Emergency, Concussion, Imaging, Med Conditions, Integ

Question 1

Areas of brain
Frontal
Occipital
Parietal
Temporal

Answer 1

Areas of brain:
Frontal:
- Personality changes
Occipital:
- center for vision
Parietal:
- proprioception, sensory processing & speech
Temporal:
- memory & word understanding

Question 2

Concussion outcome for child
13+

Answer 2

SCAT 3

Child SCAT ages 5-12

Question 3

Cardiovascular adaptations during pregnancy:

Answer 3

Inc blood volume
Inc heart rate
Inc stroke volume
Inc cardiac output

Dec in systemic vascular resistance

Question 4

Levels of consciousness

Answer 4

AVPU
Alert; able to respond
Verbal; responds only to verbal commands
Painful; responds only to painful stimuli
Unresponsive

Question 5

Types of football pads (3)

Answer 5

non cantilever pads- QB/WR. more freedom of movement. some OL who use hands more

-inside cantilever - fits under the arch of the shoulder pads and rests against the shoulder. It is more common because it is less bulky than the outside cantilever.

-Outside cantilever - sits on top of the pad, outside of the arch. It provides a larger blocking surface and affords more protection to those who are in constant contact, such as linemen.

-Double cantilever - combination
of both the inside and the outside cantilever,
affords a player the greatest amount of protection but is not feasible for all positions because of its bulk.

Question 6

proper preactivity hydration

Answer 6

17–20 oz three hours prior to the event and 7–10 oz every 10–20 minutes during the event

Question 7

WBGT - when to start being alert

Answer 7

85 deg- begin staying alert to changes

stop training if 99 degrees or higher.

Question 8

heat stroke

Answer 8

core temp >105
cold immersion
get to <102 before transport

Question 9

shock

Answer 9

moist clammy skin
increased RR
decreased BP
weak, rapid pulse- tachycardia

Question 10

hypothermia

Answer 10

mild: 95-98.6
moderate: 90-94, cessation of shivering
severe: temp <90, brady, hypotension

death at core temp 77-85

Question 11

lightning times

Answer 11

lightning–>thunder time
divide by 5
= miles away

Question 12

Ottawa Ankle Rules

Answer 12

-pain in malleolar/midfoot
-unable to WB after / in ED
-TTP at posterior tip of fibula/tibia
TTP at med/lateral malleolus
TTP at navicular or 5th MT base

Question 13

Ottawa Knee Rules

Answer 13

age >55
unable to WB
TTP at fibular head
isolated TTP at patellar
unable to flex to 90

Question 14

Pittsburgh knee rules

Answer 14

fall/blunt trauma
+ EITHER:
-age <12 or >50
-cant WB 4 steps

Question 15

Canadian C spine rules

Answer 15

*High risk factors
-age >65
-dangerous MOI
-extremeity paresthesias

*Low risk to allow safe ROM assessment:
-simple rear end
-normal sitting in ED
-ambulatory since injury
-delayed onset, no midline tenderness

*IF you can assess, can they rotate >45 deg?
*If so, NO radiograph

*If 1 high risk- need xrays
*If 2 low risk + can’t rotate to 45 = need rays

Question 16

Salter Harris classifications

Answer 16

SALTR

I: slipped, through growth plate but NOT bone involved, cannot happen if growth plate fused

II: above (most common), through most of growth plate and metaphysis

III: lower, some distance through growth plate and through epiphysis (poorer px)

IV: through/transverse/together: fracture through metaphysis, growth plate & epiphysis

V: ruined, does not displace growth plate but crush type injury, poor px

Question 17

Canadian CT rules - is CT needed after head trauma

Answer 17

-minor injury + ONE of following:

-GCS 13-15 after LOC, amnesia
-open fx
-high risk- GCS <15 2 hours after
-2+ episodes vomiting
-65+ y/o
-medium risk- amnesia before impact 30+ min

Question 18

New Orleans Criteria for imaging after head injury

Answer 18

with minor injury + ONE of following:

