DHA Sports Medicine exam questions

6 worked Sports Medicine practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Anti-Doping, Pharmacology and Sports Nutrition

   An asthmatic swimmer uses inhaled salbutamol 200 micrograms before some training sessions and competitions. Under the current WADA Prohibited List, what applies?

   1. AProhibited at all times unless a TUE is granted
   2. BProhibited in competition only, at any dose
   3. CPermitted without TUE within inhaled dose limits
   4. DPermitted only as an oral tablet
   Show answer and explanation

   Correct answer: C. Permitted without TUE within inhaled dose limits

   Inhaled salbutamol is permitted without a therapeutic use exemption up to 1600 micrograms over 24 hours, with no more than 600 micrograms in any 8 hours. Oral salbutamol is prohibited, so the oral option is wrong.

   Reference: WADA Prohibited List (S3 Beta-2 Agonists)

2. Question 2 · Lower Limb Sports Injuries

   A footballer inverts his ankle. He can walk four steps and has tenderness only over the anterior talofibular ligament. Under the Ottawa ankle rules, what is appropriate?

   1. ANo ankle radiograph is needed
   2. BAnkle radiographs are required
   3. CUrgent MRI of the ankle
   4. DCT of the ankle and foot
   Show answer and explanation

   Correct answer: A. No ankle radiograph is needed

   Ottawa rules require radiographs only for bone tenderness at the posterior edge or tip of either malleolus, or inability to bear weight for four steps. Soft-tissue tenderness over the ATFL with preserved weight bearing does not meet these criteria.

   Reference: Stiell IG, et al. Ottawa Ankle Rules, JAMA 1993

3. Question 3 · Lower Limb Sports Injuries

   A basketball player felt a pop in the knee on landing, with rapid swelling. Which examination test is most sensitive for an ACL tear?

   1. AMcMurray test
   2. BValgus stress test
   3. CLachman test
   4. DPatellar apprehension test
   Show answer and explanation

   Correct answer: C. Lachman test

   The Lachman test, done at 20-30 degrees of flexion, is the most sensitive clinical test for ACL rupture. McMurray assesses the menisci, and the valgus stress test assesses the MCL.

   Reference: Brukner and Khan's Clinical Sports Medicine, 5th ed.

4. Question 4 · Lower Limb Sports Injuries

   A volleyball player has focal mid-shaft anterior tibial pain. A lateral radiograph shows a horizontal lucent line in the anterior cortex. Why is this injury important?

   1. AIt is high risk for delayed union
   2. BIt is low risk and heals with rest
   3. CIt indicates medial tibial stress syndrome
   4. DIt indicates chronic compartment syndrome
   Show answer and explanation

   Correct answer: A. It is high risk for delayed union

   The anterior tibial cortex is on the tension side with poor blood supply, so this 'dreaded black line' is a high-risk stress fracture prone to delayed union and complete fracture. Medial tibial stress syndrome causes diffuse posteromedial pain without a cortical line.

   Reference: Warden SJ, et al. High-risk stress fractures, Curr Sports Med Rep 2014; Brukner and Khan's Clinical Sports Medicine, 5th ed.

5. Question 5 · Lower Limb Sports Injuries

   A female distance runner has groin pain on running. MRI shows a stress fracture line on the superolateral (tension) side of the femoral neck. What is the best management?

   1. ACrutches and return in 2 weeks
   2. BContinue running at lower mileage
   3. CUrgent orthopaedic internal fixation
   4. DBisphosphonate infusion alone
   Show answer and explanation

   Correct answer: C. Urgent orthopaedic internal fixation

   Tension-side femoral neck stress fractures are at high risk of displacement and avascular necrosis, so they usually need internal fixation. Protected weight bearing is reserved for small compression-side (inferomedial) fractures.

   Reference: Brukner and Khan's Clinical Sports Medicine, 5th ed.

6. Question 6 · Medical and Environmental Problems in Athletes

   A slow marathon finisher who drank at every station becomes confused and vomits. Serum sodium is 126 mmol/L. What is the most appropriate initial treatment?

   1. A100 mL bolus of 3% saline
   2. B1 litre of 0.9% saline rapidly
   3. COral water to replace sweat loss
   4. DFluid restriction and observation
   Show answer and explanation

   Correct answer: A. 100 mL bolus of 3% saline

   Symptomatic exercise-associated hyponatraemia with encephalopathy is treated with a 100 mL bolus of 3% saline, repeated up to twice if needed. Isotonic or hypotonic fluids can worsen hyponatraemia in a fluid-overloaded athlete.

   Reference: Wilderness Medical Society Guidelines for Exercise-Associated Hyponatremia 2020