AMSSM SPORTS MEDICINE CAQ STUDY GUIDE | 300+
QUESTIONS | WITH COMPLETE SOLUTIONS!!
/.What are two major types of femoral neck stress fractures?
Which carries a higher rate of complications?
Management for this more complicated Fx? - Answer-Tension side (lateral)
Compression side (medial)
Tension side: Risks
- Unstable Fx, risks of displacement
- AVN of femoral head
- Need for hip replacement
Tension side: Management:
- Non-weight bearing immediately
- Orthopedic referral
/.Compression-sided femoral neck stress fracture: When to consider surgery? - Answer-
Fracture comprising > 50% of femoral neck
/.What concept of thermoregulation occurs during cold water immersion? - Answer-
Conduction: Heat transferred from a warm surface to cold surface
/.What is is the concept of convection?
Example? - Answer-When the body exchanges heat with the surrounding air
Ex. Fans / wind cooling body
/.What is the concept of radiation re: thermoregulation?
Example? - Answer-Heat is absorbed or reflected without contact
Ex. Wearing lighter colored clothing to reflect heat
/.The sleeper stretch addresses which specific part of the shoulder?
How is this performed?
In which athletes is this most useful? - Answer-Posterior capsule
,Technique:
- Side-lying position with a roll under axilla
- Opposite extremity forces flexed elbow in a downward direction, internally rotating the
shoulder and stretching posterior capsule
Overhead-throwing athletes
/.What injuries are prevented by the sleeper stretch? - Answer-- Type II SLAP tears
- Biceps tendonitis
/.What conditions are most associated with adhesive capsulitis? - Answer--
Hyper/hypothyroidism
- DM
- Parkinson's disease
- Ischemic heart disease
- CERVICAL spondylosis
- Malignancy
/.Which types of athletes/maneuvers are at greatest risk of developing lumbosacral pars
interarticularis stress fractures (spondylolyis)? - Answer-- Recurrent lumbar extension
- Increased lumbar lordosis
- Poor abdominal strength and control
- Skeletal immaturity
- Male gender
/.Spondylolisthesis grading re: displacement - Answer-- Grade 1: 0% - 25%
- Grade 2: 25% - 50%
- Grade 3: 50% - 75%
- Grade 4: 75% - 100%
- Grade 5: Complete displacement
/.When is surgical intervention indicated in spondylolistheses? - Answer-- Persistent
symptoms in grade 1-2
- Symptomatic grade 3
- All grade 4-5
/.Lumbosacral pars interarticularis stress fractures (spondylolyis): Imaging modalities if
negative plain films? - Answer-1. Bone scan with SPECT
- Differentiate between acute and chronic lesions
2. CT scan (thin cuts through area of concern)
- Second study for staging
/.Limit on intentional weight loss? - Answer-No more than 1.5% body weight / week
,/.What are diagnostic findings of complex regional pain syndrome on triple phase bone
scan? - Answer-- Phase 1/2: Hypoperfusion
- Phase 3: Increased uptake / Juxta-articular accentuation
/.What are the two types of complex regional pain syndrome? - Answer-- Type 1: No
injury to a specific nerve
- Type 2: Evidence of injury to a specific nerve
/.What are some contributing factors that cause patellofemoral pain syndrome? -
Answer-- Hip abductor weakness (gluteus medius)
- Internally rotated femur at foot strike
- Quadriceps/VMO weakness / tightness
/.Positioning for reducing a patellar dislocation? - Answer-Hip flexed, knee extended
/.What are factors that predispose to patellar dislocation? - Answer-- Increased Q angle
- Genu valgum
- Patella alta
/.UCL injuries and MRI statistics? - Answer-MRI 100% specificity
/.What is the primary restraint to valgus stress of the elbow between 30d-120d? -
Answer-Anterior bundle of UCL
/.Risk of injury to what nerve in supracondylar Fx?