-HA
-vomit
->60
-intoxicated
-amnesia
-visible trauma above clavicle
-seizure

Question 19

HTN definition

Answer 19

140/90 on 2 different occasions

Question 20

marfan syndrome testing rules

Answer 20

echo every 6 months
no collision sports or static strenuous like weightlifting

Question 21

ehlers danlos

Answer 21

collagen tissue impacts

Question 22

liver referral

Answer 22

RUQ to shoulder/neck

Question 23

spleen

Answer 23

LUQ

Question 24

Cullen sign

Answer 24

bluish tint at umbilicus

Question 25

mcburneys point

Answer 25

1/3 distance from ASIS to umbilicus - near appendix

Question 26

MRSA 5 Cs

Answer 26

-Contact (frequent skin to skin) -Contaminated item/surface -Crowding -Compromise of skin integrity -Cleanliness

Question 27

erythasma

Answer 27

Red-brown plaques involving skin folds. Erythrasma is caused by the bacteria Corynebacterium minutissimum may compete with lesion if well covered abx for 2-4 wks

Question 28

impetigo

Answer 28

-bullous on trunk/extremities with blisters that rupture easily -non bollus - thin walled vesicles that rupture into honey colored crust topical -No new skin lesions for at least 48 hours. -Complete 72 hr directed abx -No further drainage/exudate -ctive infections may not be covered to compete

Question 29

follicitulus faruncles - return to sport rule

Answer 29

No new skin lesions for at least 48 hours. Complete 72 hr directed abx No further drainage/exudate active infections may not be covered to compete

Question 30

MRSA

Answer 30

systemic abx used on case by case same rts rules as impetigo: No new skin lesions for at least 48 hours. -Complete 72 hr directed abx -No further drainage/exudate -active infections may not be covered to compete -initially presents similar to other bacteria infections. similar to abscess/furuncle -often confused with spider bite -lesion may start as small pustule that develop into larger abcess/pustule with area of erythema & some tissue necrosi

Question 31

miliaria

Answer 31

Fine red- or skin-colored papules caused by blockage of eccrine glands due to sweating

Question 32

chillblain/pernio

Answer 32

Blotchy red or purple lesions that present several hours after cold exposure

Question 33

fungal infections

Answer 33

intertrigo tinea capitis tinea coporis tinea cruris tinea pedis tinea versicolor

Question 34

intertrigo

Answer 34

Chronic, erythematous plaques found in skin folds. Can involve scrotum safe to return to play, keep area dry/clean

Question 35

tinea captitis

Answer 35

Scaly, gray patches with mild hair loss oral antifungal 2 wks min of systemic treatment

Question 36

tinea captitis

Answer 36

Scaly, gray patches with mild hair loss toral antifungal 2 wks min of systemic treatment

Question 37

tinea corporis

Answer 37

Round, well-defined, erythematous, scaly plaque with raised borders. Tinea corporis gladiatorum (tinea corporis found in wrestlers) frequently has a more irregular lesion topical for at least 72 hours, lesion covered with gas permeable membrane

Question 38

tinea pedis

Answer 38

Erythematous, pruritic scales between the toes, on the plantar aspects, and sides of the feet may compete if lesion well covered

Question 39

tinea cruris

Answer 39

Well-defined boarder with erythematous pruritic scaly plaque in skin folds of groin. Scrotum usually not involved may compete if well covered

Question 40

tinea versicolor

Answer 40

topical 2-4 wks, can play Asymptomatic, hypopigmented or hyperpigmented macules, commonly found on trunk.

Question 41

corn, callus

Answer 41

Calluses are hyperkeratotic, nonpainful lesions caused by friction. Corns also are caused by friction, but contain a painful central core.

Question 42

piezogenic papules

Answer 42

Fatty herniations through fascial tissue in the heels. Can be painful or asymptomatic

Question 43

viral infections

Answer 43

Molluscum contagiosum HSV

Question 44

HSV RTS criteria

Answer 44

- free of systemic symptoms such as fever, malaise -no new blisters developed for 72 hours -all lesion surmounted with firm adherent crust -completed min 120 hours of systemic antiviral -active lesions cannot be covered to participate

Question 45

Molluscum contagiosum

Answer 45

Typically presents as umbilicated, or delled, flesh-colored to light-pink pearly papules, measuring 1 to 10 mm in diameter can cover with gas permeable membrane

Question 46

What to do if Type I DM is less than 100 mg/dL?

