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Sports Medicine Question Paper

Sports Medicine

Course:Physiotherapy

Institution: Kenya Medical Training College question papers

Exam Year:2014

KENYA MEDICAL TRAINING COLLEGE-PORT REITZ CAMPUS DEPARTMENT OF PHYSIOTHERAPY
END OF SEMESTER EXAMINATION MARKING SCHEME
SPORTS MEDICINE
COURSE 5 (SEPTEMBER 2011 CLASS)
DATE: Monday 13th January 2014

SECTION A: Multiple Choice Questions (40 Marks)
1. In which part of an athlete’s body could the ‘unhappy triad’ be located?
a) The glenohumeral joint.
b) The scapulothoracic joint.
c) The hip joint.
d) The knee joint.

2. For what reason should little sips of water be taken during the course of any physically demanding sport?
a) To cool down the overheating body.
b) To maintain the core body temperature.
c) To maintain to circulating volume and electrolyte balance.
d) To prevent constipation.

3. Study the following responsibilities and identify which member of the sports medicine team is directly involved in their execution: Organizing workshops; Ergonomic assessment to prevent sport-related accidents; Intensive off-the-pitch treatment of athletes; Record keeping; Organizing wellness clinics; Clinical examination and diagnosis.
a) Physician.
b) Physical Therapist.
c) Physical Trainer
d) Coach

4. In the Acute Inflammatory Response Phase, which of the following goals should be addressed last?
a) Reassurance of the athlete
b) Minimizing pain
c) Controlling swelling
d) Provision of a functional program.

5. Which of the following items of the Risk Management Plan should be attended to last in order of priority?
a) Security concerns: who will have access, who gets keys to the athletic training room?
b) Fire safety: establish safety and evacuation plans in case of fire.
c) Electrical equipment safety: how safe for use are the electrical equipment.
d) Emergency action plan: a systematic plan for accessing the emergency medical system and subsequent transportation of the injured athlete to an emergency care facility.

6. A certain food type is known to enhance fat utilization and endurance performance. It also makes calcium more available, hence allowing the sportsperson’s muscles to work more effectively. What food is it most likely to be?
a) Calcium supplement.
b) Ascorbic acid.
c) Coffee.
d) Alcohol.

7. If an athlete consumes a certain food Q and he becomes very energetic, but his movements in a sport become less coordinated, his reaction time is slowed down, he becomes less mentally alert and he is seen to call for time out frequently in order to visit the urinal, what would be the most probable composition of food Q?
a) Coffee.
b) Alcohol.
c) Tea.
d) Porridge.

8. An athlete consumes more than the recommended amount of a certain food Y two hours before the game. Soon after the start of the game he engages in a verbal exchange with his team mates. His manager notes this and gestures to him to calm down. Soon after, an opponent tackles him and he falls, landing on his back. The referee blows the whistle for a foul but that notwithstanding, the athlete gets up and lands a hot slap on his opponent’s face. The referee expels him from the match. Upon reaching the dressing room the team Physiotherapist examines him and establishes that his heart rate is 95 beats per minute. What is the most likely composition of food Y?
a) Vitamin K.
b) Coffee.
c) Alcohol.
d) Calcium supplements.

9. A long distance runner from Iceland participating in the Mombasa International Marathon withdrew from the race due to the hot and humid weather conditions at the Kenyan coast. At the time of withdrawing, he was leading the race with only four circuits remaining. He was rushed to the nearby Agha Khan Hospital and exhaustive physical examination and laboratory tests revealed progressive but gradual muscle weakness, swelling, pain, dark urine, renal dysfunction. What would be the most plausible cause of this clinical state?
a) Acute Exertional Rhabdomyolysis.
b) Exertional Heat Exhaustion.
c) Malignant Hyperthermia.
d) Exertional Hyponatraemia

10. Why should a physiotherapist not allow an athlete to consume too much fluid before, during and after exercise or sporting event?
a) The athlete may develop a stitch-in-the-side.
b) The athlete may develop exertional hyponatraemia.
c) The athlete may develop fluid poisoning.
d) The athlete may develop muscle cramps and incoordination.

11. Which of the following statements is true regarding jet lag or Circadian Dysrythmia?
a) Younger athletes adjust more rapidly.
b) It can reduce performance and predispose an athlete to injury.
c) An athlete travelling to Western countries should take coffee to overcome it.
d) All of the above.
e) None of the above.

12. Healing of tissues may not be impeded by
a) Use of corticosteroids.
b) Oedema.
c) Increased vascularization.
d) Humidity.

13. In the management of sports injuries
a) Cryotherapy speeds up the inflammatory process.
b) Controlled early mobilization enhances healing.
c) Therapeutic heat acts as an anti-inflammatory agent.
d) Immobilization is recommended since it has no adverse biochemical changes on collagen.

14. Which is the fourth item of the Kubler-Ross’s Model of Reaction to Death and Dying, given that that model also applies in an athlete’s reaction to injury?
a) Denial.
b) Anger.
c) Bargaining.
d) Depression.
e) Acceptance.

