Introducing the Newest Qbank for the ABEM Advanced EM Ultrasonography Examination

As of June 1, 2021, ABEM has opened applications for the new Focused Practice Designation (FPD) in Advanced EM. A trusted option for those preparing for the Advanced EM Ultrasonography (AEMUS) Examination now exists: the Advanced Ultrasound Qbank, designed by three leaders and advocates in emergency medicine.

The Qbank is the vision of Dr. Resa E. Lewiss, Dr. Amy Zeidan, and Dr. Penny Lema after realizing the need for a high-quality resource for ABEM-certified physicians and ultrasound fellows studying for the AEMUS FPD exam, first offered in March 2022. Beyond this need, they recognized the importance of highlighting authors with unique journeys, expertise, and knowledge. Using the Advanced Ultrasound Qbank is not only a way to easily prepare for the FPD exam but also an opportunity to support the work of this community.

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Why create an Advanced Ultrasound Qbank?

Drs. Lewiss, Zeidan, and Lema realized the need for a resource that prepared ultrasound fellows and faculty for their AEMUS FPD exam and highlighted the diversity of expertise in the ultrasound community. They are inspired by and pay homage to the legacy of the first three emergency ultrasound fellows: Beth Thomas, MD, Verena Valley, MD, and Mary Beth Phelan, MD. Based on this shared mission, the three creators brought their vision to Blueprint/Rosh Review to create the Advanced Ultrasound Qbank. 

The Advanced Ultrasound Qbank is the first Qbank geared around advanced ultrasound topics to prepare emergency ultrasound fellows for the AEMUS FPD examination.

Who is the Advanced Ultrasound Qbank for?

The Qbank was created for ABEM-certified physicians and ultrasound fellows taking the AEMUS FPD exam. However, students, residents, and clinicians of all levels can use it to build advanced ultrasound knowledge.

What does the Advanced Ultrasound Qbank contain?

The Qbank includes peer-reviewed questions and explanations using real case scenarios with accompanying ultrasound images and videos. This Qbank can help you solidify your advanced ultrasound knowledge about what normal examinations look like versus abnormal findings that could compromise a patient’s health. 

Which topics are included in the Advanced Ultrasound Qbank?

The Qbank questions are aligned with the ABEM distribution of questions for the FPD examination. The FPD will cover the core content of advanced emergency medicine ultrasonography.

Categories	Distribution
Physics and Technical Aspects of Ultrasonography	10 ± 5%
Anatomic/Diagnostic Ultrasound	60 ± 5%
Procedural Ultrasound	10 ± 5%
Clinical Ultrasonography Training with Non-Emergency Medicine Specialties*	0%
Education and Research Skills	10 ± 5%
Administration and Quality	10 ± 5%

How are the Qbank questions structured?

Practice questions are written to resemble the format and topics on your exam. All Blueprint/Rosh Review Qbanks include detailed explanations for the correct and incorrect answer choices with teaching images (and videos), hyperlinked references, and performance analytics.

Example:

A 42-year-old man presents with acute respiratory failure. A lung ultrasound is performed, which reveals predominantly A-lines with normal lung sliding in the right hemithorax. The left hemithorax has a lung zone shown in the above image. A lower extremity venous ultrasound is then performed, which reveals no evidence of a deep vein thrombosis. Based on these findings, what is the most appropriate initial treatment for this patient?

A) Antibiotics
B) Anticoagulation
C) Bronchodilators
D) Chest tube

Lung ultrasound can be used to differentiate between pneumonia, chronic obstructive pulmonary disease (COPD), acute pulmonary edema, and pneumothorax. The addition of a lower extremity venous ultrasound to a lung ultrasound can be used to evaluate for evidence of pulmonary embolism. Finding a subpleural hypoechoic region with B-lines at the far-field border, hepatization, and abolished lung sliding on ultrasound is highly specific for the diagnosis of pneumonia, especially when there is no evidence of a deep vein thrombosis (DVT). The first-line treatment would be antibiotics. Other findings on ultrasound consistent with pneumonia include focal B-lines and consolidation with dynamic air bronchograms.

Anticoagulation (B) would be the treatment for pulmonary embolism. Ultrasound findings consistent with pulmonary embolism include a lower extremity DVT and a lung ultrasound with A-lines, focal B-lines, or subpleural infarcts.

Bronchodilators (C) would be the treatment for asthma or COPD. This diagnosis would be made by the identification of lung sliding and A-lines, without evidence of a lower extremity DVT. 

A chest tube (D) would be the treatment for pneumothorax. This diagnosis would be made by the absence of lung sliding and identification of a lung point.

Where can I get started?

You can learn more about the Advanced Ultrasound Qbank here.