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Ace the ABEM Board Exam with Med-Challenger's proven Emergency Medicine Board Review. Featuring over 3,700 ABEM Exam Review questions with detailed explanations and rationales following the American Board of Emergency Medicine Exam Blueprint, board exam simulation, adaptive learning features, and hundreds of built-in CME credits, Med-Challenger's ABEM exam review is the best way to prepare for emergency medicine boards.

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"Outstanding emergency medicine board review. Passed my ABEM board exam easily and I'm loaded with CME for later. I would recommend Med-Challenger for any emergency medicine specialist seeking the best ABEM board review for the Qualifying Exam or ConCert exam."
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most powerful ABEM board review for emergency medicine board review

Med-Challenger is the most effective, easiest to use Emergency Medicine board review question bank for the American Board of Emergency Medicine Qualifying (initial certification) and ConCert examinations. Med-Challenger's emergency medicine review with intelligent EM self-assessment provides everything you need to pass the ABEM exam and fulfill other emergency medicine certification requirements such as AMA PRA Category 1 and ACEP CME credits, all in one powerful, effective, and convenient access point online.

Our pass-guaranteed Emergency Medicine board review course gets you prepared for ABEM boards fast, thanks to our constantly updated Emergency Medicine review questions, detailed answer explanations, and intelligent EM board exam simulators. Plus, our online ABEM board review course keeps serving you after exams too. Certification or recertification – Emergency Medicine board review has never been so easy, effective, or efficient. It's more than just the best emergency medicine question bank, it's lifelong emergency medicine education and ABEM MOC convenience.

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Our #1 emergency medicine question bank for ABEM exam prep is intelligent, automatically targeting any detected weaker areas of knowledge, saving your time.

3700+ Emergency Medicine Board Review Questions

High-Yield Emergency Medicine Review Questions mapped to the EM Model and ABEM board exam blueprint.

Using authoritative resources such as Rosen's and Tintinalli's emergency medicine textbooks, our emergency medicine physician editors ensure our ABEM prep course is always current and covers the latest ABEM exam blueprint. The Med-Challenger Emergency Medicine Board Review is 100% pass-guaranteed and used by the National Emergency Medicine Review live course, GME programs and healthcare organizations world-wide.

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Emergency Medicine Course Information

Emergency Medicine Review Course Information

Signs, Symptoms, and Presentations

Abdominal Pain
Acute Pelvic Pain in Women
Acute Vaginal Bleeding
Back Pain
Chest Pain
Confusion
Constipation
Cyanosis
Depressed Consciousness and Coma
Diarrhea
Dizziness and Vertigo
Dyspnea
Fever in the Adult Patient
Gastrointestinal Bleeding
Headache: Initial Approach
Hemoptysis
Jaundice
Nausea and Vomiting
Seizures: Initial Approach
Syncope
Weakness

Abdominal and Gastrointestinal Disorders

Anorectal Disorders
Appendicitis
Colitis, Ileitis, and Functional Bowel Disorders
Disorders of the Liver
Esophagus, Stomach, and Duodenum
Gallbladder and Biliary Tract Disorders
Hernias
Infectious Gastroenteritis
Obstruction, Ischemia, Perforation, Peritonitis
Pancreatitis
Pediatric Gastrointestinal Disorders

Cardiovascular Disorders

Acute Coronary Syndromes - Diagnosis and Challenges Non-ST-Elevation
Acute Coronary Syndromes - Initial Workup Non-ST-Elevation
Acute Coronary Syndromes - Medical Therapies Non-ST-Elevation
Acute Coronary Syndromes - Surgical Invasive Management Non-ST-Elevation
Acute Coronary Syndromes - Special Patient Groups ST-Elevation
Acute Coronary Syndromes - Initial Medical Care ST-Elevation
Acute Coronary Syndromes - Reperfusion Strategies ST-Elevation
Acute Coronary Syndromes - Stabilization of Complications
Cardiac Failure
Cardiac Valve Disorders
Cardiomyopathies
Circulation: Aortic Aneurysms
Circulation: Aortic Dissection
Circulation: Hypertension - Emergency Management
Circulation: Peripheral Vascular Emergencies
Dysrhythmia: Basic Concepts
Dysrhythmia: Conduction Disorders
Dysrhythmia: Implantable Devices Dysrhythmia: Pharmacology
Dysrhythmia: Supraventricular
Dysrhythmia: Ventricular
Endocarditis and Myocarditis
Pericarditis/Pericardial Tamponade (Non-Traumatic)

