MFSEM Written cheat sheet

Fick equation: VO2 = cardiac output × arteriovenous oxygen difference; VO2max is the maximal value attainable.

Energy system dominance: phosphagen 0–10 s; anaerobic glycolysis ~10 s–2 min; oxidative >2 min; most sports use mixed contributions.

ACSM intensity: moderate = 40–59% heart rate reserve or 64–76% HRmax; vigorous = 60–89% HRR or 77–95% HRmax.

HRmax estimate = 220 − age, with standard deviation about 10–12 bpm; measured values are preferred when available.

Training principles: overload, specificity, reversibility, individuality, and periodization determine adaptation.

Eccentric contractions generate higher force and more muscle damage/delayed-onset soreness than concentric actions at the same load.

Body mass loss >2% from sweating impairs aerobic performance and thermoregulation; sweat rates commonly range 0.5–2.0 L/h.

Altitude acclimatization takes about 2–3 weeks; initial responses include plasma volume reduction and later erythropoiesis.

Prolonged static stretching immediately before power activities can reduce force output; warm-up raises muscle temperature and may improve performance.

Ottawa ankle rules: radiograph if malleolar pain plus bone tenderness at posterior edge/tip of lateral malleolus or medial malleolus, or inability to bear weight four steps.

Ottawa knee rules: radiograph if age ≥55, isolated patellar tenderness, fibular head tenderness, inability to flex to 90°, or inability to bear weight four steps.

ACL examination: Lachman test is most sensitive; pivot shift is most specific.

Achilles tendon rupture: Thompson test is positive when calf squeeze fails to produce plantarflexion.

Anterior shoulder dislocation: assess axillary nerve function and obtain post-reduction imaging; recurrent instability risk is higher in young athletes.

Acute compartment syndrome: pain out of proportion, tense compartment, and pain with passive stretch; emergency fasciotomy is required.

Concussion: use SCAT6; no same-day return to play; graduated six-step return with at least 24 hours per step.

Bone stress injury: MRI is more sensitive than radiograph; address training load and low energy availability.

Rehabilitation principle: progressive loading and early mobilization generally improve soft tissue outcomes compared with prolonged immobilization.

Cardiovascular screening: exertional syncope, chest pain, unexplained dyspnea, murmur, and family history of sudden death before age 50 warrant evaluation.

Hypertrophic cardiomyopathy: unexplained LV hypertrophy, often septal thickness ≥15 mm; associated with exertional syncope and sudden cardiac death.

Exercise-induced bronchoconstriction: diagnosis supported by ≥10% fall in FEV1 after exercise challenge; warm-up and inhaled beta-2 agonist before exercise are effective.

Diabetes: exercise increases insulin sensitivity and hypoglycemia risk; check glucose before, during, and after; treat hypoglycemia with 15–30 g fast carbohydrate.

Exertional hyponatremia: serum sodium <135 mmol/L, often from excessive hypotonic fluid intake; symptoms include nausea, headache, confusion, and seizures; severe cases need hypertonic saline.

Sickle cell trait: intense exercise can trigger sickling, rhabdomyolysis, and collapse; hydration and gradual acclimatization reduce risk.

Sudden cardiac arrest: start CPR at 100–120 compressions/min with depth 5–6 cm and apply AED as soon as available.

Myocarditis: avoid exercise for 3–6 months and reassess cardiac function before return to sport.

Marfan syndrome: aortic root dilation risk; avoid collision, high-static, and isometric exercise; monitor with echocardiography.

WADA always-prohibited classes include anabolic agents, peptide hormones, growth factors, beta-2 agonists, hormone antagonists, and masking agents.

In-competition prohibited classes include stimulants, narcotics, cannabinoids, and glucocorticoids; beta-blockers are prohibited in selected sports.

TUE criteria: athlete has a medical need, no reasonable alternative, no performance enhancement beyond restoring health, and no unacceptable health risk.

Inhaled salbutamol is permitted up to 1600 µg over 24 hours, not exceeding 600 µg per 8 hours; higher doses require a TUE.

Exertional heat stroke: core temperature >40°C with CNS dysfunction; cool first with ice-water immersion and transport after cooling begins.

Lightning 30-30 rule: seek shelter when flash-to-thunder time is ≤30 seconds; wait 30 minutes after last thunder before resuming activity.

Emergency action plan: written plan covering personnel, communication, equipment, access, transport, and AED availability; rehearse regularly.

Suspected concussion: no same-day return to play; serial evaluation and graduated return after symptom resolution.

Blood-borne pathogen exposure: wash immediately, report, and obtain post-exposure evaluation; hepatitis B vaccination reduces risk.