Duke PA Pediatric Sports Evaluation
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For __% of athletes preparticipation evaluation is their only health care contact | 78
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Preparticipation evaluations should take place at least __ prior to practice to allow time for referrals and rehab | 6 weeks
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Routine labs recommended for preparticipation evaluation | None unless indicated by medical condition
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Marfan’s Syndrome causes __% of sudden cardiac death | 5
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Congenital coronary artery abnormality causes __% of sudden death | 19
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Hypertrophic cardiomyopathy causes __% of sudden death | 36
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Hypertrophic cardiomyopathy is found in __% of the population | 0.02 – 0.2
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What is the first indication of hypertrophic cardiomyopathy | Sudden death
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Common inhaled asthma meds that are accepted by NCAA and IOC | Albuterol, terbutaline, Serevent, cromolyn, inhaled steroids
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What cardiac murmurs need follow up | All murmurs >3/6, diastolic murmurs, murmurs that increase with Valsalva
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Murmur of hypertrophic cardiomyopathy increases or decreases with Valsalva | Increases
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What is the cause of the murmur associated with hypertrophic cardiomyopathy | Hypertrophy and stiffness of the left ventricle
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Murmur associated with hypertrophic cardiomyopathy __ with squatting and __ when the patient stands | Decreases, increases
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What is the characteristic of hypertrophic cardiomyopathy murmur | Systolic crescendo-decrescendo , heard best between apex and LSB, radiates to axilla but not to neck
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Why is Marfan’s syndrome associated with sudden death | Rupture of thoracic aortic aneurysm
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What is the stigmata of Marfan’s | tall/thin, long extremities, hands and feet (arm span greater than height). Sparse muscle mass, pectus deformities, hyperextensible joints, pes planus
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What constitutes the two minute orthopedic exam | Inspect symmetry, neck ROM, resist shoulder shrug/abduction, internal/external shoulder rotation, elbow flexion/extension, and pronation/supination, clench/spread fingers, back extension, back flexion, contract quads, duck walk, heel and toe standing
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“stingers” | stretch or compression injury of brachial plexus (C5-T1)
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When is it OK to play with a stretch or compression injury of the brachial plexus | First episode, no neurologic symptoms
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What is post concussion syndrome | Headache, dizziness, N/V, memory/attention deficit, may not play until resolve (up to 6 months)
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Grade __ concussion= no LOC, confusion <15 min | 1
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Grade __ concussion= no LOC, confusion >15 min | 2
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Grade __ concussion= any LOC | 3
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How soon after a grade 1 concussion can a player get back in the game | If symptoms clear in 15 min
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How many grade one concussions does it take to remove a player from the game | Remove after the second one
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When can a player with a grade 2 concussion reenter the game | May not return that day, return with negative neuro exam and asymptomatic after 1 week
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Treat a grade 3 concussion as a __ injury | C spine
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