ABEM ORAL BOARD EXAM PREP (PART
2) QUESTIONS AND ANSWERS GRADED
A+ 2025/2026
Critical Actions: CHF exacerbation - ANS 1. Oxygen
2. High-dose nitroglycerin drip / sequential SL 0.4mg NTG tablets initiated immediately
3. Furosemide
4. Aspirin
5. CCU consult
Nitroglycerin drip dosage for SCAPE (sympathetic crashing acute pulmonary edema) - ANS -
Start with high doses
- Can start at 400mcg/min (over 2-5 min) and then titrate down
- Can also give SL nitro if drip isn't readily available
- Can also give nitroglycerin through nebulizer (3-5mcg of IV solution Q15min)
Non-invasive positive pressure ventilation settings for SCAPE (sympathetic crashing acute
pulmonary edema) - ANS Start at 5 cm H2O and titrate up to 15 cm H2O. Inspiratory positive
airway pressure is supplementary
Critical Actions: Critical aortic coarctation (Neonate dyspnea/crashing) - ANS 1. Recognition
of respiratory distress
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,2. Oxygen administration, intubation
3. IV access
4. EKG, CXR
5. Recognition of cardiomegaly and cardiac causes of respiratory distress
6. Cardiology consult
7. Prostaglandin administration
Ventilator settings for congenital defect neonate - ANS - Volume 10 ml/kg or with chest rise
- O2 100%
- rate of 40
Prostaglandin E1 dose - ANS 0.05mcg/kg/min
Crashing Neonate Causes - ANS 1. Hypoglycemia - check glucose
2. Sepsis - antibiotics, cultures, LP
3. Non-accidental trauma - CTH, bone survey
4. Congenital heart defect - CXR, Prostaglandin E1
5. Inborn errors of metabolism - glucose, ammonia, pH, UA, CMP, make NPO
6. Abdominal catastrophe - KUB, upper GI, surgery consult
Critical Actions: Renal colic - ANS 1. Large bore IV access and hydration with greater than 1L
NS
2. Early pain control
3. Confirmation of diagnosis of renal colic with CT w/o contrast given first episode of colic
4. UA
5. Temperature
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Renal stone pass rate - ANS - <4mm: 90% pass rate
- 4-6mm: 50% pass rate
- >6mm: 10% pass rate
When to admit renal stones - ANS 1. Patient has an obstructed and infected stone
2. Patient has intractable pain or vomiting.
3. Patient has an acute kidney injury.
4. Patient has a single kidney or has been the recipient of a renal transplant.
5. Significant medical comorbidities are present.
6. The patient has failed outpatient medical therapy (stone not passing after 4-6 weeks).
Critical Actions: Status Epilepticus - ANS 1. Finger stick blood glucose
2. IV access
3. IV benzodiazepines
4. Head CT to evaluate for intracranial pathology
5. Labs to exclude metabolic pathology
6. Serum toxicity
7. Neurology consult for new onset seizure/status epilepticus
1st line medications for status epilepticus - ANS Benzodiazepines (diazepam, lorazepam,
midazolam)
2nd line medications for status epilepticus - ANS Phenytoin, Fosphenytoin, valproic acid,
levetiracetam
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, 3rd line medications for status epilepticus - ANS Ketamine, lacosamide, phenobarbital
IV anesthetics/sedatives for status epilepticus - ANS Medazolam drip, propofol drip,
pentobarbital drip, thiopental (infusion)
Critical Actions: Fournier gangrene - ANS 1. Full physical exam looking for source of fever
2. Adequate fluid resuscitation
3. Emergency Surgery consult
4. Broad-spectrum antibiotics
Critical Actions: Intussusception - ANS 1. NS bolus (20cc/kg)
2. Complete physical examination
3. Barium enema
4. Pediatric surgical consult
Intussussception ultrasound findings - ANS the "target" or "doughnut" sign
Treatment for intussusception - ANS - Air, saline or barium enema by radiologist
- surgical consult
Critical Actions: HIV pneumonia - ANS 1. Oxygen supplementation
2. IV fluids
3. CXR
4. UA
5. Antibiotics
6. Respiratory isolation
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