Cutaneous Disorders

Cancers of the Skin
Cutaneous Infections
Dermatitis (Non-Infectious)
Maculopapular Lesions
Papular/Nodular Lesions
Ulcerative Lesions
Vesicular/Bullous Lesions

Endocrine, Metabolic, & Nutritional Disorders

Basic Science Review: Acid-Base Regulation
Basic Science Review: Regulation of Water and Osmolarity
Clinical Context: Acid-Base Disorders
Clinical Context: Alcoholic and Lactic Acidosis
Clinical Context: Osmol and Anion Gaps
Electrolyte Disorders: Calcium, Magnesium, Phosphorus
Electrolyte Disorders: Potassium
Electrolyte Disorders: Sodium, Chloride
Endocrine Disorders: Adrenal Gland
Endocrine Disorders: Diabetic Ketoacidosis
Endocrine Disorders: Hyperosmolar Hyperglycemic State
Endocrine Disorders: Hypoglycemia
Endocrine Disorders: Thyroid Gland
Miscellaneous: Alcohol-Related Disease

Environmental Disorders

Drowning
Electrical and Lightning Injuries
Frostbite
Heat-Related Illnesses
High Altitude Disorders
Hypothermia: Accidental
Marine Animal Envenomations and Injuries
Scuba Diving and Dysbarism
Venomous Animal Injuries: Arthropods
Venomous Animal Injuries: Reptiles

Eye, Ear, Nose & Throat Disorders

Eye: Assessment
Eye: Glaucoma
Eye: Inflammation and Infection
Eye: Pharmacology
Eye: Vascular Disorders
Nose: Infection and Inflammation
Oral Cavity: Medical Disorders
Otologic Infections
Otologic Signs, Symptoms, Presentations
Throat and Soft Tissue Neck: Medical Disorders

Hematologic and Oncologic Disorders

Disorders of Hemostasis: Factor Deficiencies
Disorders of Hemostasis: Platelets/Fibrinogen
Red and White Blood Cell Disorders
Selected Oncologic Emergencies
Transfusions

Immune System Disorders

Collagen Vascular/Immune Complex Disorders
Hypersensitivity Reactions
The Immunocompromised/Solid-Organ Transplant Patient

Systemic Infectious Disorders

Bacterial Infections: Diphtheria, Pertussis, Tetanus
Bacterial Infections: Meningococcemia, Pneumococcemia
Bacterial Infections: MRSA, VRE, ESBL
Bacterial Infections: Pediatric I, II
Bacterial Infections: Tuberculosis
Coronavirus (SARS-COV-2, COVID-19)
COVID-19 During Pregnancy
Parasitic Infections
Sepsis Syndromes
Systemic Fungal Infections
Tick-Borne Illnesses
Viral Infections: Hantavirus
Viral Infections: HIV
Viral Infections: Influenza, Mononucleosis, Herpes
Viral Infections: Pediatric
Viral Infections: Rabies

Musculoskeletal Disorders (Non-Traumatic)

Bone and Joint Infections
Deep Soft Tissue Infections
Disorders of Muscles
Disorders of the Spine
Overuse Syndromes (incl. Tendinopathy and Bursitis)

Nervous System Disorders

Neurological Assessment
Central Nervous System Disorders: Delirium and Dementia
Central Nervous System Disorders: Demyelinating/Inflammatory
Central Nervous System Disorders: Seizures
Central Nervous System Disorders: Spinal Cord Syndromes
Central Nervous System Infections Headache Disorders
Stroke: Presentation
Stroke: Initial Work-Up
Stroke: Treatment
Pediatric Nervous System Disorders I, II
Neuromuscular Junction Disease
Peripheral Nervous System Disorders
Selected Cranial Nerve Disorders

