SAEM M4 Exam
True or False: gastric distension due to excessive volume or rate of ventilation impairing ventilatory
function is a reason to intubate a neonate - Answer-False
management for nursemaid elbow injury - Answer-apply pressure to the radial head while flexing and
supinating elbow
A 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? - Answer-compression fracture of the posteriolateral
aspect of the humeral head (Hill-Sachs deformity)
What are most common heart rhythms seen in pediatric arrest? - Answer-bradycardia or asystole
risk factors for neonatal resuscitation - Answer-prematurity
IUGR
multiple gestation
thick meconium
In the post-arrest setting, which of the following is the drug of choice in treating hypotension in a child: -
Answer-epi
,Low body temperatures in newborns can lead to severe physiologic consequences, which include all
EXCEPT:
Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia - Answer-3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator of: - Answer-hypoxemia
All the following are signs of hypoxemia in a newborn, EXCEPT:
Answers:
1.cyanosis
2.lethargy
3.tachycardia
4.unresponsiveness
5.bradycardia - Answer-3. tachycardia
A newborn presents to the emergency department a few days after hospital discharge. The infant has
been noted to be drooling, choking, and coughing, and the mother reports seeing bubbles at the baby's
mouth. Which is the most likely explanation?
Answers:
1.osteogenesis imperfecta
,2.inborn error of metabolism
3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula - Answer-5. tracheoesophageal fistula
Which of the following pairs of maneuvers are consistent with current recommendations for emergency
care for a choking 5-month-old infant?
Answers:
1.back blow then blind finger sweep
2.back blow then chest thrust
3.chest thrust then Heimlich maneuver
4.Heimlich maneuver then blind finger sweep
5.Heimlich maneuver then chest thrust - Answer-2.back blow then chest thrust
All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT:
Answers:
1.If administering succinylcholine, pretreatment with atropine is always indicated in children under age
10.
2.Lidocaine pretreatment is usually provided to children with head trauma.
3.When deciding which size endotracheal tube to use, one may approximate by using the size of the
small finger or nares as a reference.
4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to
intubation for children under age ten.
5.Uncuffed endotracheal tubes are the preferred devices used in children under 6-8 years of age. -
Answer-4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to
intubation for children under age ten.
, 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 - Answer-2. cocaine
A mother brings in her 4 year old child who was happily eating "blackberries" from weeds in the garden
and is now acting strangely. She has identified them as Belladonna from a quick internet search. Which
physical examination finding might you also expect to find in this child?
Answers:
1.Diaphoresis
2.Flushed skin
3.Miosis
4.Urinary incontinence - Answer-2. flushed skin
For which of the following cases is activated charcoal therapy most appropriate?
Answers:
1.Acetaminophen overdose
2.Drain cleaner ingestion
3.Iron supplement overdose
True or False: gastric distension due to excessive volume or rate of ventilation impairing ventilatory
function is a reason to intubate a neonate - Answer-False
management for nursemaid elbow injury - Answer-apply pressure to the radial head while flexing and
supinating elbow
A 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? - Answer-compression fracture of the posteriolateral
aspect of the humeral head (Hill-Sachs deformity)
What are most common heart rhythms seen in pediatric arrest? - Answer-bradycardia or asystole
risk factors for neonatal resuscitation - Answer-prematurity
IUGR
multiple gestation
thick meconium
In the post-arrest setting, which of the following is the drug of choice in treating hypotension in a child: -
Answer-epi
,Low body temperatures in newborns can lead to severe physiologic consequences, which include all
EXCEPT:
Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia - Answer-3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator of: - Answer-hypoxemia
All the following are signs of hypoxemia in a newborn, EXCEPT:
Answers:
1.cyanosis
2.lethargy
3.tachycardia
4.unresponsiveness
5.bradycardia - Answer-3. tachycardia
A newborn presents to the emergency department a few days after hospital discharge. The infant has
been noted to be drooling, choking, and coughing, and the mother reports seeing bubbles at the baby's
mouth. Which is the most likely explanation?
Answers:
1.osteogenesis imperfecta
,2.inborn error of metabolism
3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula - Answer-5. tracheoesophageal fistula
Which of the following pairs of maneuvers are consistent with current recommendations for emergency
care for a choking 5-month-old infant?
Answers:
1.back blow then blind finger sweep
2.back blow then chest thrust
3.chest thrust then Heimlich maneuver
4.Heimlich maneuver then blind finger sweep
5.Heimlich maneuver then chest thrust - Answer-2.back blow then chest thrust
All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT:
Answers:
1.If administering succinylcholine, pretreatment with atropine is always indicated in children under age
10.
2.Lidocaine pretreatment is usually provided to children with head trauma.
3.When deciding which size endotracheal tube to use, one may approximate by using the size of the
small finger or nares as a reference.
4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to
intubation for children under age ten.
5.Uncuffed endotracheal tubes are the preferred devices used in children under 6-8 years of age. -
Answer-4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to
intubation for children under age ten.
, 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 - Answer-2. cocaine
A mother brings in her 4 year old child who was happily eating "blackberries" from weeds in the garden
and is now acting strangely. She has identified them as Belladonna from a quick internet search. Which
physical examination finding might you also expect to find in this child?
Answers:
1.Diaphoresis
2.Flushed skin
3.Miosis
4.Urinary incontinence - Answer-2. flushed skin
For which of the following cases is activated charcoal therapy most appropriate?
Answers:
1.Acetaminophen overdose
2.Drain cleaner ingestion
3.Iron supplement overdose
