100+ Free ABP Sports Medicine Practice Questions

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According to the AAP/AHA 14-element pre-participation cardiovascular screening, which of the following is one of the four required FAMILY-history items?

Family member who completed a marathon

Premature death (sudden or unexpected) before age 50 attributable to heart disease in one or more relatives

Family member with hypertension diagnosed after age 60

Family member with mitral valve prolapse on echocardiogram

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2026 Statistics

Key Facts: ABP Sports Medicine Exam

100

FREE Practice Questions

Built around the ABP Pediatric Sports Medicine content blueprint

25%

MSK Injuries Weighting

Largest blueprint domain

14-pt

AAP/AHA PPE Cardiac Screen

7 personal + 4 family + 3 physical

6 steps

Return-to-Play Progression

≥24 hours per step, then medical clearance

≥104°F

Exertional Heat Stroke + AMS

Cold-water immersion gold standard

1 yr

Sports Medicine Fellowship Required

ACGME-accredited prerequisite

The ABP Pediatric Sports Medicine subspecialty exam is a 1-day, ~200-question CBT (~8 hours) issued by the American Board of Pediatrics for pediatricians who have completed a 1-year ACGME Sports Medicine fellowship. Major content domains: Pediatric MSK Injuries 25%, Concussion 20%, PPE/Cardiac Screening 15%, Apophyseal/Overuse 10%, Sports-Related Medical Conditions 10%, Female Athlete Triad/RED-S 5%, Adaptive/Special Athletes 5%, RTL/RTP 5%, Anti-Doping/Supplements 5%. Application fee is approximately $2,200 (set annually). MOC every 10 years plus annual MOCA-Peds.

Sample ABP Sports Medicine Practice Questions

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

1According to the AAP/AHA 14-element pre-participation cardiovascular screening, which of the following is one of the four required FAMILY-history items?

A.Family member who completed a marathon

B.Premature death (sudden or unexpected) before age 50 attributable to heart disease in one or more relatives

C.Family member with hypertension diagnosed after age 60

D.Family member with mitral valve prolapse on echocardiogram

Explanation: The AAP/AHA 14-point PPE screen includes 4 family-history items: premature sudden/unexpected death <50 from heart disease, disability from heart disease in a close relative <50, knowledge of HCM/long QT/Marfan/dysrhythmia in a family member, and any unusual cardiac event in a family member. Late-onset hypertension or MVP without other features are not part of the screen.

2Which of the following is the MOST common cause of sudden cardiac death in young athletes in the United States?

A.Long QT syndrome

B.Wolff-Parkinson-White syndrome

C.Hypertrophic cardiomyopathy (HCM)

D.Commotio cordis

Explanation: Hypertrophic cardiomyopathy is the most common identifiable cause of sudden cardiac death in young US athletes. It is autosomal dominant with sarcomere protein mutations (most commonly MYH7 and MYBPC3). Long QT and WPW are causes but less common. Commotio cordis is the leading STRUCTURAL-heart-NEGATIVE cause but is less frequent overall.

3What is the current AHA/AAP position on routine 12-lead ECG screening as part of the standard pre-participation physical for asymptomatic US youth athletes?

A.Mandatory ECG for all athletes 12-25 years

B.ECG required only in NCAA D-I athletes

C.Routine ECG is NOT recommended for the general youth athlete population

D.ECG required only in male athletes

Explanation: The AHA and AAP do NOT recommend routine 12-lead ECG screening of asymptomatic youth athletes in the US, citing low disease prevalence, high false-positive rates, cost, and limited downstream infrastructure. This contrasts with Italy, which has mandated ECG screening since the 1982 Medical Protection of Athletes law. The 14-point history/physical remains the US standard.

4A 16-year-old basketball player is struck in the chest by a ball and collapses. Bystanders begin CPR. What rhythm is MOST likely if commotio cordis is the cause?

