Sports Rehabilitation — MCQs
Which of the following phases are directly involved in the recovery phase of the disaster cycle?
An athlete sustained an injury around the knee joint, suspecting cartilage damage. Which of the following is the investigation of choice?
What is the first step taken in case of multiple injuries of face and neck?
Evidence based therapy of Bell's palsy include(s):
A football player experienced a twist in the ankle and knee. Clinically, no bone injury was appreciated. The examiner is performing the test shown in the image. Which test is this?
Following are the indications of cryotherapy
Lachman's test is performed with the knee in what degree of flexion?
Fracture at which site affects the longitudinal growth of a bone?
Omovertebral bone is associated with?
Early recovery of Sudeck's atrophy can be best managed by which of the following interventions?
Sports Rehabilitation Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following phases are directly involved in the recovery phase of the disaster cycle?
- A. Response and Rehabilitation
- B. Mitigation and Rehabilitation
- C. Response and Preparedness
- D. Rehabilitation and Reconstruction (Correct Answer)
Explanation: ***Rehabilitation and Reconstruction*** - **Rehabilitation** is the short-term recovery phase focusing on restoring essential services, providing temporary shelter, medical care, and supporting affected populations to resume normal activities. - **Reconstruction** is the long-term recovery phase involving rebuilding damaged infrastructure, permanent housing, economic restoration, and development improvements. - These two phases together constitute the **recovery phase** of the disaster cycle according to standard disaster management frameworks (WHO, NDMA). *Mitigation and Rehabilitation* - While **rehabilitation** is correctly part of recovery, **mitigation** is traditionally considered a separate continuous phase or part of preparedness, focused on reducing future disaster risks. - **Mitigation** measures are implemented throughout the disaster cycle, not specifically as a direct component of the recovery phase. *Response and Rehabilitation* - **Response** refers to immediate life-saving actions during and immediately after a disaster (search and rescue, emergency medical care, evacuation). - **Response** precedes the recovery phase and is distinct from it, though **rehabilitation** is indeed part of recovery. *Response and Preparedness* - **Preparedness** involves planning, training, and resource allocation before a disaster occurs. - **Response** is the immediate action during/after the disaster. - Neither constitutes the recovery phase, which follows after the immediate response is complete.
Question 2: An athlete sustained an injury around the knee joint, suspecting cartilage damage. Which of the following is the investigation of choice?
- A. Clinical examination
- B. Arthroscopy (Correct Answer)
- C. Arthrotomy
- D. X-ray
Explanation: ***Arthroscopy*** - **Arthroscopy** is the definitive investigation for **cartilage damage** as it allows for direct visualization of the knee joint's internal structures. - It not only confirms the diagnosis but can also facilitate simultaneous **repair or débridement** of damaged cartilage. *X-ray* - **X-rays** are primarily used to assess **bone structures** and detect fractures or significant joint space narrowing, not soft tissue injuries like cartilage. - They are generally **insufficient** for diagnosing subtle or early cartilage damage. *Clinical examination* - A **clinical examination** is crucial for initial assessment and suspicion of cartilage injury, but it cannot definitively diagnose the extent or type of cartilage damage. - It helps guide further investigations but is **not specific enough** to confirm cartilage integrity. *Arthrotomy* - **Arthrotomy** involves a larger incision to open the joint, which is more **invasive** than arthroscopy and typically reserved for open surgical repairs or complex reconstructions, not as a primary diagnostic tool for cartilage. - It carries a **higher risk of complications**, such as infection and prolonged recovery, compared to arthroscopy.
Question 3: What is the first step taken in case of multiple injuries of face and neck?
- A. Maintenance of airway (Correct Answer)
- B. Reconstruction
- C. IV fluids
- D. Blood transfusion
Explanation: ***D.Maintenance of airway*** - In any trauma scenario, especially involving the face and neck, ensuring a **patent airway** is the absolute priority due to the risk of obstruction by blood, edema, or foreign bodies. - Failure to establish a secure airway can lead to rapid **hypoxia** and death before any other interventions can be performed. *C.Reconstruction* - **Reconstruction** is a definitive treatment step that addresses the structural damage but is performed much later, after the patient's condition has been stabilized. - This option is concerned with long-term functional and cosmetic outcomes, not immediate life-saving measures. *B.IV fluids* - Administering **IV fluids** is crucial for managing hypovolemic shock if present, but airway control always takes precedence in immediate life support. - While important, fluid resuscitation addresses circulatory stability, which is secondary to maintaining oxygenation via a clear airway. *A.Blood transfusion* - **Blood transfusion** is indicated for significant blood loss leading to circulatory instability and is part of resuscitation, but it comes after establishing an airway and often after initial fluid resuscitation. - Addressing severe anemia and hypovolemia with blood products is vital but does not precede securing the airway in managing immediate life threats.
