FAMILY MEDICINE – SPORTS MEDICINE CERTIFICATED
NEWEST EXAM FOR THE AMERICAN BOARD OF FAMILY
MEDICINE (ABMS) | Q&A WITH RATIONALES
(GUARANTEED PASS)
This document is a study guide for the ABFM Sports Medicine
Certification Exam, a sub-specialty certification for family physicians.
The exam is administered by the American Board of Family Medicine
(ABFM) in conjunction with the American Boards of Emergency Medicine,
Pediatrics, and Physical Medicine and Rehabilitation. This high-yield
question bank delivers 300 comprehensive board-style multiple-choice
questions with verified updated answers and detailed clinical rationales
mapped directly to the American Board of Family Medicine (ABFM) Sports
Medicine blueprint. It covers the five essential domains of sports medicine
care, including emergency management, musculoskeletal injuries, and
advanced diagnostic sports pharmacology. Designed to mimic the
complexity of the actual Certificate of Added Qualifications (CAQ)
examination, this premium study resource guarantees maximum
preparation efficiency for residents and fellows seeking board
certification.
,Question 1
A 22-year-old collegiate basketball player sustains an acute eversion
ankle injury. Radiographs are negative for fractures. On physical
examination, there is marked tenderness over the anterior inferior
tibiofibular ligament and pain is elicited with external rotation of the foot.
Which of the following is the most appropriate next step in management?
A) Immediate application of a short cast for 6 weeks
B) Non-weight-bearing in a removable boot and referral for early
functional rehabilitation
C) Urgent surgical primary repair of the damaged ligaments
D) Immediate return to play with protective rigid taping
VERIFIED UPDATED ANSWER: B
RATIONALE: This clinical presentation is highly indicative of a
syndesmotic or "high" ankle sprain, characterized by an eversion
mechanism, injury to the anterior inferior tibiofibular ligament
(AITFL), and a positive external rotation test. Unlike standard lateral
ankle sprains, high ankle sprains require prolonged protection to
avoid widening of the ankle mortise. The initial treatment consists of
a non-weight-bearing period in a boot or cast followed by
progressive functional rehabilitation. Rigid cast immobilization for 6
weeks is avoided due to resultant severe stiffness, and surgery is
reserved for syndesmotic instability demonstrated on stress
radiographs.
,Question 2
A 45-year-old marathon runner presents with progressive lateral knee
pain that worsens when running downhill. Examination reveals localized
exquisite tenderness over the lateral femoral condyle when the knee is
flexed to 30 degrees. There is no joint effusion, and meniscus signs are
negative. What is the most likely diagnosis?
A) Pes anserine bursitis
B) Lateral meniscus tear
C) Iliotibial band (ITB) friction syndrome
D) Patellofemoral pain syndrome
VERIFIED UPDATED ANSWER: C
RATIONALE: Iliotibial band (ITB) friction syndrome is an overuse
injury commonly seen in runners and cyclists. Pain is
characteristically located over the lateral femoral condyle, where
friction occurs at roughly 30 degrees of knee flexion (Noble's
compression test). Downhill running increases the duration of the
contact phase near this angle, exacerbating the condition. Pes
anserine bursitis causes medial knee pain, lateral meniscus tears
typically present with mechanical symptoms (locking/catching) and
an effusion, and patellofemoral pain presents anteriorly.
Question 3
, During a pre-participation evaluation of a 16-year-old high school football
player, a harsh systolic murmur is heard along the left sternal border.
The intensity of the murmur increases significantly when the patient
changes from a squatting to a standing position and during a Valsalva
maneuver. What is the most appropriate definitive management step?
A) Clear for all competitive sports as this represents an innocent murmur
B) Order a 12-lead ECG and transthoracic echocardiogram, and restrict
from high-intensity sports pending results
C) Clear for sports but recommend avoidance of heavy weightlifting
D) Refer to pulmonology for exercise-induced bronchospasm evaluation
VERIFIED UPDATED ANSWER: B
RATIONALE: The dynamic changes of this murmur (increasing with
decreased venous return during standing or Valsalva) are
pathognomonic for hypertrophic cardiomyopathy (HCM). HCM is a
leading structural cause of sudden cardiac death in young athletes.
Any suspected structural cardiac anomaly on a pre-participation
physical requires temporary sports restriction and diagnostic
workup with both an ECG and an echocardiogram before athletic
clearance can be considered.
