100+ Free ABFM Sports Medicine Practice Questions

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Question 1

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A 22-year-old female collegiate soccer player sustains a non-contact pivot injury with an audible pop, immediate effusion within 2 hours, and a positive Lachman exam. MRI confirms a complete ACL tear with no meniscal or cartilage injury. As the primary care sports medicine physician, what is the most appropriate initial recommendation regarding surgical versus non-operative management?

Mandatory immediate ACL reconstruction within 2 weeks to prevent secondary injury

Shared decision-making — ACL reconstruction is typically recommended for a young, highly active pivoting-sport athlete wishing to return to cutting sports

Non-operative management with bracing and PT is equally effective in all patients regardless of activity level

Delay surgery for at least 12 months to allow ligamentous healing

to track

2026 Statistics

Key Facts: ABFM Sports Medicine Exam

200

Multiple-Choice Questions

ABFM Sports Medicine CAQ — two 100-question sections

~5 hours

Total Exam Time

Two 2-hour sections plus break

35%

MSK Conditions (Largest Domain)

2026 ABFM blueprint effective January 1, 2026

$1,300

Combined Application + Exam Fee

ABFM 2026 fee schedule; $400/yr maintenance

5 boards

Multi-Board Recognition

ABFM, ABEM, ABIM, ABP, ABPMR conjoint subspecialty

12 months

ACGME Fellowship Required

Minimum Sports Medicine fellowship prerequisite

The ABFM Sports Medicine CAQ is a 200-question one-day exam delivered in two 100-question sections (approximately 5 hours total) at Pearson VUE centers. The 2026 blueprint (effective January 1, 2026) weights the exam 35% MSK conditions, 30% medical conditions, 20% emergency conditions, 10% preventive aspects, and 5% foundations of practice. Passing is criterion-referenced. ABFM administers the exam on behalf of all co-sponsoring boards (ABEM, ABIM, ABP, ABPMR) — all candidates take the same exam through their primary board.

Sample ABFM Sports Medicine Practice Questions

Try these sample questions to test your ABFM Sports Medicine exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 22-year-old female collegiate soccer player sustains a non-contact pivot injury with an audible pop, immediate effusion within 2 hours, and a positive Lachman exam. MRI confirms a complete ACL tear with no meniscal or cartilage injury. As the primary care sports medicine physician, what is the most appropriate initial recommendation regarding surgical versus non-operative management?

A.Mandatory immediate ACL reconstruction within 2 weeks to prevent secondary injury

B.Shared decision-making — ACL reconstruction is typically recommended for a young, highly active pivoting-sport athlete wishing to return to cutting sports

C.Non-operative management with bracing and PT is equally effective in all patients regardless of activity level

D.Delay surgery for at least 12 months to allow ligamentous healing

Explanation: For a young, high-demand pivoting-sport athlete, ACL reconstruction is typically recommended via shared decision-making because non-operative management in this population is associated with recurrent instability and increased risk of meniscal/chondral damage. Timing is usually 3-6 weeks post-injury after swelling resolves and full ROM returns — not within 2 weeks (poor outcomes) and not delayed 12 months (secondary injuries accrue). Non-op management is a reasonable option for older or lower-demand patients but is not equivalent for cutting-sport athletes.

2A 16-year-old female gymnast presents for pre-participation physical. She reports menarche at age 15, currently has 6 cycles per year, trains 25 hours/week, and restricts calories. BMI 17.8 kg/m². She has had two metatarsal stress fractures in 18 months. Which triad best describes her condition?

A.Overtraining syndrome, disordered eating, and iron deficiency

B.Low energy availability, menstrual dysfunction, and low bone mineral density

C.Osteoporosis, amenorrhea, and hypothyroidism

D.Rhabdomyolysis, dehydration, and hyponatremia

Explanation: The Female Athlete Triad (now broadened to RED-S, Relative Energy Deficiency in Sport) comprises low energy availability (with or without disordered eating), menstrual dysfunction (amenorrhea/oligomenorrhea), and low bone mineral density. Recurrent stress fractures are a sentinel sign. RED-S expands the triad to recognize systemic effects (metabolic, cardiovascular, GI, immune) and applies to male athletes as well.