Psychobehavioral Disorders

Emergency Psychiatric Evaluation
Schizophrenia/Psychotic Disorders
Somatic Symptom Disorders
Suicide Violence, Abuse, Neglect: Assault (incl. sexual)
Violence, Abuse, Neglect: Elderly Citizens

Renal and Urogenital Disorders

Male Genital Problems: Noninfectious
Nephropathy, Contrast-Induced
Nephroureterolithiasis
Renal Failure: Acute
Renal Failure: Chronic
Renal Transplantation
Sexually Transmitted Infections: Male
Urinary Retention
Urinary Tract Infection
Urological Assessment

Thoracic-Respiratory Disorders

Acute Upper Airway Disorders (Incl. Peds.)
Disorders Of Pleura, Mediastinum, And Chest Wall
Obstructive/Restrictive Diseases: Fibrosis/Emphysema/Exposures (Incl. Peds) I, II
Obstructive/Restrictive Diseases: Reactive Lower Airway Disorders (Incl. Peds)
Pulmonary Embolism/Hypertension/Edema Pulmonary Infections (Incl. Peds)

Obstetrics and Gynecology

Gynecologic Infections: Genital Lesions
Gynecologic Infections: Vaginal Discharge
Pregnancy: Acute Medical/Surgical Complications
Pregnancy: Acute Obstetric Complications
Pregnancy: General Approach to the Pregnant Patient
Pregnancy: Labor, Delivery and Their Complications
Pregnancy: Preexisting Medical Illness

Toxicologic Disorders

General Approach to the Poisoned Patient
Acetaminophen Toxicity
Antibiotics Toxicity and Side Effects
Anticholinergics Toxicity
Anticonvulsant Toxicity
Antidepressants Toxicity (incl. Serotonin Syndrome)
Antipsychotics Toxicity
Aspirin and NSAIDs Toxicity
Bronchodilator Toxicity
Cardiovascular Drug Toxicity
Caustic Ingestion
Cocaine and Other Sympathomimetics Toxicity
Hallucinogen Toxicity
Heavy Metal Toxicity
Hydrocarbon Toxicity
Inhaled Toxins
Lithium Toxicity
Opiate Toxicity
Pesticide Toxicity (incl. Organophosphates)
Sedatives and Hypnotics Toxicity (incl. Barbiturates, Benzodiazepines)
Toxic Alcohols
Toxic Plant Ingestions (incl. Mushrooms)

Traumatic Disorders

Bites - Mammals (incl. Humans)
Burns: Chemical
Burns: Thermal
EENT Trauma: Eye
EENT Trauma: Nose
EENT Trauma: Oral-Dental
EENT Trauma: Otologic
Orthopedic Injuries: Ankle
Orthopedic Injuries: Cervical Spine
Orthopedic Injuries: Femur and Hip
Orthopedic Injuries: Foot
Orthopedic Injuries: Hand
Orthopedic Injuries: Humerus and Elbow
Orthopedic Injuries: Knee and Lower Leg
Orthopedic Injuries: Shoulder
Orthopedic Injuries: Wrist and Forearm
Special Populations: Geriatric Trauma
Special Populations: Trauma in Pregnancy
Trauma: Abdominal
Trauma: Face
Trauma: Foreign Bodies
Trauma: Genitourinary
Trauma: Head
Trauma: Multiple and Blast Injuries
Trauma: Pelvic
Trauma: Peripheral Vascular Injury
Trauma: Soft Tissue Neck
Trauma: Spinal Cord
Trauma: Thoracic - Cardiovascular Injuries
Trauma: Thoracic - Chest Wall
Trauma: Thoracic - Esophageal Injuries
Trauma: Thoracic - Pulmonary Injuries

Airway, Ventilation, Resuscitation

Advanced Airway: Adult
Airway: Pediatric
Breathing: Ventilatory Support (Adult/Pediatric)
Resuscitation: Adult Cardiac
Resuscitation: Brain (After Cardiac Arrest)
Resuscitation: Neonatal
Resuscitation: Pediatric
Resuscitation: Shock
Resuscitation: Trauma