Complications from this? - Answer-Median nerve
Masks compartment syndrome
/.Valgus extension overload - Radiographic findings? - Answer-Small irregular loose
bodies in posterior elbow
/.What is a differentiating feature between lateral epicondylitis and radial tunnel
syndrome? - Answer-Lateral epicondylitis:
- Wrist extension worse
Radial tunnel syndrome:
- Supination worse
/.HLA viscosupplementation: Agents and risk of pseudoseptic reactions
Why? - Answer-- Synvisc (Highest risk, high molecular weight)
- Euflexxa (moderate molecular weight)
- Supartz, Hyalgan (Lowest risk, low molecular weight)
, /.Postmenopausal osteoporosis vs. senile osteoporosis:
- Type of bone loss
- Resultant Fx - Answer-Postmenopausal osteoporosis:
- Trabecular bone
- Distal radius, vertebral Fx
Senile osteoporosis:
- Cortical AND trabecular bone
- Hip, long bone, vertebral Fx
/.Valgus extension overload - Sx? - Answer-- Posteromedial elbow pain
- Worse during DECELERATION and FOLLOW THROUGH phases of throwing
/.How does valgus extension overload differ from ulnar collateral ligament injury? -
Answer-VEO:
- Posteromedial elbow pain in terminal extension during DECELERATION and
FOLLOW THROUGH phases
Ulnar collateral ligament injury:
- Posteromedial elbow pain during ACCELERATION phase
/.Physical exam maneuver for hypothenar hammer syndrome?
What structure is tested? - Answer-Allen test:
- Assess patency of superficial palmar arch
/.Order of hip external rotators (cephalad to caudad) - Answer-- Piriformis
- Superior gemellus
- Obturator internus
- Inferior gemellus
- Quadratus femoris
/.What is a Monteggia fracture? - Answer-Fracture of the proximal third of the ulna with
anterior radial dislocation
/.Tx of non-bony mallet finger? - Answer-Splint in full extension for 6-8 weeks
/.Proximal intersection syndrome - What is it? - Answer-Tenosynovitis of second dorsal
compartment (ECRL, ECRB) where it crosses UNDER the first dorsal compartment
(APL, EPB)
/.Conditions that predispose to chilblains? - Answer-Cold, wet
/.Difference between middle ear squeeze and inner ear squeeze regarding symptoms? -
Answer-Middle ear squeeze:
- Ear pain, vertigo, CONDUCTIVE hearing loss
QUESTIONS | WITH COMPLETE SOLUTIONS!!
/.What are two major types of femoral neck stress fractures?
Which carries a higher rate of complications?
Management for this more complicated Fx? - Answer-Tension side (lateral)
Compression side (medial)
Tension side: Risks
- Unstable Fx, risks of displacement
- AVN of femoral head
- Need for hip replacement
Tension side: Management:
- Non-weight bearing immediately
- Orthopedic referral
/.Compression-sided femoral neck stress fracture: When to consider surgery? - Answer-
Fracture comprising > 50% of femoral neck
/.What concept of thermoregulation occurs during cold water immersion? - Answer-
Conduction: Heat transferred from a warm surface to cold surface
/.What is is the concept of convection?
Example? - Answer-When the body exchanges heat with the surrounding air
Ex. Fans / wind cooling body
/.What is the concept of radiation re: thermoregulation?
Example? - Answer-Heat is absorbed or reflected without contact
Ex. Wearing lighter colored clothing to reflect heat
/.The sleeper stretch addresses which specific part of the shoulder?
How is this performed?