3A 58-year-old recreational tennis player has chronic right shoulder pain for 6 months. MRI shows a partial-thickness articular-sided supraspinatus tear (~30%). Physical exam reveals full passive ROM, pain with Neer/Hawkins, Jobe's weakness, but no drop-arm sign. What is the most appropriate first-line treatment?

A.Immediate arthroscopic rotator cuff repair

B.Structured physical therapy focused on scapular stabilization and posterior cuff strengthening ± subacromial corticosteroid injection

C.6-week immobilization in abduction pillow

D.Reverse total shoulder arthroplasty

Explanation: Partial-thickness rotator cuff tears (especially <50% thickness) in patients without significant weakness respond well to conservative management — 3-6 months of structured PT with scapular stabilization, posterior cuff strengthening, and activity modification. Subacromial corticosteroid injection may provide short-term pain relief allowing participation in PT. Surgery is reserved for failed conservative treatment (typically 6 months), full-thickness tears in active patients, or significant functional deficit. Immobilization would worsen adhesive capsulitis risk.

4A 35-year-old runner has 6 months of midportion Achilles tendinopathy unresponsive to RICE and NSAIDs. Which evidence-based treatment has the strongest support as first-line rehabilitation?

A.Corticosteroid injection into the Achilles tendon

B.Alfredson eccentric heel-drop protocol (3 sets of 15 reps, twice daily, for 12 weeks)

C.Surgical tenotomy and debridement

D.Extended immobilization in a walking boot for 8 weeks

Explanation: The Alfredson eccentric loading protocol — 3 sets of 15 reps of heel drops (both straight and bent knee) twice daily for 12 weeks — has the strongest evidence for midportion Achilles tendinopathy. Pain during exercise is acceptable if it resolves after. Intratendinous corticosteroid injection is CONTRAINDICATED (increased rupture risk). Immobilization worsens tendon deconditioning. Surgery is reserved for failure of 6+ months of appropriate rehabilitation.

5A 60-year-old patient with Kellgren-Lawrence grade 3 knee osteoarthritis presents for office-based treatment. Regarding intra-articular corticosteroid injections for knee OA, which of the following is most accurate?

A.No limit exists on the frequency of injections — monthly injections are encouraged

B.Injections provide short-term pain relief (typically 4-8 weeks); total exposure is generally limited to ≤3-4 per year due to cartilage toxicity concerns

C.Corticosteroid injections are curative for knee OA and delay need for arthroplasty

D.There is strong evidence that hyaluronic acid outperforms corticosteroid at 12 months

Explanation: Intra-articular corticosteroid injections for knee OA provide short-term (4-8 week) pain relief. Current consensus limits injections to ≤3-4 per year (some guidelines favor 2-3) due to evidence of accelerated cartilage loss with more frequent injections (McAlindon 2017 JAMA trial). Hyaluronic acid has modest and contested evidence; AAOS no longer strongly recommends it. No injection is curative for OA. Activity modification, weight loss, PT, and NSAIDs remain first-line.

6A 14-year-old basketball player collapses during practice. An on-field AED confirms ventricular fibrillation. Which of the following factors has the strongest association with survival from sudden cardiac arrest in young athletes?

A.Age of the athlete

B.Time from collapse to first shock (AED-defibrillation ≤3 minutes dramatically improves survival)

C.Presence of bystander who calls 911

D.Supplemental oxygen availability

Explanation: Time from collapse to defibrillation is the single most powerful predictor of survival from witnessed SCA. Each minute delay reduces survival ~10%. AED delivery within 3 minutes approaches 80-90% survival; delays >5 minutes drop survival below 50%. Emergency action plans mandate AED placement and staff training. Continuous CPR during AED retrieval preserves myocardial viability. Supplemental oxygen and 911 calls are important but secondary to defibrillation timing.