2) QUESTIONS AND ANSWERS GRADED
A+ 2025/2026
Critical Actions: CHF exacerbation - ANS 1. Oxygen
2. High-dose nitroglycerin drip / sequential SL 0.4mg NTG tablets initiated immediately
3. Furosemide
4. Aspirin
5. CCU consult
Nitroglycerin drip dosage for SCAPE (sympathetic crashing acute pulmonary edema) - ANS -
Start with high doses
- Can start at 400mcg/min (over 2-5 min) and then titrate down
- Can also give SL nitro if drip isn't readily available
- Can also give nitroglycerin through nebulizer (3-5mcg of IV solution Q15min)
Non-invasive positive pressure ventilation settings for SCAPE (sympathetic crashing acute
pulmonary edema) - ANS Start at 5 cm H2O and titrate up to 15 cm H2O. Inspiratory positive
airway pressure is supplementary
Critical Actions: Critical aortic coarctation (Neonate dyspnea/crashing) - ANS 1. Recognition
of respiratory distress
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,2. Oxygen administration, intubation
3. IV access
4. EKG, CXR
5. Recognition of cardiomegaly and cardiac causes of respiratory distress
6. Cardiology consult
7. Prostaglandin administration
Ventilator settings for congenital defect neonate - ANS - Volume 10 ml/kg or with chest rise
- O2 100%
- rate of 40
Prostaglandin E1 dose - ANS 0.05mcg/kg/min
Crashing Neonate Causes - ANS 1. Hypoglycemia - check glucose
2. Sepsis - antibiotics, cultures, LP
3. Non-accidental trauma - CTH, bone survey
4. Congenital heart defect - CXR, Prostaglandin E1
5. Inborn errors of metabolism - glucose, ammonia, pH, UA, CMP, make NPO
6. Abdominal catastrophe - KUB, upper GI, surgery consult
Critical Actions: Renal colic - ANS 1. Large bore IV access and hydration with greater than 1L
NS
2. Early pain control
3. Confirmation of diagnosis of renal colic with CT w/o contrast given first episode of colic
4. UA
5. Temperature
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Renal stone pass rate - ANS - <4mm: 90% pass rate
- 4-6mm: 50% pass rate
- >6mm: 10% pass rate
When to admit renal stones - ANS 1. Patient has an obstructed and infected stone
2. Patient has intractable pain or vomiting.
3. Patient has an acute kidney injury.
4. Patient has a single kidney or has been the recipient of a renal transplant.
5. Significant medical comorbidities are present.
6. The patient has failed outpatient medical therapy (stone not passing after 4-6 weeks).
Critical Actions: Status Epilepticus - ANS 1. Finger stick blood glucose
2. IV access
3. IV benzodiazepines
4. Head CT to evaluate for intracranial pathology
5. Labs to exclude metabolic pathology
6. Serum toxicity
7. Neurology consult for new onset seizure/status epilepticus
1st line medications for status epilepticus - ANS Benzodiazepines (diazepam, lorazepam,
midazolam)
2nd line medications for status epilepticus - ANS Phenytoin, Fosphenytoin, valproic acid,
levetiracetam
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, 3rd line medications for status epilepticus - ANS Ketamine, lacosamide, phenobarbital
IV anesthetics/sedatives for status epilepticus - ANS Medazolam drip, propofol drip,
pentobarbital drip, thiopental (infusion)
Critical Actions: Fournier gangrene - ANS 1. Full physical exam looking for source of fever
2. Adequate fluid resuscitation
3. Emergency Surgery consult
4. Broad-spectrum antibiotics
Critical Actions: Intussusception - ANS 1. NS bolus (20cc/kg)
2. Complete physical examination
3. Barium enema
4. Pediatric surgical consult
Intussussception ultrasound findings - ANS the "target" or "doughnut" sign
Treatment for intussusception - ANS - Air, saline or barium enema by radiologist
- surgical consult
Critical Actions: HIV pneumonia - ANS 1. Oxygen supplementation
2. IV fluids
3. CXR
4. UA
5. Antibiotics
6. Respiratory isolation
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