Answer 46

Specifically NATA recommends; Administer 10 g to 15 g of fast-acting carbohydrate: eg, 4 to 8 glucose tablets, 2 T honey. Measure blood glucose level. Wait approximately 15 min and remeasure blood glucose. If blood glucose level remains low, administer another 10 g to 15 g of fast-acting carbohydrate. Recheck blood glucose level in approximately 15 min. If blood glucose level does not return to the normal range after second dosage of carbohydrate, activate emergency medical system. Once blood glucose level is in the normal range, athlete may wish to consume a snack (eg, sandwich, bagel)

Question 47

2 requirements to diagnosis EIA?

Answer 47

-Symptoms -Obstructed Airways dec by 10-15 % in FEV Both with exercise

Question 48

Rescue inhaler medication

Answer 48

rapid acting inhaled B2-agonists

Question 49

Classification of Asthma:

Answer 49

Step 1: mild: FEV in 1 sec or PEF >80% Step 4: severe FEV or PEF <60%

Question 50

If PEF is < 80% of best or predicited what is the initial treatment?

Answer 50

Inhale a rapid-acting B2 agonist up to 3 tx in 1 hr

Question 51

Volkmanns contracture

Answer 51

Ischemic contracture occurs when there is a lack of blood flow to the forearm could be caused by increased pressure due to swelling or compartment syndrome leads to contracture deformities of the fingers, hand and wrist

Question 52

Major Risk Factors for Hypertrophic Cardiomyopathy?

Answer 52

Prior cardiac arrest* Family Hx of SCD Unexplained syncope Left ventricular wall thickness > 30 mm Abnormal blood pressure response to exercise Nonsustained spontaneous ventricular tachycardia

Question 53

When to RTS after liver injury

Answer 53

when enzymes have normalized

Question 54

Severe hypoglycemia

Answer 54

Mental status changes Autonomic Changes Collapse Treat w/ glucagon 1 mg subcutaneous Intramuscular injection

Question 55

RR Emergency

Answer 55

>25 breaths/min

Question 56

EIA can be triggered by: What will you see a dec in?

Answer 56

cooler & dryer air drawn into the lungs Dec in FEV1

Question 57

When should insulin dependent diabetics postpone exercise?

Answer 57

level is above 250 w/ presence of urine keytones OR above 300

Question 58

Mono recovery time, RTS

Answer 58

spleen at risk first 21 days initial recovery 7 days but really 2-3 wks asymptomatic to rts, 3 wks rest

Question 59

Scoliosis: What is the cut off score for the Adam’s forward bend test?

Answer 59

Difference in 8 mm side to side or 7 degrees (correlates to a COBB angle of 20 degrees) Can be measured with a scoliometer

Question 60

Y balance cut off

Answer 60

anterior reach- 4cm posterior/lat-6cm

Question 61

scoliosis- who should be referred to ortho

Answer 61

Skeletally immature children w/ curves >20 deg Cobb angle OR fully mature adolescents with curves greater than 40 degrees

Question 62

Types of football pads (3)

Answer 62

non cantilever pads- QB/WR< more freedom of movement. some OL who use hands more nside cantilever - fits under the arch of the shoulder pads and rests against the shoulder. It is more common because it is less bulky than the outside cantilever. Outside cantilever - sits on top of the pad, outside of the arch. It provides a larger blocking surface and affords more protection to those who are in constant contact, such as linemen. Double cantilever - combination of both the inside and the outside cantilever, affords a player the greatest amount of protection but is not feasible for all positions because of its bulk.

Question 63

Types of football pads (3)

Answer 63

non cantilever pads- QB/WR< more freedom of movement. some OL who use hands more nside cantilever - fits under the arch of the shoulder pads and rests against the shoulder. It is more common because it is less bulky than the outside cantilever. Outside cantilever - sits on top of the pad, outside of the arch. It provides a larger blocking surface and affords more protection to those who are in constant contact, such as linemen. Double cantilever - combination of both the inside and the outside cantilever, affords a player the greatest amount of protection but is not feasible for all positions because of its bulk.