7According to the AHA 14-element pre-participation cardiovascular screening for athletes, how many elements are personal/family history questions versus physical examination findings?

A.7 history + 7 physical exam elements

B.10 history + 4 physical exam elements

C.12 history + 2 physical exam elements

D.4 history + 10 physical exam elements

Explanation: The AHA 14-element cardiovascular screening (endorsed in the PPE monograph 5th edition) comprises 10 medical history questions (7 personal: exertional chest pain, unexplained syncope, excessive exertional dyspnea, prior murmur, elevated BP, prior restriction, prior cardiac testing; and 3 family history: unexplained death <50, disability from heart disease <50, HCM/long QT/Marfan/arrhythmia in relative) plus 4 physical examination elements (heart murmur auscultation supine + standing, femoral pulses for coarctation, Marfan stigmata, bilateral brachial BP).

8Which of the following is the most common cause of sudden cardiac death in competitive athletes under age 35 years in the United States?

A.Commotio cordis

B.Hypertrophic cardiomyopathy (HCM)

C.Long QT syndrome

D.Arrhythmogenic right ventricular cardiomyopathy (ARVC)

Explanation: Hypertrophic cardiomyopathy is the most common cause of SCD in US athletes under age 35 (approximately 25-35% of cases in most registries). Congenital coronary artery anomalies are second. Commotio cordis, long QT, WPW, and ARVC also contribute but less commonly. Prevalence of HCM is approximately 1:500 in the general population. First-degree relatives should be screened. Italian registries place ARVC higher due to regional genetic variation.

9A 17-year-old football player sustains a suspected concussion after a helmet-to-helmet hit. He is confused, has a headache, and is unsteady. Per the 6th International Consensus Statement on Concussion in Sport (SCAT6 / Amsterdam 2022), which of the following is the most appropriate immediate action?

A.Clear him to return to play if symptoms resolve in 15 minutes

B.Remove him from play, do not return him to play the same day, perform SCAT6 sideline assessment, and refer for medical evaluation

C.Administer oral ibuprofen and reassess in 30 minutes

D.Obtain emergent head CT before any further assessment

Explanation: When a concussion is suspected, the athlete must be immediately removed from play and not returned the same day — this is a universal consensus rule (SCAT6/Amsterdam 2022). The SCAT6 sideline tool (replacing SCAT5) guides assessment. Same-day return increases risk of second impact syndrome. CT imaging is not routinely required unless red flags are present (GCS <15, focal neuro deficit, deteriorating mental status, seizure, persistent vomiting, suspected skull fracture). NSAIDs may mask symptoms and are avoided acutely.

10Per CDC HEADS UP and the Amsterdam consensus, a concussed student-athlete must typically achieve which milestone BEFORE beginning the graduated return-to-play progression?

A.Full return to competitive games

B.Complete return-to-learn (full academic participation without accommodations)

C.Normal neuroimaging findings

D.Negative drug screen

Explanation: Both CDC HEADS UP and the Amsterdam 2022 consensus recommend completing return-to-learn (full academic participation without symptom-provoking accommodations) BEFORE starting the graduated return-to-play progression. Cognitive load recovery precedes physical exertion recovery. This reduces symptom recurrence. Return-to-play is a 6-stage progression (symptom-limited activity → light aerobic → sport-specific → non-contact drills → full contact practice → return to sport) with minimum 24 hours at each stage.

About the ABFM Sports Medicine Exam

The ABFM Sports Medicine Certificate of Added Qualifications is a multi-board subspecialty certification conjointly developed by ABFM, ABEM, ABIM, ABP, and ABPMR. Family physicians pursuing this CAQ demonstrate expertise in primary-care sports medicine — emphasizing non-operative management, office-based injections, return-to-play counseling, pre-participation physical evaluation, and longitudinal athlete care. Candidates must complete an ACGME-accredited Sports Medicine fellowship of at least 12 months and maintain primary ABFM certification.