A.Asystole

B.Pulseless electrical activity

C.Ventricular fibrillation

D.Sinus tachycardia

Explanation: Commotio cordis is sudden cardiac arrest from a low-energy blunt blow to the precordium during the vulnerable repolarization window (10-30 ms before T-wave peak), inducing ventricular fibrillation in a structurally normal heart. Survival depends on early defibrillation, making accessible AEDs at youth sporting events critical.

5A 14-year-old with Marfan syndrome wants to play competitive basketball. Which physical-exam finding from the AAP/AHA PPE would prompt cardiac referral BEFORE clearance?

A.Pectus excavatum alone

B.Auscultation in supine and standing for HCM murmur changes and assessment of femoral pulses, plus stigmata of Marfan syndrome

C.Cardiac auscultation only in the supine position

D.Resting heart rate above 60 bpm

Explanation: The 3 cardiac PHYSICAL items on the 14-point screen are: heart auscultation supine and standing (HCM murmur intensifies with decreased preload), femoral pulse assessment (coarctation), and assessment for Marfan stigmata, plus brachial blood pressure. A patient with known Marfan needs cardiology and echocardiogram for aortic root dimensions before clearance.

6Which mutation pattern is MOST consistent with familial hypertrophic cardiomyopathy?

A.Autosomal recessive sarcomere mutation

B.Autosomal dominant mutation in sarcomere proteins such as MYH7 or MYBPC3

C.X-linked recessive dystrophin mutation

D.Mitochondrial heteroplasmy

Explanation: Familial HCM is autosomal dominant with incomplete penetrance, most commonly involving sarcomere protein genes — beta myosin heavy chain (MYH7) and myosin-binding protein C (MYBPC3) account for the majority. First-degree relatives of an affected individual should undergo cardiac screening.

7Per the AAP/AHA personal-history items on the 14-point PPE, which of the following is one of the seven required questions?

A.Number of hours of weekly training

B.Chest pain or discomfort with exertion

C.Use of a mouthguard

D.Sport-specific injury history

Explanation: The 7 personal-history items include exertional chest pain/discomfort, exertional syncope/near-syncope, excessive exertional fatigue or shortness of breath, prior detection of a heart murmur, elevated blood pressure, prior cardiac restriction from sports, and prior cardiac testing. Training hours and mouthguard use are not part of the cardiac screen.

8A 13-year-old soccer player passes out during practice without warning and has a normal post-event exam. Which evaluation step is MOST appropriate before return to sport?

A.Reassurance and immediate return to play

B.Resting 12-lead ECG and cardiology referral; restrict from sports until cleared

C.Trial of oral fluids and high-salt diet for 1 week

D.Order an EEG before any cardiac evaluation

Explanation: Exertional or unexplained syncope in a young athlete is a red flag for arrhythmogenic causes (long QT, HCM, CPVT, anomalous coronary). The athlete should be removed from sport, an ECG obtained, and cardiology consulted. Vasovagal syncope is a diagnosis of exclusion in this setting.

9An ECG on a 17-year-old endurance athlete shows sinus bradycardia at 48 bpm, voltage criteria for LVH, and early repolarization. The MOST appropriate interpretation is:

A.Diagnostic of HCM; restrict from sports

B.Athlete's heart adaptations; not pathologic in isolation

C.Brugada syndrome

D.Long QT syndrome

Explanation: The Seattle/International criteria distinguish normal training-related ECG findings (sinus bradycardia, isolated voltage criteria for LVH, early repolarization, incomplete RBBB) from pathologic changes (T-wave inversion beyond V1-V2, ST depression, pathologic Q waves, prolonged QT). Isolated training-related findings do not require further evaluation.

10An automated external defibrillator (AED) at a high-school sporting venue is BEST justified by which evidence-based principle?

A.Survival from sudden cardiac arrest declines roughly 7-10% for every minute defibrillation is delayed

B.AEDs treat asystole effectively

C.AEDs replace the need for CPR

D.AEDs eliminate sudden cardiac death entirely

Explanation: Each minute without defibrillation in witnessed VF arrest reduces survival by 7-10%. Public access defibrillation programs and on-site AEDs at youth athletic venues are recommended by the AHA, AAP, and NATA. CPR + early defibrillation are the proven survival drivers.

