Sports Preparticipation PE Lecture Powerpoint Flashcards
The purpose of a Preparticipation physical exam
Not to disqualify athletes at risk for sudden death as it is a preventative and therapeutic tool to allow athletes to participate in sports safely, vary in guidelines depending on organization
When should a sports physical be done?
Ideally not less than 6 weeks before first practice
Most important part of a PPE
The history - more than half of diagnoses derived from here come from history
Majority of all sudden cardiac deaths in athletes are…
….CV related, most often hypertrophic cardiomyopathy, historical questeions should raise suspicion of CV abnormalities
Hypertrophic cardiomyopathy
Hallmark of physical exam finding in HCM is systolic murmur that increases with intesnity with valsalva and decreases when laying down
Should routine PPE include ekg?
AHA recommends against as it isn’t warranted and has a possibility of finding too many false positives
Physical signs of marfan syndrome (7)
- tall/thin
- scoliosis
- micrognathia
- nearsightedness
- flexible joints
- flat feet
- pectus deformity
Prehypertension vs stage 1 hypertension vs stage 2 hypertension PPE guidelines
Prehypertension has no sports restriction but should follow up in 6 months Stage 1 has no sports restriction but should follow up in 1-2 weeks Stage 2 has follow up in 1 week and are restricted from class IIIa to IIIc sports
Different components of the physical exam for the PPE
- HEENT
- Neck (cervical nerve roots via spurlings test)
- lungs
- cardiac
- GU (hernia check if indicated by history)
- musculoskeletal screening
2 absolute contraindications to sports participation
- fever
- carditis
Are ancillary studies indicated in PPE?
Only in high risk patients
4 possible outcomes for clearance regarding PPE
1) cleared without restriction
2) cleared with recommendation for further eval or treaetment
3) not cleared pending further eval or treatment
4) not cleared for certain or all sports (typically a specialist would determine this)
