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DOT > DOT > Flashcards

DOT Flashcards

1
Q

DOT regulates what types of vehicles/passengers?

A

Gross vehicles weight >10,0001 lbs
Transport 8 passengers for profit
Transport 15 passengers
Carries HAZMAT

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2
Q

Which dept. operates within the DOT and oversees the medical cert of drivers?

A

FMCSA

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3
Q

Hearing test(s) absolutely required

A

Whisper and audiogram

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4
Q

Vision test(s) absolutely required

A

Distant, peripheral, color

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5
Q

Urinalysis components

A

Specific gravity, protein, blood, glucose

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6
Q

If the driver requires an exemption when do they see the ME?

A

The driver must see ME first. If eligible to drive except for exemption, driver certified at least 6 months

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7
Q

Components of a satisfactory ETT (exercise tolerance test)

A

Capacity of 6 METS
Resting HR>85% predicted
Rise systolic BP >20mm Hg w/o angina
No significant ST depression or elevation

Driver should not experience orthostatic symptoms upon standing

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8
Q

Myocardial infarction (MI) waiting period

A

2 months post MI. Must have satisfactory ETT prior to recert

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9
Q

Angina pectoris reasons to DQ

A

Resting/unstable angina
Abnormal ETT
Ischemic changes on ECG
Medication intolerance

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10
Q

Percutaneous coronary intervention (PCI, stents, balloons) waiting period

A

1 week

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11
Q

Reasons to disqualify individuals with PCI (percutaneous coronary intervention)

A

Incomplete healing at access site
Resting angina
Ischemic changes on ECG

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12
Q

Monitoring after PCI

A

Wait 1 week
ETT 3-6 months post PCI
Then every 2 years
Certify for 1 year

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13
Q

Waiting period for CABG

A

3 months
Certify- 1 year

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14
Q

Post CABG requirements for certification

A

Complete 3 month period
LVEF >= 40%
Asymptomatic
Card clearance

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15
Q

Post CABG monitoring

A

ETT every 2 years for 5 years the annual

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16
Q

Stage 1 HTN

A

140-159/90-99

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17
Q

If driver has no history of hypertension and has blood pressure 140-156/90-99

A

No hx of HTN and no on trx certify for 1 year card

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18
Q

If driver’s BP is 140-159/90-99 with hx of HTN, on trx, or continues with stage 1 HTN after 1 year certificate how long do you certify?

A

One time 3 month certification

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19
Q

If patient returns after 3 month certification for stage 1 with BP > 140/90 how long to qualify?

A

Disqualify- must show BP control

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20
Q

Stage 2 HTN

A

160-179/100-109

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21
Q

Stage 2 HTN certification no hx of HTN or trx

A

3 months one time. At recheck must have BP <140/90 or disqualification until provides evidence of control

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22
Q

Stage 3 HTN

A

> =180/110

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23
Q

If driver presents with BP >180/110 how long to certify?

A

Disqualification until evidence of control < 190/90 the certify for 6 month. ME decides at recheck on case by case if longer recert is appropriate

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24
Q

General valvular hearts disease criteria

A

ECHO to determine severity
Symptoms
Pulmonary HTN (pressure >=50% systemic systolic BP)
ETT > 6 METS
Frequency and symptoms associated with arrhythmia

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25
Q

Hypertrophic cardiomyopathy

A

Disqualify, ECHO required for diagnosis

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26
Q

Restrictive cardiomyopathy

A

Disqualify

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27
Q

Cert requirements for Idiopathic dilated cardiomyopathy and CHF

A

Asymptomatic, no ventricular arrhythmia, LVEF 40% to 50%
Cert for 1 year- must have cardiology clearance, echocardiography and holster monitoring

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28
Q

CHF DQ

A

Symptomatic or
Ventricular arrhythmia with LVEF <50% or
LVEF <40%

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29
Q

AFib waiting period

A

1 month

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30
Q

AFib cert requirements

A

Tolerating meds with no SEs
Card clearance
RR controlled
No underlying disease

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31
Q

AFib monitoring

A

None unless on anticoagulant then required monthly INRs

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32
Q

Ventricular arrhythmia should be evaluated for what?