Question 4
A 34-year-old female triathlete presents with a 3-month history of deep,
aching groin pain that worsens with impact activities. Recently, she has
developed pain at rest and at night. Physical examination reveals limited
NEWEST EXAM FOR THE AMERICAN BOARD OF FAMILY
MEDICINE (ABMS) | Q&A WITH RATIONALES
(GUARANTEED PASS)
This document is a study guide for the ABFM Sports Medicine
Certification Exam, a sub-specialty certification for family physicians.
The exam is administered by the American Board of Family Medicine
(ABFM) in conjunction with the American Boards of Emergency Medicine,
Pediatrics, and Physical Medicine and Rehabilitation. This high-yield
question bank delivers 300 comprehensive board-style multiple-choice
questions with verified updated answers and detailed clinical rationales
mapped directly to the American Board of Family Medicine (ABFM) Sports
Medicine blueprint. It covers the five essential domains of sports medicine
care, including emergency management, musculoskeletal injuries, and
advanced diagnostic sports pharmacology. Designed to mimic the
complexity of the actual Certificate of Added Qualifications (CAQ)
examination, this premium study resource guarantees maximum
preparation efficiency for residents and fellows seeking board
certification.
,Question 1
A 22-year-old collegiate basketball player sustains an acute eversion
ankle injury. Radiographs are negative for fractures. On physical
examination, there is marked tenderness over the anterior inferior
tibiofibular ligament and pain is elicited with external rotation of the foot.
Which of the following is the most appropriate next step in management?
A) Immediate application of a short cast for 6 weeks
B) Non-weight-bearing in a removable boot and referral for early
functional rehabilitation
C) Urgent surgical primary repair of the damaged ligaments
D) Immediate return to play with protective rigid taping
VERIFIED UPDATED ANSWER: B
RATIONALE: This clinical presentation is highly indicative of a
syndesmotic or "high" ankle sprain, characterized by an eversion
mechanism, injury to the anterior inferior tibiofibular ligament
(AITFL), and a positive external rotation test. Unlike standard lateral
ankle sprains, high ankle sprains require prolonged protection to
avoid widening of the ankle mortise. The initial treatment consists of
a non-weight-bearing period in a boot or cast followed by
progressive functional rehabilitation. Rigid cast immobilization for 6
weeks is avoided due to resultant severe stiffness, and surgery is
reserved for syndesmotic instability demonstrated on stress
radiographs.
,Question 2
A 45-year-old marathon runner presents with progressive lateral knee
pain that worsens when running downhill. Examination reveals localized
exquisite tenderness over the lateral femoral condyle when the knee is
flexed to 30 degrees. There is no joint effusion, and meniscus signs are
negative. What is the most likely diagnosis?
A) Pes anserine bursitis
B) Lateral meniscus tear
C) Iliotibial band (ITB) friction syndrome
D) Patellofemoral pain syndrome
VERIFIED UPDATED ANSWER: C
RATIONALE: Iliotibial band (ITB) friction syndrome is an overuse
injury commonly seen in runners and cyclists. Pain is
characteristically located over the lateral femoral condyle, where
friction occurs at roughly 30 degrees of knee flexion (Noble's
compression test). Downhill running increases the duration of the
contact phase near this angle, exacerbating the condition. Pes
anserine bursitis causes medial knee pain, lateral meniscus tears
typically present with mechanical symptoms (locking/catching) and
an effusion, and patellofemoral pain presents anteriorly.
Question 3
, During a pre-participation evaluation of a 16-year-old high school football
player, a harsh systolic murmur is heard along the left sternal border.
The intensity of the murmur increases significantly when the patient
changes from a squatting to a standing position and during a Valsalva
maneuver. What is the most appropriate definitive management step?
A) Clear for all competitive sports as this represents an innocent murmur
B) Order a 12-lead ECG and transthoracic echocardiogram, and restrict
from high-intensity sports pending results
C) Clear for sports but recommend avoidance of heavy weightlifting
D) Refer to pulmonology for exercise-induced bronchospasm evaluation
VERIFIED UPDATED ANSWER: B
RATIONALE: The dynamic changes of this murmur (increasing with
decreased venous return during standing or Valsalva) are
pathognomonic for hypertrophic cardiomyopathy (HCM). HCM is a
leading structural cause of sudden cardiac death in young athletes.
Any suspected structural cardiac anomaly on a pre-participation
physical requires temporary sports restriction and diagnostic
workup with both an ECG and an echocardiogram before athletic
clearance can be considered.
Question 4
A 34-year-old female triathlete presents with a 3-month history of deep,
aching groin pain that worsens with impact activities. Recently, she has
developed pain at rest and at night. Physical examination reveals limited
