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1
Q

Medical cert with FMCSA physical qualifications is required for commercial vehicle drivers in interstate commerce for the following four possible criteria?

A
  1. Combined gross vehicle weight or weight rating of 10,001 lbs or more
  2. 9-15 passengers including drive for compensation
  3. 16 or more passengers including the drive for compensation or not
  4. Hazardous material transport using placard under hazardous material regulation
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2
Q

Psych conditions to DQ on exam?

A

Active psychosis, negative symptoms prominent, and adverse medication side effects

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3
Q

1st gen antidepressant?

A

Do not certify (MAOIs/TCAs) unless exceptional circumstance

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4
Q

MDD and Bipolar ?

A

6 month symptom free after non-psych MDD

1 year symptom free after severe depression, suicide attempt, and manic episode

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5
Q

Hypnotic use?

A

Lowest effective dose for 2 weeks

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6
Q

Anxiolytics?

A

Must be stable and well controlled

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7
Q

Non-discretionary medical standards?

A

Seizures, vision, and hearing

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8
Q

Vision requirements?

A

20/40 in EACH eye w/wo correction, 70 degrees horizontal meridian in each eye, and red/green/amber (basic color vision)

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9
Q

If corrective lenses required to pass test?

A

Must be used while driving

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10
Q

Monocular vision? One eye does not meet 20/40 w/wo correction

A

DQ, consider vision exemption program

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11
Q

Telescopic lens?

A

DQ

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12
Q

ITDM ?

A

No exemption program any more, need to consult with treating provider, though

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13
Q

Vision exemption requirements?

A

Driving records, optho/opto within past 3 months

Exemption for 2 years with annual exam

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14
Q

Hearing standard?

A

Only required in one ear. 1) forced whisper at no less than 5 feet, only one ear to pass 2) Fail the forced whisper, audiogram with 500, 1000, and 2000 hz avg. Better ear must average less than 40db for the above freq

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15
Q

Menieres Dz?

A

DQ

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16
Q

Vertigo

A
  • DQ if uncontrolled
  • 2 month symptom free with dx of BPV and acute/chronic peripheral vestibulopathy
  • DQ for labyrinthe fistula or non-functioning
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17
Q

Concern with diabetes and meds?

A

Hypoglycemia, insulin and incretin mimetics are higher risk. Symptoms past 12 months, may need to f/u with PCM

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18
Q

Diabetes certification period?

A

Max 2 years, can do 1. Provider preference.

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19
Q

ITDM certify?

A

Annual, MCSA-5876 within 45 days by treating provider. There is no exemption program, use the treating provider form mentioned.

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20
Q

Severe retinopathy?

A

DQ

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21
Q

Exenatide (byetta)?

A

Incretin mimetic, increased hypoglycemia with sulfonylurea. 1 year cert guidance

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22
Q

NIDDM?

A

Generally 1 year, but not required

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23
Q

A1C that’s acceptable?

A

There is no specific A1C

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24
Q

Stage 1 HTN?

A

140-159/90-99 mm Hg
1 year cert, annual < or = 140/90
<160/90 but not at goal, extend for 3 mo x 1

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25
Q

Stage 2 HTN?

A

160-179/100-109
1 x 3 mo
annually if < or = 140/90

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26
Q

Stage 3 HTN?

A

> or = 180/110
Don’t certify until < or = 140/90
Only 6 month certification in the future

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27
Q

Pacemaker?

A

Can certify after appropriate waiting period

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28
Q

ICD?

A

DQ even if inactivated

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29
Q

Anticoagulant tx for cardiac condition?

A

1 month to stabilize, max cert 1 year. INR and then monthly INR afterwards

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30
Q

EF for heart condition?

A

> or = 40%

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31
Q

Pulmonary HTN

A

DQ

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32
Q

Cardiac parameters after MI etc, testing?

A

ETT > 6 mets, HR >= 85%, rise in systolic >= 20 w/o angina, no st depression

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33
Q

CHD

A

Needs to be well controlled and may get more info

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34
Q

AAA ?

A

< 4.0 cm and asymptomatic, 1 year cert
4-5 cm asymptomatic and vascular surgeon, annual cert afterwards
5 cm or greater, symptomatic. DQ, wait 3 month after surgery and then annual cert

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35
Q

thoracic aneurysm

A

< 3.5 cm can clear

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36
Q

DVT?

A

If symptomatic, DQ

Coumadin regulated for 1 month and then consider annual certification

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37
Q

Post MI?

A

Wait 2 months. Cardiac tests to ensure good functional status, clearance. May cert for 1 year.

38
Q

Angina?

A

3 months of no resting angina, aka unstable. Then 1 year cert

39
Q

PCI?

A

1 week wait period. Initial for 6 months, cert. Then ETT 3-6 months post-PCI (make sure no re-occlusion)

40
Q

CABG ?

A

3 month wait afterwards, cert for 1 year after wait period. Card clearance and healed sternum. 5 years post CABG, consider annual ETT.

41
Q

For most murmur heart?

A

Mild - echo q5 yr
Mod - echo q1-2 yr
Severe - DQ, 3 month wait post surgery

42
Q

Valve replacement?

A

3 month wait post surgery. Cards clearance. Echo post DC

Mechanical - EF >=40%, monthly INR

43
Q

MV (stenosis) balloon procedure?

