Sports Medicine Prometric exam questions with answers

1. Question 1Anti-Doping, Pharmacology and Sports Nutritionmedium

   An athlete tests positive for a stimulant that was in an unlabelled supplement she bought online. Which principle of the World Anti-Doping Code applies?

   1. ANo violation if intent to cheat cannot be proven
   2. BLiability rests only with the supplier
   3. CA violation applies only to repeat positive tests
   4. DStrict liability for any substance in her sample
   Show answer and explanation▾

   Answer: D. Strict liability for any substance in her sample

   Under strict liability, athletes are responsible for any prohibited substance found in their sample whether or not they intended to use it. Lack of intent may affect the sanction but not whether a violation occurred.

2. Question 2Anti-Doping, Pharmacology and Sports Nutritionhard

   A triathlete racing for about 5 hours asks how much carbohydrate to take during the event. What is the recommended upper intake?

   1. AUp to 20 g/h from glucose drinks alone
   2. BUp to 200 g/h from any source
   3. CNone; racing fasted improves fat oxidation
   4. DUp to 90 g/h from glucose-fructose mixes
   Show answer and explanation▾

   Answer: D. Up to 90 g/h from glucose-fructose mixes

   For events longer than about 2.5 hours, up to 90 g/h of carbohydrate using multiple transportable carbohydrates (such as glucose and fructose) is advised. Glucose alone is limited by intestinal transport to about 60 g/h.

3. Question 3Exercise Physiology, Prescription and Special Populationsmedium

   A pregnant runner at 28 weeks asks about continuing to exercise. Which finding is an absolute contraindication to aerobic exercise?

   1. AUncomplicated singleton pregnancy
   2. BPersistent third-trimester vaginal bleeding
   3. CGestational diabetes controlled by diet alone
   4. DPre-pregnancy regular running
   Show answer and explanation▾

   Answer: B. Persistent third-trimester vaginal bleeding

   Persistent second or third trimester bleeding is an absolute contraindication to exercise in pregnancy. Gestational diabetes is not a contraindication; exercise is part of its management.

4. Question 4Exercise Physiology, Prescription and Special Populationsmedium

   By convention, what oxygen consumption does 1 metabolic equivalent (MET) represent?

   1. A1.0 mL/kg/min
   2. B7.0 mL/kg/min
   3. C3.5 mL/kg/min
   4. D10.5 mL/kg/min
   Show answer and explanation▾

   Answer: C. 3.5 mL/kg/min

   One MET is defined as an oxygen uptake of 3.5 mL/kg/min, roughly resting metabolism while seated. Activity intensity is expressed as multiples of this; 7.0 mL/kg/min would be 2 METs.

5. Question 5Sports Cardiology and Pre-participation Screeningeasy

   A 14-year-old is struck in the chest by a cricket ball and collapses, pulseless. What is the most important immediate action?

   1. APlace in recovery position and observe
   2. BStart CPR and use an AED at once
   3. CGive oxygen and wait for ambulance
   4. DCheck for rib fracture before CPR
   Show answer and explanation▾

   Answer: B. Start CPR and use an AED at once

   Commotio cordis causes ventricular fibrillation, and survival depends on immediate CPR and early defibrillation. Waiting or observing wastes the minutes in which defibrillation works.

6. Question 6Lower Limb Sports Injuriesmedium

   A netball player has a grade II lateral ankle sprain. Which management gives the best functional outcome?

   1. ABelow-knee cast for 6 weeks
   2. BStrict bed rest and non-weight bearing
   3. CFunctional support with early exercise
   4. DEarly primary surgical ligament repair
   Show answer and explanation▾

   Answer: C. Functional support with early exercise

   Functional treatment, with a brace or tape and early progressive exercise, gives faster return to sport than immobilisation. Surgery is not first-line for acute lateral ankle sprains.

7. Question 7Sports Cardiology and Pre-participation Screeninghard

   A rower has a septal wall thickness of 14 mm, an LV cavity of 58 mm and normal diastolic function. After 3 months of detraining, wall thickness falls to 12 mm. What is the most likely diagnosis?

   1. AHypertrophic cardiomyopathy
   2. BCardiac amyloidosis
   3. CHypertensive heart disease
   4. DAthlete's heart
   Show answer and explanation▾

   Answer: D. Athlete's heart

   An enlarged LV cavity, normal diastolic function and regression of hypertrophy with detraining favour physiological athlete's heart. HCM typically has a small cavity, impaired relaxation and no regression on detraining.

8. Question 8Upper Limb and Spine Injurieseasy

   A tennis player has lateral elbow pain worse on gripping and resisted wrist extension. Which tendon origin is most commonly involved?