A

Underlying disease

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33
Q

Qualifying requirements for drivers with ventricular arrhythmias or coronary heart disease

A

Non sustained Vtach with LVEF>=40%
No symptoms
Card clearance
One month wait after successful drug therapy

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34
Q

Implantable cardiac defibrillator certification

A

Disqualify

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35
Q

Pacemaker monitoring

A

Documenting of pacemaker checks
DQ if no documentation of function

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36
Q

Neurocardiogenic syncope certification requirements

A

3 months after pacemaker implantation
Documented correct function by pacemaker center
Asymptomatic
Do not qualify if symptomatic

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37
Q

Congenital heart disease requirement

A

Annual should have evaluation by cardiologist knowledgeable in adult congenital heart disease

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38
Q

Congenital heart disease-post surgical waiting period

A

Should have testing to evaluate cardiac fxn and note rhythm disturbances

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39
Q

Pulmonary HTN certification

A

DQ

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40
Q

Definition of pulmonary HTN

A

Pulmonary artery mean -
25mm Hg at rest
30mm HG with exercise

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41
Q

AAA 4.0-5.0cm certification standards

A

recommend yearly US
Not certified if surgical repair recommended.

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42
Q

AAA <4.0 cm certification standards

A

1 year certification if asymptomatic

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43
Q

What size thoracic aneurysm is disqualifying?

A

> 3.5cm
Can certify if at least 3 months after surgical repair and cleared by cardiovascular specialist.

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44
Q

Peripheral vascular disease (lower extremity pain) certification

A

DQ

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45
Q

Waiting period after peripheral vascular surgery

A

3 months
No claudication
Annual certification

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46
Q

DVT certification standards

A

No waiting period
If anticoagulant therapy needs to meet monitoring guidelines
1 year certification

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47
Q

Intracerebral hemorrhage and subarachnoid hemorrhage requirements

A

If ruptured aneurysm or AVM not surgically repaired- medically disqualified

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48
Q

waiting period cerebellar or brain stem strokes

A

1 year

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49
Q

Stroke disqualifiers

A

Incomplete waiting period
Residual impairment interferes with driving
Anticoagulants
Seizure medications
Hx of Seizures

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50
Q

Motor neuron disease certification requirements

A

Permanent DQ

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51
Q

Malignant tumors of the CNS

A

Permanent DQ

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52
Q

Huntington’s disease

A

Permanent DQ

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53
Q

Which neurological conditions are likely to be disqualifying but possible certification depending on disease state and course?

A

MS
Peripheral neuropathies
Myopathies
Neuromuscular junction deficits
Benign brain tumors
Dyskinesias
Treatable dementias
Cerebellar ataxias

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54
Q

Symptom free waiting period for benign positional vertigo

A

2 months symptoms free

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55
Q

Benign positional vertigo

A

DQ

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56
Q

Meniere’s disease

A

DQ- very unpredictable

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57
Q

Acute and chronic peripheral vestibulopathy

A

Driver may be certified if symptom free for 2 months

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58
Q

Surgical repaired intracerebral hemorrhage and subarachnoid hemorrhage waiting period

A

1 year after event
Cleared by neurology
No recurrent symptoms
No CNS meds

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59
Q

Waiting period cerebellar or brain stem strokes

A

1 year

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60
Q

waiting period cortical/subcortical stroke

A

5 years

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61
Q

Dementia certification

A

Permanent DQ

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62
Q

Wilson’s disease

A

Permanent DQ

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63
Q

Labyrinthine Fistula

64
Q

Epilepsy

A

Permanently DQ

65
Q

Hx of epilepsy, seizure free and off meds for 10 years under doctor’s supervision

A

can be medically certified

66
Q

Single unprovoked seizure

A

Can be certified if seizure free and off anticonvulsant meds for at least 5 years

67
Q

Symptomatic seizure in presence of acute structural insult to CNS

A

Certify if seizure free for 2 years and off anti-seizure medication

68
Q

Driver is actively psychotic

69
Q

Amitriptyline use

A

DQ- drug is sedating- antidepressant and nerve pain SRI

70
Q

Methadone use

A

DQ- narcotic

71
Q

Opioids

A

Usually disqualifying
Exception:
Prescribed by PCP familiar with driver’s medical hx and has advised drug will not adversely affect machine operation

72
Q

Alcohol consumption waiting period before driving

73
Q

Schedule 1 drug use- Cocaine, marijuana, meth etc

74
Q

Marijuana

A

DQ even if legal in states

75
Q

Alcoholism waiting period

A

None
Certify if:
Normal exam
Clearance from HCP
Completed treatment program

76
Q

Fixed minimal defects that don’t interfere with ability to operate vehicle documentation

A

Document exact physical findings
Lack of interference with vehicle operation
Refer to SPE
Check box on long form and card
Certify for 2 years

77
Q

Fixed deficit examples

A

Missing arm, leg, foot, hand, thumb and index fingers on the same hand.
Marked limitation ROM major joints, neck or spine

78
Q

Suspicion of substance abuse

A

DQ and refer to appropriate psychologist, psychiatrist or SAP
Do not preform drug or alcohol test

79
Q

Drivers are responsible for what types of duties?

