Sports Injuries: Epidemiology and Prevention Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Sports Injuries: Epidemiology and Prevention. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 1: Which of the following is NOT a core component of the WHO's global STI control strategy?
- A. Case management
- B. Universal mandatory screening (Correct Answer)
- C. Strategic information systems
- D. Prevention services
Sports Injuries: Epidemiology and Prevention Explanation: ***Universal mandatory screening***
- While screening is part of STI control, **universal mandatory screening** for all STIs in the general population is not a core component of the WHO's strategy due to feasibility, cost, and ethical considerations.
- The strategy emphasizes **targeted screening** for at-risk populations and opportunistic screening.
*Case management*
- **Case management**, including accurate diagnosis and effective treatment, is a critical component for managing current infections and preventing further transmission.
- This involves syndromic or etiologic approaches to treatment and partner notification.
*Strategic information systems*
- **Strategic information systems** are essential for monitoring trends, evaluating interventions, and informing policy decisions related to STI control.
- This includes surveillance data, program monitoring, and research.
*Prevention services*
- **Prevention services** are a cornerstone of the WHO's strategy, aiming to reduce the incidence of new infections.
- These services encompass health education, condom promotion and distribution, vaccination, and pre-exposure prophylaxis (PrEP).
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 2: In an accident case, after the arrival of medical team, all should be done in early management except;
- A. Glasgow coma scale
- B. Check BP (Correct Answer)
- C. Stabilization of cervical vertebrae
- D. Check Respiration
Sports Injuries: Epidemiology and Prevention Explanation: ***Check BP***
- In the **immediate/early management** of trauma (primary survey), while circulation assessment is crucial, the **initial assessment of circulation** focuses on:
- **Pulse rate and quality** (radial, carotid)
- **Capillary refill time**
- **Skin color and temperature**
- **Active hemorrhage control**
- **Formal blood pressure measurement** with a cuff, while important, is typically recorded during or after these rapid initial assessments, as it takes more time to obtain an accurate reading.
- In the context of this question, among the four options listed, BP measurement is relatively less immediate compared to the other life-saving priorities (airway protection, breathing assessment, C-spine stabilization, and GCS).
- **Note:** This is a nuanced distinction - BP is assessed during primary survey, but the other three options have more immediate life-threatening implications if not addressed.
*Glasgow coma scale*
- **GCS assessment** is part of the **"D" (Disability)** step in the ATLS primary survey.
- It is performed early to assess neurological status and level of consciousness.
- GCS <8 indicates need for **definitive airway protection** (intubation).
- This is a critical early assessment that guides immediate management decisions.
*Stabilization of cervical vertebrae*
- **C-spine immobilization** is part of the **"A" (Airway)** step - "Airway with cervical spine protection."
- It is performed **simultaneously** with airway assessment using a **rigid cervical collar**.
- This is the **first priority** in trauma management to prevent secondary spinal cord injury.
- All trauma patients should be assumed to have C-spine injury until proven otherwise.
*Check Respiration*
- **Respiratory assessment** is part of the **"B" (Breathing)** step in the ATLS primary survey.
- This involves checking:
- **Respiratory rate and pattern**
- **Chest wall movement**
- **Air entry bilaterally**
- **Signs of tension pneumothorax or flail chest**
- This is an immediate life-saving priority and must be assessed early.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 3: Which of the following ligaments is injured in an ankle inversion injury?
- A. Calcaneofibular ligament
- B. Posterior talofibular ligament
- C. Deltoid ligament
- D. Anterior talofibular ligament (Correct Answer)
Sports Injuries: Epidemiology and Prevention Explanation: ***Anterior talofibular ligament***
- The **anterior talofibular ligament (ATFL)** is the most commonly injured ligament in an **ankle inversion sprain** due to its position and weaker structure.
- It connects the **fibula** to the **talus** anteriorly, and when the foot inverts, this ligament is stretched and often torn first.
*Calcaneofibular ligament*
- The **calcaneofibular ligament (CFL)** is also an important lateral ankle ligament that can be injured in **severe inversion sprains**.
- It is often damaged in conjunction with the ATFL, but typically only after the ATFL has already been compromised through an ankle inversion injury.
*Posterior talofibular ligament*
- The **posterior talofibular ligament (PTFL)** is the strongest of the **lateral collateral ligaments** and is rarely injured in isolation.
- Injury to the PTFL usually occurs in cases of **severe, high-grade ankle dislocations** or very forceful inversion injuries, often involving other ligaments.
*Deltoid ligament*
- The **deltoid ligament** is a strong, fan-shaped ligament located on the **medial side of the ankle**.
- It resists **eversion** of the ankle, meaning it is more commonly injured in **eversion sprains**, not inversion sprains.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 4: Ruptured tendons are most commonly seen in
- A. Overuse (Correct Answer)
- B. Direct trauma from injury
- C. Structural abnormalities from birth
- D. Tumor-related structural changes
Sports Injuries: Epidemiology and Prevention Explanation: ***Overuse***
- Chronic **overuse** leads to **microtrauma and degeneration** within the tendon, weakening it over time and making it susceptible to rupture even with minimal acute stress.