Procedural Sedation

Procedural Sedation: Adult
Procedural Sedation: Pediatric

Wound Management

Wound Management: General
Wound Management: Closure Techniques
Wound Management: Escharotomy
Wound Management: Incision and Drainage
Wound Management: Nail Trephination

EMS and Disaster Response Systems

Air and Ground EMS Transport
Disaster Preparedness
Disasters/Terrorism: Biological
Disasters/Terrorism: Chemical
Disasters/Terrorism: Explosives
Disasters/Terrorism: Radiation (incl. Nuclear)

Laws, Ethics, and Professionalism

Consent, Error Disclosure, and Other Ethical-Legal Challenges
EMTALA
End of Life Care
Optimizing Patient Safety
Optimizing Care During Conflict and Crisis
Optimizing Care of Culturally Diverse Populations
Physician Wellness and Impairment
Prevention and Control of Injury

Sample Question 1

A 48-year-old man presents with a painful and swollen right knee after minor trauma. His past medical history is notable for moderate hemophilia B with a baseline factor IX level of 3% of normal levels. His exam is normal except for a right knee effusion and pain on active and passive motion of the right knee.

His WBC is 7300/microliter, hemoglobin is 15.2 g/dL, hematocrit 47%, and platelets 225,000.

You are concerned about a right knee hemarthrosis.

What is the next step to stop the bleeding into the knee joint?

Infuse 50 units/kg of recombinant factor IX
Infuse 20 ml/kg of fresh frozen plasma
Infuse 2 units fresh frozen plasma
Observation unless he becomes hemodynamically unstable

Educational Objective:

Recall the management of hemarthrosis in a patient with hemophilia.

Key Point:

Hemarthroses and their resulting joint damage are a major cause of morbidity in people with hemophilia and should be treated emergently upon diagnosis. 

Explanation:

Doses are calculated on the basis that 1 unit/kg of factor VIII leads to a rise in plasma factor VIII of approximately 2%. EXAMPLE: 50 units/kg will increase factor VIII level by ~100%. Doses are rounded UP to the nearest vial size. There are standard and extended half-life products.

A rough estimate is that it takes 30% of normal levels to prevent bleeding and 50-100% of normal levels to stop bleeding. In emergent situations, 50 units/kg are usually transfused, thus aiming at 100% factor VIII activity. Depending on the patient’s resistance to external Factor VIII, transfusing 50 units/kg will at least assure 50% activity and hopefully closer to 100%.

Although fresh frozen plasma can be used, the volume required becomes prohibitive when it exceeds about 10-15 ml/kg. Therefore, factor concentrates - in this case of factor IX - are preferred (either high purity or recombinant factor IX). 

Pearl: In patients with hemophilia, both head injury and major joint hemarthrosis require the same amount of factor replacement. 

Reference:

Dupré AA. Disorders of Hemostasis. (Chapter 114) In: Walls R, et al. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed., 2018: 1485-1496.e2

Clotting Factor Concentrates. The Royal Children’s Hospital Melbourne. 

Bolton-Maggs, PHB and Pasi KJ, Haemophilias A and B, Lancet. 2003; 361:1801-9

Sample Question 2

Which of the following is the most significant benefit of fixed-wing aircraft over rotor-wing aircraft?

pressurized cabins that can combat the physiologic impact of gas laws
increased turbulence
noisier cabins
decreased capacities of the patient, crew, and medical equipment

Educational Objective:

List the advantages and disadvantages of various aircraft used for air medical transport.

Key Point:

The ability of pressurized cabins in a fixed-wing airplane to provide controlled environments allows for fewer patient-management problems.

Explanation:

Fixed-wing aircraft have many benefits over rotor-wing aircraft (helicopter). The most significant benefit of a fixed-wing aircraft is its pressurized cabins that can combat the physiologic impact of gas laws.

Compared with a helicopter, an airplane (fixed-wing aircraft) provides increased range, greater speed, and increased patient, crew, and equipment capacity. Decreased noise and turbulence provide a smoother ride.

Reference:

Walls R, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed., 2017.

Sample Question 3

A urine culture is recommended in all of the following patients except which one?