A

wait 4 weeks post procedure

44
Q

MVP ?

A

Consider cert 1 year

45
Q

Hypertrophic/restrictive cardiomyopathy?

46
Q

Idiopathic, dilated cardiomyopathy, and CHF ?

A

Asymp, Vent A, LVEF <= 50%

Asymp, no Vent Arrhythmias < 40%

47
Q

Afib?

A

1 month anticoag reg if needed

48
Q

A flutter?

A

1 month post ablation wait

49
Q

Pacemaker wait times?

A

1 month wait SA/AV block

3 month wait neurocardiogenic and hypersensitive carotid sinus

50
Q

ICD ?

51
Q

heart transplant?

A

1 year wait afterwards. q6 mo recert with cards eval afterwards

52
Q

DQ resp conditions?

A

hypoxia at rest, cough syncope, unstable

53
Q

antihistamines?

A

1st gen sedation
2nd gen - less sedating
abstain 12 hours prior to driving

54
Q

Asthma and COPD?

A

must be controlled, FEV1 > 65%, PaO2 > 65 mm Hg

55
Q

pneumothorax?

A

No cert if 2 or more spontaneous on same side with no surgical correction

56
Q

o2 while driving?

A

Most of the time DQ

57
Q

narcolepsy?

58
Q

grip strength test?

A

There is no specific test

59
Q

SPE ?

A

Fixed deficit of foot, leg, hand, or arm. Not something progressive like MS. Renew q 2 yrs

60
Q

MSK conditions that are rare to DQ

A

Myotonia, Isaac’s, Stiff-Man

61
Q

MS?

A

consider if specialist eval and well controlled. Eval motor and vision. Cognition and mood eval

62
Q

Dialysis?

63
Q

CKD stages?

A

Stage 1 or 2, q 2yrs
Stage 3, annual
Stage 4, q 6 months
Stage 5, Dialysis then DQ

64
Q

Epilepsy?

A

DQ also if taking antiseizure meds for seizures

65
Q

Non-epileptic seizure or LOC of unknown cause?

A

6 month wait period of meds, neuro eval

66
Q

Intracerebral or subarachnoid hemorrhage?

A

w/o risk for seizures, wait 1 year off meds monitored

w/ risk for seizures, 5 years seizure free off meds monitored

67
Q

childhood febrile seizures?

A

If well controlled and resolved after childhood

68
Q

Epilepsy wait period to drive ?

A

10 yrs off antiseizure meds monitored and seizure free

DQ if still taking meds for seizures

69
Q

Single unprovoked seizure?

A

5 years off antiseizure med and seizure free

70
Q

Mild TBI?

A

< 30 min, no dural penetration

2 year cert

71
Q

Moderate TBI?

A

> 30 min -24 hrs, LOC, no dural penetration
2 year wait (5 year if early seizures)
cert 1 year

72
Q

Severe TBI?

A

> 24 hours, LOC, any dural penetration

DQ

73
Q

Seizure exemption program?

A

epilepsy: 8 yr seizure free (off meds and stable past 2 years)
single unprovoked? 4 yr seizure free (off meds and stable past 2 years)

74
Q

HA?

A

Incapacitating then DQ

75
Q

BPV and acute/chronic vestibulopathy?

A

2 months asymptomatic, then cert 2 years

76
Q

Aseptic meningitis?

A

No seizure risk

77
Q

Bacterial/viral meningitis w/o early seizures?

A

1 yr seizure free and off meds

78
Q

Bacterial meningitis with early seizures?

A

5 yr seizure free and off meds

79
Q

Viral meningitis with early seizures?

A

10 yr seizure free and off meds

80
Q

CNS tumors ?

A

DQ malignant or benign

81
Q

CNS tumor removal?

A

1 year wait, benign tumor removal and no seizures in meantime
2 year wait for supratentorial tumor and spinal , seizure free during period

82
Q

Dementia?

83
Q

Stroke?

A

cerebellum/brainstem - 1 year wait
cortical/subcortical - 5 year wait
On oral anticoagulants or meds that depress nervous system, don’t cert

84
Q

TIA ?

A

1 year wait

85
Q

Paraplegic ?

86
Q

Parkinson Dz?

A

If mild may consider cert with neuro consults

87
Q

Psych condition to DQ ?

A

Schizophrenia and active psychosis

88
Q

Methadone use?

89
Q

ECT tx?

A

6 month wait period afterwards

90
Q

Meds that DQ a driver?

A

From FMCSA webpage:
A driver cannot take a controlled substance or prescription medication without a prescription from a licensed practitioner.
If a driver uses a drug identified in 21 CFR 1308.11 (391.42(b)(12)) or any other substance such as amphetamine, a narcotic, or any other habit forming drug, The driver is medically unqualified.
There is an exception: the prescribing doctor can write that the driver is safe to be a commercial driver while taking the medication. In this case, the Medical Examiner may, but does not have to certify the driver.
Any anti-seizure medication used for the prevention of seizures is disqualifying.
The Medical Examiner has 2 ways to determine if any medication a driver uses will adversely affect safe operation of a CMV:
1. Review each medication - prescription, non-prescription and supplement
2. Request a letter from the prescribing doctor

DOT Exam (1 decks)

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