- This is particularly common in tendons that experience **repetitive strain**, such as the Achilles tendon, rotator cuff, and patellar tendon.
*Direct trauma from injury*
- While acute, high-impact **direct trauma** can cause tendon ruptures, it is not the most common mechanism overall.
- Many traumatic ruptures occur in tendons already weakened by **chronic degeneration**, rather than purely healthy tendons.
*Structural abnormalities from birth*
- **Congenital structural abnormalities** are relatively rare causes of primary tendon rupture.
- These conditions usually present earlier in life with functional limitations rather than sudden rupture in adulthood.
*Tumor-related structural changes*
- **Tumors** can, in rare cases, weaken tendons and lead to rupture, but this is a far less common cause compared to overuse.
- Tendon compromise due to a tumor usually involves direct invasion or pressure, which is not the predominant etiology for the majority of tendon ruptures.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 5: An 18-year-old athlete presents with acute knee pain and hemarthrosis after pivoting. The Lachman test is positive. Which ligament is most likely injured?
- A. Posterior Cruciate Ligament
- B. Anterior Cruciate Ligament (Correct Answer)
- C. Lateral Collateral Ligament
- D. Medial Collateral Ligament
Sports Injuries: Epidemiology and Prevention Explanation: ***Anterior Cruciate Ligament***
- The **Lachman test** is the most sensitive clinical test for diagnosing an **ACL tear**, indicating anterior tibial translation.
- **Pivoting injuries** and **hemarthrosis** (blood in the joint) are classic signs of a severe ACL injury, often involving bone bruising.
*Posterior Cruciate Ligament*
- PCL injuries are less common and typically result from a direct blow to the **anterior tibia** while the knee is flexed or a hyperextension injury.
- The primary test for PCL integrity is the **posterior drawer test**, which assesses posterior tibial translation.
*Lateral Collateral Ligament*
- LCL injuries usually result from a **varus stress** to the knee, often in contact sports, and can cause pain on the lateral aspect of the knee.
- The **varus stress test** is used to assess LCL integrity, but it does not cause hemarthrosis as frequently as an ACL tear.
*Medial Collateral Ligament*
- MCL injuries are common and result from a **valgus stress** to the knee (a blow to the outside of the knee).
- The **valgus stress test** assesses MCL integrity, causing pain on the medial aspect of the knee and typically not resulting in acute hemarthrosis unless other structures are also injured.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 6: Commonest ligament injured in ankle injury ?
- A. Anterior talofibular ligament (Correct Answer)
- B. Calcaneofibular ligament
- C. Posterior talofibular ligament
- D. Spring ligament
Sports Injuries: Epidemiology and Prevention Explanation: ***Anterior talofibular ligament***
- The **anterior talofibular ligament (ATFL)** is the **most frequently injured ligament** in ankle sprains because it is the weakest and most commonly stretched during **inversion injuries**.
- Its position makes it vulnerable during movements where the foot rolls inward, a common mechanism for ankle sprains.
*Calcaneofibular ligament*
- The **calcaneofibular ligament (CFL)** is stronger than the ATFL and is typically injured with more severe inversion forces, often in conjunction with ATFL rupture.
- While it plays a crucial role in ankle stability, it is not the *most* commonly injured ligament.
*Posterior talofibular ligament*
- The **posterior talofibular ligament (PTFL)** is the strongest of the lateral ankle ligaments and is rarely injured in isolated ankle sprains.
- Its injury usually signifies a **severe ankle sprain** with significant talar displacement or dislocation.
*Spring ligament*
- The **spring ligament**, also known as the **plantar calcaneonavicular ligament**, is located on the medial side of the foot and supports the medial longitudinal arch.
- It is not directly involved in typical ankle sprains, which primarily affect the lateral collateral ligaments.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 7: A 17-year-old boy from Calcutta was playing football when he was tackled by another player. The opponent hit the lateral aspect of his knee. He presented to a hospital 1 week after the injury, complaining of swelling and pain in his right knee. On physical examination of his right knee, there is a large effusion. There is increased laxity (as compared to his uninjured knee) of his knee when his knee is passively placed in a valgus (abducted) position. In addition, there is significant anterior translation of his tibia with respect to his femur when his knee is tested at ninety degrees of flexion. Injury to which of the following structures most likely accounts for the increased laxity of his knee when his knee is passively placed in a valgus position?
- A. Patellar ligament
- B. Medial collateral ligament (Correct Answer)
- C. Anterior cruciate ligament
- D. Lateral collateral ligament
Sports Injuries: Epidemiology and Prevention Explanation: **Medial collateral ligament**
- **Valgus stress** on the knee, which involves an abduction force on the tibia, primarily tests the integrity of the **medial collateral ligament (MCL)**. Increased laxity in this position indicates an MCL injury.
- The MCL resists forces that push the knee inward (valgus forces) and is commonly injured by direct blows to the lateral aspect of the knee.
*Patellar ligament*
- The **patellar ligament** connects the patella to the tibia and is crucial for knee extension.
