Sports physical

Question 1

Preparticipation evaluation

Answer 1

important to make sure adolescent athlete is healthy enough for sports

• CV screening - asking specific questions about symptoms and careful PE
• Other - previous injuries? LOC?

Question 2

Hypotension

Answer 2

• Dizziness, visual disturbances

- triggered by volume depletion, skipping meals

Question 3

Evaluation of syncope

Answer 3

brief LOC and postural tone resulting from inadequate cerebral perfusion

• self-limited, lasts 1 minute
• history, PE, EKG sufficient for evaluation of syncope

Question 4

History of syncope

Answer 4

• associated with exertion or exercise –> CARDIAC WORKUP

* prolonged LOC, cyanosis, chest pain, palpitations –> further work up

Question 5

EKG evaluation for syncope

Answer 5

will pick up arrhythmias (WPW, long QT)

- 90% of kids with cardiomyopathy will have abnormal EKG –> considered a screening test

Question 6

Osgood-schlatter disease

Answer 6

condition of irritation of growth plate at tibial tuberosity (self-limiting and resolves with rest)

Question 7

Creatine

Answer 7

may improve performance during brief high intensity exercise

- SE: weight gain (water retention), cramps, predisposed sprains, decreased kidney function

Question 8

Sports history screening questions

Answer 8

1. Chest pain or SOB with exercise?
2. High BP or murmur?
3. Irregular heart beat?
4. Racing heart?
5. LOC or concussion?
6. Seizure?
7. Do you have both kidneys?
8. Stroke or heart attack before 50?
9. Anyone died suddenly without reason?
10. Sports-related injuries?

Question 9

Common causes of chest pain in adolescents?

Answer 9

1. Musculoskeletal - precordial catch syndrome (benign)

- costochondritis - benign

Question 10

Hypertrophic cardiomyopathy

Answer 10

many gene loci have been identified for the autosomal inheritance of hypertrophic cardiomyopathy

Question 11

Asking about chest pain

Answer 11

Onset - abrupt, gradual
Quality - sharp, dull, pressure
Timing - how long it lasts?
Radiation - does it and where?
Aggravating - exercise, insipration
Alleviating - rest, meds?

Question 12

Non-chest causes of chest pain

Answer 12

gastritis, alcohol, tobacco, intoxicants, stimulants, cocaine, NSAIDs

Question 13

Precordial catch syndrome

Answer 13

brief chest wall pain, not associated with exertion, sporadic, sharp, exacerbated by breathing

Question 14

Costochondritis

Answer 14

similar to precordial catch syndrome but longer duration pain

Question 15

Strategy to talk about performance enhancing drugs

Answer 15

1. Lack of efficacy
2. Increase aggressive tendencies
3. Testicular atrohpy
4. Just say no
5. Drug testing
6. Consequences/side effects

Question 16

Musculoskeletal exam

Answer 16

accounts for 50% of abnormalities in preparticipation exams

1. SYMMETRY IN
   - strength
   - muscle bulk
   - range of motion

Question 17

Immunizations for adolesences

Answer 17

Tdap - recommended at 11-12 y.o. (booster shot)
MCV - recommended at 11-12 y.o. with booster at 16
HPV - recommended for boys and girls at 11-12 y.o.

Question 18

CV Exam

Answer 18

1. Start with blood pressure
2. Palpate radial pulses
3. Auscultate supine and sitting

Question 19

GU Exam in males

Answer 19

Mandatory part of exam for pre-sports physicals

• check for inguinal hernia
• check for undescended testes

Question 20

Tanner staging

Answer 20

1 - prepubertal (genitals aren’t enlarging)
2 - small amounts of pubic hair, genital skin darker
3 - genital enlargement and curly dark pubic hair
4 - Full pubic hair and larger genitals
5 - pubic hair on inner thighs and adult size genitals