EM
• Febrile infant workup
• Pediatric airway differences
• Croup, epiglottitis
• Dehydration management
• Sepsis recognition
6. Neurology Emergencies
• Stroke (ischemic vs hemorrhagic)
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• tPA eligibility
• Status epilepticus treatment
• Meningitis management
• Increased intracranial pressure
7. Infectious Disease & Sepsis
• Sepsis bundles (fluids, lactate, antibiotics)
• Septic shock vasopressors
• Necrotizing fasciitis recognition
• Meningitis empiric therapy
8. Procedures
• Intubation steps
• Chest tube insertion indications
• Central line complications
• Lumbar puncture contraindications
9. OB/GYN Emergencies
• Ectopic pregnancy
• Preeclampsia/eclampsia
• Postpartum hemorrhage
• Shoulder dystocia
10. Ethics & Systems
• Informed consent
• Capacity vs competence
• AMA discharge risks
• Documentation standards
BATCH 1 — ABEM-STYLE MCQs WITH RATIONALES (1–50)
1. A 65-year-old patient presents with sudden chest pain radiating to the back and unequal blood
pressures in both arms. What is the most likely diagnosis?
A. Myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
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Correct Answer: B. Aortic dissection
Rationale: Sudden tearing chest pain with pulse/BP discrepancy strongly suggests aortic dissection.
2. Which initial intervention is most important in a patient with suspected tension pneumothorax?
A. Chest X-ray confirmation
B. Immediate needle decompression
C. CT scan chest
D. Bronchodilator therapy
Correct Answer: B. Immediate needle decompression
Rationale: Tension pneumothorax is a clinical diagnosis requiring emergent decompression.
3. Which medication is preferred for induction during rapid sequence intubation in hypotensive
trauma patients?
A. Ketamine
B. Propofol
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C. Thiopental
D. Midazolam
Correct Answer: A. Ketamine
Rationale: Ketamine maintains blood pressure due to sympathetic stimulation.
4. A patient with suspected opioid overdose presents with respiratory depression. What is the first-
line antidote?
A. Flumazenil
B. Naloxone
C. Atropine
D. Physostigmine
Correct Answer: B. Naloxone
Rationale: Naloxone reverses opioid-induced respiratory depression.
5. What is the most appropriate initial treatment for suspected septic shock?
EMERGENCY PHYSICIAN – ABEM (AMERICAN BOARD OF
EMERGENCY MEDICINE) EXAM ACTUAL QUESTIONS
AND DETAILED ANSWERS WITH RATIONALES LATEST
UPDATE THIS YEAR
EMERGENCY PHYSICIAN – ABEM EXAM
HIGH-YIELD SUMMARIZED EXAM COVERAGE (POINT FORM)
1. Airway & Respiratory Emergencies
• Airway assessment (Difficult airway predictors, RSI indications)
• Oxygenation vs ventilation failure
• RSI drugs (etomidate, ketamine, succinylcholine, rocuronium)
• Ventilator settings basics (ARDS, COPD, asthma)
• Status asthmaticus management
• Pneumothorax (tension vs simple)
• Pulmonary embolism diagnosis and treatment
• Respiratory failure causes (Type 1 vs Type 2)
2. Cardiovascular Emergencies
• ACLS algorithms (VF/VT, PEA, asystole)
• Acute coronary syndrome (STEMI/NSTEMI management)
• Aortic dissection recognition
• Heart failure acute pulmonary edema treatment
• Arrhythmias (SVT, AFib, VT)
• Shock types (cardiogenic, distributive, hypovolemic, obstructive)
3. Trauma (ATLS principles)
• Primary survey (ABCDE)
• Hemorrhagic shock management
• FAST exam use
• Traumatic brain injury management
• Spinal precautions
• Chest trauma (tamponade, flail chest)
4. Toxicology
• Opioid overdose (naloxone use)
• Acetaminophen toxicity (N-acetylcysteine)
• TCA overdose (QRS widening treatment)
• Organophosphate poisoning
• Carbon monoxide poisoning
• Alcohol withdrawal management
5. Pediatrics EM
• Febrile infant workup
• Pediatric airway differences
• Croup, epiglottitis
• Dehydration management
• Sepsis recognition
6. Neurology Emergencies
• Stroke (ischemic vs hemorrhagic)
, Page 2 of 111
• tPA eligibility
• Status epilepticus treatment
• Meningitis management
• Increased intracranial pressure
7. Infectious Disease & Sepsis
• Sepsis bundles (fluids, lactate, antibiotics)
• Septic shock vasopressors
• Necrotizing fasciitis recognition
• Meningitis empiric therapy
8. Procedures
• Intubation steps
• Chest tube insertion indications
• Central line complications
• Lumbar puncture contraindications
9. OB/GYN Emergencies
• Ectopic pregnancy
• Preeclampsia/eclampsia
• Postpartum hemorrhage
• Shoulder dystocia
10. Ethics & Systems
• Informed consent
• Capacity vs competence
• AMA discharge risks
• Documentation standards
BATCH 1 — ABEM-STYLE MCQs WITH RATIONALES (1–50)
1. A 65-year-old patient presents with sudden chest pain radiating to the back and unequal blood
pressures in both arms. What is the most likely diagnosis?
A. Myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
, Page 3 of 111
Correct Answer: B. Aortic dissection
Rationale: Sudden tearing chest pain with pulse/BP discrepancy strongly suggests aortic dissection.
2. Which initial intervention is most important in a patient with suspected tension pneumothorax?
A. Chest X-ray confirmation
B. Immediate needle decompression
C. CT scan chest
D. Bronchodilator therapy
Correct Answer: B. Immediate needle decompression
Rationale: Tension pneumothorax is a clinical diagnosis requiring emergent decompression.
3. Which medication is preferred for induction during rapid sequence intubation in hypotensive
trauma patients?
A. Ketamine
B. Propofol
, Page 4 of 111
C. Thiopental
D. Midazolam
Correct Answer: A. Ketamine
Rationale: Ketamine maintains blood pressure due to sympathetic stimulation.
4. A patient with suspected opioid overdose presents with respiratory depression. What is the first-
line antidote?
A. Flumazenil
B. Naloxone
C. Atropine
D. Physostigmine
Correct Answer: B. Naloxone
Rationale: Naloxone reverses opioid-induced respiratory depression.
5. What is the most appropriate initial treatment for suspected septic shock?