- Injury to the patellar ligament would affect the ability to straighten the knee and would be tested by examining extensor mechanism integrity, not valgus laxity.
*Anterior cruciate ligament*
- The **anterior cruciate ligament (ACL)** primarily prevents anterior translation of the tibia relative to the femur and resists rotational forces.
- While the patient has significant anterior translation, the question specifically asks about laxity in a valgus position, which is an MCL test.
*Lateral collateral ligament*
- The **lateral collateral ligament (LCL)** resists **varus stress** (adduction force) on the knee, preventing the knee from bowing outward.
- An injury to the LCL would manifest as increased laxity when the knee is passively placed in a varus, not valgus, position.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 8: A young athlete complains of pain in the groin and weakness in the hip following a sports injury. An MRI shows a tear in which muscle that is commonly associated with groin injuries?
- A. Adductor longus (Correct Answer)
- B. Iliopsoas
- C. Rectus femoris
- D. Gluteus medius
Sports Injuries: Epidemiology and Prevention Explanation: ***Adductor longus***
- The **adductor longus** is a primary **groin muscle** involved in hip adduction and commonly injured during sports activities requiring sudden changes in direction or kicking.
- A tear in this muscle is a frequent cause of **groin pain** and weakness in athletes.
*Iliopsoas*
- The **iliopsoas** is a powerful hip flexor, and while injuries can cause pain in the groin region, a tear typically manifests as weakness in **hip flexion**, not primarily adduction.
- Pain from an iliopsoas injury is often felt deeper in the groin or hip, sometimes radiating down the thigh.
*Rectus femoris*
- The **rectus femoris** is one of the quadriceps muscles that crosses both the hip and knee joints; tears cause pain and weakness in **hip flexion** and **knee extension**.
- Injuries are more common with activities involving sprinting or kicking, but the primary pain location is usually more anterior thigh rather than deep groin.
*Gluteus medius*
- The **gluteus medius** is a primary hip abductor and stabilizer; injuries typically cause pain on the **lateral aspect of the hip** or buttock, not the groin.
- Weakness in this muscle would primarily affect hip abduction and stability during weight-bearing.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 9: Patient had an injury to thumb causing thumb abduction. Which of the following can happen?
- A. Kaplan lesion
- B. Game keepers thumb (Correct Answer)
- C. Mallet finger
- D. Bennett fracture
Sports Injuries: Epidemiology and Prevention Explanation: ***Gamekeeper's thumb***
- A **Gamekeeper's thumb**, or **skier's thumb**, is an injury to the **ulnar collateral ligament (UCL)** of the thumb's metacarpophalangeal (MCP) joint.
- This injury commonly occurs due to a **forceful abduction** and hyperextension of the thumb.
*Kaplan lesion*
- A **Kaplan lesion** refers to an avulsion fracture of the radial styloid process, usually associated with scaphoid fractures.
- This lesion is typically related to wrist injuries, not primarily thumb abduction.
*Bennett fracture*
- A **Bennett fracture** is an intra-articular fracture at the base of the first metacarpal bone.
- It usually results from an axial load applied to a partially flexed thumb, rather than pure abduction.
*Mallet finger*
- A **mallet finger** is an injury to the **extensor tendon** of the finger, causing the fingertip to remain in a flexed position.
- This injury typically affects the distal interphalangeal (DIP) joint of any finger and is not directly related to thumb abduction.
Sports Injuries: Epidemiology and Prevention Indian Medical PG Question 10: While playing football, a 19-year-old college student receives a twisting injury to his knee when being tackled from the lateral side. Which of the following conditions most likely has occurred?
- A. Tear of the medial meniscus (Correct Answer)
- B. Ruptured fibular collateral ligament
- C. Tenderness on pressure along the fibular collateral ligament
- D. Injured posterior cruciate ligament
Sports Injuries: Epidemiology and Prevention Explanation: **Tear of the medial meniscus**
- A **twisting injury** to the knee, especially when tackled from the lateral side (which can force the leg into valgus stress), commonly causes a **tear of the medial meniscus**.
- The **medial meniscus** is less mobile and more firmly attached than the lateral meniscus, making it more susceptible to injury during twisting forces.
*Ruptured fibular collateral ligament*
- A rupture of the **fibular collateral ligament (FCL)**, also known as the **lateral collateral ligament (LCL)**, typically results from a **varus stress** (a blow to the medial side of the knee), which is contrary to a tackle from the lateral side.
- While twisting can contribute to knee injuries, isolate FCL tears from a lateral-side tackle are less likely than meniscal damage.
*Tenderness on pressure along the fibular collateral ligament*
- Tenderness along the **fibular collateral ligament** would indicate an injury to this structure, but a twisting injury from the lateral side is less likely to directly damage the FCL compared to the medial structures.
- This symptom alone does not fully explain the mechanism of injury and the common resulting pathology in this scenario.
*Injured posterior cruciate ligament*
- The **posterior cruciate ligament (PCL)** is most commonly injured by a direct blow to the anterior tibia when the knee is flexed (a **dashboard injury**) or by a hyperflexion injury.
- A twisting injury from the lateral side is a less common mechanism for isolated PCL injury.
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