Our Questions

Just like you’ll see on the actual exam. Based on the American Board of Emergency Medicine format.

No “negatively phrased” questions, no “all of the following except”, no “A and B”…you know what we mean. In order for a test question to be high quality, it must satisfy two basic criteria:

  1. Must address important content
  2. Must be well structured
Question » Stem » Lead in click-05

A 60-year-old woman with a history of diabetes presents to the Emergency Department with altered mental status and a blood glucose of 35 mg/dL. She receives 50 g of dextrose and her mental status improves. One hour later, she is confused and diaphoretic, and her blood glucose is 40 mg/dL. Which of the following agents is most likely responsible for her condition?

Our Answer Choices

Building difficulty into the question. Meet the Challenge.

A question’s difficulty is defined by the choice of distractors. Good distractors determine the difficulty level of a question. Therefore, good distractors are one of the most important features of a high quality question.


Understanding why an answer choice is incorrect is just as important as knowing why it is correct

Our Explanations

Synthesized for optimized learning and recall & created with a purpose

Every question contains a detailed explanation for the correct and incorrect answer choices and integrated media for those that learn best by visual stimuli. Understanding a topic cannot be learned in isolation. You require context. We take deliberate steps to deliver a comprehensive explanation linking the most important components to master a topic.

The calcified wall of an abdominal aortic aneurysm (AAA) is visualized in this radiograph. The most common plain film findings of an AAA is a curvilinear calcification of the aortic wall or a paravertebral soft tissue mass. Rarely with longstanding aneurysms, is erosion of one or more vertebral bodies seen. Atherosclerosis, age > 60 years, smoking, and family history are all important predisposing factors for the development of AAA. An AAA is a disease of aging and is rare before age 50 years. It is found in 5%–10% of elderly men screened with ultrasound. AAAs progressively enlarge, weakening the vessel wall, and ultimately rupture resulting in fatal hemorrhage. The most important factor in determining the risk of rupture is the size of the aneurysm. The rupture risk increases dramatically with increased aneurysmal size, and most ruptured AAAs have diameters > 5 cm. Rupture usually occurs in the retroperitoneum; even those who make it to the OR still have a mortality close to 50%. The classic triad of a ruptured AAA is pain, hypotension, and a pulsatile abdominal mass, although many patients have only 1 or 2 of these components. Pain usually localizes to the abdomen, back, or flank, and is sometimes tragically misdiagnosed as renal colic. Treatment involves hemodynamic support and definitive repair by a vascular surgeon.

Enhanced learning

Explanations contain integrated audio and visual content to further clarify meaning of the core concept. By representing information using audio cues and spatially with images, you are able to focus on meaning, reorganize and group similar ideas easily and make better use of your audio and visual memory.

More than just a question

Advanced reinforcement

To optimize recall and understanding of a topic we link concepts to help you express knowledge, thoughts and ideas and build relationships between them.


Taking Your Learning One Step Further

After each question explanation is a straightforward factoid-based question with a simple, memorizable answer that serves as reinforcement for the corresponding topic.

(Q) What is the most common cause of epistaxis?

(A) Digital trauma (nose picking).


Cutting edge, staying up to date

Gain a deeper understanding by linking standard board material with cutting edge clinical knowledge

Antibiotics for nasal packing have no proven benefit: No randomized controlled trials evaluating the effect of antibiotics on outcomes following epistaxis are known (at least to us). The evidence that does exist, however, suggests that antibiotics are unnecessary and potentially harmful. The incidence of toxic shock syndrome (TSS) with nasal packing following nasal surgery is extremely low and there have been no cases of toxic shock syndrome reported in the literature following nasal packing for spontaneous epistaxis.


Break it down, Keep it simple.

Boiling it down to the most high yield concepts


  • 90% are anterior
  • Kiesselbach’s plexus: Most common source of anterior bleeds
  • Sphenopalatine artery: Most common source of posterior bleeds
  • Have patient blow nose or suction blood
  • Anterior bleeding: direct pressure, packing, cautery
  • Posterior bleeding: packing (Foley, gauze pack, intranasal balloon device)
  • Antibiotics after packing – no clear benefit
  • Posterior nasal packing → vagal stimulation → bradycardia/bronchoconstriction
  • Admit patients with posterior packing to a monitored bed

Powerful Analytics

Progress, performance, predictions

“If you can’t measure it, you can’t manage it.” Rosh Review provides you with key statistics and robust analytics to create an efficient and effective learning strategy.


Focus your learning on what matters

Identify your strengths and weaknesses based on the ABEMs Emergency Medicine Model.

Peer comparison

Compare your answer choices to the answers provided by other medical students, emergency medicine residents, and emergency physicians around the country.

Probability of Passing Your Exam

Using data generated by our previous users, we can predict your probability of passing the ABEM initial certification and ConCert® exams.

“We have had awesome results with the ROSH review. Using since 2013. Residents love it and have seen a nice increase in In-service exam scores.”

Dr. Robert Strony, Program Director

Emergency Medicine Question Topics

ABEM publishes a content blueprint for the material that will appear on your exam.

This blueprint is how we determine which material appears in your Qbank.

Cardiovascular 10%
Traumatic Disorders 10%
Signs, symptoms, presentations 9%
Abdominal and GI 8%
Thoracic-Respiratory Disorders 8%
Procedures and Skills 8%
Head, Ear, Eye, Nose and Throat Disorders 5%
Nervous System Disorders 5%
Systemic Infectious Disorders 5%
Toxicologic Disorders 5%
Obstetrics and Gynecology 4%
Psychobehavioral Disorders 4%
Environmental 3%
Renal and Urogenital Disorders 3%
Other Core Competencies 3%
Musculoskeletal Disorders (Non-traumatic) 3%
Endocrine 2%
Hematologic Disorders 2%
Immune System Disorders 2%
Cutaneous 1%
Total 100%


Emergency Medicine

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5,000 One Step Further questions and answers (All new!)

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