15. Which of the following does not explain the importance of on-the-field injury assessment?
a) It is a universal protocol in sports medicine.
b) It helps determine the nature of injury.
c) It provides information regarding direction of treatment.
d) Without it appropriate acute care cannot be provided.

16. Which of the following statements is incorrect regarding the initial handling of unconsciousness resulting from sports injury?
a) The physiotherapist should assume neck and spine injury until proved otherwise.
b) If athlete is unconscious and breathing, nothing should be done until consciousness resumes.
c) If lying prone and breathing, the athlete should be carefully log-rolled into supine and then observed until consciousness resumes.
d) If lying prone and not breathing, the athlete should be log-rolled carefully into supine position then CPR begun immediately.

17. When instituting an off-the-field evaluation of injury which question among these listed should the athlete be asked last?
a) What is the matter?
b) How and when did it occur?
c) Did you hear or feel something?
d) In which direction did the movement occur?

18. The stage of an infectious disease during which an athlete develops watery eyes, runny nose, slight fever and malaise and the athlete can transfer pathogen to other hosts hence should be isolated to prevent transmission is referred to as
a) Prodromal stage.
b) Acute stage.
c) Decline stage.
d) Recovery stage.

19. Which of the following correctly explains the difference between therapeutic and conditioning exercises?
a) Therapeutic exercises apply in the course of treatment whereas conditioning exercises are used in prevention of or recovery from injury.
b) Conditioning exercises apply in the course of treatment whereas therapeutic exercises are used to minimize risk of injury.
c) Therapeutic exercises have a higher demand on stroke volume and maximum oxygen uptake as compared to conditioning exercises.
d) Conditioning exercises have a lower demand on stroke volume and maximum oxygen uptake as compared to therapeutic exercises.

20. Among the observations required in management of foot injuries is whether the athlete ‘favours a foot’. What does ‘favouring a foot’ imply?
a) Being so mindful of his foot.
b) Relieving one foot from weight-bearing roles.
c) Pampering one foot in preference to the other.
d) Taking extreme care about how much weight to transfer to his feet.

21. A professional triple-jumper complains of paresthesia and severe intermittent pain in forefoot. The pain is relieved with non-weight bearing while toe hyperextension increases symptoms. Which of these disorders is the athlete most likely to be suffering from?
a) Sesamoiditis.
b) Metatarsal stress fractures.
c) Morton’s neuroma.
d) Plantar fasciitis.

22. If physical examination of an athlete revealed a positive Morton’s test, which of the following would be a differential diagnosis?
a) Metatarsalgia.
b) Morton’s toe.
c) Apophysitis of the calcaneum.
d) Retrocalcaneal bursitis.

23. The Tinel’s sign is a special test which when performed in the foot assesses the integrity of:
a) Dorsalis pedis artery.
b) Posterior tibial nerve.
c) Posterior tibial artery.
d) Tarsal tunnel syndrome.

24. Which of the following statements is not true regarding sports-related foot injuries?
a) The weight-bearing role of the foot makes it so prone to injury.
b) The weight-bearing role of the foot contributes to delayed healing of its injury.
c) The relatively poor venous drainage contributes to delayed healing of foot injury.
d) The bones of the foot fracture easily under stress because they are not long bones.

25. A hockey player lies on the pitch while slapping on the ground in agony. He reports to his team physiotherapist that he felt a sharp pain at his left ankle joint after stepping awkwardly as he was running for the ball. The physiotherapist performs the following special test: with lower leg stabilized, the physiotherapist rotates the foot laterally to create stress on structures around the joint. Identify the test.
a) Talar Tilt Test.
b) Kleiger’s Test.
c) Medial Subtalar Glide Test.
d) Anterior Drawer Test.

26. Which of these injuries cannot be examined by use of the Talar Tilt Test?
a) Torn calcaneofibular ligament.
b) Torn anterior talofibular ligament.
c) Torn posterior talofibular ligaments.
d) Torn deltoid ligament.
e) None of the above.

27. What is not the appropriate management for Grade 2 ligament sprain?
a) RICE for at least first 72 hours; X-ray exam to rule out fracture; crutches 5-10 days, progressing to weight bearing.
b) RICE for 1-2 days; limited weight bearing initially and then active rehabilitation and return to activity in 7-10 days.
c) Will require protective immobilization but begin ROM exercises early to aid in maintenance of motion and proprioception.
d) Taping to provide support during early stages of walking and running

28. Sports that involve sudden starts, sudden stops or sudden change of direction and irritation of the fat pad of the foot are likely to cause
a) Heel contusion.
b) Plantar fasciitis.
c) Collapse of the longitudinal arches
d) Pes cavus.

29. The Kleiger’s test is appropriate as a special test for the clinical diagnosis of
a) Damage to the deltoid ligament.
b) Tear of the anterior cruciate ligament.
c) Damage to the anterior talofibular ligament.
d) Tear of the posterior talofibular ligament.

