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SAEM M4 Exam Newest 2025/2026 Complete
Questions And Correct Detailed Answers (Verified
Answers) |Brand New Version!!
With respect to laboratory findings in diabetic ketoacidosis (DKA) and
hyperglycemic hyperosmolar nonketotic coma (HHNC), all of the
following guidelines are generally true EXCEPT:
Answers:
1.Patients with HHNC typically have blood glucose > 700 mg/dL,
whereas patients with DKA have blood glucose > 350 mg/dL.
2.Serum ketones are present in patients with DKA but not usually in
patients with HHNC.
3.Serum bicarbonate is typically severely low (<10mEq) in patients with
either DKA or HHNC.
4.Serum osmolality in patients with HHNC is typically > 350 mOsm/L.
5.BUN is elevated more in patients with HHNC (>50 mg/dL) than in
patients with DKA (25-50 mg/dL). - ANSWER-3.Serum bicarbonate is
typically severely low (<10mEq) in patients with either DKA or HHNC.
Regarding the treatment of hyperosmolar hypertonic nonketotic coma
(HHNC) and its associated symptoms, which of the following is correct:
Answers:
1.Half of the fluid deficit should be corrected over the first hour and the
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remainder over the following 8 hours.
2.Since patients are not acidotic, close monitoring of glucose is not
necessary.
3.Hyperosmolarity should be corrected within the first few hours in the
emergency department.
4.Phenytoin (Dilantin) is often ineffective for seizures associated with
HHNC.
5.In HHNC patients with severe dehydration, bleeding diathesis is a
major clinical concern. - ANSWER-4.Phenytoin (Dilantin) is often
ineffective for seizures associated with HHNC.
Regarding the development of cerebral edema in patients being treated
for DKA, all of the following are true EXCEPT:
Answers:
1.Cerebral edema typically occurs six to ten hours following onset of
treatment.
2.Children have a higher incidence of cerebral edema.
3.Mannitol and steroids should be administered immediately to any
patient suspected of developing cerebral edema.
4.Mortality of patients developing cerebral edema is 90%.
5.Patients with serum glucose below 250 mg/dL still being treated with
insulin are most likely to develop clinically evident cerebral edema. -
ANSWER-3.Mannitol and steroids should be administered immediately
to any patient suspected of developing cerebral edema.
Metabolic abnormalities often seen with hypothyroidism include all of
thefollowing EXCEPT:
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Answers:
1.hyponatremia
2.hyperglycemia
3.hypercholesterolemia
4.respiratory acidosis from hypoventilation
5.anemia - ANSWER-2.hyperglycemia
Laboratory abnormalities typically seen with adrenal insufficiency
include all of the following EXCEPT:
Answers:
1.hypoglycemia
2.hyponatremia
3.hypokalemia
4.hypercalcemia
5.azotemia - ANSWER-3.hypokalemia
Regarding the treatment of suspected but not confirmed adrenal
insufficiency, which of the following is most appropriate?
Answers:
1.cosyntropin 0.25mg IV x 1
2.dexamthasone 4mg IV every 6 hours
3.hydrocortisone 100mg IV every 6 hours
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4.cortisone 100mg IM every 6 hours
5.withholding of steroids until confirmation of the diagnosis of adrenal
insufficiency - ANSWER-2.dexamthasone 4mg IV every 6 hours
Symptoms of secondary adrenal insufficiency include all of the
following EXCEPT:
Answers:
1.weakness
2.anorexia
3.hyperpigmentation
4.nausea and vomiting
5.weight loss - ANSWER-3.hyperpigmentation
True or False: gastric distension due to excessive volume or rate of ventilation
impairing ventilatory function is a reason to intubate a neonate -
SOLUTION=False
management for nursemaid elbow injury - SOLUTION=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? - SOLUTION=compression fracture
of the posteriolateral aspect of the humeral head (Hill-Sachs deformity)
SAEM M4 Exam Newest 2025/2026 Complete
Questions And Correct Detailed Answers (Verified
Answers) |Brand New Version!!
