Menu

5. Sports Medicine MCQs

Practice Set 189 of 360

This practice set contains high-yield board review questions covering key concepts in 5. Sports Medicine. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 3761

Topic: 5. Sports Medicine

A 16-year-old female experiences a primary lateral patellar dislocation while dancing. Radiographs reveal a large osteochondral loose body in the lateral gutter. What is the most appropriate management?

. Cylinder cast in extension for 6 weeks
. Immediate medial patellofemoral ligament (MPFL) reconstruction
. Arthroscopic evaluation for loose body removal or fixation
. Tibial tubercle medialization osteotomy

Correct Answer & Explanation

. Cylinder cast in extension for 6 weeks

Explanation

While first-time patellar dislocations are typically treated nonoperatively, the presence of an osteochondral loose body is a classic indication for early surgical intervention. Arthroscopy allows for removal or fixation of the fragment and evaluation of the articular surface.

Question 3762

Topic: Knee Sports

Which of the following anatomical variants is considered an independent risk factor for sustaining a non-contact anterior cruciate ligament (ACL) tear?

. Increased intercondylar notch width
. Increased posterior tibial slope
. Decreased posterior tibial slope
. Increased patellar height (Patella alta)

Correct Answer & Explanation

. Increased intercondylar notch width

Explanation

An increased posterior tibial slope is a well-established bony risk factor for ACL tears. A steeper slope increases the anterior translational force on the tibia during axial loading, thereby placing greater strain on the ACL.

Question 3763

Topic: 5. Sports Medicine

A 45-year-old manual laborer presents with anterior shoulder pain. He has a positive O'Brien test and MRI confirms an isolated Type II SLAP tear. After failing 6 months of physical therapy, what surgical intervention provides the most reliable clinical outcome?

. SLAP repair using suture anchors
. Subpectoral biceps tenodesis
. Diagnostic arthroscopy with SLAP debridement
. Coracoacromial ligament release

Correct Answer & Explanation

. SLAP repair using suture anchors

Explanation

In patients older than 35-40 years with a Type II SLAP tear, biceps tenodesis provides more reliable pain relief and a lower complication/revision rate compared to SLAP repair. SLAP repairs in older patients are associated with high rates of postoperative stiffness.

Question 3764

Topic: Shoulder & Hip Sports

A 55-year-old male fell onto his outstretched right arm. He now complains of significant shoulder weakness. Physical examination demonstrates increased passive external rotation compared to the contralateral shoulder and a positive Bear Hug test. Which tendon is ruptured?

. Supraspinatus
. Infraspinatus
. Teres minor
. Subscapularis

Correct Answer & Explanation

. Supraspinatus

Explanation

The Bear Hug test is highly sensitive and specific for subscapularis pathology. Furthermore, an acute subscapularis tear results in increased passive external rotation due to the loss of the anterior restricting structure.

Question 3765

Topic: 5. Sports Medicine

Chronic traumatic encephalopathy (CTE) is increasingly recognized in athletes with a history of repetitive concussive and subconcussive impacts. Which of the following is the hallmark neuropathological finding in CTE?

. Amyloid-beta plaques in the basal ganglia
. Alpha-synuclein inclusions in the substantia nigra
. Perivascular hyperphosphorylated tau deposits in the depths of cortical sulci
. TDP-43 inclusions in the anterior horn cells

Correct Answer & Explanation

. Amyloid-beta plaques in the basal ganglia

Explanation

The definitive diagnosis of CTE requires post-mortem neuropathological examination. The hallmark finding is the perivascular accumulation of hyperphosphorylated tau protein, uniquely distributed at the depths of the cortical sulci.

Question 3766

Topic: Knee Sports

A 14-year-old boy presents with insidious onset of anterior knee pain and catching. Radiographs demonstrate an osteochondritis dissecans (OCD) lesion. What is the most common anatomic location for this lesion?

. Medial aspect of the lateral femoral condyle
. Lateral aspect of the medial femoral condyle
. Central trochlear groove
. Inferior pole of the patella

Correct Answer & Explanation

. Medial aspect of the lateral femoral condyle

Explanation

Osteochondritis dissecans (OCD) of the knee most commonly affects the lateral aspect of the medial femoral condyle. This location accounts for approximately 70-80% of all knee OCD lesions.

Question 3767

Topic: 5. Sports Medicine

During a routine pre-participation physical, a 16-year-old football player uses the SCAT6 tool to establish a baseline. What is the primary purpose of obtaining a baseline SCAT6 score in a healthy athlete?

. To predict the athlete's risk of sustaining a future concussion
. To provide normative data for comparison if a suspected head injury occurs
. To identify undiagnosed structural brain abnormalities
. To determine the athlete's cognitive eligibility for contact sports

Correct Answer & Explanation

. To predict the athlete's risk of sustaining a future concussion

Explanation

The primary utility of baseline testing (such as the SCAT6) is to provide individualized normative data for the athlete. If a concussion occurs, comparing post-injury scores to the baseline helps clinicians accurately assess cognitive deficits and track recovery.

