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DOT Study > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

49 CFR 391.41 b 4

A

Cardiovascular physical qualifications

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2
Q

49 CFR 391.43 f

A

Cardiovascular medical examination

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3
Q

Minimally invasive cardiovascular procedures

A

Coronary steering

Arrhythmia ablation procedures

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4
Q

True or false: implantable defibrillators are disqualifying

A

True

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5
Q

True or false: OTC supplements may interfere with prescription medications and cause CV symptoms

A

True

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6
Q

Causes of ephedra

A

Tachycardia

Hypertension

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7
Q

Garlic, ginkgo, goldenseal can interact with the blood thinners causing?

A

Excessive bleeding

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8
Q

Licorice can cause

A

HTN

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9
Q

Additional tests for cardiovascular disease

A 
Electrocardiographs
Stress tests
Ejection fractions
Vascular studies
Labs
X-rays
Drug levels
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10
Q

Maximum certification for cardiovascular diseases

A

1 year

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11
Q

New York heart association (NYHA) classification

A

4 categories I-Iv

Iv more severe - limitations in physical activity/ decreased overall health

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12
Q

What test can be required for monthly monitoring

A

INR for anticoagulant

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13
Q

Non modifiable CVD risk factors

A

Age 45 high risk 60 higher risk

Makes high risk, post menopausal women high risk

Family hx- premature cvd 1degree relative- males less than 55, less than 65

Race - African highest risk

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14
Q

Modifiable CVD risk factors

A 
HTN
smoking
Cholesterol
High triglycerides 
Obesity
Sed. Lifestyle 
Diabetes
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15
Q

CHD risk equivalent conditions include

A

Diabetes

PVD

Framingham risk predicting 20% over next 10 years
Age over 45 yoa w/multiple risk factors

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16
Q

Qualifications to certify CHD

A

Asymptomatic
No ischemic changes on ecg
No incapacity
No exercise tolerance test abnormalities

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17
Q

Waiting period/certification for CHD

A

Waiting: none no certification until stable

Max. Cert. 1 yr

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18
Q

Exercise tolerance test

A

Exercise to a workload if >6 Mets through Bruce stage ii.

Heart rate >85% of predicted maximum (unless on beta blockers)

Rise in SBP >20 without angina

No ST depression or elevation and no marked t-wave abnormalities

No ventricle dysthymia’s

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19
Q

No certification for MI if:

A

recurrent angina

Post MI ejection fraction <40%

Abnormal ETT

Evidence of ischemia, arrhythmia

Ischemic changes at rest on ECG

Unable to tolerate current meds

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20
Q

Can certify MI when:

A 
2 months post MI
Cleared by cardiology
Passed ETT
no angina
EF >40%
Tolerating Current meds
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21
Q

Ejection fraction less than 40%

A

Disqualifying

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22
Q

Annual certification requirements for MI

A

ETT every 2 years

Cardiology examination

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23
Q

Percutaneous coronary intervention certification qualifications

A 
1 week post procedure 
Cardiology approval
Tolerating meds
Neg ETT 3-6 months after 
No rest angina
No ischemic changes on ecg
No incomplete healing or complications
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24
Q