With respect to laboratory findings in diabetic ketoacidosis (DKA) and
hyperglycemic hyperosmolar nonketotic coma (HHNC), all of the
following guidelines are generally true EXCEPT:
Answers:
1.Patients with HHNC typically have blood glucose > 700 mg/dL,
whereas patients with DKA have blood glucose > 350 mg/dL.
2.Serum ketones are present in patients with DKA but not usually in
patients with HHNC.
3.Serum bicarbonate is typically severely low (<10mEq) in patients with
either DKA or HHNC.
4.Serum osmolality in patients with HHNC is typically > 350 mOsm/L.
5.BUN is elevated more in patients with HHNC (>50 mg/dL) than in
patients with DKA (25-50 mg/dL). - ANSWER-3.Serum bicarbonate is
typically severely low (<10mEq) in patients with either DKA or HHNC.
Regarding the treatment of hyperosmolar hypertonic nonketotic coma
(HHNC) and its associated symptoms, which of the following is correct:
Answers:
1.Half of the fluid deficit should be corrected over the first hour and the
,2|Page
remainder over the following 8 hours.
2.Since patients are not acidotic, close monitoring of glucose is not
necessary.
3.Hyperosmolarity should be corrected within the first few hours in the
emergency department.
4.Phenytoin (Dilantin) is often ineffective for seizures associated with
HHNC.
5.In HHNC patients with severe dehydration, bleeding diathesis is a
major clinical concern. - ANSWER-4.Phenytoin (Dilantin) is often
ineffective for seizures associated with HHNC.
Regarding the development of cerebral edema in patients being treated
for DKA, all of the following are true EXCEPT:
Answers:
1.Cerebral edema typically occurs six to ten hours following onset of
treatment.
2.Children have a higher incidence of cerebral edema.
3.Mannitol and steroids should be administered immediately to any
patient suspected of developing cerebral edema.
4.Mortality of patients developing cerebral edema is 90%.
5.Patients with serum glucose below 250 mg/dL still being treated with
insulin are most likely to develop clinically evident cerebral edema. -
ANSWER-3.Mannitol and steroids should be administered immediately
to any patient suspected of developing cerebral edema.
Metabolic abnormalities often seen with hypothyroidism include all of
thefollowing EXCEPT:
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Answers:
1.hyponatremia
2.hyperglycemia
3.hypercholesterolemia
4.respiratory acidosis from hypoventilation
5.anemia - ANSWER-2.hyperglycemia
Laboratory abnormalities typically seen with adrenal insufficiency
include all of the following EXCEPT:
Answers:
1.hypoglycemia
2.hyponatremia
3.hypokalemia
4.hypercalcemia
5.azotemia - ANSWER-3.hypokalemia
Regarding the treatment of suspected but not confirmed adrenal
insufficiency, which of the following is most appropriate?
Answers:
1.cosyntropin 0.25mg IV x 1
2.dexamthasone 4mg IV every 6 hours
3.hydrocortisone 100mg IV every 6 hours
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4.cortisone 100mg IM every 6 hours
5.withholding of steroids until confirmation of the diagnosis of adrenal
insufficiency - ANSWER-2.dexamthasone 4mg IV every 6 hours
Symptoms of secondary adrenal insufficiency include all of the
following EXCEPT:
Answers:
1.weakness
2.anorexia
3.hyperpigmentation
4.nausea and vomiting
5.weight loss - ANSWER-3.hyperpigmentation
True or False: gastric distension due to excessive volume or rate of ventilation
impairing ventilatory function is a reason to intubate a neonate -
SOLUTION=False
management for nursemaid elbow injury - SOLUTION=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? - SOLUTION=compression fracture
of the posteriolateral aspect of the humeral head (Hill-Sachs deformity)
