AMSSM Sports Medicine CAQ Study
Guide 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 conditions are most associated with adhesive capsulitis? - Answer--
Hyper/hypothyroidism
- DM
- Parkinson's disease
- Ischemic heart disease
- CERVICAL spondylosis
- Malignanc
/.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
/.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
/.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? - Answer-Allen test:
- Assess patency of superficial palmar arch
/.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
Guide 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 conditions are most associated with adhesive capsulitis? - Answer--
Hyper/hypothyroidism
- DM
- Parkinson's disease
- Ischemic heart disease
- CERVICAL spondylosis
- Malignanc
/.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
/.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
/.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? - Answer-Allen test:
- Assess patency of superficial palmar arch
/.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
