Exam Flashcards
1
Q
Absolute nondiscretionary conditions
A
diabetes on insulin, epilepsy, hearing loss
2
Q
Those with seizures can quality if
A
last seizure and last seizure med taken was more than 5 years ago
3
Q
To meeting hearing standard, the driver must be able to complete hearing test in
A
at least one ear.
4
Q
Whisper test is passed if able to hear at ____
A
5 feet or greater
5
Q
If failed whisper test, then next step is
A
refer for audiometric testing
6
Q
Audiometry is calculated by average hearing loss at
A
500, 1000, and 2000 Hz
7
Q
The driver cannot have an average loss of ___ in ONE ear.
A
more than 40 dB
8
Q
Must have visual acuity of at least ____ in each eye and both eyes
A
20/40
9
Q
Must have field of vision of at least ____ in both eyes
A
70 degrees
10
Q
Must be able to recognize these colors
A
red, amber, green
11
Q
Those with amputations, immobile joints, or paralysis cannot quality unless they’ve been issued a
A
SPE
12
Q
FEV1 needs to be
A
greater than 65%
13
Q
FVC needs to be
A
greater than 60%
14
Q
FEV1/FVC needs to be
A
greater than 65%
15
Q
If patient fails LFTs, then
A
ABG needed
16
Q
ABG needs to have Pa02 greater than ____ and PaC02 less than ____
A
65; 45
17
Q
Those patients with BMI greater than ____ need to be considered for sleep study
A
30-33
18
Q
Drivers with HTN can be certified for max of
A
1 year
19
Q
Certification requirements for drivers with CVD/MI
A
max certification for 1 year, ETT every 2 years
20
Q
Audiometric results that would disqualify driver would be
A
both ears having average greater than 40 dB
21
Q
Mission is focused on reducing crashes, injuries, and fatalities involving large trucks and buses
A
FMCSA
22
Q
The mission of the _______ is to promote the safety of America’s roadways through the promulgation and implementation of medical regulations, guidelines and policies that ensure commercial motor vehicle drivers engaged in interstate commerce are physically qualified to do so
A
Office of Medical Programs
23
Q
The primary mission of the _____ is to improve highway safety by producing trained, certified medical examiners who can effectively determine if a commercial motor vehicle driver’s health meets Federal Motor Carrier Safety Administration standards.”
A
National Registry of Certified Medical Examiners
24
Q
medical certification is required for drivers that
A
- have a combined weight of 10,000 lb or more;
- transport 9-15 passengers;
- transport 16 or more passengers with/without compensation;
- transports hazardous mateirals
25
certification cannot exceed
2 years
26
an alternative physical qualification standard for the driver with a fixed musculoskeletal deficit of an extremity who cannot physically qualify to drive
SPE
27
The only two exemption programs
diabetes and vision
28
two or more unprovoked seizures
epilepsy
29
Those with ICD
should be disqualified xt
30
disqualifying vision includes
- monocular vision,
| - one contact lens that corrects distant while the other corrects near;
31
converting ISO to ANSI standards:
subtracting __ dB from ISO for 500 Hz,
subtracting __ dB from ISO for 1000 Hz,
subtracting __ dB from ISO for 2000 Hz,
14; 10; 8.5
32
another BP measurement must be taken if initial is
greater than 140/90
33
A one-time, three-month medical certificate is granted in these two cases:
- Stage 2 HTN;
| - driver has stage 1 that hasn't reached goal of less than 140/90 at recert
34
stage 1 HTN
140-159/90-99
35
stage II HTN
160-179/100-109
36
Stage III HTN
greater than 180/110
37
UA tests for
specific gravity, blood, protein, and glucose
38
minimum amount of time to keep records of driver's medical records and certificate
3 years
39
SPE certificate is valid for
2 years
40
A driver with monocular vision
can apply for exemption if otherwise qualified
41
The otherwise medically qualified driver with a Federal vision exemption can be recertified for
one year
42
these people have high risk of cataracts
gout, diabetes, steroid use
43
Most common cause of retinopathy is
diabetes
44
syllables for whispered ear test
three, two-syllable words
45
avoid saying this during forced whisper
s-words
46
those with vertigo can be certified if they have been symptom-free for _____
at least 2 months
47
recommended to disqualify these ear conditions
Meniere's, labyrinthine fistula
48
An individual diagnosed with Stage 1 hypertension may be certified for ____
one year
49
Stages of certification for stage 1 HTN
If first time having stage I, then one year certificate.
If next year it is still above 140/90, then a one-time certificate for 3 months can given.
If at 3 months still above 140/90, then can disqualify until reached goal.
50
Stages of certification for Stage 2 HTN
First time having stage II, then one time certification for 3 months.
If still not at goal, then can disqualify
51
The driver who is disqualified for stage 3 hypertension may be recertified for ___ if BP is lowered to less than 140/90 and medications are well tolerated.
6 months
52
examples of secondary HTN
pheochromocytoma, primary aldosteronism, renovascular disease
53
Those on coumadin can be certified for max of ____
1 year
54
Those on coumadin can be certified if they've be stable on meds for at least ____ and ____
1 month; have monthly INR monitoring
55
waiting period after AAA repair
3 months
56
A driver with AAA can be certified if it is less than
4 cm and asymptomatic
57
A driver with AAA can be certified if it is less than 5 cm AND
has clearance by cardiovascular specialist.