Percutaneous coronary intervention waiting/ max cert

A

Waiting period 1 week

Max cert 1 year

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25
Requirements for Percutaneous coronary intervention ETT
ETT 3-6 months after PCI | Every 2 years after
26
Certification qualifications coronary artery bypass graft surgery
3 months waiting ``` Left ventricle ejection fraction greater or equal to 40% after CABG Cardio okay Asymptomatic Tolerance to meds ETT 5 years after ```
27
CABG waiting period/max. Cert.
Waiting 3 months | Max 1 year
28
Heart transplant requirements
Asymptomatic Tolerates meds Clearance from cardio No signs of transplant rejection
29
Heart transplant waiting/certification
Waiting 1 year | Max. Cert 6 months
30
Angina pectoris unstable
Certification not recommended
31
Angina pectoris stable
Can certify
32
Angina pectoris waiting/max. Cert
Waiting 3 months no rest angina, change in angina pattern Max. Cert. 1 year
33
Angina pectoris certification qualifications
Stable angina Asymptomatic Tolerates meds SBP not <95 no orthostatic drop >20 with standing Passed ETT
34
Consideration with angina medications
Can potentially cause hypotension/orthostatic
35
Angina pectoris monitoring requirements
Biennial ETT | Cardio clearance
36
Can not certify which heart conditions
Hypertrophic cardiomyopathy Restrictive cardiomyopathy
37
Certification for CFH related to dilated cardiomyopathy
Asymptomatic Tolerates meds No ventricle arrhythmias
38
CHF requirements for certification
LVEF greater than or equal to 40% | Cardiology eval with ekg and holter monitoring
39
Syncope certification requirements
Has been treated for symptomatic disease Asymptomatic Tolerates meds Low risk falls/syncope Cardio/neurologist clearance
40
Max cert for syncope
1 year | No waiting period recommendations
41
Neurcardiogenic syncope qualifications to certify
Documented correct functioning pacemaker Asymptomatic
42
Neurocardiogenic syncope requirements for certification
Annual exam Pacemaker checks Asymptomatic
43
Neurocardiogenic syncope waiting/max. Cert
Waiting 3 months after pacemaker implantation Max cert. 1 year
44
Hypertensive carotid sinus with syncope
Documented pacemaker functioning | Asymmetrical
45
Hypertensive carotid sinus with syncope waiting/max cert
Waiting 3 months after pacemaker 1 year max cert
46
Hypersensitive carotid sinus with syncope annual requirements
Annual exam Pacemaker checks Asymptomatic
47
Line atrial fibrillation
Max cert 1 year | Annual exam
48
Atrial fibrillation as cause of or risk for stroke
Anticoagulation adequate x1 month INR monitored monthly Rate Rhythm controlled Cardio approved
49
Atrial fibrillation with stroke risk max cert
1 year
50
Atrial fibrillation after thoracic surgery
Anticoagulant 1 month INR monitored monthly Rate Rhythm controlled Cardio ok
51
Atrial fibrillation after thoracic surgery max cert.
1 year
52
Atrial flutter
``` Asymptomatic Isthmus ablation performed Arrhythmia treated Cleared by electrophysiologies street Rate Rhythm controlled ```
53
Atrial flutter waiting/max cert
Wait after isthmus ablation 1 month 1 year cert
54
Underlying diagnosis coronary heart disease
No VT LVEF >40% Asymptomatic Cleared cardio
55
Coronary heart disease waiting/ max. Cert/ requirements
Wait: 1 month after drug therapy Max. Cert. 1 month Annual- cardiology exam
56
Ventricular tachycardia
No sustained VT No hx of no sustained VT with LVEF <40% No syncope/near
57
V tach certification frequency
1 yr with cardiology examination
58
Do not certify cardiology conditions
Hypertrophic cardiomyopathy Long Qt interval syndrome Brigades syndrome
59
Sinus node dysfunction and Av block
One month after pacemaker implant Correct function documented Underlying dz not disqualifying
60
Sinus node dysfunction and av block waiting/max. Cert and annual requirements
Waiting 1 month after pacemaker Max cert. 1 year Annual exam. Pacemaker checks
61
Implantable defibrillators
Disqualifying
62
Aneurysm <4.0cm
Asymptomatic 3 months after surgical repair Cleared by cardio 1 year certification
63
Aneurysm > 4 but less than <5
Asymptomatic Cleared by cardio 3 months after surgical repair Max cert 1 year
64
Don’t certify aneurysm
>5cm Increased in size o.5 during 6 months Surgical repair recommended with no compliance Symptomatic
65
Thoracic aneurysm
<3.5 3 months after surgical repair Cleared by cardio 1 year max cert
66
Aneurysm / visceral and peripheral artery and venous vessels
3 months after surgical repair Cleared by cardio 1 year max
67
Peripheral vascular disease
No other cardiovascular consitions
68
Don’t certify peripheral vascular disease if
Symptomatic Pain at rest 3 months after revascularization
69
DVT
Increased risk for developing long hours of sitting Can be source for PE Adequate treatment decreases recurrence by 80%
70
Certify DVT requirements
No residual/acute DVT Etiology confirmed and treated 1 year cert Monitoring guidelines with anticoagulant
71
True or false: you should certify a driver who has an underlying neurological condition and taking an anticoagulant with risk of bleeding?
False
72
Superficial phlebitis and or varicose veins
Etiology confirmed with treatment No DVT 2 year certification
73
Mild Aortic stenosis
Echo every 5 years
74
Moderate aortic stenosis
Asymptomatic | Echocardiogram 1-2 years
75
Severe aortic stenosis
Surgically repaired Waiting period met Cleared by cardiology 2d echocardiogram prior to discharge
76
After a heart transplant the minimum waiting period is ______ and the max certification period is ______
One year - 6 months
77
For mild aortic stenosis an electrocardiography should be repeated every _____ years. For moderate aortic stenosis an echocardiogram should be repeated every _____
Five 1-2
78
A driver underwent surgical repair of a 6cm abdominal aortic aneurysm 3 months ago. The driver may be certified for ?
1 year
79
A driver with congestive heart failure recently had an echocardiogram demonstrating an ejection fraction of 44%. The driver may be certified for __— if the driver meets all other qualifications for chf
One year
80
What are common symptoms of chf
Swelling in the legs, ankles or other body parts
81
Guidelines for supraventricular tachycardia include. 1. Certification should be granted only after adequate anticoagulation is demonstrated for 3 months. 2. Certification for atrial flutter may be considered if the driver is one month following ismuths ablation.
2 only
82
The waiting period for hypertrophic cardiomyopathy is
There is no waiting period. This is disqualifying
83
Recommendations for ETT for drivers with coronary heart disease are?
3-6 months after Percutaneous coronary intervention Every 2 years after

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