30. Refer to the following slides:

What is the objective of the activity highlighted in the slides?
a) Strength training.
b) Core stabilization.
c) Flexibility training.
d) Endurance training.

SECTION B: Short Answer Questions (40 Marks)

31. Match the roles in column A with the personnel responsible in column B. Different roles may be the responsibility of the same personnel. (5 marks)

Column-A Column-B
1. Training on team tactics and team formation
Coach Psychologist
Physical therapist
Physician
Athlete
Coach

2. Clinical examination and diagnosis.
Physical therapist
3. Intensive off-the-pitch treatment of athletes
Physical therapist
4. Ergonomic assessment to prevent sport-related accidents; Physical therapist
5. Medical diagnosis and ultimate determination of athlete’s physical condition. Physician
6. The first to note emotional stress in an athlete.
Coach
7. Professional management of stress and emotional instability. Psychologist
8. Referral for specialist care. Physical therapist
9. Observe healthy lifestyles. Athlete
10. Prompt reporting of injury and illness. Athlete

32. Describe the activities to be considered in an Emergency Action Plan. (6 marks)
a. Accessing emergency personnel outside setting in the event of emergency
b. Include transportation of athletes to emergency facilities
c. Meeting with outside personnel is necessary to determine roles and rules regarding athlete and equipment care.

33. Study the slide below and use it to answer the questions that follow. (4 marks)

a. Identify the equipment highlighted.
Dynamic cock-up splint
b. State the stage of sports injury management when it is used.
Rehabilitation
c. For which sports injury is it indicated?
Wrist drop resulting from injury to the radial nerve
d. Describe its therapeutic effects.
Stimulation and re-education of radial nerve and extensors of the wrist and hand. Maintenance of wrist JROM and Improve strength of the grip.

34. Study the slide below and use it to answer the questions that follow.

a. Describe the theme of this slide. (2 marks).
Empowering the athlete about his injury.
b. Briefly explain the importance of what is going on in the slide (theme). (3 marks)
Psychological support to enable the athlete to cope with the injury.

35. State indications for each of the following triangle bandages. (5 marks)
a. Cervical arm sling. (one indication)
i. to support forearm, wrist and hand injuries
b. Shoulder arm sling. (two indications)
i. Forearm support when a shoulder girdle injury exists
ii. Also used when cervical sling is irritating
c. Sling and swathe.(two indications)
i. utilized to stabilize arm in instances of shoulder dislocations
ii. Used to stabilize the arm in upper limb fractures

36. Name the grades of muscle strain (3 marks) and describe the characteristics of each grade (3 marks).
a. Grade I - Some fibers have been stretched or actually torn resulting in tenderness and pain on active movement. Movement painful but full range present
b. Grade II – A number of fibers have been torn and active contraction is painful, usually a depression or divot is palpable, some swelling and discoloration result
c. Grade III- Complete rupture of muscle or musculotendinous junction, significant impairment, with initially a great deal of pain that diminishes due to nerve damage

37. Briefly explain how emotional stress can predispose an athlete to injury. (4 marks).
a. Due to emotion, skill and coordination are sacrificed, potentially resulting in injury.
b. The athlete may become overtly aggressive and make reckless tackles.
c. Stress slows the athlete’s reflexes hence his reaction time.
d. Personal image/low esteem and undernutrition.

38. Given the types of sports-related shocks as Hypovolemic shock, Septic shock, Neurogenic shock, Anaphylactic shock and Psychogenic shock, select the one that correctly fits the following descriptions: (5 marks)
a. Hypovolemic - Decreased blood volume resulting in poor oxygen transport.
b. Neurogenic - Caused by general vessel dilation which does not allow typical 6 litres of blood to fill system, decreasing oxygen transport.
c. Psychogenic - Syncope or fainting caused by temporary dilation of vessels reducing blood flow to the brain.
d. Septic - Result of bacterial infection where toxins cause smaller vessels to dilate
e. Anaphylactic -Result of severe allergic reaction.

SECTION C: Long Essay Question (20 Marks)
39. A rugby player complains of an injury to his foot after being stepped on by an opponent. Describe the appropriate management of this injury from immediately upon injury to when he is fully fit and ready to return to competition. (The management should see you diagnosing the injury as fracture base of 5th metatarsal).

• Jones Fracture
– Etiology
• Fracture of metatarsal caused by inversion and plantar flexion, direct force (stepped on) or repetitive trauma
• Most common = base of 5th metatarsal
– Sign and Symptoms
• Immediate swelling, pain over 5th metatarsal
• High nonunion rate and course of healing is unpredictable
– Management
• Controversial treatment
• Crutches with no immobilization, gradually progressing to weight bearing as pain subsides
– May allow athlete to return in 6 weeks
• If nonunion occurs, internal fixation may be required
• Bone stimulators have also been suggested.

Sports Medicine question paper

Sports Medicine Question Paper

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