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Medical And Dermatological Considerations Flashcards

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1
Q

What condition accounts for ~50% of all deaths in sports in those less than 35 years?

A

Sudden Cardiac Death

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2
Q

What condition accounts for the majority of Sudden Cardiac Deaths?

A

Hypertrophic Cardiac Myopathy

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3
Q

What is the most common symptom of Hypertrophic Cardiac Myopathy?

A

Exertional dyspnea is most common reported symptom. Often asymptomatic (55-80%).

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4
Q

Which of the following conditions has a genetic contribution: Hypertrophic Cardiac Myopathy, Coronary Artery Anomalies, Myocarditis, Marfan Syndrome, Sickle Cell Trait?

A

HCM, MS, SCT

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5
Q

What test can be used to confirm Myocarditis?

A

Endomyocardial biopsy (gold standard). Also can use ECG

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6
Q

What is Marfan syndrome? How does it affect the cardiovascular system?

A

A connective tissue disorder. Cardiac changes = dilation of aorta, valve prolapse, proximal pulmonary artery enlargement

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7
Q

What serious conditions are more likely to occur in those with Sickle Cell Trait due excessive exercise in hot and humid environments?

A

Heat related illness, rhabdomyolysis, splenic infarct, renal dysfunction and vascular occulusions

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8
Q

What serious cardiovascular conditions would exclude those athletes from high intensity, competitive sport?

A

Hypertrophic Cardiac Myopathy, coronary artery anomalies, Marfan Syndrome (depends on cardiac function and aortic size - low to moderate competitive sports may be allowed)

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9
Q

What are the signs and symptoms of Exertional Rhabdomyolysis?

A

-Painful, swollen muscles -Excessive weakness -Altered gait -Brownish urine (inc creatine kinase levels = can lead to acute renal failures = EMERGENCY)

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10
Q

What condition can splenic infarct be a result of? What are the signs and symptoms of splenic infarct?

A

-Sickle Cell Trait -Severe muscle cramping -Collapse -Epigastric pain -Nausea

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11
Q

What is the RETURN TO PLAY guideline for post EXERTIONAL RHABDOMYOLYSIS?

A

-Post hospital D/C - avoid exertion for 2 weeks -Progress through 3-week long phases (stretching and light aerobic progressing to light resistance activity) -VERY SLOW recovery due to increased risk for recurrence for weeks to months *requires consistent monitoring and medical management

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12
Q

What is a likely mechanism for Exercise Induced Bronchospasm? (Not exercise or asthma)

A

Dry, cool air

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13
Q

What test is used to diagnose Exercise Induced Bronchospasm?

A

Forced Expiratory Volume in 1 sec-> if reduced by 10% = positive (tested pre and within 30 min post exercise)

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14
Q

Other than short term b2-agonists and other medications, what is one way to reduce the incidence of Exercise Induced Bronchospasm ?

A

Warm up - breathe through nose

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15
Q

What are some guidelines to prevent hypoglycemia?

A

-Consume CHO pre-exercise if blood glucose <100mg/dL -Decrease insulin 25-50% 1-2 hours per-exercise AND 50% at meal preceding exercise (NATA recommendation)

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16
Q

What are the signs and symptoms of hypoglycemia?

A

Mild= Headache, dizziness, hunger, tremors, anxious, tachycardia Severe = confusion, blurred vision, loss of motor control, seizures, aggressive behavior, LOC

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17
Q

What are the treatment guidelines for an athlete with mild hypoglycemia?

A
  1. If <100 mg/dL, provide 15-20 grams of simple CHO 2. Wait 15 min - recheck glucose and if <100, give another 15-20 gram serving 3. Repeat every 15 min *if levels don’t increase =EMS *if levels return to normal = follow up with meal or snack
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18
Q

After activating EMS for an athlete suffering from a severe case of hypoglycemia (unconscious), what actions should you take?

A

Inject glucagon - buttock, thigh or arm - per manufacturers instructions

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19
Q

What are the signs and symptoms of hyperglycemia?

A

Nausea, dehydration, altered cognition and/or lethargy, fruity breath (with keto acidosis) Treatment = non CHO hydration

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20
Q

What activities should be avoided with the pregnant athlete?