About the ABP Sports Medicine Exam

The ABP Pediatric Sports Medicine subspecialty certification validates expert pediatric sports medicine knowledge for ABP-certified pediatricians who have completed a 1-year ACGME-accredited Sports Medicine fellowship. Sports Medicine certification is co-sponsored by the ABFM, ABEM, ABIM, ABPMR, and ABP — each board administers its own version, with ABP issuing certification for pediatric diplomates. The exam emphasizes pediatric musculoskeletal injuries (Salter-Harris fractures, growth-plate considerations), concussion (Child SCAT5, return-to-learn/play), AAP/AHA 14-point pre-participation cardiovascular screening, apophyseal/overuse injuries unique to youth (Osgood-Schlatter, Sever, Little League shoulder/elbow), sports-related medical conditions (EIB, T1D, sickle cell trait, heat illness), Female Athlete Triad/RED-S, adaptive and special-population athletes, return-to-learn/play protocols, and anti-doping/supplement safety in youth. Maintenance of certification follows the 10-year ABP MOC cycle plus annual MOCA-Peds questions.

Questions

100 scored questions

Time Limit

8 hours (CBT)

Passing Score

Scaled by ABP

Exam Fee

~$2,200 (American Board of Pediatrics (ABP))

ABP Sports Medicine Exam Content Outline

25%

Pediatric Musculoskeletal Injuries

Salter-Harris I-V (II most common ~75%; V worst prognosis), supracondylar humerus fractures (FOOSH, AIN palsy, brachial artery), nursemaid's elbow (hyperpronation or supination + flexion), buckle/torus + greenstick fractures, toddler's fracture, SCFE (knee = hip pain, non-weight-bearing + ortho), Legg-Calvé-Perthes, transient synovitis vs septic arthritis (Kocher), spondylolysis (stork test), OCD (medial femoral condyle, capitellum), ACL tears with physeal-sparing reconstruction, apophyseal avulsions (ASIS sartorius).

20%

Concussion in Pediatrics & Adolescents

Child SCAT5 (5-12) vs SCAT5 (13+), no LOC required for diagnosis, mBESS balance, PECARN red flags, neurometabolic cascade with vulnerability window, second-impact syndrome rare but fatal in youth, post-concussion symptoms, sub-symptom-threshold aerobic (Buffalo treadmill) and active rehabilitation per Amsterdam 2022 consensus, vestibulo-ocular therapy, multi-concussion shared decision-making.

15%

Pre-Participation Physical Exam (PPE) & Cardiac Screening

AAP/AHA 14-point: 7 personal hx (chest pain/discomfort, syncope, exertional fatigue, prior murmur, HTN, prior cardiac restriction, prior cardiac testing), 4 family hx (premature death <50, disability <50, HCM/long QT/Marfan/dysrhythmia, unusual cardiac death), 3 physical (heart auscultation supine + standing, femoral pulses, Marfanoid features) + BP. HCM autosomal dominant MYH7/MYBPC3 — most common SCD cause. US AAP/AHA: NO routine ECG; Italy mandates ECG since 1982. Athlete's heart vs pathologic ECG (Seattle/International criteria). Commotio cordis (VF in vulnerable repolarization window) → AED.

10%

Apophyseal & Overuse Injuries

Osgood-Schlatter (tibial tubercle, 10-15 yo), Sinding-Larsen-Johansson (inferior patella), Sever (calcaneal apophysitis 8-12 yo, heel squeeze), Iselin (5th MT base, parallel line), Little League shoulder (proximal humeral physeal stress, Salter-Harris I-equivalent), Little League elbow (medial epicondyle apophysitis from valgus stress), gymnast wrist (distal radius physeal stress). Pitch Smart pitch counts. Sport specialization limits (≤ child's age in hours/week). FIFA 11+ / PEP for ACL prevention.

