[The Physician and Sportsmedicine]

CME Self Test

Accredited by the American College of Sports Medicine

October 1996
Expiration Date: October 31, 1997
2.75 Credits

THE PHYSICIAN AND SPORTSMEDICINE - VOL 24 - NO. 10 - OCTOBER 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.


Nutrition Adviser: Nutrition Knowledge (page 15)

1. Who would be the best candidate for taking a multivitamin?
A. An athlete who eats fewer than 1,500 calories a day
B. An athlete who trains regularly
C. An elderly active person
D. An obese sedentary person

2. If a person is exercising and eating a nonfat diet, but still not losing weight, he or she should try
A. drinking more water
B. exercising more
C. replacing some carbohydrate calories with fat calories
D. skipping one meal a day


Rehab Adviser: Using RICE for Injury Relief (page 33)

3. Ice massage should be used for how many minutes?
A. 5-10
B. 11-15
C. 16-20
D. 21-25


Neck Pain: Part 1: Narrowing the Differential (page 37)

4. Which spinal nerve radiates pain to the posterior arm, dorsal forearm, and index and middle fingers?
A. C-5
B. C-6
C. C-7
D. C-8

5. Which test is most likely to help detect cervical radiculopathy?
A. Adson's
B. Elbow flexion
C. Phalen
D. Spurling

6. A 22-year-old crew member who had 1 week of neck and shoulder pain experienced upper-extremity numbness into the index and middle fingers after strenuous rowing. Which of the following is most useful to rule out a significant nerve root injury?
A. Electromyography
B. Magnetic resonance imaging
C. Plain radiographs
D. Reflex, strength, and foraminal compression tests


Pitted Keratolysis: A Common Infection of Active Feet (page 51)

7. Which symptom listed below is not typically associated with pitted keratolysis?
A. Considerable inflammation
B. Craterlike lesions
C. Hyperhidrosis
D. Pungent odor

8. Which of the following is not one of the recommendations regarding footwear use during treatment for pitted keratolysis?
A. Always wear socks with shoes
B. Change socks often
C. Wash socks with antibacterial detergent
D. Wear shoes that "breathe"

9. Which topical treatment is not available over the counter for treatment of pitted keratolysis?
A. Clindamycin
B. Clotrimazole
C. Miconazole
D. Whitfield's ointment


Detecting and Treating Common Fractures of the Foot and Ankle: Part 2: The Midfoot and Forefoot (page 58)

10. An opponent fell on the heel of a 17-year-old football player's plantar-flexed foot. The patient had immediate pain and couldn't walk. Examination reveals extreme tenderness in his midfoot region with mild flattening of his arch. The next step is to
A. apply a short-leg walking cast and have the patient bear weight as tolerated with crutches and return in 3 weeks
B. begin physical therapy that includes edema-reducing modalities
C. obtain anteroposterior, lateral, and oblique radiographs to rule out tarsometatarsal disruption
D. prescribe a compression wrap, icing, and weight bearing as tolerated until tenderness subsides

11. A 35-year-old overweight man has dull pain along his lateral midfoot of about 2 weeks' duration. Radiographs reveal a transverse, nondisplaced fracture at the metaphyseal-diaphyseal junction of the fifth metatarsal. Treatment should include
A. open reduction and internal fixation with a bone graft
B. a short leg non-weight-bearing cast for 6 weeks
C. a short leg walking cast and range of motion exercises
D. a stiff-soled shoe and low-impact activities

12. A 23-year-old female soccer player sustains a displaced fracture of the fifth toe during a collision with another player. Treatment will likely involve
A. "buddy taping" to the adjacent toe
B. follow-up radiographs
C. a nonwalking cast for 3 weeks
D. surgical repair to prevent osteoarthritis


When Is Disqualification From Sports Justified? (page 75)

13. The Rehabilitation Act of 1973 and the Americans With Disabilities Act of 1990
A. apply to almost all intercollegiate and interscholastic sports programs
B. do not apply to professional sports teams
C. expressly prohibit discrimination against injured athletes
D. render a physician liable for determining medical ineligibility

14. Which of the following characteristics of a medical condition is least likely to be grounds for excluding an athlete from competition?
A. Poses a risk that can be effectively reduced by medication
B. Poses an unreasonable risk of personal harm
C. Presents a significant risk to other participants
D. Prevents an athlete from playing well enough to compete successfully

15. Which condition is least likely to be grounds for excluding an athlete from competition?
A. Heart disease
B. Missing paired organ
C. Spinal stenosis


Exercise Adviser: Exercising When You're Overweight (page 81)

16. Of the activities listed, the best for an obese person just starting an exercise program is
A. bicycling 45 minutes daily
B. jogging 15 minutes daily
C. step aerobics three times a week
D. walking 20 minutes daily


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 10/31/97


Answers: 1. A, 2. C, 3. A, 4. C, 5. D, 6. D, 7. A, 8. C, 9. A, 10. C, 11. B, 12. A, 13. A, 14. A, 15. B, 16. D


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