In which athletes is this most useful? - Answer-Posterior capsule
,Technique:
- Side-lying position with a roll under axilla
- Opposite extremity forces flexed elbow in a downward direction, internally rotating the
shoulder and stretching posterior capsule
Overhead-throwing athletes
/.What injuries are prevented by the sleeper stretch? - Answer-- Type II SLAP tears
- Biceps tendonitis
/.What conditions are most associated with adhesive capsulitis? - Answer--
Hyper/hypothyroidism
- DM
- Parkinson's disease
- Ischemic heart disease
- CERVICAL spondylosis
- Malignancy
/.Which types of athletes/maneuvers are at greatest risk of developing lumbosacral pars
interarticularis stress fractures (spondylolyis)? - Answer-- Recurrent lumbar extension
- Increased lumbar lordosis
- Poor abdominal strength and control
- Skeletal immaturity
- Male gender
/.Spondylolisthesis grading re: displacement - Answer-- Grade 1: 0% - 25%
- Grade 2: 25% - 50%
- Grade 3: 50% - 75%
- Grade 4: 75% - 100%
- Grade 5: Complete displacement
/.When is surgical intervention indicated in spondylolistheses? - Answer-- Persistent
symptoms in grade 1-2
- Symptomatic grade 3
- All grade 4-5
/.Lumbosacral pars interarticularis stress fractures (spondylolyis): Imaging modalities if
negative plain films? - Answer-1. Bone scan with SPECT
- Differentiate between acute and chronic lesions
2. CT scan (thin cuts through area of concern)
- Second study for staging
/.Limit on intentional weight loss? - Answer-No more than 1.5% body weight / week
,/.What are diagnostic findings of complex regional pain syndrome on triple phase bone
scan? - Answer-- Phase 1/2: Hypoperfusion
- Phase 3: Increased uptake / Juxta-articular accentuation
/.What are the two types of complex regional pain syndrome? - Answer-- Type 1: No
injury to a specific nerve
- Type 2: Evidence of injury to a specific nerve
/.What are some contributing factors that cause patellofemoral pain syndrome? -
Answer-- Hip abductor weakness (gluteus medius)
- Internally rotated femur at foot strike
- Quadriceps/VMO weakness / tightness
/.Positioning for reducing a patellar dislocation? - Answer-Hip flexed, knee extended
/.What are factors that predispose to patellar dislocation? - Answer-- Increased Q angle
- Genu valgum
- Patella alta
/.UCL injuries and MRI statistics? - Answer-MRI 100% specificity
/.What is the primary restraint to valgus stress of the elbow between 30d-120d? -
Answer-Anterior bundle of UCL
/.Risk of injury to what nerve in supracondylar Fx?
Complications from this? - Answer-Median nerve
Masks compartment syndrome
/.Valgus extension overload - Radiographic findings? - Answer-Small irregular loose
bodies in posterior elbow
/.What is a differentiating feature between lateral epicondylitis and radial tunnel
syndrome? - Answer-Lateral epicondylitis:
- Wrist extension worse
Radial tunnel syndrome:
- Supination worse
/.HLA viscosupplementation: Agents and risk of pseudoseptic reactions
Why? - Answer-- Synvisc (Highest risk, high molecular weight)
- Euflexxa (moderate molecular weight)
- Supartz, Hyalgan (Lowest risk, low molecular weight)
, /.Postmenopausal osteoporosis vs. senile osteoporosis:
- Type of bone loss
- Resultant Fx - Answer-Postmenopausal osteoporosis:
- Trabecular bone
- Distal radius, vertebral Fx
Senile osteoporosis:
- Cortical AND trabecular bone
- Hip, long bone, vertebral Fx
/.Valgus extension overload - Sx? - Answer-- Posteromedial elbow pain
- Worse during DECELERATION and FOLLOW THROUGH phases of throwing
/.How does valgus extension overload differ from ulnar collateral ligament injury? -
Answer-VEO:
- Posteromedial elbow pain in terminal extension during DECELERATION and
FOLLOW THROUGH phases
Ulnar collateral ligament injury:
- Posteromedial elbow pain during ACCELERATION phase
/.Physical exam maneuver for hypothenar hammer syndrome?
What structure is tested? - Answer-Allen test:
- Assess patency of superficial palmar arch
/.Order of hip external rotators (cephalad to caudad) - Answer-- Piriformis
- Superior gemellus
- Obturator internus
- Inferior gemellus
- Quadratus femoris
/.What is a Monteggia fracture? - Answer-Fracture of the proximal third of the ulna with
anterior radial dislocation
/.Tx of non-bony mallet finger? - Answer-Splint in full extension for 6-8 weeks
/.Proximal intersection syndrome - What is it? - Answer-Tenosynovitis of second dorsal
compartment (ECRL, ECRB) where it crosses UNDER the first dorsal compartment
(APL, EPB)
/.Conditions that predispose to chilblains? - Answer-Cold, wet
/.Difference between middle ear squeeze and inner ear squeeze regarding symptoms? -
Answer-Middle ear squeeze:
- Ear pain, vertigo, CONDUCTIVE hearing loss