Question 4: Evidence based therapy of Bell's palsy include(s):
- A. Steroid (Correct Answer)
- B. Facial nerve massage
- C. Acyclovir
- D. Facial nerve stimulation
Explanation: ***Steroid*** - **Corticosteroids**, such as prednisone, are the mainstay of treatment for Bell's palsy, particularly when initiated early (within 72 hours of symptom onset) [1]. - They work by reducing **inflammation and swelling** of the facial nerve, which can alleviate compression and promote recovery. *Facial nerve massage* - While supportive therapies like physical therapy can be helpful for **muscle re-education** and preventing contractures, facial nerve massage itself is not an evidence-based therapy for improving nerve function in acute Bell's palsy. - Its efficacy in **nerve regeneration** or speeding recovery has not been scientifically proven. *Acyclovir* - **Antivirals** like acyclovir or valacyclovir are sometimes used in conjunction with steroids if a **herpes simplex virus (HSV) etiology** is suspected, but their standalone use for Bell's palsy is not evidence-based and their benefit in addition to steroids is debated [1]. - The primary evidence points to a viral etiology in some cases, but the direct benefit of antivirals over steroids alone is not consistently robust across studies. *Facial nerve stimulation* - **Electrical stimulation** of the facial nerve is not recommended and may even be harmful in the acute phase of Bell's palsy. - It has not been shown to improve outcomes and can potentially impede natural nerve regeneration or cause **synkinesis** [1].
Question 5: A football player experienced a twist in the ankle and knee. Clinically, no bone injury was appreciated. The examiner is performing the test shown in the image. Which test is this?
- A. Posterior drawer for PCL
- B. McMurray
- C. Lachman (Correct Answer)
- D. Anterior drawer for ACL
Explanation: ***Lachman*** - The image shows the examiner holding the distal thigh and proximal tibia, with the knee flexed at a **20-30 degree angle**, applying an **anterior translational force** to the tibia. This specific maneuver is characteristic of the Lachman test. - The Lachman test is highly sensitive for detecting **anterior cruciate ligament (ACL) tears**, particularly in acute injuries, due to the reduced hamstring spasm compared to the anterior drawer test. *Posterior drawer for PCL* - The posterior drawer test involves flexing the knee to **90 degrees** and applying a **posterior force** to the tibia to assess the integrity of the **posterior cruciate ligament (PCL)**. - The position of the knee in the image (flexed at a shallower angle) and the direction of the applied force (anteriorly towards the femur) do not match the technique for a posterior drawer test. *McMurray* - The McMurray test is performed to evaluate **meniscal tears** by flexing, extending, and rotating the knee while applying a varus or valgus stress. - The maneuver in the image, involving direct anterior translation of the tibia with the knee in slight flexion, is not consistent with the McMurray test. *Anterior drawer for ACL* - While also testing the **ACL**, the anterior drawer test typically involves flexing the knee to **90 degrees** and sitting on the foot, then pulling the tibia anteriorly. - The knee flexion angle in the image is much shallower than 90 degrees, making it inconsistent with the standard anterior drawer test.
Question 6: Following are the indications of cryotherapy
- A. Hemoangiomas
- B. Epistaxis
- C. Vasomotor rhinitis
- D. All of the options (Correct Answer)
Explanation: ***All of the options*** - **Cryotherapy** is a versatile treatment that can be effectively used for all the conditions listed: **hemoangiomas**, **epistaxis**, and **vasomotor rhinitis**. - Its mechanism involves controlled tissue destruction through freezing, making it suitable for various dermatological and ENT applications. *Hemoangiomas* - **Cryotherapy** can be used for treating certain types of smaller, superficial **hemoangiomas**, especially in locations where other treatments might be more invasive. - The freezing process causes **vascular damage** and thrombosis, leading to the regression of the *vascular lesion*. *Epistaxis* - **Cryotherapy** can be employed to control **epistaxis** (nosebleeds), particularly in cases where **cautery** or packing is less effective or unsuitable. - It works by freezing and destroying the **bleeding vessels** in the nasal mucosa, forming a scab that prevents further bleeding. *Vasomotor rhinitis* - **Cryotherapy** to the **inferior turbinates** can be a treatment option for **vasomotor rhinitis** resistant to medical therapy. - The freezing process causes **mucosal injury** and fibrosis, which can reduce the hyperactivity of the nasal turbinates and alleviate symptoms like chronic *rhinorrhea* and **congestion**.
Question 7: Lachman's test is performed with the knee in what degree of flexion?
- A. 5
- B. 20 (Correct Answer)
- C. 70
- D. 90
Explanation: ***20*** - The **Lachman's test** is most accurately performed with the knee in **20-30 degrees of flexion** to better isolate the **anterior cruciate ligament (ACL)**. - This neutral position allows the posterior capsule and other secondary restraints to be relaxed, making an **ACL tear** more evident during anterior translation of the tibia. *5* - Positioning the knee at only **5 degrees of flexion** is not ideal, as it may keep the **posterior capsule** under too much tension, potentially masking an **ACL injury**. - This position does not adequately relax the secondary stabilizers, which can lead to a false negative result for **ACL laxity**. *70* - At **70 degrees of flexion**, the knee is too bent to effectively assess the **ACL**. - In this position, the **menisci** and other structures can block clear anterior translation, and it is more common for other knee stability tests like the **anterior drawer test** to be performed. *90* - With the knee flexed to **90 degrees**, the **anterior drawer test** is typically performed, not the Lachman's test. - In this position, the **posterior horn of the menisci** can interfere with anterior translation, making the Lachman's test less sensitive for detecting an **ACL tear**.
