Case 6 - 16 yo pre-participation evalulation

Question 1

What is the main body system to focus on in the pre-participation evaluation.

Answer 1

cardiac

Question 2

What are the two common triggers of hypotension among adolescent athletes?

Answer 2

volume depletion

skipping meals

Question 3

What’s the cause of osgood-schlatter?

Answer 3

irritation of the growth plate at the tibial tuberosity

Question 4

What is the most common cause of chest pain in children?

Answer 4

musculoskeletal: precordial catch syndrome and costochondritis

Question 5

How does precordial catch present?

Answer 5

sudden, sporadic onset of sharp pain usually along the left sternal border, often exacerbated with deep inspiration. episodes last a few seconds to minutes and resolve spontaneously. pain can be “broken” with forced deep inspiration

Question 6

Hypertrophic cardiomyopathy inheritance is autosomal ______.

Answer 6

dominant

Question 7

What are some strategies for talking with adolescents about performance-enhancing drugs?

Answer 7

1. Lack of proof of efficacy
2. They just increase aggressive tendencies
3. They can cause testicular atrophy (and nobody wants small balls)
4. “just say no” for pre-teens since they don’t think abstractly yet
5. Warn them they could be caught with drug testing
6. Give examples of consequences with recent high-profile course cases for professional athletes

Question 8

When should you first think about giving the Tdap?

Answer 8

at the pre-adolescent visit around 11-12 years of age

Question 9

What’s the difference between the DTap and Tdap?

Answer 9

DTap contains 3-5x more diptheria toxoid. and diptheria becomes less of an issue once you’re not a kid anymore

Question 10

The meningococcal vaccine is recommended at age 11-12 with a booster at age ___

Answer 10

16

Question 11

Which HPV vaccine is approved for boys: the quadrivalent or bivalent?

Answer 11

quadrivalent only

bivalent is just for girls (only prevents cervical cancer, not warts)

Question 12

Too lazy to make Tanner Staging Cards…

Answer 12

Look it up…

Question 13

What does HEADSS scand for?

Answer 13

Home
Education/Employment
Activities
Drug Use
Sex
Suicide

Question 14

What is the purpose of doing a genital exam in a pre-participation exam for a male?

Answer 14

look for inguinal hernia (would need to think carefully about sprinting and weight lifting) and undescended testicle (would need to be extra careful to wear a cup in a contact sport)

Question 15

In any adolescent with a history of syncope, what diagnostic test should you obtain?

Answer 15

EKG

Question 16

What specifically is the EKG looking for?

Answer 16

Evidence of hypertrophic cardiomyopathy (will be seen on 90% of EKGs)