Sports Preparticipation PE Lecture Powerpoint

Question 1

The purpose of a Preparticipation physical exam

Answer 1

Not to disqualify athletes at risk for sudden death as it is a preventative and therapeutic tool to allow athletes to participate in sports safely, vary in guidelines depending on organization

Question 2

When should a sports physical be done?

Answer 2

Ideally not less than 6 weeks before first practice

Question 3

Most important part of a PPE

Answer 3

The history - more than half of diagnoses derived from here come from history

Question 4

Majority of all sudden cardiac deaths in athletes are…

Answer 4

….CV related, most often hypertrophic cardiomyopathy, historical questeions should raise suspicion of CV abnormalities

Question 5

Hypertrophic cardiomyopathy

Answer 5

Hallmark of physical exam finding in HCM is systolic murmur that increases with intesnity with valsalva and decreases when laying down

Question 6

Should routine PPE include ekg?

Answer 6

AHA recommends against as it isn’t warranted and has a possibility of finding too many false positives

Question 7

Physical signs of marfan syndrome (7)

Answer 7

• tall/thin
• scoliosis
• micrognathia
• nearsightedness
• flexible joints
• flat feet
• pectus deformity

Question 8

Prehypertension vs stage 1 hypertension vs stage 2 hypertension PPE guidelines

Answer 8

Prehypertension has no sports restriction but should follow up in 6 months
Stage 1 has no sports restriction but should follow up in 1-2 weeks
Stage 2 has follow up in 1 week and are restricted from class IIIa to IIIc sports

Question 9

Different components of the physical exam for the PPE

Answer 9

• HEENT
• Neck (cervical nerve roots via spurlings test)
• lungs
• cardiac
• GU (hernia check if indicated by history)
• musculoskeletal screening

Question 10

2 absolute contraindications to sports participation

Answer 10

• fever

- carditis

Question 11

Are ancillary studies indicated in PPE?

Answer 11

Only in high risk patients

Question 12

4 possible outcomes for clearance regarding PPE

Answer 12

1) cleared without restriction
2) cleared with recommendation for further eval or treaetment
3) not cleared pending further eval or treatment
4) not cleared for certain or all sports (typically a specialist would determine this)