daily question

[Scott Rand]

The femoral nerve arises from the __________ nerve root and supplies motor function to the (list at least 4) muscles. 

 

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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]

What motor deficiency would be seen with a L4-5 disc herniation?

[Scott Rand]

A 14-year-old female presents for a pre-sports physical. She complains of back discomfort when she "sits at school for a long time." Her exam reveals scoliosis with a left-sided curve. An MRI of the spine is indicated to rule out which of the following conditions?

 

A.     Intraspinal syrinx

B.      Narrowing of disk space

C.      Schmorl nodes

D.     Irregularities in vertebral endplates

E.      Loss of anterior vertebral height

 

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[Scott Rand]

Myocarditis and Return to Play After a diagnosis of myocarditis, what is the recommended minimum duration before an athlete can return to competitive sports?

 

A. 2 weeks

B. 1 month

C. 3 months

D. 6 months

E. 12 months

 

[Scott Rand]

Athlete’s Heart Adaptations What is the primary physiological adaptation in an athlete's heart that leads to increased stroke volume?

 

A. Increased left ventricular wall thickness

B. Increased left ventricular cavity size

C. Decreased resting heart rate

D. Increased myocardial oxygen demand

 

[Scott Rand]

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) Which of the following is a hallmark feature of arrhythmogenic right ventricular cardiomyopathy (ARVC)?

 

A. Left ventricular hypertrophy

B. Right ventricular dilation and dysfunction

C. Prolonged PR interval

D. Concentric hypertrophy

 

[Scott Rand]

Mechanism of SCD in HCM What is the primary mechanism of exercise-induced sudden cardiac death in athletes with hypertrophic cardiomyopathy?

A. Coronary artery spasm

B. Ventricular arrhythmias

C. Aortic dissection

D. Pulmonary embolism

 

[Scott Rand]

 

When evaluating anterior knee pain, the defining characteristics of patellar tendinitis include which one of the following?

A.     There are findings on imaging that are “pathognomic” for patellar tendinitis

B.      Surgery is more effective than rehabilitation

C.      Patellar tendinitis is common and rarely requires treatment

D.     Training errors are the most common cause

 

[Scott Rand]

A 50 y/o male complains of right medial knee pain x 6 months after an injury sustained while playing rugby.  He was diagnosed with a medial meniscal injury 4 months ago, underwent surgical debridement, and has recovered uneventfully, but continues to have the same medial knee pain.    Pain is deep aching/burning, often nocturnal, and radiates from the VMO region to the medial lower leg and dorsomedial ankle/foot.   Pain is worsened by sitting a lap top on his lap for a prolonged time.   There are no weaknesses or vascular changes noted on exam.  He has no success with NSAIDs or conservative therapies and pushes for further diagnostic testing.  Your next step in making a diagnosis is:

A.     MRI of the knee to evaluate the meniscus or other intra articular pathology

B.      Local nerve block at the adductor canal

C.      Lumbar Spine MRI to look for causes of lumbar radiculopathy

D.     Repeat Arthroscopy of the knee

 

[Scott Rand]

A 27-year-old recreational soccer player injures his knee after colliding with an opposing player during a game. On physical exam, his Lachman is graded as 1A. He has laxity to varus stress with the knee flexed to 30 degrees. Dial test of the tibia shows increased external rotation at 30 degrees, but not at 90 degrees in comparison to the contralateral leg. Which of the following structure(s) are torn?

 

1. Anterior cruciate ligament (ACL)

2. Lateral collateral ligament (LCL)

3. Anterior cruciate ligament (ACL) and lateral collateral ligament (LCL)

4. Lateral collateral ligament (LCL) and posterolateral corner (PLC)

5. Posterior cruciate ligament (PCL) and posterolateral corner (PLC)

 

[Scott Rand]

You see a patient in the emergency room with an acute lateral patellar dislocation. Which of the following factors is associated with the highest risk of persistent patellar instability?

1. Younger age

2. Increased Q-angle

3. Male gender

4.  Previous patellar instability event

5. Amount of lateral patellar tilt