Sports Medicine Past Paper PDF

1. **Rugby player tooth avulsed and covered in dirt. What is appropriate immediate treatment?** - A. Cover/store tooth in gauze - B. Stick back into socket without cleaning - C. Clean it carefully with water, whilst holding it by the roots - D. Clea...

1. **Rugby player tooth avulsed and covered in dirt. What is appropriate immediate treatment?** - A. Cover/store tooth in gauze - B. Stick back into socket without cleaning - C. Clean it carefully with water, whilst holding it by the roots - D. Clean out socket thoroughly with gauze - E. Inject LA and Adrenaline into socket - **Answer:** B - **Explanation:** The critical time is the first minute. An avulsed tooth should be retrieved and handled by the crown. If dirty, irrigate with saline or milk, or suck clean under the tongue. Debris should not be scraped off the root. If the patient is alert, reimplant and splint the tooth, then bite down on gauze. Otherwise, store in milk. With suitable storage, the tooth can be reimplanted by a dentist within hours of injury. 2. **Weight training for 12 year old** - A. Significant hypertrophy expected - B. Most injuries occur to the growth plates - C. Significant prevention of sporting injuries - D. Direct correlation between strength training and severity of sports-related injuries - E. Makes you fully sick bro - **Answer:** C - **Explanation:** Resistance training in children enhances muscular strength and power, improves cardiovascular risk profile, improves motor skill performance, and increases young athletes\' resistance to sports-related injuries. 3. **Regarding hip arthroscopy for athlete** - A. Benefit is low at 2 years afterwards - B. Evidence of good effect up to 10 years - C. Good evidence when combining labral repair and osteoplasty - D. Significant complication rate of 20% - E. Labral tears definitely lead to OA - **Answer:** B - **Explanation:** Systematic review of arthroscopy in FA shows a complication rate of 17% and 88% return to sport. Warwick consensus suggests physio-led rehab is associated with improvement of symptoms for at least 2 years, with reports of surgery describing significant improvement in symptoms up to 10 years. 4. **Immobilisation of an injured limb and strength loss** - A. 34% loss of muscle strength daily over first week - B. Fast twitch show greater atrophy than slow twitch - C. Start to lose strength after 24 hours of immobilisation - D. Loss of strength increases after a week of immobilisation - E. Muscle loss is the same regardless of fiber type - **Answer:** A - **Explanation:** Muscle strength decreases most dramatically during the first week of immobilisation. Slow twitch fibers show greater atrophy than fast twitch. 5. **Exertional headaches most likely underlying cause** - A. Aneurysms - B. Raised ICP - C. Something cardiac - D. Arnold Chiari malformation - E. Normal pressure hydrocephalus - **Answer:** B or C - **Explanation:** It has been postulated that exertional headache is due to dilation of the pain-sensitive venous sinuses at the base of the brain as a result of increased cerebral arterial pressure due to exertion. 6. **Exertional headaches (recent onset in a soccer player, either during or shortly after activity) / what is the most appropriate course of action** - A. Take 25-50mg Indocid an hour before exercise - B. Sumitriptan at onset of symptoms - C. Ondansetron - D. Gradual warm up - E. Tramadol - **Answer:** Gradual warm up or pre-exercise NSAIDs - **Explanation:** Acute treatment of headaches is most commonly treated with typical nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen. Prophylactic treatment may include medications such as indomethacin or other NSAIDs. 7. **Regarding exercise for treatment of chronic hypertension, which is incorrect:** - A. Needs to be performed at \>60% of VO2max - B. High intensity exercise better than lower intensity at lowering BP - C. Need to keep diastolic blood pressure below 105mmHg while exercising - D. Resistance exercise should be high weight, low repetitions - E. Resistance exercise alone is effective in lowering BP - **Answer:** D - **Explanation:** High intensity exercise is better than lower intensity at lowering blood pressure. Resistance exercise should be high weight, low repetitions. 