Questions

200 scored questions

Time Limit

Approximately 5 hours (two 2-hour sections)

Passing Score

Criterion-referenced scaled passing standard set by ABFM

Exam Fee

$1,300 application + exam (2026); $400/yr maintenance (American Board of Family Medicine (ABFM))

ABFM Sports Medicine Exam Content Outline

35%

Sports- & Exercise-Related MSK Conditions

Non-op primary care management — ACL (surgical vs conservative, female athlete triad, ACL-RSI), meniscus, rotator cuff conservative PT + subacromial injection, overuse tendinopathy eccentric loading, office ultrasound-guided injections, patellofemoral pain, stress fractures, pediatric apophyseal injuries

30%

Sports- & Exercise-Related Medical Conditions

Cardiac screening (HCM, long QT, Marfan, commotio cordis, AHA 14-element PPE), EIB/EILO/VCD, rhabdomyolysis, female athlete triad/REDS, nutrition and supplements, WADA doping, environmental illness, chronic disease and exercise, Exercise is Medicine, FITT-VP prescription, adaptive sports

20%

Care of Emergency Conditions

Sudden cardiac arrest, AED on-field ≤3 min survival, exertional heat stroke core ≥40.5°C/105°F cold water immersion, cervical spine injury, concussion and second impact syndrome, anaphylaxis, exercise-associated collapse and hyponatremia, SCFE, Salter-Harris physeal injury

10%

Preventive Aspects of Sports Medicine

PPE 5th edition monograph 14-element AHA, HCM first-degree family screening, Marfan 2+ features, ECG controversy, disqualification guidelines AHA/BJSM, return-to-play 6-step progression, return-to-learn, FIFA 11+ and PEP, bone health, heat acclimatization 10-14 d

Foundations of Practice

Team physician responsibilities, sideline coverage, medicolegal issues, biostatistics and evidence-based sports medicine, ethics, coordinating care with athletic trainers, medical action plans, anti-doping TUE process, consent and minors

How to Pass the ABFM Sports Medicine Exam

What You Need to Know

Passing score: Criterion-referenced scaled passing standard set by ABFM
Exam length: 200 questions
Time limit: Approximately 5 hours (two 2-hour sections)
Exam fee: $1,300 application + exam (2026); $400/yr maintenance

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABFM Sports Medicine Study Tips from Top Performers

1Master the AHA 14-element pre-participation physical evaluation — know the 10 medical history and 4 physical exam elements verbatim; understand the ECG controversy (routine ECG screening not recommended by AHA/AAP but endorsed by European societies) and Seattle/International criteria for interpreting athlete ECGs

2Memorize concussion return-to-play gradual 6-step progression (symptom-limited activity → light aerobic → sport-specific exercise → non-contact drills → full-contact practice → return to game) with minimum 24 hours at each stage; know SCAT6 for sideline and SCOAT6 for office assessment, and CDC HEADS UP return-to-learn before return-to-play

3Know exertional heat stroke management cold: core temperature ≥40.5°C (105°F) with CNS dysfunction — immediate field cold water immersion (CWI) is the gold standard, cool first transport second, target <39°C before transport; never use ice packs/evaporation alone when CWI is available

4Understand office-based injection pharmacology — knee OA: hyaluronic acid weak evidence but common, corticosteroids limited to ≤3-4/year due to cartilage concerns; subacromial: corticosteroid + anesthetic for impingement; trigger finger: single corticosteroid injection 60-70% effective; PRP evidence strongest for lateral epicondylitis and knee OA, controversial for Achilles

5Recognize female athlete triad / RED-S (Relative Energy Deficiency in Sport) — low energy availability, menstrual dysfunction, low bone mineral density; DEXA indicated after 6 months amenorrhea; treat with increased caloric intake rather than OCPs alone (OCPs mask cycles without restoring bone density)

Frequently Asked Questions

What is the ABFM Sports Medicine CAQ exam?

The ABFM Sports Medicine Certificate of Added Qualifications (CAQ) is a multi-board subspecialty certification administered by the American Board of Family Medicine. It is conjointly developed with ABEM, ABIM, ABP, and ABPMR — all five boards use the same exam content pool. Family physicians take the exam through ABFM after completing an ACGME-accredited Sports Medicine fellowship. The CAQ validates expertise in primary-care sports medicine, emphasizing non-operative management, office-based injections, concussion care, pre-participation physicals, and return-to-play counseling.

