100+ Free ABIM Sports Medicine Practice Questions

Musculoskeletal Anatomy & Injury

Knee (Lachman, anterior/posterior drawer, McMurray, valgus/varus stress, patellar grind/apprehension; ACL/PCL/MCL/LCL, meniscus); shoulder (Empty Can/Jobe, Hawkins-Kennedy, Neer, drop arm, apprehension/relocation, Speed/Yergason; rotator cuff, AC separation Rockwood I-VI, instability); ankle (anterior drawer ATFL, talar tilt CFL, syndesmotic squeeze, Ottawa Ankle Rules; sprains, Achilles rupture with Thompson test); spine (SLR, FABER, stork test for spondylolysis); hip (FADIR for FAI, Trendelenburg).

Concussion & Head Injuries

SCAT5/SCAT6 sideline assessment, no LOC required for diagnosis, second-impact syndrome, return-to-learn before return-to-play, 6-stage stepwise return-to-play (symptom-limited activity → light aerobic → sport-specific → non-contact drills → full-contact practice → return to play), CDC HEADS UP, Lystedt-style state legislation, sub-symptom-threshold aerobic exercise for prolonged recovery (Amsterdam 2022), CTE post-mortem tauopathy.

Pre-Participation Physical (PPE) & Cardiac Screening

AHA 14-element screen (7 personal history, 4 family history, 3 physical exam — heart auscultation supine and standing, femoral pulses for coarctation, Marfan stigmata, BP). Hypertrophic cardiomyopathy as #1 cause of SCD in young U.S. athletes. ECG screening controversy (US AHA history-only vs. Italian/European mandatory ECG). Long QT, Brugada, ARVC, WPW, commotio cordis from chest blow during T-wave. AED placement and emergency action plans.

Exercise Physiology & Performance

VO2max, lactate (anaerobic) threshold, RPE Borg 6-20 and CR-10 scales, FITT principle, periodization (macro/meso/microcycle), supercompensation, energy systems (ATP-PCr, anaerobic glycolysis, aerobic), athlete's heart vs. HCM, ACSM exercise prescription (≥150 min/week moderate aerobic plus resistance ≥2 d/wk), plyometrics and the stretch-shortening cycle, overtraining (unexplained underperformance) syndrome.

Sports-Related Medical Conditions

Exercise-induced bronchoconstriction (EIB) — EVH challenge, pre-exercise SABA; diabetes with CGM and pre-exercise carbs; sickle cell trait with NCAA mandated confirmation and exertional sickling risk; exertional heat stroke (≥40°C with CNS dysfunction, cold-water immersion gold standard); exertional rhabdomyolysis (CK >5× ULN, aggressive isotonic IV fluids); exercise-associated hyponatremia (3% hypertonic saline for symptomatic EAH); infectious mono with splenic rupture risk; herpes gladiatorum NCAA/NFHS return criteria.

Female Athlete Triad / RED-S

ACSM 2014 Triad: low energy availability (with or without disordered eating), menstrual dysfunction, low BMD. IOC RED-S 2014 (updated 2018, 2023) — broader, applies to male and female athletes. Energy availability <30 kcal/kg FFM/day disrupts LH pulsatility. ISCD pediatric BMD criteria (Z-score ≤-2.0 = 'low BMD for chronological age'). Functional hypothalamic amenorrhea work-up (FSH, LH, estradiol, TSH, prolactin). Calcium 1000-1300 mg/d and vitamin D 600-1000 IU/d; transdermal estradiol with cyclic progesterone preferred over OCPs for BMD. Female Athlete Triad Coalition Cumulative Risk Assessment (CRA).

Doping & Anti-Doping

WADA (World Anti-Doping Agency) maintains the Code and the annually updated Prohibited List (effective January 1). USADA implements in the U.S. Therapeutic Use Exemption (TUE) requires significant health impairment, no enhancement beyond normal health, no permitted alternative, and no consequence of prior non-medical use. Glucocorticoids by oral/IV/IM/rectal routes prohibited in-competition (2022). Tramadol added in-competition prohibited January 1, 2024. Standard sanction for first intentional non-specified violation = 4 years (2021 Code). Inhaled beta-2 agonist dose limits (salbutamol 1600 mcg/24 h, formoterol 54 mcg/24 h, salmeterol 200 mcg/24 h).

Pediatric / Adolescent Sports Issues

Apophysitis: Osgood-Schlatter (tibial tubercle), Sinding-Larsen-Johansson (inferior patella), Sever (calcaneus). Panner disease (osteochondrosis of the capitellum, ages 7-12) vs. OCD of the capitellum (ages 13-15). Little League shoulder (proximal humeral epiphysiolysis) and elbow (medial epicondyle apophysitis). Spondylolysis in extension-loading sports. Salter-Harris physeal fracture types I-V. AAP/Little League pitch count limits (~85/game at 11-12). AAP/AOSSM/AMSSM sport-specialization guidance — defer to age 15-16, ≤8 months/year, weekly hours ≤ age in years. Juvenile OCD of the knee (medial femoral condyle).

Rehabilitation & Return-to-Play

Criteria-based return after ACL reconstruction (≥9 months, LSI ≥90% strength and hop testing, ACL-RSI psychological readiness ≥65). Patellofemoral pain syndrome — hip and core strengthening with quadriceps strengthening. Achilles tendinopathy — Alfredson eccentric protocol (3 × 15 twice daily × 12 weeks). FIFA 11+, PEP, and KIPP neuromuscular training programs reduce non-contact ACL injuries 30-50% in female athletes. Functional milestones for ankle sprain return (single-leg balance, full WB, ≥80-90% strength symmetry).