8. **Regarding recovery of glycogen stores after training in soccer players, which is worst for restoring:** - A. Fartlek - B. Anaerobic sprints - C. Aerobic running less than 60mins - D. Eccentric training - E. Circuit training - **Answer:** A - **Explanation:** If carbohydrates are not continued during endurance activities, glycogen stores are depleted in approximately 60-90 minutes. 9. **Which is an absolute contraindication to an exercise stress test?** - A. Unstable angina - B. Pulmonary hypertension - C. Complete LAD obstruction (relative) - D. Ventricular arrhythmia (only if uncontrolled and causing symptoms) - E. Uncontrolled diabetes - **Answer:** A - **Explanation:** Absolute contraindications to cardiac stress testing include acute myocardial infarction, high-risk unstable angina, symptomatic severe aortic stenosis, uncontrolled arrhythmia causing symptoms or hemodynamic instability, unstable heart failure, acute pulmonary embolus, and acute aortic dissection. 10. **Regarding frostbite** - A. Should be rapidly rewarmed - B. Appearance of large bullae after rewarming is poor prognosis - C. Will undergo spontaneous necrosis and amputation 12 months afterwards - D. Surgical amputation within first couple of weeks - E. Hemorrhagic blisters should be drained - **Answer:** C - **Explanation:** Field warming should not be instituted until refreezing can be prevented. The injured part should be protected with a loose bulky splint during transport for definitive care. Hypothermia should be treated first. 11. **Which of the following medications increase the risk of heat illness by interfering with sweating?** - A. Amphetamine - B. Beta-blocker - C. Colchicine - D. Calcium channel blocker - E. Antihistamine - **Answer:** E - **Explanation:** Antihistamines can have antimuscarinic actions, affecting the parasympathetic system and sweating response. 12. **60 year-old bloke exercising and getting muscle pain. Which of his meds is the LEAST likely cause of his myopathy?** - A. Cimetidine - B. Metoprolol - C. Statin - D. NSAID - E. Colchicine - **Answer:** B - **Explanation:** Drug-induced myopathies include cimetidine, statins, and colchicine. Statins are generally the worst. 13. **Which ECG change is not normal in athletes?** - A. Early repolarisation - B. Type I second degree heart block (Wenkebach) - C. Sinus bradycardia \>30bpm - D. Junctional escape rhythm - E. Ventricular couplets - **Answer:** E - **Explanation:** Abnormal findings on the athlete ECG include T wave inversion, ST segment depression, pathological T waves, complete LBBB, intraventricular conduction delay, left axis deviation, left atrial enlargement, RV hypertrophy pattern, ventricular preexcitation, prolonged QT interval, short QT interval, Brugada-like ECG pattern, atrial tachyarrhythmia, and ventricular arrhythmias. 14. **Which is an indication for surgery in radial head fracture?** - A. 25% angulation - B. 20% articular surface involvement but undisplaced - C. Small undisplaced fracture following elbow dislocation (been reduced) - D. Mechanical block at 100 degrees of flexion - E. 2mm displaced fracture - **Answer:** D - **Explanation:** Surgical opinion should be obtained for radial head fractures with mechanical block to motion. Surgical ORIF or radial head replacement is considered for better anatomical reduction. 15. **What is the most common benign bone tumour in childhood/adolescence?** - A. Osteochondroma - B. Osteosarcoma - C. Osteoblastoma - D. Unicameral bone cyst - E. Chondromyoid fibroma - **Answer:** A - **Explanation:** Osteochondroma accounts for 10% of all bone tumours and 35% of all benign bone tumours. It is most commonly found in the lower limb. 16. **What is the quickest time you can adjust (per time zone) when travelling west?