A

Activities with increased risk of: falling, collision *supine activities after 1st trimester (compression of inferior vena cava)

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21
Q

What measures should be utilized to guide exercise prescription with the pregnant athlete?

A

HR (vs RPE) -> HR target <20 yrs = 140-155 (goes down 5 every decade)

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22
Q

What is the primary concern with athletes returning to play post MONONUCLEOSIS diagnosis?

A

SPLENOMEGALY = can rupture from return to contact sports RTP = gradual When asymptomatic and normal energy level = RTP min 3 weeks post symptom onset (4 weeks for contact sports)

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23
Q

Which layer of skin is responsible for regulating body temperature and HOW?

A

-Dermis -regulated via ANS -sweat glands secrete fluid with cooling via evaporation -superficial capillaries dilate/constrict to increase/reduce heat loss

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24
Q

What is the primary function of the EPIDERMIS?

A

protects - barrier against external environment

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25
What is the primary function of the SUBCUTANEOUS LAYER?
-insulate and help with temperature regulation
26
What factors increase RISK for developing BLISTERS? What areas of the body are these more common?
- Risks = moist skin, poor fitting equipment, increased temp, increased intensity and duration of activity - Areas = distal extremities where skin is thicker (palmas soles)
27
How should BLISTERS be TREATED?
-Small = leave intact; cover to protect (second skin, moleskin) -Large = clean, drain (leave skin roof), clean (antibiotic ointment), use donut pad to protect -Large with skin flap = remove flap, clean (soap and water), antiseptic, cover (occlusive dressing),
28
What are some methods for PREVENTING blisters?
-Keep skin dry (double up socks, talcum powder, moisture wicking material) -break in shoes/equipment gradually -proper fitting equipment
29
What is another term for HYPERKERATOSIS? What is is?
- Callus -thickening of epidermal layer of skin due to friction
30
How should CALLUSES be treated?
- if not painful - leave alone - if painful or excessive = soak, puma stone/emery file, urea cream/salycytic acid
31
What are CORNS? How are they managed?
- hyperkeratosis at focal areas (usually bony prominences) -proper fitting footwear, correct poor mechanics, control excessive sweating
32
What is INTERTRIGO? How does it present? How is it treated? How is it prevented?
-Chafing - skin rubbing together with other skin or material (e.g., shirt) -S+S = red plaques; red, raw skin in advanced case - TX = clean skin, OTC corticosteroid (for inflammation); refer if advanced (possible infection) -Prevent = decrease friction (loose, soft clothing), keep skin dry (talcum powder, petroleum jelly)
33
What is ACNE MECHANICA? How is it managed?
-acne due to: heat, increased pressure, repetitive forces on skin (due to tight uniforms/equipment) -TX = remove/modify irritant, refer to dermatologist
34
What is AURICULAR HEMATOMA?
-blood pools between skin and cartilage of pinna (anteriorly) due to direct trauma -TX = may be left alone (may lead to infection ,necrosis) OR can drain (aspirate OR catheter, incision if larger, or 2-7 days post injury)
35
Define and classify each type of wound: Laceration, Abrasion, Avulsion, Puncture, Contusion
- Laceration = tearing of skin (uneven borders) - Abrasion = friction trauma where top layer of skin is sheared off - Avulsion = skin torn off (partial or complete) - Puncture = piercing of skin - Contusion = direct blunt force to skin causing hematoma
36
Which wounds should be referred to MD?
Laceration, Puncture (increased risk for infection), Avulsion (with full thickness tear)
37
What is the common treatment for all wounds?
- Clean (soap and water), dressing \* abrasion = topical antibiotics if bad (monitor for infection) \* contusion = PRICE
38
What types of sports have the highest skin infection incidence? Give one example.
Contact sports (wrestling ~ 73.6%)
39
What is bacteria? What are the two most frequent pathogens causing skin infections?