A young adult male with classic UTI symptoms and positive urinalysis
A child with a positive urinalysis
A neonate with unexplained fever and a negative urinalysis
A young adult female with classic UTI symptoms and positive urinalysis

Young adult females with a classic presentation of cystitis do not require urine culture unless they are immunocompromised. Neonates unexplained fever require culture even if urinalysis is negative. Urine culture is indicated in both children and young adult males.

Reference:
Finnell SM, Carroll AE, Downs SM, Subcommittee on Urinary Tract Infection. Technical report—Diagnosis and management of an initial UTI in febrile infants and young children. Pediatrics 2011; 128:e749

Sample Question 4

A 46-year-old woman with a history of depression and long-term use of benzodiazepine and tricyclic antidepressants is brought to the emergency department after she was found to be obtunded. An empty pill bottle was found next to her and she is suspected of overdosing on her clonazepam. She was last seen normal 6 hours earlier. In addition to depression, her past medical history also includes diabetes mellitus.

The medications she is taking include metformin, clonazepam, amitriptyline, and acetaminophen/hydrocodone. All pills counts appear correct except for clonazepam.

On examination, she is obtunded, snoring, and smells strongly of alcohol. Vitals are: BP 105/55 mm Hg, P 98 beats/minute, RR 10 breaths/minute, pulse oximetry 89% on 100% oxygen, T 36.4°C (rectally). Her scalp is without signs trauma. Pupils are 6 mm and reactive. Oral examination, her mouth is clear and moist. Chest examination reveals poor effort, rhonchi at right base. Cardiac results are regular. Abdomen is soft with no mass and positive bowel sounds. Neurologic examination reveals no increased motor tone, reflexes 1+ and equal. Finger stick glucose is 126, electrocardiography reveals a sinus rhythm, QRS 90 msec, QTc 420 msec. Electrolytes are normal, an ethanol level pending is pending, and the acetaminophen level is less than 10 mcg/mL.

Initial management of this patient's condition should include which of the following?

endotracheal intubation
intravenous naloxone 2 mg, repeat in 5 minutes if no response
2 amps sodium bicarbonate bolus, followed with 5% dextrose in water with 3 amps sodium bicarbonate at twice maintenance
intravenous flumazenil 0.2 mg over 30-45 seconds; repeat every 2 minutes up to 3 mg total dose or arousal
physostigmine 2 mg slowly over 5 minutes

This patient has signs of respiratory failure from her combined overdose of ethanol and clonazepam. Ethanol/benzodiazepine can lead to significant respiratory depression. This patient is hypoventilating with poor effort and a saturation of only 89% despite supplemental oxygen. Endotracheal intubation would be the safest and most appropriate course of management. Flumazenil should not be given to individuals chronically on a benzodiazepine because its use may precipitate acute withdrawal and seizures. Chronic alcoholism is also a relative contraindication to the use of flumazenil, although this patient does not have a known history of this.

Signs of tricyclic overdose would include anticholinergic signs such as dilated pupils, tachycardia, and diminished bowel sounds as well as cardiac toxicity with a prolonged QRS duration or an r-wave in aVR of greater than 3 mm. Her presentation does not suggest co-ingestion of her tricyclic antidepressant. If there were signs of tricyclic antidepressant cardiac toxicity, then sodium bicarbonate and serum alkalinization would be indicated.

The examination results are also not consistent with opioid toxicity, so naloxone would not be expected to be beneficial. Physostigmine is used to reverse anticholinergic toxicity, although it is contraindicated in patients who have ingested a tricyclic antidepressant.

References:
Gussow L, Carlson A. Sedative hypnotics. In: Marx JA, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed., 2010:2071-2082.
Lee DC, Ferguson K. Sedative-hypnotics. In: Nelson LS, et al, eds. Goldfrank's Toxicologic Emergencies. 9th ed., 2010.

Sample Question 5

A 35-year-old man complains of episodes of confusion, sweating, palpitations, and lightheadedness approximately 2 to 3 hours after eating for the past month. His medical history is notable for gastric bypass surgery 6 months ago, hypertension, and hyperlipidemia. He takes hydrochlorothiazide and rosuvastatin. He does not smoke cigarettes, drink alcohol, or use illicit drugs. He sells antique cars for a living.