10%

Sports-Related Medical Conditions

EIB (10-15 min post-exercise onset; albuterol 15 min pre-exercise first-line; alternatives cromolyn, montelukast). T1D in sport (CGM, basal reduction ~50% during exercise, 30-60 g carbs/hour endurance, delayed nocturnal hypoglycemia). Sickle cell trait (NCAA mandatory testing 2010 after Dale Lloyd II death — exertional sickling, rest/cool/hydrate). Exertional heat stroke ≥104°F + AMS — cold-water immersion 'cool first, transport second' (Korey Stringer Institute). Exertional hyponatremia → hypertonic saline. Mononucleosis splenic precaution 3-4 wk. Herpes gladiatorum NFHS skin rules. EILO/VCD.

Female Athlete Triad / RED-S

Female Athlete Triad (Yeager 1992 / ACSM 2007): low energy availability ± disordered eating, menstrual dysfunction (FHA), low BMD. RED-S (IOC 2014, updated 2018, 2023 = REDs CAT2): broader than female-only; multi-system effects. Screening with LEAF-Q and REDs CAT2. DEXA spine + TBLH using Z-scores in pediatrics. Treatment: restore energy availability (≥45 kcal/kg FFM/day), multidisciplinary (sports med + dietitian + mental health). OCPs do NOT improve BMD.

Adaptive Sports & Special Athletes

Special Olympics (intellectual disability focus) vs Paralympics (physical impairments + visual impairment with classification systems including B1-B3 visual). Down syndrome — 2024 Special Olympics policy moved away from routine cervical X-rays; focus on history + neuro exam. Wheelchair athletes with SCI ≥T6 — autonomic dysreflexia (HA, HTN, sweating above lesion; sit upright, drain bladder). Cerebral palsy — multidisciplinary individualized assessment. Single-paired organ counseling. Transgender athlete inclusion per AAP.

Concussion Return-to-Learn / Return-to-Play, Pediatric Specific

Return-to-Learn (RTL): 4 stages — (1) 24-48h cognitive rest, (2) light cognitive activity, (3) partial school, (4) full school no high-stress testing. Then Return-to-Play (RTP): 6 stages — (1) symptom-limited activity, (2) light aerobic, (3) sport-specific noncontact, (4) noncontact training drills, (5) full-contact practice with medical clearance, (6) return to play. Minimum 24 hours per step; drop back if symptoms return. Most state laws (Lystedt model) require education, removal from play with suspected concussion, and written medical clearance.

Anti-Doping & Supplement Safety in Youth

WADA Prohibited List: anabolic agents and peptide hormones (GH, EPO) always prohibited; stimulants and narcotics in-competition. Therapeutic Use Exemption (TUE) required for ADHD stimulants in WADA-tested sport. Caffeine REMOVED from prohibited list 2004 (now Monitoring Program). AAP recommends against energy drinks (caffeine + taurine + guarana) in adolescents. Use only third-party-certified supplements (NSF Certified for Sport, Informed Sport, BSCG). AAP/NATA caution on creatine in athletes <18 due to limited safety data.

How to Pass the ABP Sports Medicine Exam

What You Need to Know

Passing score: Scaled by ABP
Exam length: 100 questions
Time limit: 8 hours (CBT)
Exam fee: ~$2,200

Keys to Passing

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

ABP Sports Medicine Study Tips from Top Performers

1Memorize the AAP/AHA 14-point screen by structure: 7 personal history (chest pain/discomfort with exertion, syncope/near-syncope, exertional fatigue, prior heart murmur, hypertension, prior cardiac restriction, prior cardiac testing), 4 family history (premature death <50 from heart disease, disability <50 from heart disease, HCM/long QT/Marfan/dysrhythmia in family member, unusual family cardiac event), 3 physical (auscultation supine + standing, femoral pulses, Marfanoid features) plus BP. Know that the US position is NO routine ECG (vs. mandatory ECG in Italy since 1982).

2For Salter-Harris fractures, use the SALTR mnemonic: I = Slip across physis, II = Above physis (metaphysis fragment, most common ~75%), III = Lower / through epiphysis (intra-articular), IV = Through metaphysis + physis + epiphysis (intra-articular), V = Crush of physis (worst prognosis, often retrospective). Type II is the most common pediatric physeal fracture; type V has the worst growth-arrest prognosis.