- Bacteria = single cell prokaryotic microorganisms (no membrane encloses nucleus) - staphylococcus and streptococcus
40
What is the cause of IMPETIGO (bacterial infection)? What part of the skin is infected? What are the 3 variants of IMPETIGO?
- Poor hygiene - epidermis - NON-BULLOUS (kids- face, nose, mouth and extremities; honey coloured lesion) - BULLOUS (trunk, buttocks; “arch” looking lesion) - ECTHYMA (affects dermis; “punched out” lesion; may have systemic symptoms - fever, malaise, pruritis/itching)
41
Who is at increased risk for ERYSIPELAS (bacterial infection)? What treatment is recommended for this condition?
- Athletes who have trauma/friction injury that hasn't been treated properly (clean, dressed) - Penicillin
42
Which bacterial skin infection is commonly seen on SKIN FOLDS? What diagnostic tool is used to identify this condition?
- Erythrasma - Wood's Lamp (UV light = organism is fluorescent coral, red)
43
What is the difference between bacterial infections FOLLICULITIS, FURUNCLES, CARBUNCLES, SKIN ABCESS?
- Folliculitis = infection of hair follicle at epidermis - Furuncles = infection of hair follicle at dermis, subcutaneous tissue (with abscess) - Carbuncles = collection of furuncles (drain from many follicles) - Skin Abscess = pus collection in dermis and deep layers
44
How is FOLLICULITIS, FURUNCLES, CARBUNCLES, SKIN ABCESS treated?
- Folliculitis = abstain from shaving, usually spontaneous recovery (persistent = topical antibiotics; if widespread = oral) - Other conditions = if small --\> warm compress to encourage drainage; if large --\> incision, drain, antibiotics (oral)
45
How long does it take for HOT TUB FOLLICULITIS (bacterial infection) to appear after exposure to pool/hot tub not properly treated? How long does it take to clear up?
- ~48 hours - ~1 week
46
What is the NAME of a bacterial INFECTION of the tissue around a nail? How is it TREATED?
- Paronychia - TX = warm saline solution, topical anti-bacterial, incision and drain (if purulent)
47
CELLULITIS (bacterial infection): how is it acquired? Who is at increased risk of developing it?
- Pathogen enters break in the skin and colonizes - Immunocompromised, DM
48
What are the signs and symptoms of CELLULITIS (bacterial infection)? How is it treated?
- red, swollen, glossy, warm and pain to touch - TX: keep skin hydrated (reduce cracking); elevate to control edema; refer to MD
49
Which organism causes most of the common FUNGAL SKIN INFECTIONS?
- DERMATOPHYTOSIS - requires keratin to grow - "Ringworm" when it affects hair and skin
50
What bacterial skin infection presents initially with a single painful deep nodule that can rupture and form abscess (that drains purulent material)? How is it classified/graded? Is is a bacterial condition?
- Hydradenitis Suppurativa - Hurley Staging System - Not bacterial \*refer to MD
51
How does OTITIS EXTERNA (bacterial infection) present? How is it caused?
- inflammation of external auditory canal, auricle (sometimes infected); pain when pulling on ear - caused by: water polluted with bacteria; scratching or sticking foreign objects in ear
52
What are some TREATMENTS for OTITIS EXTERNA (bacterial infection)? How can it be prevented?
- TX = acetic acid or eardrops (antibiotic or steroid); AVOID GETTING EARS WET - Prevent = don’t stick objects in ears; clear ears of water after swimming; use ear plugs when swimming
53
Why should you always REFER TO MD with athlete suspected of skin bacterial infection?
- any bacterial infection can be methicillin resistant and IF NOT TREATED PROPERLY = FATAL
54
How is MRSA transmitted?
Skin to skin contact; increased susceptibility with broken/injured skin
55
What are some precautions to take to prevent spread of skin BACTERIAL INFECTIONS among athletes?
- Cover skin lesions - clean and DISINFECT showers, weight rooms, mats - encourage showering after competition, practices - Don’t share uniforms, towels, equipment (and clean in hot water) - Report skin lesions to medical personnel immediately
56
What skin VIRUS presents as small pearly papules, usually \<20 in athletes? How is it acquired?
- MOLLUSCUS CONTAGIOSUM - spread via skin to skin contact OR if towels/equipment infected
57