How many questions are on the exam and how long does it take?

The exam contains 200 single-best-answer multiple-choice questions delivered in two 100-question sections on one day (approximately 5 hours total including breaks). It is computer-based at Pearson VUE centers. The 2026 blueprint effective January 1, 2026 weights MSK conditions 35%, medical conditions 30%, emergency conditions 20%, preventive aspects 10%, and foundations of practice 5%. Questions emphasize primary-care decision-making rather than operative technique.

What are the eligibility requirements for the ABFM Sports Medicine CAQ?

Candidates must hold active ABFM family medicine certification, have completed a minimum 12-month ACGME-accredited Sports Medicine fellowship, maintain an active, unrestricted medical or osteopathic license in the US or Canada, and submit fellowship verification documentation. CAQ-holders must maintain continuous primary ABFM certification — if family medicine certification lapses, the CAQ also lapses. Annual CAQ maintenance fees and participation in continuous certification are required.

How much does the ABFM Sports Medicine CAQ cost?

The 2026 combined application and exam fee is approximately $1,300 (paid to ABFM). Ongoing CAQ maintenance is approximately $400 per year. Candidates from other co-sponsoring boards (ABEM, ABIM, ABP, ABPMR) pay fees set by their primary board — ABEM candidates typically pay $470 application + $1,745 exam through ABEM. All candidates take the same exam but register through their primary board.

Is the exam identical across ABFM, ABEM, ABIM, ABP, and ABPMR?

Yes. The Sports Medicine CAQ is a conjoint examination — all five co-sponsoring boards use the same exam content pool and the same blueprint. ABFM administers the exam on behalf of all boards. Candidates register through their primary specialty board (e.g., family physicians via ABFM, emergency physicians via ABEM, physiatrists via ABPMR), but the exam itself is identical. This reflects the multidisciplinary nature of sports medicine practice.

What are the highest-yield topics for primary-care sports medicine?

MSK conditions (35%) dominate — know non-operative management pathways: rotator cuff conservative PT plus subacromial injection, knee OA hyaluronic acid injection, trigger finger injection, eccentric loading for Achilles/patellar tendinopathy, and the PRP/corticosteroid evidence base. Medical conditions (30%) emphasize PPE AHA 14-element screening, HCM (most common cause of sudden cardiac death <35 yr), exertional heat stroke (core ≥40.5°C/105°F — immediate cold water immersion), and concussion SCAT6/SCOAT6 with 6-step return-to-play. WADA doping classes, female athlete triad/REDS, FITT-VP exercise prescription, and ACSM guidelines (150 min/wk moderate or 75 min vigorous) are high-yield across domains.

How should I study for the ABFM Sports Medicine CAQ?

Plan 6-9 months of structured review during or immediately after fellowship. Start with MSK physical exam and non-op management, then move into cardiac screening and concussion, medical conditions and exercise prescription, and finally pediatric/environmental/practice-of-medicine topics. Use the 2026 ABFM blueprint to allocate study time proportionally. Review the PPE 5th edition monograph, CDC HEADS UP concussion guidance, SCAT6/SCOAT6 tools, Seattle/International ECG criteria, and current ACSM exercise guidelines. Complete thousands of practice questions and take at least two timed full-length practice exams. AMSSM review courses and the AMSSM Sports Medicine Fellowship in-training exam are strong adjuncts.

What is the pass rate for the ABFM Sports Medicine CAQ?

First-time pass rates across co-sponsoring boards typically run 85-92% for fellowship-trained candidates, based on AMSSM and ABFM historical reports. Candidates who complete an ACGME-accredited Sports Medicine fellowship and prepare using the official blueprint, AMSSM review materials, and timed practice exams consistently perform well. Recertification candidates (CAQ holders returning for continuous certification) have slightly higher pass rates than initial candidates.