** - A. 6 hours - B. 12 hours - C. 16 hours - D. 1 day - E. 2 days - **Answer:** B - **Explanation:** Jet lag is more debilitating when travelling in an easterly direction. Ideally, one day per time zone crossed is needed to adjust. 17. **Right-handed adolescent tennis player with 3 weeks left lower back pain. What is the most likely diagnosis?** - A. Pars defect - B. Pars stress - C. Paravertebral muscle strain - D. Facet joint - E. SIJ dysfunction - **Answer:** B - **Explanation:** Very competitive tennis is a risk factor for spondylolysis. In adolescence, pushing technique to advance professionally can lead to back pain. 18. **With comparison to skiing which of the below is true** - A. Snowboarding has higher head injury rates - B. Ankle sprains and fractures are less common in snowboarding - C. Knee injuries are less common in snowboarding - D. Injuries due to landing from jumps are less common snowboarding - E. ACL injuries are more common in snowboarding - **Answer:** C - **Explanation:** Knee injuries are less common in snowboarding compared to skiing. Ankle sprains and fractures are more common in snowboarding. 19. **Exercise associated muscle cramps. Which is correct?** - A. Central neural cause - B. Peripheral neural cause - C. Electrolyte disturbance cause - D. More common in dehydrated than euhydrated - E. Central and peripheral neural causes - **Answer:** E - **Explanation:** Exercise-associated muscle cramps (EAMC) are a result of altered neuromuscular activity, with disturbances at various levels of the central and peripheral nervous systems and skeletal muscle. 20. **School children going on snowboarding trip. Which of the following is correct?** - A. Hard boots better protection and less injuries - B. Helmets and wristguards good evidence for children - C. Hip pads decrease the risk of wrist fracture and shoulder dislocation - D. Elbow pads decrease the risk of common injuries - E. Backbone guards decrease the risk of concussion - **Answer:** C - **Explanation:** Hip pads and knee pads decrease the overall risk of common injuries. Hip pads specifically decrease the risk of wrist fractures and joint dislocation. 21. **Dancer with posterior ankle pain crepitus en pointe demi pointe. What is the most likely diagnosis?** - A. FHL tenosynovitis - B. Achilles tendinopathy - C. Tibialis posterior tendinopathy - D. Os trigonum - E. Peroneal tendinopathy - **Answer:** A - **Explanation:** Flexor hallucis longus (FHL) tenosynovitis, or dancer\'s tendinitis, occurs from overuse and microtrauma resulting from repetitive dorsiflexion and plantarflexion. FHL tenosynovitis is the most likely diagnosis due to the crepitus. 22. **Which Tanner stage? Coarse hair across pubis but not on inner thighs.** - A. 1 - B. 2 - C. 3 - D. 4 - E. 5 - **Answer:** 3 - **Explanation:** Tanner stage 3 is characterized by coarse hair across the pubis but not on the inner thighs. 23. **What is the most common stress fracture in ballet dancers?** - A. Base 2nd MT - B. Base 5th MT - C. Rib - D. Navicular - E. Medial malleolus - **Answer:** A - **Explanation:** A base of the 2nd metatarsal is the most common stress fracture in dancers. 24. **Athlete with vit D level of 25. Which is correct management?** - A. Nothing as it is normal - B. 3000-5000 units daily then recheck in 10-12 weeks - C. 1000 units daily then recheck in 10-12 weeks - D. Sun exposure only Face and arms in summer 6-7 min Mid morning and afternoon, or in winter 7-40 minutes at noon. - E. 10000 IU/day and recheck at 1 month - **Answer:** B - **Explanation:** Guidelines to prevent deficiency include sun exposure and dietary and supplement sources. Treat deficiency with 3000-5000 IU/day for 6-12 weeks, then 1000 IU ongoing. 25. **How many days does it take to adapt to the new time zone for each hour of time zone changed (or something like this) during travel** - A. 1 - B. 2 - C. 3 - D. 4 - E. 5 - **Answer:** A - **Explanation:** It takes one day per time zone to adapt. Jet lag is disruption to circadian rhythm, which synchronizes the body clock.