[The Physician and Sportsmedicine]

CME Self Test

Accredited by the American College of Sports Medicine

November 1996
Expiration Date: November 30, 1997
2.75 Credits

THE PHYSICIAN AND SPORTSMEDICINE - VOL 24 - NO. 11 - NOVEMBER 96

This CME activity was planned and produced in accordance with the Accreditation Council for Continuing Medical Education (ACCME) Essentials. The American College of Sports Medicine (ACSM) is accredited by the ACCME to sponsor continuing medical education for physicians.

The ACSM designates this continuing education activity for 2.75 hours in Category 1 of the Physician's Recognition Award of the American Medical Association (AMA). ACSM CEC or National Athletic Trainers' Association (NATA) CEU credit is also offered.

To participate in this program, you must read the material carefully, answer the test questions, obtain a passing grade (a minimum score of 60% must be obtained), and complete the credit evaluation form.

After answering the test questions, go to the end of this test to score your exam. To receive credit verification, fill out and sign the form confirming you have read the materials and obtained a minimum passing score.

Print out this test and circle the best answer for each of the following questions.


Managing Successive Head Injuries: Which Tests Guide Return to Play? (page 25)

1. A head injury in which the brain rebounds against the inner surface of the skull opposite where the skull has been hit is termed a(n)
A. contrecoup injury
B. embolic stroke
C. second-impact syndrome
D. subarachnoid hemorrhage

2. What symptom is often present in a postconcussive headache that is not present in a trauma-induced migraine?
A. Neurologic impairment
B. Pain
C. Seizure


Swimmer's Shoulder: Targeting Treatment (page 39)

3. Which of the following is a common cause of swimmer's shoulder in adolescents?
A. Poor proprioception
B. Subacromial bursitis
C. Underdeveloped shoulder musculature
D. Voluntary scapular winging

4. First-line evaluation of a swimmer with shoulder pain should include tests for strength, impingement, and
A. circulation
B. instability
C. nerve conduction

5. The goal of strength training in the treatment or prevention of swimmer's shoulder is to
A. build the anterior chest wall
B. correct muscle imbalance
C. increase flexibility
D. increase triceps endurance


Neck Pain: Part 2: Optimizing Treatment and Rehabilitation (page 54)

6. A 22-year-old male crew member has 1 week of neck and shoulder pain and reports right arm numbness into the index and middle fingers after strenuous rowing. Which of the following is the least rational approach to rehab?
A. Have the patient discontinue rowing until pain and dysesthesias resolve
B. Prescribe 3 weeks of a full-strength nonsteroidal anti-inflammatory drug
C. Recommend a cervical collar until the patient resumes rowing
D. Refer the patient to a physical therapist

7. Ten years later, the same (now recreational) rower returns, saying his neck pain has been chronic for 5 years and flares up after daily workouts. He maintains a regular stretching and strengthening program for his upper body and neck. The next step would be to
A. encourage the patient to stop rowing
B. prescribe regular narcotics
C. recommend regular manual therapies
D. tell the patient to decrease the frequency of rowing

8. A competitive 33-year-old female tennis player has sustained mild-to-moderate neck strains three times in the last 2 years but has experienced no pain between injuries. She can make a full return to play when she has
A. flexion strength greater than extension strength
B. lateral bending on the injured side within 25% of the opposite side
C. mild pain only at the extremes of lateral neck motion
D. pain-free full cervical range of motion


Surfing, Windsurfing, Snowboarding, and Skateboarding: Medical Aspects of Board Sports (page 62)

9. Blisters are most commonly seen in which of the following sports?
A. Skateboarding
B. Snowboarding
C. Surfing
D. Windsurfing

10. The most common chronic condition among windsurfers is
A. arthritis
B. low-back pain
C. patellar tendinitis
D. rotator cuff injury

11. Snowboarders wearing soft boots (rather than hard plastic boots) are more prone to what type of injury?
A. Ankle injury
B. Hip injury
C. Knee injury
D. Midshaft tibia injury


Identifying Exercise Allergies: Exercise-Induced Anaphylaxis and Cholinergic Urticaria (page 76)

12. A patient with cholinergic urticaria who is not having anaphylactic symptoms should be treated with which of the following?
A. Amitriptyline hydrochloride
B. Epinephrine
C. Hydroxyzine hydrochloride
D. Ranitidine hydrochloride

13. Physical findings in a patient who has acute exercise-induced anaphylaxis usually include which of the following?
A. Altered mental status
B. Diffuse large urticarial wheals
C. Melena
D. Myalgias

14. Which of the following is the most common symptom in patients who have exercise-induced anaphylaxis?
A. Blurred vision
B. Headache
C. Itching
D. Small papules surrounded by macular edema


Nutrition Adviser: Fruits and Veggies (page 97)

15. Eating which of the following vegetables is specifically linked to a decreased rate of prostate cancer?
A. Broccoli
B. Carrot
C. Onion
D. Tomato


Preferred credit hour type (check only one):
___ AMA (CME Category 1)
___ ACSM (CEC)
___ NATA (CEU)
Evaluation of credit offering:
1. Was material:  ___ New or ___ Review for you?
2. Was material:  Presented clearly?  ___ Yes ___ No
                  Covered adequately? ___ Yes ___ No
3. Did material meet the objectives as stated in the 
abstract ("In brief")?  ___ Yes ___ No
4. Will you be able to use the information learned from this 
credit offering in your profession?  ___ Yes ___ No
If yes, how:___________________________________________________
Please attach business card, print legibly, or type on 
each form:
Name: _________________________________  Degree:  _____________
Address: ______________________________________________________
City: _____________________  State: _____  Zip: _______________
Business Phone: (_____)____________________
Fax:            (_____)____________________
___ ACSM Member (ACSM ID# ______________________)
___ Nonmember   (ID# ___________________________)
I attest that I have read the articles and answered the test 
questions using the knowledge gained through the articles provided 
in this issue and received a passing grade (minimum score 60%).
Signature: ____________________________________ Date: __________
___ Change my address as shown above, effective date: __________
To receive credit, mail these pages or photocopies of them, with 
check or money order in the amount of $15 (ACSM members) or 
$20 (nonmembers) for each CME Self Test to: 
                       Education Department
                       American College of Sports Medicine
                       Box 1440, Indianapolis, IN 46206-1440 USA.

Expires 11/30/97


Answers: 1. A, 2. A, 3. C, 4. B, 5. B, 6. C, 7. D, 8. D, 9. D, 10. B, 11. A, 12. C, 13. B, 14. C, 15. D


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