A

Pre and post trip safety checks
Making sure the vehicle is properly loaded
Securing the load
Driving

80
Q

Non fixed deficit

A

If they are not able to meet standards then DQ. No eligible for SPE

81
Q

Stage 1 and 2 CKD

A

Certify for 2 years

82
Q

Stage 3 CKD

A

Certify annually

83
Q

Stage 4 CKD

A

With normal BP and EKG - Certify for 6 months
Elevated BP, Stage 1 or 2- Certify for 3 months
Stage 3 HTN- DQ

84
Q

Hemodialysis and peroneal dialysis

85
Q

General appearance check

A

Marked overweight
Tremor
Signs of alcoholism or drug use

86
Q

Eyes check

A

PERRLA
Motility
Ocular muscle imbalance
EOM
Nystagmus
Exopthalmos

87
Q

Eyes- ask patient about

A

Retinopathy
Cataracts
Aphakia
Glaucoma
Macular degeneration

88
Q

Ears check

A

Scarring TM
Occlusion of external canal
Perforated eardrum

89
Q

Mouth and throat check

A

Irremediable deformities likely to interfere with breathing or swallowing

90
Q

Heart check

A

Murmurs
Extra sounds
Enlarged heart
Pacemaker
ICD

91
Q

Lungs and chest check

A

Abnormal wall expansion
Abnormal respiratory rate
Abnormal breath sounds
Dyspnea
Cyanosis
Abnormal findings may require further testing

92
Q

Abdome and viscera

A

Enlarged liver
Enlarged spleen
Masses
Bruits
Hernia
Significant abdominal muscle weakness

93
Q

Vascular check

A

Abnormal pulses
carotid or arterial bruits
varicose veins

94
Q

Gentiourinary check

95
Q

Pulmonary embolism waiting period

A

3 months after embolus

96
Q

PE documentation

A

Symptoms
Oxygen use
Medications
If on anticoagulants - INR and frequency

97
Q

DQ post PE

A

Hypoxemia at rest
Symptomatic
Insufficiently anti-coagulated
Severe abnormal lung function

98
Q

Visual acuity

A

Must have at least 20/40 in both eyes

99
Q

What id the driver can’t tell the difference between red, green, yellow?

A

DQ no exemptions

100
Q

Monocular vision

A

Obtain monocular vision exemption

101
Q

Telescopic lenses

A

DQ- not allowed

102
Q

Monocular vision

103
Q

Requirements for FMCSA vision exemption

A

Driving with visual deficit for at least 3 years
Excellent safe driving record
CMV driving as the primary vocation
Yearly full examination by ophthalmology/optometrist who attest vision in better eye meets the standard
Must have annual exam. Vision exemption good for 2 years

104
Q

Acceptable levels of glucose control

A

FBG: <200
2 hour postprandial <235
hgba1c <10%

105
Q

Insulin use

A

Requires exemption

106
Q

Hypoglycemic episodes DQ

A

Seizures
LOC
Assistance from another person
Impaired cognitive deficit without warning
2 or more hypoglycemic episodes in the last 5 years

107
Q

Loss of pedal or positional sensation

108
Q

DM and resting tachycardia

109
Q

DM and orthostatic HTN

110
Q

What level of FEV1 requires additional testing?

A

FEV1 <65% normal

111
Q

What are the next steps after an abnormal FEV1?

A

Pulse Ox (must be >92%)
ABG
Arterial PO2 <65 below 5,000 ft or 60mm above 500 feet
OR
PCO2 45 mm HG = DQ

112
Q

Temporary disqualification advised in patient with asthma who:

A

Status asthmaticus
Severe coughing spells
FEV1 <65%
pO2 <65mmHg
Frequent hospitalizations

113
Q

Cor Pulmonale

A

DQ until lung disease is resolved/successfully treated

114
Q

Pulmonary HTN

115
Q

What is the next step if driver has experienced excessive sleepiness driving

A

DQ and require sleep study/review compliance

116
Q

What is the next step if driver has experienced crash associated with falling asleep?