Question 8: Fracture at which site affects the longitudinal growth of a bone?
- A. Epiphyseal plate (Correct Answer)
- B. Diaphysis
- C. Epiphysis
- D. Metaphysis
Explanation: ***Epiphyseal plate*** - The **epiphyseal plate**, also known as the **growth plate**, is a cartilaginous disc responsible for the **longitudinal growth** of long bones. - A fracture in this region can damage the **chondrocytes** and disrupt the normal ossification process, potentially leading to **growth arrest** or limb length discrepancies. *Diaphysis* - The **diaphysis** is the **shaft** or central part of a long bone. - While a fracture here can cause pain and instability, it typically does not directly affect the **longitudinal growth** potential of the bone. *Epiphysis* - The **epiphysis** is the end part of a long bone, initially separated from the main bone by cartilage but later fused with it. - Although it contains the epiphyseal plate in growing individuals, a fracture to the epiphysis itself (excluding the growth plate) primarily affects the **joint surface** and stability, rather than longitudinal growth directly. *Metaphysis* - The **metaphysis** is the transitional zone between the diaphysis and the epiphysis, adjacent to the growth plate. - While fractures in this area can be close to the growth plate, a metaphyseal fracture generally does not directly damage the **growth plate cartilage** to the same extent as a fracture through the plate itself, making its impact on longitudinal growth less direct or severe.
Question 9: Omovertebral bone is associated with?
- A. Sprengel's deformity (Correct Answer)
- B. Hemivertebra
- C. Scoliosis
- D. Cervical rib
Explanation: ***Sprengel's deformity*** - An **omovertebral bone** is the most common associated skeletal anomaly with **Sprengel's deformity**, a congenital elevation of the scapula. - This fibrous, cartilaginous, or osseous bar connects the **superior medial border of the scapula** to the **cervical spine**. *Hemivertebra* - A **hemivertebra** is a congenital malformation where only half of a vertebral body develops, leading to a **wedge-shaped vertebra**. - While it can cause spinal deformities, it is **not directly associated** with an omovertebral bone. *Scoliosis* - **Scoliosis** is a lateral curvature of the spine, which can be congenital, neuromuscular, or idiopathic. - Although it can be secondary to or co-exist with other spinal anomalies, **scoliosis itself is not directly linked** to the presence of an omovertebral bone. *Cervical rib* - A **cervical rib** is a supernumerary rib arising from the seventh cervical vertebra, which can cause symptoms of **thoracic outlet syndrome**. - It is a distinct congenital anomaly and has **no direct association** with an omovertebral bone connecting the scapula to the spine.
Question 10: Early recovery of Sudeck's atrophy can be best managed by which of the following interventions?
- A. Intraarterial injection of articaine.
- B. Intraarterial injection of novacaine. (Correct Answer)
- C. Both intraarterial injection of articaine and novacaine.
- D. Neither intraarterial injection of articaine nor novacaine.
Explanation: **Explanation:** **Sudeck’s Atrophy**, also known as Complex Regional Pain Syndrome (CRPS) Type 1, is a condition characterized by post-traumatic pain, swelling, and vasomotor instability, typically occurring after fractures (e.g., Colles' fracture). The underlying pathophysiology involves an **overactive sympathetic nervous system** leading to persistent vasospasm and localized ischemia. **Why Option B is Correct:** The management of early-stage Sudeck’s atrophy focuses on breaking the "pain-vasospasm-pain" cycle. **Intra-arterial injection of Novocaine (Procaine)** acts as a powerful vasodilator and local anesthetic. By injecting it into the main artery of the affected limb (e.g., brachial artery), it provides immediate sympathetic blockade, improves peripheral blood flow, and reduces the intense burning pain, facilitating early mobilization. **Why Other Options are Incorrect:** * **Option A:** Articaine is a local anesthetic primarily used in dentistry. While it has a rapid onset, it is not the traditional or clinically documented agent of choice for intra-arterial sympathetic blockade in CRPS management compared to Novocaine. * **Option C & D:** Since Novocaine is the specific established treatment for this intervention in classical orthopedic teaching, these options are incorrect. **Clinical Pearls for NEET-PG:** * **Radiological Hallmark:** "Spotty" or patchy osteoporosis (sudden demineralization) seen on X-ray. * **Clinical Features:** The "4 Ds" – Discoloration, Dependency edema, Degenerative changes (stiffness), and Desensitization (hyperalgesia). * **Gold Standard Diagnosis:** Triple-phase bone scan (shows increased uptake). * **Other Treatments:** Physiotherapy (most important), Vitamin C (prophylaxis), and Guanethidine blocks.
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