AT BOC Prep Domain II - Examination, Assessment and
Diagnosis Questions With Complete Solutions
. A baseball coach who is 6 weeks status post rotator cuff repair
is rehabilitating in your athletic training room. You assess the
range of motion of the coach ' s glenohumeral joint. What is the
normal range of motion for shoulder flexion without scapular
elevation?
A. 0°-120°
B. 0°-180°
C. 0°-90°
D. 0°-135°
E. 0°-160° Correct Answer A: The glenohumeral joint allows
for 120° of forward fl exion without scapular elevation. When
the scapula is permitted to elevate, the normal range of
glenohumeral fl exion increases to 180°.
. A patient you are seeing in your clinic has consistently
complained of fatigue, chronic pain, and stiffness in various
joints for the past 2 to 3 months. She notes pain to palpation of
several joints, and some warmth and joint effusion are present as
well. The patient has been doing her own research online and
tells you that she is pretty confident that she has fibromyalgia.
How would you respond?
A. Encourage the patient to begin taking a magnesium and folic
acid supplement to minimize the effects of the condition.
B. Suggest that the patient see a psychiatrist for possible
antidepressant therapy.
C. Encourage the patient to share her concerns with her
physician, but remind her that active evidence of joint
,inflammation such as heat and effusion is not present in patients
with fibromyalgia.
D. Suggest that the patient see her physician and ask to be
screened for Lyme disease. Correct Answer C: Fibromyalgia is
characterized by a minimum 3-month history of fatigue, pain,
and stiffness. The pain must be present to palpation at 11 of 18
identifi ed sites and must occur bilaterally above and below the
waist without evidence of active joint infl ammation
. As a high school athletic trainer, you receive a phone call from
a local physician ' s office requesting copies of your
preparticipation physical and evaluation notes from a 16-year-
old football player ' s recent knee injury. How should you best
respond to this request?
A. A release of records must be signed by the athlete, and then
they can be faxed to the requesting physician.
B. The requested records may be faxed or mailed to the
requesting physician ' s office.
C. The athlete ' s mother may call and request the records be
sent, and then the records can be faxed to the requesting
physician
D. The coach requests the records be sent on behalf of the
athlete, and then the records can be faxed to the requesting
physician.
E. The athlete and a parent may come by the athletic training
clinic and pick up copies of his records to take to the physician.
Correct Answer E: Because the athlete is under age, a parent or
legal guardian must be present to request medical
documentation. This complies with Health Insurance Portability
and Accountability Act (HIPAA) regulations
,. You are evaluating a patient who complains of a "squeaky"
sensation along the back of the lower leg into the foot. A
palpable nodule can be felt along the distal tendon. Plantar
flexion is painful and weak, and passive dorsiflexion is limited
by pain at the end range. Which of the following is the most
appropriate differential diagnosis for this patient?
A. Heel spur, calcaneal stress fracture, fat pad syndrome, plantar
fasciitis
B. Os peroneum syndrome, lateral ankle, syndesmotic ankle
sprain
C. Osteochondritis dissecans, medial tibial stress syndrome,
deep vein thrombosis
D. Subcutaneous calcaneal bursitis, insertional Achilles
tendonitis, Sever ' s disease Correct Answer D: Each of the
conditions listed is consistent with Achilles tendinopathies,
which must be screened to determine the specifi c injury.
A 12-year-old basketball camper reports anterior knee pain
focused at the inferior insertion of the patellar tendon. What
apophyseal injury should you suspect?
A. Sever ' s disease
B. Osgood-Schlatter disease
C. Salter-Harris II fracture
D. Larsen-Johansson disease
E. Legg-Calvé-Perthes disease Correct Answer B: Osgood-
Schlatter disease is a common knee condition in adolescents.
This condition is an apophysitis characterized by pain at the
tibial tuberosity, the distal attachment of the patella tendon
A 13-year-old adolescent athlete presents for evaluation of pain,
stiffness, and swelling in multiple joints that have been present
, in varying degrees of intensity for more than 6 months without
any mechanism of injury. Joint stability tests are within normal
limits. Which of the following conditions would be in your
differential diagnosis?
A. Apophysitis
B. Raynaud disease
C. Juvenile idiopathic arthritis
D. Multiple sclerosis Correct Answer C: Juvenile idiopathic
arthritis (JIA) should be included in the differential diagnosis
any time a child younger than 16 years of age presents with
unexplained joint pain for which other diagnoses have been
excluded
A 14-year-old skateboarder falls while performing a trick and
externally rotates his foot. The anterior tibiofibular ligament is
intact, but you suspect he may have sustained a fracture. Which
fracture is most likely based on this information?
A. Salter-Harris V fracture of the distal tibia
B. Talar dome fracture
C. Tillaux ' s fracture
D. Fibular avulsion fracture
E. Jones' fracture Correct Answer C: Tillaux ' s fracture is a
type III Salter-Harris fracture, typically caused by abduction and
external rotation of the foot. This mechanism is also typical for
an anterior tibiofi bular ligament tear. When the anterior tibiofi
bular ligament does not tear, this typically results in an avulsion
fracture of the anterior tibial tubercle.
A 17-year-old female volleyball player reports experiencing a
forceful inversion and plantar flexion of her right ankle when
she landed on her teammate ' s foot following a block. After
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