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Question 1: Which of the following receptors is involved in the constipating and respiratory depressant effects of opioids?

  1. Kappa

  2. Delta

  3. Mu-1

  4. Mu-2

  5. Mu-3

Reference: Fine PG, Portenoy RK. "Chapter 2: The Endogenous Opioid System". A Clinical Guide to Opioid Analgesia. McGraw Hill. 2004. P. 11. Erowele GI. Alvimopan (Entereg), a Peripherally Acting mu-Opioid Receptor Antagonist For Postoperative Ileus. Pharmacy and Therapeutics. 2008;33(10):574-583.

Question 2: A 6-year-old male presents for a pre-participation physical for T-ball. He has no significant medical history, and his family history is unremarkable. He is at the 50th percentile for height and weight. Vision is intact. There is no strabismus or amblyopia. Extraocular muscles and visual fields are intact. Lungs are clear. Cardiovascular exam is normal. Muscle tone is symmetric. He does not have evidence of inguinal hernia or testicular mass, and his testes are descended bilaterally. His gait is normal, and his strength and muscle tone are symmetric. His mother is concerned about his participation in sports and asks you many questions. Which of the following is true?

  1. Physical exam is more sensitive than personal and family history of a candidate at pre-participation physical.

  2. Family history of musculoskeletal disease is the most critical determinant of future morbidity or mortality.

  3. Pre-participation physical is highly effective in determining risk of sudden death in athletes.

  4. Children should be screened routinely with 12-lead ECG to rule out long-QT syndrome.

  5. American College of Sports Medicine does not recommend routine exercise stress-testing in children starting a vigorous exercise program.

References: 1. 2.

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