daily question
Scott Rand
What physiological mechanism primarily accounts for the increase in VO₂ max following endurance training?
Scott E Rand, MD FAAFP CAQSM
Director, Primary Care Sports Medicine Fellowship
Co Director of Sports Medicine, Houston Methodist Orthopedics and Sports Medicine Willowbrook
Assistant Professor of Clinical Family Medicine Houston Methodist Academic Institute
Adjunct Assistant Professor of Family and Community Medicine, Texas A&M University
Assistant Professor of Family Medicine in Clinical Medicine Weill Cornell Medical College.
13802 Centerfield Dr Suite 300
Houston, TX 77070
Scott Rand
A triathlete reports persistent fatigue, decreased performance, and resting tachycardia despite adequate sleep and nutrition. Describe the underlying neuroendocrine changes in overtraining syndrome and how exercise physiology informs your diagnostic approach.
A) Increased testosterone:cortisol ratio
B) Hypothalamic-pituitary-adrenal axis dysregulation
C) Enhanced sympathetic activity and improved HR variability
D) Elevated anabolic hormone levels
Scott Rand
A 29 year old hockey player complains of one day of eye pain. The pain began suddenly while he was sharpening his skates without using eye protection. Upon exam, his visual acuity is intact, as are extraocular movements. Seidel’s test is negative. Inspection shows scleral erythema and a ½ mm brownish staining at 12 o’clock superior to the iris. In addition to standard management and removal of this corneal foreign body, what steps must be taken in this case?
A. Expansion of microbial coverage to include atypical organisms
B. Patching for 1 week to decrease spreading inflammation
C. Removal of products of iron oxidation from the cornea
D. Repair of corneal perforation in the operating room
E. Prolonged course of mydriatics