NMS Q&A Family Medicine

chap ter 29Sports MedicineExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST in eachcase. Many items found in Tests 23 and 24 pertain to sportsmedicine as well.1 Which of the following maneuvers tests theinfraspinatis muscle?(A) Empty bucket test(B) With the arm held passively horizontal and theelbow flexed 90 degrees to point directly upwardthe shoulder is rotated internally to bring theforearm into the horizontal position (Hawkinstest)(C) The drop arm test (patient lowers the armactively slowly from 160 abduction)(D) Active internal rotation of the shoulder againstresistance(E) Active external rotation of the arm againstresistance2 A 35-year-old runner complains of pain and paresthesiason the medial plantar surface of the rightankle and heel, aggravated by toeing in (ventriflexionand pronation movement) during the donning of histrack shoes. There is no specific area of tendernessto palpation. Which of the following is the likelydiagnosis?(A) Plantar fasciitis(B) Tarsal tunnel syndrome(C) Stress fracture second metatarsal (MT)(D) herniated nucleus pulposus (HNP) L5 root(E) Peripheral neuropathy3 Which of the following is the most effective managementof exercise-induced asthma?(A) Inhaled glucosteroids(B) Inhaled anticholinergic agonists(C) 48 hours of prednisone in advance(D) Inhaled Beta adrenergic drug(E) Administration of oxygen prior to an athleticevent4 A 35-year-old athletic man complains of pain andtenderness at a point just distal to the right lateralcondyle. The man is right-side dominant. He wasactive in “major” sports in his youth but has onlyrecently taken up tennis. His condition may be causedor aggravated by each of the following activities,except for which one?(A) Grasping and turning a doorknob(B) Driving a screw with a manual screwdriver(C) Vigorous hand shaking(D) Using the overhead tennis serve(E) Employing wrist extension in the tennis backhandstroke5 An 18-year-old male senior high school athlete hasbeen training hard early in the spring track season.He complains of pain in the left knee region when heruns over a quarter of a mile (0.4 km), and he wishesto have relief so that he may pursue his goal of repeatinghis performance as district champion in his longdistanceevent. The pain had a gradual onset andthere has been no identifying moment of injury.There is neither morning stiffness nor “gelling” withafternoon inactivity. Each of the following conditionscould be a serious consideration as the cause of thesymptoms, except for which one?(A) Iliotibial band syndrome(B) Rheumatoid arthritis(C) Anserine bursitis(D) Popliteal tendonitis(E) Patellar tendonitis6 A 15-year-old boy is going out for football for thefirst time. His pubescence is accelerating and he hasgrown 3 in. (7.6 cm) in the past year. You are performinga preparticipation sports physical examination.The aortic second sound is louder than thepulmonic second sound, but the P 2 sound is of normalintensity. You hear a systolic “diamond shaped”murmur along the left sternal border. There is neitherprecordial heave nor thrill. You ask the patientto perform a Valsalva maneuver and find that themurmur is enhanced. You then ask the patientto squat and then auscultate again, only to findthat the murmur disappears. He has no complaintof shortness of breath. He manifests no cyanosis or179