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39 Cards in this Set
- Front
- Back
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Which of the following kids is prohibited from playing sports?
A) An otherwise healthy child with fever B) A child with pericarditis C) A child with endocarditis D) A child with hepatosplenomegaly E) All of the above. B) |
E.
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What are the criteria for heat stroke?
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Temp > 105℉
Hot Dry Skin CNS depression (lethargy or confusion) |
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What is the physiologic complication of heat stroke?
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release of endotoxins and cytokines resulting in end-organ damage.
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What is the treatment for heat stroke?
A) Ice pack to the neck, groin and axilla B) Cold IV fluids C) Cooling blanket D) Oral rehydration E) Evaporation |
A) Ice pack to the neck, groin and axilla
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A 12yo boy is brought to the ED after being hit in the eye during a boxing match. You note the pupils to be asymmetric and the child complains of significant vision disturbance in the injured eye. What is your diagnosis? What is your next step?
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Hyphema. Call opthalmology and have patient lie with head at 30 degree angle.
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What is an ocular blowout fracture?
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It is where the orbital floor or wall is fractured.
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I have sustained blunt trauma to the eye. I have double vision when looking to the left and you note a dysconjugate gaze on one side. My pupils are responsive. What is my diagnosis?
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Blowout fracture of the eye
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I have severe pain and tearing without any diplopia or dysconjugate gaze. What is my diagnosis?
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Corneal abrasion
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I have blood in the anterior chamber of my eye and have vision deficits without any diplopia. What is my diagnosis?
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Hyphema
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I have severe pain and photophobia without diplopia. What is my diagnosis?
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Traumatic iritis
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I have a visual defect in the peripheral field, like things are closing like a curtain. You do not note dysconjugate gaze. What is my diagnosis?
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Detached retina.
See page 309 of picture book. Look for arial view of mars, obscured by clouds. |
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A 16yo boy has red irritated right eye. His symptoms have persisted despite removal of his contact lenses 9 hours ago. On exam you not conjunctival irritation and difficulty keeping his eye open. His funduscopic exam is normal and his pupils are PERRLA. There is no discharge but there is diffuse uptake on fluorescein stain and no focal uptake is noted. What is the next step in management?
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Diagnosis is NOT corneal abrasion because that would have had focal uptake of staining.
Diffuse staining in a contact lens wearing patient is a sign of gram negative infection and/or ulceration of the corneal epithelium. Treatment is consult opthalmology |
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Which tendon or ligament is affected in most ankle injuries?
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anterior talofibular ligament
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Which of the following statements regarding ankle injuries is True and which are False?
1. 75% of sports injuries involve the lower extremities 2. Contusions and ankle sprains are the most common injuries 3. 85% of ankle injuries are sprains of anterior ligaments 4. Most injuries of knee and ankle are due to incomplete healing of a previous injury. |
1, 2, and 4 are true.
3 is false. It is the lateral ligaments that are usually involved in ankle injuries. |
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When can a child go back to sports after an injury?
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When one of the following occur.
Full ROM Full Strength No Swelling No pain No joint instability |
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A 16yo was playing football when after a tackle he was unable to bear weight on his knee. He heard his knee "pop." On exam, he has an effusion of his right knee. He also has a positive drawer sign. Where do you suspect is his injury? How do you confirm your diagnosis?
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ACL. MRI will confirm.
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A 10yo gymnast has had left wrist pain over 3 months which has gotten progressively worse. She does not recall any specific injury. On exam, there is no swelling with normal ROM and with no pain at all noted on the wrist joint itself. Point tenderness is limited to the distal radius. What is the most likely explanation for the wrist pain? What is the best management? What would you see on x-ray?
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Given that there is no pain over the wrist joint, scaphoid fracture and wrist sprain are not possible.
This is a distal radial epiphyseal injury. If she were to continue her practices, she would likely disrupt her growth plate, so she needs to rest and splint the wrist until it is healed. She can not bear weight on the wrist until it heals, but can do other exercises |
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How do you treat a non-displaced mid-shaft clavicular fracture?
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Sling and home
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How do you manage a medial clavicular fracture?
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Get a CT and go from there
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A boy comes in with distal superior clavicular pain and has a negative x-ray. What is his most likely diagnosis?
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Acromioclavicular separation
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True or False.
A concussion, by definition, entails LOC. |
False. It just needs an alteration in mentation.
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What is the definition and management of Grade 1 concussion?
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Confusion but no LOC and no amnesia. Remove from game. Examine every 5 minutes. If no symptoms after 20 minutes, may return to play.
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What is the definition and management of Grade 2 concussion?
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Confusion with amnesia but no LOC. Remove from game. Examine frequently for more severe symptoms. 24 hour followup. If no symptoms after 1 week, may return to play.
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What is the definition and management of Grade 3 concussion?
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LOC. Remove from game. Take to ER. No sports for 2 weeks.
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Which sport has the most head injuries of the following sports?
A) Football B) Hockey C) Boxing D) Basketball E) Rodeo F) Wrestling |
A.
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Which of the following require mouthguards? (pick any that apply)
A) Football B) Hockey C) Boxing D) Basketball E) Discus F) Wrestling G) Shotput |
All of them
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True or False.
Kids with braces must wear a mouthguard for all sports. |
True
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Which of the following would inhibit a patient from playing contact sports?
A) Splenomegaly B) Hepatomegaly C) One functioning paired organ D) Repeated concussions E) Failing school F) All of the above. |
F.
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You suspect mono in a patient who has splenomegaly. What is your best management?
A) Steroids B) IVIG C) Prohibit from school D) Prohibit from contact sports E) Exchange transfusion |
D.
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Of the following effects of anabolic steroid use. Which are true and which are false.
A) Hirsuitism and low voice in girls B) Early closure of epiphyseal plates in girls C) Acne in boys D) Gynecomastia in boys E) High pitched voice in boys F) Hypogonadism in boys G) Hypertension in boys and girls. H) Arrhythmias in boys and girls I) Seizures in boys and girls |
All are true except H and I
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How long do PO and IM steroids stay in the system?
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PO: days-weeks
IM: 6 months |
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Of the following lab findings, which is not associated with steroid use?
A) Elevated LFTs B) Elevated PT/PTT C) Elevated LDL D) Decreased HDL E) Oligospermia and azoospermia |
B.
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True or False.
Hyperactivity is a sign of steroid withdrawal. |
False. Depression is a sign of steroid withdrawal.
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True or False.
Growth Hormone is not detected in current drug testing. |
True
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What is the best hydration plan for a marathon runner?
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Sweat is hypotonic, which is why water is fine for most athletic rehydration under an hour. Athletes for more than one hour should have 6-8% dextrose in their fluids.
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A teenager has nephrotic syndrome in remission and would like to participate in sports. What guidance do you give regarding which sports and how much fluid intake?
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All sports and usual fluids, because she is in remission.
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True or False.
Short term weight loss results in decreased muscle endurance. |
True. you are losing water.
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What is a good weight loss guide?
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No more than 3 pounds/week OR 1.5% body weight/week
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A star athlete is being recruited for college football. You do CXR and note cardiomegaly and then do an ECHO which reveals cardiac hypertrophy. What is your recommendation?
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No restrictions. These are normal findings for athletes.
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