Question 3768

Topic: 5. Sports Medicine

A 17-year-old high school football player sustains a concussion. He is asymptomatic at rest after 4 days. He completes a light aerobic exercise phase without symptoms. What is the next step in his return-to-play protocol?

. Return to full competition
. Rest for another 24 hours
. Sport-specific exercise
. Non-contact training drills
. Full contact practice

Correct Answer & Explanation

. Return to full competition

Explanation

The standard graduated return-to-play protocol progresses through: symptom-limited activity, light aerobic exercise, sport-specific exercise, non-contact training drills, full-contact practice, and return to sport. After completing light aerobic exercise, the next phase is sport-specific exercise.

Question 3769

Topic: Knee Sports

During an anterior cruciate ligament (ACL) reconstruction, placing the femoral tunnel too anteriorly (high in the notch) will result in which of the following biomechanical consequences?

. The graft will be tight in flexion and loose in extension
. The graft will be loose in flexion and tight in extension
. The graft will be tight in both flexion and extension
. The graft will be loose in both flexion and extension
. Impingement of the posterior cruciate ligament (PCL)

Correct Answer & Explanation

. The graft will be tight in flexion and loose in extension

Explanation

A femoral tunnel placed anterior to the isometric point increases the distance between the tibial and femoral attachment sites as the knee flexes. This results in a graft that is excessively tight in flexion and loose in extension, limiting terminal knee flexion.

Question 3770

Topic: 5. Sports Medicine

A 20-year-old collegiate baseball pitcher undergoes a Type II SLAP repair with suture anchors after failing nonoperative management. What is the most common postoperative complication that prevents return to his previous level of play?

. Recurrent anterior instability
. Loss of external rotation
. Hardware failure
. Biceps tendon rupture
. Axillary nerve neurapraxia

Correct Answer & Explanation

. Recurrent anterior instability

Explanation

In throwing athletes, SLAP repairs are notorious for causing postoperative stiffness, specifically a loss of external rotation. This restriction limits their late cocking phase, significantly decreasing pitching velocity and preventing return to pre-injury performance levels.

Question 3771

Topic: Knee Sports

A 25-year-old soccer player sustains an isolated Grade II posterior cruciate ligament (PCL) sprain. What is the most appropriate initial management?

. Early arthroscopic PCL reconstruction
. Protected weight-bearing with a dynamic brace and quadriceps strengthening
. Immobilization in 90 degrees of flexion
. Aggressive hamstring strengthening program
. High tibial osteotomy

Correct Answer & Explanation

. Early arthroscopic PCL reconstruction

Explanation

Isolated Grade I and II PCL injuries are treated nonoperatively with a brief period of immobilization in extension or use of a dynamic PCL brace to prevent posterior tibial sag. Rehabilitation focuses heavily on quadriceps strengthening to counteract posterior tibial translation.

Question 3772

Topic: Shoulder & Hip Sports

A 19-year-old rugby player has recurrent anterior shoulder dislocations. CT imaging

reveals 25% anterior glenoid bone loss. What is the most appropriate definitive surgical management?

. Arthroscopic Bankart repair
. Arthroscopic Bankart repair with Remplissage
. Coracoid transfer (Latarjet procedure)
. Open inferior capsular shift
. Subscapularis advancement

Correct Answer & Explanation

. Arthroscopic Bankart repair

Explanation

Glenoid bone loss exceeding 20-25% is a contraindication to an isolated soft-tissue Bankart repair due to unacceptably high recurrence rates. A bony augmentation procedure, such as the Latarjet procedure, is the gold standard for definitive stabilization.

Question 3773

Topic: 5. Sports Medicine

Which of the following best describes the pathophysiology of Second Impact Syndrome in a concussed athlete who returns to play prematurely?

. Acute subdural hematoma from bridging vein rupture
. Massive cerebral edema due to loss of cerebral autoregulation
. Rebound intracranial hypotension and tonsillar herniation
. Progressive tau protein deposition in the basal ganglia
. Acute hydrocephalus from aqueductal stenosis

Correct Answer & Explanation

. Acute subdural hematoma from bridging vein rupture

Explanation

Second Impact Syndrome occurs when a brain sustains a second concussive injury before symptoms from an earlier concussion have resolved. It leads to a failure of cerebral vascular autoregulation, resulting in massive, rapid brain swelling and potential herniation.

Question 3774

Topic: Knee Sports

A 45-year-old recreational runner feels a 'pop' in the back of his knee while squatting. MRI shows a medial meniscus posterior root tear with meniscal extrusion. Biomechanically, this injury is most equivalent to which of the following?

. Total meniscectomy
. Anterior cruciate ligament rupture
. Posterior cruciate ligament rupture
. Peripheral longitudinal meniscal tear
. Partial meniscectomy

Correct Answer & Explanation

. Total meniscectomy

Explanation

A posterior root tear disrupts the hoop stresses of the meniscus, causing it to extrude under load. Biomechanically, this failure to convert axial loads into hoop stresses renders the knee functionally equivalent to one that has undergone a total meniscectomy.