A

DQ and require sleep study/review compliance

117
Q

What is the next step if driver has had ENT surgery and the findings of a post op sleep eval are pending

A

DQ or review compliance

118
Q

What BMI does the expert panel recommend for sleep study?

119
Q

What neck circumference is a referral for obstructive sleep apnea?

A

Males:17
Females: 15

120
Q

Minimally acceptable use of CPAP for certification?

A

4 hours per night, 70% nights

121
Q

ENT surgical post op waiting period (OSA)

A

1 month
Individuals should have no excessive daytime sleepiness and should have a post op sleep study with an AHI <= 10 at 30 days or more after procedure

122
Q

After ENT surgical procedure for OSA what is needed for recertification?

A

Yearly sleep study with AHI <= 10 or negative maintenance of wakefulness test

123
Q

Bariatric surgery for OSA waiting period

A

Certification without use of CPAP = 6 month
May still be certified if they are complaint with CPAP

124
Q

Oral appliances for OSA

125
Q

TIA waiting period

126
Q

TIA requirements for certification

A

Completion waiting period
Clearance from neurology
No seizures during waiting period
DQ if using anticoagulant or anti seizure meds

Same for thrombotic and embolic infarction

127
Q

Myocardial infarction waiting period

128
Q

Requirements for initial post MI certification

A

Asymptomatic
Card clearance
ETT 85% predicted HR OR Echo LVEF >= 40%
No ischemia on ECG

129
Q

Post MI recertification requirements

A

Asymptomatic
Card clearance
ETT every other year

130
Q

Pneumothorax waiting period

A

None- must have documented XR showing recovery

131
Q

documentation needed for pneumothorax

A

Onset and number of pneumos
Which side
Spontaneous or traumatic
Symptoms at rest or with exertion
Lack of oxygen use
Meds
providers name and location

132
Q

How long to certify a driver with hx of pneumothorax who is stable and asymptomatic?

A

Up to 2 years

133
Q

If a driver has a history of pneumothorax and has hypoxemia at rest

134
Q

If a driver has a hx of pneumothorax and has cough syncope

135
Q

If a driver has a history of a pneumothorax and uses oxygen

136
Q

If a driver has a hx of a pneumothorax and has abnormal lung function

137
Q

What happens if a driver has had 2 or more pneumothoraces on the same side without pleurodesis?

A

DQ until procedure is done and driver has recovered

138
Q

Waiting period non psychotic major depression without suicide attempt

139
Q

Waiting period severe depression, manic episode, suicide attempt

140
Q

Waiting period brief reactive psychosis

141
Q

Waiting period brief reactive psychosis

142
Q

Waiting period following ECT

A

6 months symptom free

143
Q

waiting period anxiety disorder

A

One year with caution depending on medications

144
Q

Waiting period for schizophrenia

145
Q

Waiting period for bipolar disorder

146
Q

Abnormal PFT

A

FEV1 <65%
FEV1/FVC <65%
FVC <60%

147
Q

Abnormal ABG

A

PaO2 <65mm HG
PCO2 45mmHg

148
Q

Aortic Regurgitation monitoring

A

Echo every 2-3 years. Certify for 1 year

149
Q

Aortic regurgitation guidelines

A

Certify if:
Mild or moderate with normal LV function
No LV dilation
Asymptomatic

150
Q

Aortic Stenosis Monitoring

A

Echo every 5 years if mild
Echo every 1-2 years if moderate

Do not certify if- Angina, HF, Syncope, AFib EF<50%, Thromboembolism

151
Q

Severe aortic stenosis

152
Q

Mitral regurgitation monitoring

A

Mild- none
Moderate- Annual echo
Severe- Echo every 6-12 months

Do not certify if
Symptomatic
can’t achieve >6METs
AFib
LV disfunction
Thromboembolism
Ruptured chorade
Flail leaflet
Pulmonary HTN

153
Q

Mitral regurgitation monitoring

A

Mild- none
Moderate- Annual echo
Severe- Echo every 6-12 months

Do not certify if
Symptomatic
can’t achieve >6METs
AFib
LV disfunction
Thromboembolism
Ruptured chorade
Flail leaflet
Pulmonary HTN

154
Q

Mitral stenosis monitoring

A

Mild- none
Moderate- Annual Echo
Must be asymptomatic

155
Q

Severe mitral stenosis

156
Q

Waiting period for repair valvular disease

A

3 months
Must get card clearance

DOT (1 decks)

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