sports med

Question 1

why is power lifting dangerous for teens

Answer 1

risk of apophyseal avulsion fx

Question 2

heat exhaustion

Answer 2

milder form of heat illness

• mild dehydration
• core temp < 104
• HA, N/V, thirsty

Question 3

sweating in heat exhaustion or heat stroke?

Answer 3

exhaustion

Question 4

heat stroke

Answer 4

• temp > 105
• flushed, hot, DRY skin
• CNS depression- confused, vertigo, syncope, lethargy
• severe dehydration

Question 5

dangers of untreated heat stroke

Answer 5

end organ damage 2/2 endotoxin and cytokine release

Question 6

treatment of heat stroke (4)

Answer 6

• rehydrate with IV fluids only
• pressors if needed
• evaporative cooling is less stressful and just as effective as ice bath
• don’t cool below 101 as this can lead to hypothermia

Question 7

grade 1 spain

Answer 7

minor stretching of the ligament

minimal discomfort or loss of fxn

Question 8

grade 2 sprain

Answer 8

ligaments are partially torn
tenderness and swelling
ecchymosis
some loss of function

Question 9

grade 3 sprain

Answer 9

ligament is completely torn

significant pain, tenderness, swelling, loss of function

Question 10

when can a child with a sprain return to sports (5)

Answer 10

• full ROM
• full strength
• no swelling
• no pain
• no joint instability

Question 11

most common ankle injury

Answer 11

sprain of the anterior talofibular ligament

Question 12

pain over the physis in a pre adolescent child

Answer 12

assume salter harris 1 fx

EVEN if xray nl

Question 13

injury with change in direction off a pivoted knee

Answer 13

subluxation of the patella

can hear a pop with injury

Question 14

sx with subluxation of the patella

Answer 14

pain over the lateral aspect of the patella with deformity over the medial aspect
can hear a pop with injury

Question 15

how does prepatellar bursitis present

Answer 15

anterior knee pain over the patella with swelling

NSAIDs and padding

Question 16

patellofemoral syndrome

Answer 16

• presents as anterior knee pain
• sports with running, jumping, or squatting
• *more common in females d/t higher q angle
• no role for xray

Question 17

tx for patellofemoral syndrome

Answer 17

• knee brace
• patellar taping
• NSAIDs
• refer to ortho if no improvement in 4-6 mos

Question 18

injury 2/2 blunt trauma to thigh which presents with large aea of swelling

Answer 18

soft tissue hematoma

Question 19

pain over the anatomical snuff box

Answer 19

scaphoid fx of the wrist

negative xrays are common

Question 20

complication to worry about with supracondylar fx

Answer 20

neurovascular compromise

look for pain on passive extensions

Question 21

sign on xray c/w supracondylar fx

Answer 21

posterior fat pad- 2/2 effusion a/w fx

*anterior fat pad can be nl

Question 22

an 11 y/o FOOSH while supinated and extended- what is the injury?

Answer 22

elbow dislocation

Question 23

a 13 y/o hit directly to the arm causing it to laterally rotate on impact- what is the injury?

Answer 23

epiphyseal fx

Question 24

patient falls back on a posteriorly rotated, abducted arm- what is the injury?

Answer 24

anterior humeral dislocation

Question 25

patient with pain over the distal clavicle with prominence noted over the area or point tenderness- what is the injury?

Answer 25

acromioclavicular injury

Question 26

patient with injury 2/2 direct force to the posterior shoulder with pain over the sternoclavicular joint and possible respiratory discomfort- what is the injury?

Answer 26

posterior sternoclavicular dislocation

Question 27

pt with shoulder and upper arm pain, withOUT asymmetry on exam- what is the injury?

Answer 27

proximal humeral head fx

Question 28

pt wth shoulder pain with elevating and lowering the arm, without any deformity. In addition this will present as chronic pain most likely in the absence of acute injury

Answer 28

rotator cuff injury

Question 29

do shoulder dislocations need imaging?

Answer 29

yes! dx clinical, but need to evaluate for additional fx

Question 30

management of shoulder dislocation

Answer 30

sling and need to fill place between arm and body with pillow

Question 31

return to play criteria

Answer 31

1- complete rest, stay home and relax 2- walk around/light activity- no activities with resistance (weight lifting) 3- movement c/w sport they wish to return to, minimal resistance 4- training drills, no contact 5- full contact 6- return to play

Question 32

should you remove equipment for patient injured on playing field?

Answer 32

NO always leave helmet on remove facemask to a/w respiratory

Question 33

sport that causes most neck injuries

Answer 33

football

Question 34

these 4 things mandate no contacts sports

Answer 34

1- splenomegaly 2- hepatomegaly 3- 1 kidney 4- repeated concussions

Question 35

what is the leading cause sports related eye injury

Answer 35

baseball

Question 36

physiologic findings of anabolic steroids (5)

Answer 36

- voice change - hirsutism in females - gynecomastia in males - hypertension - mood change * **NO arrhythmia or seizures!!

Question 37

lab findings with anabolic steroid use

Answer 37

- elevated LFTs - low HDL - increased LDL - oligospermia and azoospermia

Question 38

cardiac findings that you need to refer to cards for in teen athletes (3)

Answer 38

- fixed splint second heart sound - systolic murmur 3/6 or greater - any diastolic murmur