Peds Sports

Question 1

Contraindications

Absolute: all sports

Answer 1

Acute pericarditis or myocarditis

Cardiomyopathy

Severe Pulmonary HTN

R to L cardio shunting

Fever

Question 2

Contraindications

Avoid Contact Sports

Answer 2

Splenomegaly

Acute hepatomegaly

Contagious skin lesions

Single Kidney

Question 3

Contraindications
High Dynamic Sports

High Static Sports

Answer 3

High Dynamic Sports
Ventricular dysfunction

High Static Sports
Essential HTN
L heart obstructive Dz
Marfan Syndrome

Question 4

Not Contraindicated

Answer 4

Well-controlled epilepsy

Poorly-controlled epilepsy - avoid swimming, riflery, archer

DM - hydration and insulin

Sickle cell Disease - hydration, overexertion, overheating, chilling, altitude

Sickle cell trait - hydration, altitude

HIV

Question 5

Down Syndrome

Answer 5

Abnormal collagen produced

Need cardio evaluation due to increased congenital heart Dz

Atlantoaxial Subluxation - 15%, annular ligament
Lateral views in flexion/extension
Sx - Fatigue, difficulty walking, abnormal position of neck, sensory deficits, hyperreflexia,
MRI to evaluate

Question 6

Percent of injuries in H.S. practice

Answer 6

55%

Question 7

Risk by sport

Answer 7

Girls’ Cross-country

Football

Wrestling

Girls’ soccer

Boys’ Cross-country

Boys’ Soccer

Boys’ Basketball

Question 8

Indirect Fatalities

Answer 8

Cardio 70-90%
Noncardiovascular 6-22%
Undetermined in 4%

Question 9

Cardiovascular fatalities

Answer 9

MC - Hypertrophic Cardiomyopathy - AD inheritance

Commotio Cordis

Coronary Artery anomalies

Myocarditis
Ruptured AA
Arrhythmogenic R ventricular cardiomyopathy
Aortic Stenosis
Cardiomyopathies

Question 10

Noncardiovascular Fatalities

Answer 10

Hyperthermia

Rhabdomyolysis

Status Asthmaticus

Electrocution

Anaphylaxis

Drug use/abuse

Question 11

Head & Neck Injuries

-Hematomas

Answer 11

Subdural hematoma - Sx take mins - days to occur
Injury to venous structures below the dura matter

Epidural hematoma - Sx lucid interval followed by severe HA
Damage to Middle Meningeal artery via temporal skull fx

Question 12

Acute Concussion - Evaluation

Answer 12

Orientation

Speech

Short/Long term memory

CN

TM

Concentration

Coordination

Question 13

Concussion Tx

Answer 13

Rest

Obs - closely for first 24 hrs

Avoid pain meds that increase risk of bleeding

Daily f/u while symptomatic

Cognitive rest