A review of systems is notable for an 80-pound weight loss. His body mass index is 32 kg/m². Physical examination findings are otherwise normal.

During one of these episodes, his blood glucose level is 35 mg/dL, his insulin level is 86 mIU/L (normal < 30), and his C-peptide is 7.3 ng/mL (normal < 0.6).

What is the most likely cause of his symptoms?

nesidioblastosis
vitamin B12 deficiency
adrenal insufficiency
exogenous insulin use
dumping syndrome

Educational Objective:

Discuss the differential diagnosis of hypoglycemia.

Key Point:

The physician should recognize the signs of nesidioblastosis.

Explanation:

The most likely cause in this patient is nesidioblastosis. Hypoglycemia can be either insulin-mediated or non–insulin-mediated. In non–insulin-mediated hypoglycemia, such as adrenal insufficiency or liver failure, the insulin level in the blood during hypoglycemia is appropriately low. In insulin-mediated hypoglycemia, the insulin level is inappropriately not suppressed. If the C-peptide level is low, the insulin results from an exogenous injection. If the C-peptide level is elevated with the insulin, then the insulin comes from islet cells; thus, the differential diagnosis should include insulinoma, sulfonylurea ingestion, and islet-cell hyperplasia (nesidioblastosis), which is associated with weight loss after gastric bypass surgery and can in turn cause dumping syndrome (but the dumping syndrome does not cause the hypoglycemia).

Reference:

Goldman L, Schafer AI. Goldman's Cecil Medicine. 24th ed., 2012.

Target Audience

Med-Challenger EM is intended for practitioners of acute and primary care or clinicians and registered nurses otherwise involved in the diagnosis and treatment of acute, emergent, or chronic medical problems.

Educational Objectives

After completing this activity, the participant should be better able to:

Confidently manage the broad spectrum of acute and chronic medical problems encountered in the practice of emergency medicine
Formulate appropriate differential diagnoses for patients presenting with acute and chronic medical problems of uncertain etiology.
Efficiently initiate therapeutic and diagnostic procedures for patients presenting with acute and chronic medical disorders.
Cope effectively with the uncertainty that is inherent in the initial treatment of acute and chronic disorders.
Handle efficiently the spectrum of common disorders involving all organ systems. In particular, the physician will be better equipped to resuscitate seriously ill patients and to diagnose and treat acute medical disorders.

Faculty

Andrea C. Eberly, MD, M.S., FAAEM

Mary Alice O'Brien, DNP, APRN, FNP-BC

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Challenger Corporation. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Designation Statement

AMA Credit - The Postgraduate Institute for Medicine designates this enduring material for a maximum of 258.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ANCC Credit - The maximum number of hours awarded for this Continuing Nursing Education activity is 258.0 contact hours.

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Emergency Medicine Board Review
Product Comparison

Take a look at premiere Emergency Medicine knowledge products from leading vendors.

FEATURE	MED-C EM	Rosh Review	Hippo EM	Board Vitals
Questions	3700+	3700+	1200	600
AMA Category 1 CME	258	100	150	35
ACEP-approved CME	60	0	0	0
Labor-free	Yes	No	Yes	No
Smart Exam Simulator	Yes	No	No	No
Custom Learning Rx	Yes	No	No	No
Low-Cost All-Product Renewal	Yes	No	No	No
Multi-Course Single Login	Yes	No	No	No
Physician-led Content	Yes	Yes	Yes	Yes
Built for more than Boards	Yes	No	No	No

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Non-ST-Elevation Acute Coronary Syndromes – Special Patient Groups, Free CME Quiz – Earn AMA and ANCC Credits Free

August 2, 2022

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Non-ST-Elevation Acute Coronary Syndromes – Special Patient Groups, Free CME Quiz – Earn AMA and ANCC Credits Free

CME Quick Quiz Game

"Amazing Emergency Medicine Exam Prep."

Emergency Medicine Review Packages

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EM Cert

EM MOC

EM PRO

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Emergency Medicine
Board Review

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