What VIRUS is responsible for COMMON WARTS (verracuae vulgaris, plantaris)? What is a hallmark sign?
- HPV - “black seeds” (when paired with blade)
58
List some different TREATMENT OPTIONS for common warts.
- cryotherapy (liquid nitrogen) - debride and use salicylic acid - silver nitrate (topical) \* per MD decision
59
How is HSV transmitted? How does it travel through the body and where is it stored?
- Herpes simplex Virus = contact with active infected area - travels via sensory nerves; stays dormant in neural ganglia
60
What type of HERPES affects the head, face and upper body? What are the signs and symptoms?
- Gladitorum (wrestlers herpes or mat pox)- a form of HSV-1 - S+S = painful vesicular lesions that ulcerate
61
What is the GOAL of treating HSV? How is it treated?
- Goal of treatment = decrease duration, decrease transmission - Anti-viral therapy within 48 hours - can treat symptoms with antibiotics
62
Which organism causes most of the common FUNGAL SKIN INFECTIONS?
- DERMATOPHYTOSIS - requires keratin to grow - "Ringworm" when it affects hair and skin
63
What is a disorder caused by FUNGI that affects the nail?
- OMYCHOMYCOSIS
64
What are two primary testing methods for diagnosing FUNGAL infections of the skin?
- KOH preparation - fungal culture
65
What is the difference between TINEA - capitis, corporis, cruris, unguium, pedis?
- CAPITIS (scalp, hair; contact with pillows, hats, combs; associated with poor hygiene) - CORPORIS (direct contact or contact with contaminated objects; red ring-shape) - CRURIS ("jock itch"; males\>females; red patches) - UNGUIUM (nail; thick, yellow, lifting of nail) - PEDIS ("athletes foot"; pruritis/burning, scales or blisters; common b/t digits)
66
What is a recommendation for those athletes with TINEA CORPORIS?
- Avoid practice, matches to avoid spreading
67
How do you treat FUNGAL infections?
- Topical (cream) or oral anti-fungal medications
68
What determines how much UV light is required to burn skin (melanin)?
- How much melanin (color) - distance from sun - medications that increase sensitivity to sun (NSAIDs, tetracycline antibiotics)
69
What are the different types of SUNBURN?
- superficial - superficial partial thickness - deep partial thickness (blistering)
70
How should SUNBURNS be treated?
- Relieve symptoms (aloe, cold compress, NSAIDs) - Refer to MD if signs of infection (pussy discharge, temp \>100.4 deg
71
Why is it important to RECOGNIZE and correctly REMOVE TICKS? How should they be REMOVED?
- Ticks feed for hours to transmit disease (Lyme) - Use FINE tweezers; get close to skin; pull FIRM but GENTLE \* Monitor S+S = if systemic illness, neuro symptoms, paresthesia, paralysis --\> refer to MD
72
How are MOSQUITO BITES treated?
- Antihistamines = stop allergy symptoms (i.e., Benadryl) - Corticosteroids (more serious cases)
73
How are BEE/WASP STINGS treated?
- Remove stinger - Cold compress, wash skin, topical anesthetic (maybe) \*IF ALLERGIC = EPI-PEN and REFER TO MD
74
What are the two types of CONTACT DERMATITIS?
- Allergic: allergen contacts skin -\> hypersensitivity rxn (i.e., poison ivy) - Irritant: disruption of skin via substance (environmental - cold, water; chemical - acids, alkalis) = causes inflammation
75
What are the signs and symptoms of ALLERGEN CONTACT DERMATITIS
- Usually PRURITIS (itching), and red plaques - May start 24-48 hours after exposure \*symptoms vary depending on irritant
76
How should you TREAT Contact Dermatitis?
- REMOVE from ALLERGEN/IRRITANT - Clean with soap and water - Topical corticosteroids (allergen and irritant) - Moisturizers PRN (irritant)
77
What are some PRECAUTIONS the SCS can take to prevent SKIN INFECTIONS in athletes?
- Good hygiene (showering after activity) - Frequent hand washing - Uniforms and clothes = launder after use - Clean equipment and facilities frequently - EDUCATE athletes and coaches (high contact sports like wrestling = check for lesions frequently) - Cover = dress lesions to avoid contact with others (wound or seepage) - HOLD athletes from competition (if can't be covered properly AND/OR not healed); some competitions may require MD clearance

Sport Prep (10 decks)

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