SAEM EXAM QUESTIONS 2023-2024 ACTUAL EXAM 400
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
An 80 year old nursing home patient is brought to the emergency department with
an acute onset of confusion. Which of the following metabolic abnormalities is the
most likely explanation?
A. hypocalcemia
B. hypokalemia
C. hypernatremia
D. hyperphosphatemia – ANSWER- C. hypernatremia
Rationale: The differential diagnosis of acute confusional states is lengthy. It
includes many metabolic\/nutritional abnormalities including hypoglycemia, hypo-
\/hypernatremia, and hypercalcemia. Hypokalemia alone, however, is not a
common cause of altered mental status.
Which factor is least reliable in differentiating between organic and inorganic
causes of confusion?
A. acute versus chronic onset
B. Vital sign abnormalities
C. Presence of attention deficit
D. Signs of trauma – ANSWER- C. Presence of attention deficit
Rationale: Presence of an attention deficit is common to all confusional states. All
the other options may be used to differentiate organic versus non-organic causes of<\/p>\n\n\n\n
confusion. Characteristics of organic causes include acute onset, abnormal vital
signs, fluctuating level of consciousness, possibly signs of trauma, and\/or focal
neurologic signs. Inorganic (functional) causes commonly illustrate chronic onset,
stable vital signs, absence of trauma or focal neurologic symptoms, and\/or
delusions and illusions.
With regard to specific causes of hypertension, which of the following is true?
A. Hypertensive encephalopathy is more likely than hypertensive stroke in
patients whose mental status changes are reversible
B. Hypertensive encephalopathy causes adverse outcomes over days or weeks,
rather than hours
C. Patients with stroke syndromes must have blood pressure normalized as quickly
as possible to reduce the risks of worsening neurological deficit
D. Laboratory analysis is rarely useful in cases of confirmed pediatric
hypertension
E. Laboratory analysis is rarely useful in cases of confirmed hypertension in
pregnant patients – ANSWER- A. Hypertensive encephalopathy is more likely than
hypertensive stroke in patients whose mental status changes are reversible
Rationale: Hypertensive encephalopathy is a true medical emergency, and can
cause coma and death over hours; however, encephalopathy due to hypertension is
more likely reversible than encephalopathy from other causes. Avoidance of
overzealous blood pressure lowering is particularly critical for patients with
strokes. Laboratory analysis can be important in cases of hypertension in pediatric
patients (for whom renal\/renovascular or pheochromocytoma may be identified)
and in pregnant patients (for whom laboratory testing can help establish diagnoses
such as the HELLP syndrome).
A 29 year old woman is found seizing by her husband and is rushed to the
emergency department. On presentation, she is noted to have a BP of 162\/112, is
still seizing, and looks puffy all over. Her husband tells you that they are expecting<\/p>\n\n\n\n
their first child in a few months. Which of the following is the next best step in this the previous evening. This morning he experienced palpitations, diaphoresis, and SAEM EXAM QUESTIONS 2023-2024 ACTUAL EXAM 400REAL EXAM QUESTIONS AND CORRECT DETAILEDANSWERS WITH RATIONALES (VERIFIED ANSWERS)|ALREADY GRADED A+An 80 year old nursing home patient is brought to the emergency department withan acute onset of confusion. Which of the following metabolic abnormalities is themost likely explanation?A. hypocalcemiaB. hypokalemiaC. hypernatremiaD. hyperphosphatemia – ANSWER- C. hypernatremiaRationale: The differential […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-116771","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/116771","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=116771"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/116771\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=116771"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=116771"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=116771"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
patient’s care?
A. Control the seizures with magnesium sulfate.
B. Draw blood to check CBC, LFT’s, BUN, and creatinine.
C. Notify the labor floor that the patient is in the emergency department.
D. Perform a CT scan of head if seizures persist.
E. Start hydralazine to decrease the patient’s blood pressure. – ANSWER- A.
Control the seizures with magnesium sulfate.
Rationale: Antihypertensive therapy is only indicated in eclampsia if the diastolic
blood pressure remains > 110 mm Hg after seizures are controlled because rapid
lowering of blood pressure can result in uterine hypoperfusion. All the other
choices (A-D) are appropriate in the management of the patient with eclampsia.
Which of the following is not<\/em> a feature of febrile seizures?
A. generalized tonic-clonic seizure
B. duration less than 15 minutes
C. associated with a rapid rise in body temperature
D. occurs in children ages 3 months to 5 years
E. associated with postictal state of 30 minutes – ANSWER- E. associated with
postictal state of 30 minutes
Rationale: Febrile seizure is not associated with a postictal period. The child
usually rapidly regains alertness. Intracranial mass or infection should be a concern
if the duration of seizure is greater than 15 minutes or if altered mental status
persists after the cessation of seizure activity.
A 47 year old man with a history of alcohol abuse presents to the ED after having a
seizure. His past includes both seizures and blackouts. His last alcoholic drink was<\/p>\n\n\n\n
dizziness before losing consciousness and having a seizure lasting under a minute.
Which of the following is true<\/em> statement with to alcohol and its association with
seizures?
A. In people with an underlying seizure disorder, excessive alcohol intake is a
risk-factor for seizure due to increased likelihood of head injury, predisposition to
metabolic disorders, and lowered seizure threshold.
B. Alcohol intake itself can precipitate seizures due to the neurotoxic effects of
alcohol and its metabolites.
C. Cessation of alcohol can precipitate seizures as part of the alcohol withdrawal
syndrome.
D. All of the above statements are true.
E. All of the above statements are false. – ANSWER- D. All of the above
statements are true.
A 68 year old diabetic male, previously living independently, is brought in by his
family. He has been acting abnormally for two days. The family reports he is
awake all night and sleepy during the day. He is confused about where he is and
the time of day, and sometimes doesn’t recognize his daughter and son-in-law. At
other times he appears and acts almost normally. Which of the following is true<\/em>
regarding his condition?
A. Infection is an unlikely cause of his condition unless his temperature is > 102\u00b0.
B. Dementia is the most likely cause of his condition and the family must be
counseled.
C. Medications are an unlikely cause of this condition in the elderly.
D. Patients can be agitated and combative, or calm and quiet in this condition.
E. Treatment includes maximizing sensory input. – ANSWER- D. Patients can be
agitated and combative, or calm and quiet in this condition.
<\/p>\n","protected":false},"excerpt":{"rendered":"