SAEM SET 1 EXAM WITH 100

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SAEM SET 1 EXAM WITH 100%

CORRECT ANSWERS

Question : The chest X-ray in the Figure was taken

in an intoxicated patient who is conversant, but an unreliable historian. The X-ray findings are best

described as indicating:

[image]

• Esophageal foreign body
• Intratracheal foreign body
• mediastinitis from esophageal perforation
• normal chest

Correct answer: A. Esophageal foreign body

The answer is A. The film reveals a classic appearance of a round foreign body (in this case, a pull-top from a beer can) in the esophagus. The foreign body appears to lie outside the tracheal shadow. There is no sign of mediastinal air (which would be expected with penetrating trauma). The X-

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ray reveals no signs of mediastinitis, but the risk of esophageal perforation and ultimate mediastinitis prompts endoscopic intervention in this patient.

Question : An 18 year old hockey player is hit in the

mouth with a puck, fracturing a maxillary canine tooth. He brings the severed piece of tooth with him.On physical exam, the tooth is fractured halfway between the tip and the gumline. The exposed fracture site has a yellowish tinge without blood. Of the following choices, which is the most appropriate management for this patient?

• No specific treatment required
• Application of calcium hydroxide, placement of

aluminum foil, and dental follow-up

• Placement of tooth fragment in saline gauze,

outpatient dental follow-up

• Immediate dental consult to avoid abscess

formation

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• Replace fractured piece and place acrylic splint

Correct answer: D. Immediate dental consult to

avoid abscess formation

The answer is D. Ellis II dental fracture involves enamel and dentin. The fracture site typically has a yellowish tinge. Ellis III dental fractures are characterized by exposure of pinkish pulp and often blood. These fractures require immediate dental consultation to prevent abscess formation.

Question : A 22 year old man is punched in the nose

during a fight. He presents to the emergency department with obvious nasal bone deformity.Pressure controls the bleeding. Physical exam reveals no maxillary bone or orbital rim tenderness, intact vision and extraocular movement. The oropharynx and mandible are unremarkable. Nasal inspection reveals a swollen, ecchymotic, tender

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nasal septum. Which of the following is the most appropriate initial step?

• Outpatient follow-up with an ENT specialist to

surgically correct a deviated septum

• Plastic surgery consult for immediate reduction of

nasal fracture

• Facial CT scan to rule out more serious facial

fractures

• Incision and drainage of the septal hematoma

followed by nasal packing

• Needle aspiration of the septal hematoma

Correct answer: D. Incision and drainage of the

septal hematoma followed by nasal packing

Question : A 24 year old woman is playing

racquetball and sustains a direct blow from the ball to the right eye. She presents to the emergency department complaining of eye pain and double