   1. AFlexor carpi radialis longus
   2. BDistal biceps brachii
   3. CExtensor carpi radialis brevis
   4. DCommon flexor-pronator
   Show answer and explanation▾

   Answer: C. Extensor carpi radialis brevis

   Lateral elbow tendinopathy mainly involves the origin of extensor carpi radialis brevis at the lateral epicondyle. Pronator teres and flexor carpi radialis arise medially and are involved in medial epicondylalgia.

9. Question 9Medical and Environmental Problems in Athletesmedium

   A footballer collapses at a summer training session with a rectal temperature of 41 C and confusion. Medical staff are on site. What is the best approach?

   1. ATransport immediately, then start cooling in hospital
   2. BGive paracetamol and observe in shade
   3. CCool only the head and neck with ice packs
   4. DCool first with cold-water immersion, then transport
   Show answer and explanation▾

   Answer: D. Cool first with cold-water immersion, then transport

   For exertional heat stroke with on-site staff and equipment, 'cool first, transport second' with cold-water immersion gives the best survival. Delaying cooling for transport increases organ damage.

10. Question 10Rehabilitation, Field Care and Professional Ethicsmedium

    A footballer has an acute calf muscle strain. According to the PEACE and LOVE approach, what should be avoided in the first days?

    1. AElevation of the limb
    2. BAnti-inflammatory medication
    3. CCompression bandaging
    4. DEducation about recovery
    Show answer and explanation▾

    Answer: B. Anti-inflammatory medication

    PEACE advises avoiding anti-inflammatory drugs early, because inflammation is part of tissue repair. Protection, elevation, compression and education are all part of the framework.

11. Question 11Rehabilitation, Field Care and Professional Ethicsmedium

    A runner with 4 months of mid-portion Achilles tendinopathy wants to avoid injections. Which programme has the strongest evidence?

    1. AProgressive (eccentric) tendon loading
    2. BComplete rest in a walking boot
    3. CRepeated corticosteroid injections
    4. DNight splint without any exercise
    Show answer and explanation▾

    Answer: A. Progressive (eccentric) tendon loading

    Progressive loading programmes such as Alfredson eccentric training are the first-line treatment for mid-portion Achilles tendinopathy. Corticosteroid injections near the Achilles risk rupture and are not recommended.

12. Question 12Sports Cardiology and Pre-participation Screeningmedium

    An asymptomatic 19-year-old footballer's screening ECG shows T-wave inversion over 1 mm in leads V5, V6, I and aVL. What is the most appropriate next step?

    1. AReassure: normal athletic adaptation
    2. BRepeat ECG in 12 months
    3. CExercise stress test only
    4. DEchocardiogram and cardiac MRI
    Show answer and explanation▾

    Answer: D. Echocardiogram and cardiac MRI

    Lateral T-wave inversion is abnormal under the international criteria and may be the first sign of cardiomyopathy, so it needs echocardiography and usually cardiac MRI. Anterior T-wave inversion in V1-V4 can be normal in black athletes, but lateral inversion is not.

13. Question 13Upper Limb and Spine Injuriesmedium

    A cyclist falls on an outstretched hand and has anatomical snuffbox tenderness. Initial scaphoid radiographs are normal. What is the most appropriate management?

    1. ADischarge without follow-up
    2. BImmobilise and arrange early MRI
    3. CMobilise freely and review if pain persists
    4. DRefer for immediate fixation
    Show answer and explanation▾

    Answer: B. Immobilise and arrange early MRI

    A clinically suspected scaphoid fracture with normal initial films should be immobilised, and MRI is the preferred early test because occult fractures are common. Missing them risks nonunion and avascular necrosis.

14. Question 14Upper Limb and Spine Injuriesmedium

    A 15-year-old fast bowler has low back pain worse on extension and on standing on one leg while arching backwards. What is the most likely diagnosis?

    1. ALumbar intervertebral disc prolapse at L4-5
    2. BSpondylolysis of the pars interarticularis
    3. CSacroiliac joint dysfunction
    4. DEarly ankylosing spondylitis
    Show answer and explanation▾

    Answer: B. Spondylolysis of the pars interarticularis

    Extension-related back pain in adolescents doing repeated hyperextension, such as fast bowling or gymnastics, suggests a pars interarticularis stress injury, usually at L5. Disc prolapse more often causes flexion-related pain and radicular symptoms.

15. Question 15Upper Limb and Spine Injuriesmedium

    A goalkeeper cannot actively extend the distal interphalangeal joint of his finger after a ball strike. Radiographs show no fracture. What is the correct treatment?

    1. AContinuous DIP extension splint for 6-8 weeks
    2. BBuddy strapping with early active movement
    3. CSplint the PIP joint in flexion
    4. DOpen surgical tendon repair within 48 hours
    Show answer and explanation▾

    Answer: A. Continuous DIP extension splint for 6-8 weeks

    A closed tendinous mallet finger is treated with a splint holding the DIP joint in extension continuously for about 6-8 weeks; any flexion during this time restarts the healing period. Buddy strapping does not hold the joint extended.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.