3Concussion: NO LOC required for diagnosis (occurs in <10% of cases). Use Child SCAT5 for ages 5-12 and SCAT5 for 13+. Always do RTL (4 stages) BEFORE RTP (6 stages), minimum 24 hours per step. Most state laws (Lystedt model from Washington 2009) mandate concussion education, removal from play with suspected injury, and WRITTEN medical clearance before return.

4Heat illness: cold-water (ice-water) immersion is the gold standard for exertional heat stroke (≥104°F + altered mental status). The Korey Stringer Institute mantra is 'cool first, transport second' — survival approaches 100% with rapid CWI. Antipyretics do not work for exertional heat stroke. Heat acclimatization protocols over 14 days are the best prevention.

5Female Athlete Triad (low energy availability, menstrual dysfunction, low BMD) and RED-S (IOC 2014, updated 2023 = REDs CAT2) — restoring ENERGY AVAILABILITY (≥45 kcal/kg FFM/day) is the cornerstone treatment, NOT OCPs. OCPs do not improve bone density and may mask functional menstrual recovery.

Frequently Asked Questions

What is the ABP Pediatric Sports Medicine subspecialty exam?

Sports Medicine certification is co-sponsored by the ABFM, ABEM, ABIM, ABPMR, and ABP. The American Board of Pediatrics issues Sports Medicine subspecialty certification for pediatric diplomates after they complete a 1-year ACGME-accredited Sports Medicine fellowship. The exam is a 1-day computer-based test of approximately 200 single-best-answer multiple-choice items at Pearson VUE that validates expertise in pediatric sports medicine — concussion, musculoskeletal injuries, the pre-participation physical exam, sports medical conditions, RED-S, adaptive sports, and anti-doping.

Who is eligible to sit the ABP Sports Medicine exam?

Candidates must (1) hold a current ABP General Pediatrics initial certification, (2) have completed a 1-year ACGME-accredited Sports Medicine fellowship at a program co-sponsored by one of the participating ABMS boards, and (3) hold a valid unrestricted medical license. Program-director attestation of fellowship completion and clinical competence is also required.

What does the exam cost and how is it scheduled?

The application fee is approximately $2,200, set annually by ABP. The exam is offered at Pearson VUE Professional Testing Centers. Registration typically opens in the spring with a fall administration. Confirm exact fee, dates, and deadlines at abp.org/content/sports-medicine.

How is the exam content organized?

The exam emphasizes pediatric-specific content. The major weighted domains used in this practice bank are: Pediatric Musculoskeletal Injuries (25%), Concussion in Pediatrics & Adolescents (20%), Pre-Participation Physical Exam & Cardiac Screening (15%), Apophyseal & Overuse Injuries (10%), Sports-Related Medical Conditions (10%), Female Athlete Triad / RED-S (5%), Adaptive & Special Athletes (5%), Pediatric Return-to-Learn/Return-to-Play (5%), and Anti-Doping & Supplement Safety in Youth (5%).

What are the highest-yield topics?

Highest-yield topics include the Salter-Harris classification (especially type II — most common, type V — worst prognosis), the AAP/AHA 14-point pre-participation cardiac screen and HCM, the Child SCAT5/SCAT5 distinction with the stepwise Return-to-Learn (4 stages) → Return-to-Play (6 stages) progression and state Lystedt-model laws, exercise-induced bronchoconstriction (albuterol 15 min pre-exercise), exertional heat stroke management with cold-water immersion ('cool first, transport second'), sickle cell trait exertional sickling (NCAA 2010 mandate), Female Athlete Triad / RED-S energy availability, and the WADA Prohibited List + TUE process for ADHD stimulants.

How does Maintenance of Certification (MOC) work?

ABP Sports Medicine MOC follows the 10-year continuing certification cycle plus annual MOCA-Peds quarterly questions for the underlying General Pediatrics certification. Diplomates also engage in approved Part 4 quality improvement activities and pay annual MOC fees. Sports Medicine subspecialty diplomates must maintain underlying ABP General Pediatrics certification.