Question 3775

Topic: Shoulder & Hip Sports

A 24-year-old volleyball attacker presents with posterior shoulder pain during the cocking phase of serving. Exam shows a positive posterior impingement sign. Pathophysiologically, this condition is characterized by contact between the posterosuperior glenoid labrum and which structure?

. Anterior band of the inferior glenohumeral ligament
. Undersurface of the supraspinatus and infraspinatus tendons
. Superior subscapularis tendon
. Biceps anchor
. Middle glenohumeral ligament

Correct Answer & Explanation

. Anterior band of the inferior glenohumeral ligament

Explanation

Internal impingement occurs in overhead athletes during maximum abduction and external rotation. It is characterized by the undersurface of the posterior supraspinatus and anterior infraspinatus tendons impinging against the posterosuperior glenoid labrum.

Question 3776

Topic: Knee Sports

During reconstruction of the medial patellofemoral ligament (MPFL) for recurrent patellar instability, the anatomical femoral attachment site (Schöttle's point) is best identified radiographically in relation to which landmarks?

. 1 mm anterior to the posterior cortex extension and 2.5 mm distal to the posterior origin of the medial femoral condyle
. Anterior to Blumensaat's line and proximal to the posterior cortex line
. 1 mm anterior to the posterior cortex extension line and 2.5 mm proximal to the posterior border of Blumensaat's line
. Distal to the medial epicondyle and anterior to the collateral ligament origin
. Proximal to the adductor tubercle on the anterior femoral flare

Correct Answer & Explanation

. 1 mm anterior to the posterior cortex extension and 2.5 mm distal to the posterior origin of the medial femoral condyle

Explanation

Schöttle's point marks the isometric femoral origin of the MPFL. On a strict lateral radiograph, it is located 1 mm anterior to the posterior cortical extension line, 2.5 mm proximal to the posterior border of Blumensaat's line, and proximal to the posterior origin of the medial femoral condyle.

Question 3777

Topic: 5. Sports Medicine

A 28-year-old skier sustains a knee dislocation and undergoes immediate field reduction. In the emergency department, pulses are symmetric and normal. What is the most appropriate next step in vascular assessment?

. Immediate vascular surgery consultation
. Routine discharge with 24-hour follow-up
. Measurement of Ankle-Brachial Index (ABI)
. Diagnostic arthroscopy to assess cruciate ligaments
. Venous duplex ultrasound

Correct Answer & Explanation

. Immediate vascular surgery consultation

Explanation

Following a knee dislocation, normal palpable pulses do not exclude an intimal tear of the popliteal artery. An Ankle-Brachial Index (ABI) should be measured; an ABI < 0.9 mandates further imaging, such as a CT angiogram, while an ABI > 0.9 allows for serial clinical observation.

Question 3778

Topic: Knee Sports

The most devastating neurovascular complication during tibial tunnel drilling for a posterior cruciate ligament (PCL) reconstruction is injury to which of the following structures?

. Popliteal artery
. Common peroneal nerve
. Tibial nerve
. Saphenous nerve
. Anterior tibial artery

Correct Answer & Explanation

. Popliteal artery

Explanation

The popliteal artery lies directly posterior to the PCL tibial attachment site on the posterior capsule. Over-penetration of the guide pin or drill during tibial tunnel creation is a well-known risk for catastrophic popliteal artery injury.

Question 3779

Topic: Knee Sports

A 14-year-old gymnast presents with vague anterior knee pain. Radiographs

reveal an osteochondritis dissecans (OCD) lesion. In the knee, what is the most common anatomic location for an OCD lesion?

. Lateral aspect of the medial femoral condyle
. Medial aspect of the lateral femoral condyle
. Central trochlea
. Inferior pole of the patella
. Lateral aspect of the lateral femoral condyle

Correct Answer & Explanation

. Lateral aspect of the medial femoral condyle

Explanation

The classic and most frequent location for an osteochondritis dissecans (OCD) lesion in the knee is the lateral aspect of the medial femoral condyle. It accounts for roughly 70-80% of all knee OCD lesions.

Question 3780

Topic: 5. Sports Medicine

During a soccer match, a player clashes heads with an opponent. He is conscious but confused. Which of the following components of the SCAT5 (Sport Concussion Assessment Tool 5) is specifically designed to evaluate his immediate memory?

. Months of the year in reverse order
. Serial sevens
. Repeating a list of 5 or 10 words
. Finger-to-nose testing
. Asking the current venue and half of the game

Correct Answer & Explanation

. Months of the year in reverse order

Explanation

In the SCAT5, immediate memory is tested by reading a list of 5 or 10 words and having the athlete repeat them back across multiple trials. Questions about the venue test orientation (Maddocks score), while months in reverse or digits backward assess concentration.

Test Yourself

Switch to an interactive, timed exam simulation to truly master this topic.

On this Page