58
waiting time after PE
3 months
59
max certification for 2 years for these CV conditions
superficial phlebitis, varicose veins
60
A driver with thoracic aneurysm can be certified if it is less than
3.5 cm
61
Waiting time after thoracic aneurysm
3 months, clearance from cardiovascular specialist
62
electronic devices that treat cardiac arrest, ventricular fibrillation, and ventricular tachycardia
Implantable Cardioverter-Defibrillators
63
an implantable device designed to treat bradycardia
pacemaker
64
waiting period after pacemaker insertion is __ month(s) if d/t sinus node dysfunction or AV block
1
65
waiting period after pacemaker insertion is __ month(s) if d/t neurocardiogenic syncope or hypersensitive carotid sinus syncope
3
66
A driver is not qualified if LVEF is
less than 40%
67
waiting period for MI
at least 2 months
68
Driver with hx of MI can be qualified if they are
- asymptomatic for at least 3 mo,
- passes ETT,
- LVEF greater than 40%
69
Driver can certified with ____ angina
stable
70
waiting time for CABG
at least 3 months
71
monitoring and testing needed for post-CABG
annual ETT after 5 years
72
waiting time after PCI
1 week
73
certification requirements after PCI
initial f/u within 6 months, then annually after
74
Those post-PCI should have a ____ within 3-6 months
ETT
75
congenital downward displacement of the tricuspid valve
Ebstein anomaly
76
max certification after heart transplant
6 months
77
The driver should abstain from antihistamine medication for ____ prior to operating a vehicle
12 hours
78
PFTs are indicated in these drivers:
- hx of any lung disease;
- symptoms of SOB, cough, wheezing;
- smoking in those 35 and older
79
If pulse ox is less than ___, an ABG is recommended
92%
80
provoked seizures can be caused by
meds, anesthesia, hypoglycemia, fever
81
side effects of anticonvulsants
depressed mood, decreased reflexes, unsteadiness, sedation
82
For mild insult without early seizures, stroke without risk for seizures, or SAH without risk for seizures, minimum waiting period is
1 year
83
clearance for seizures requires
being off of seizure meds and seizure free;
clearance from neurologist;
normal neuro exam
84
max certification for febrile seizures
2 years if occurred before age 5
85
driver with hx of single unprovoked seizure needs to be seizure free and off meds for at least
5 years
86
minimum waiting period for bacterial meningitis with early seizures
5 years
87
minimum waiting period for viral meningitis with early seizures
10 years
88
certification for those with peripheral neuropathy
DO NOT certify
89
minimum waiting time s/p strokes not a risk for seizures
1 year
90
minimum waiting time s/p strokes at risk for siezures
5 years
91
these kinds of hemorrhages and strokes are not associated with an increased risk for seizures.
cerebellum and brainstem
92
these kinds of hemorrhages and strokes are associated with an increased risk for seizures.
Cortical and subcortical
93
has no dural penetration or loss of consciousness and lasts for fewer than 30 minutes
mild TBI
94
does not penetrate the dura but causes a loss of consciousness lasting longer than 30 minutes, but less than 24 hours
moderate TBI
95
waiting period for mild to moderate TBI
2 years seizure free and off meds
96
neuro disorders that have 10 year waiting period
epilepsy, viral encephalitis with seizures
97
neuro disorders that have 5 year waiting period
single unprovoked seizure, bacterial meningitis with seizures
98
The SPE applies only to _____ of the extremities, not those caused by a ______
fixed deficits; progressive disease.
99
examples of grip strength tests
dyamometer, squeezing a sphygmomanometer
100
The diabetes qualification standard parameter is ____, not the diagnosis of diabetes mellitus.
use of insulin
101
Hemoglobin A1c (HbA1c) greater than ___ is an indicator of poor blood glucose control.
10%
102
Proof of grandfathered status is the original letter from ___ granting the right to continue to drive as long as the driver can meet physical qualification requirements.
1996
103
hypoglycemia can be self-treated by the ingestion of at least _____ of glucose tablets or carbohydrates
20 grams
104
Diabetes Exemption requires this monitoring
- annual eval by endocrinologist;
- annual vision eval;
- blood sugar recordings
105
blood sugar recordings for diabetes exemption drivers should record sugars
before driving and every 2-4 hours while driving
106
blood glucose levels for those on diabetes exemption should be between
100-400
107
waiting time for diabetes
1 month if previously on diabetic meds; 2 months if newly diabetic just starting on meds
108
waiting time s/p ECT
6 months
109
minimum waiting period if driver is symptom free from a brief reactive psychosis or schizophreniform disorder
6 months
110
Certification for driver with substance abuse may require successful completion of a
substance abuse professional (SAP) rehab program
111
drugs that disqualify driver
schedule I drugs, amphetamines, narcotics, methadone, marijuana
112
What to do if driver passes hearing test in one ear but fails in other ear
can certify for 2 years
113
Chantix
immediate disqualification
114
Antabuse
med taken for substance abuse; can be disqualifying
115
CPAP monitoring
must provide CPAP compliance reports annually
116
waiting period for severe depression and suicide attempts
1 year
117
stable angina must be static with these 4 conditions
Emotion
Extreme in weathers
Exertion
Ecstacy
118
examples of changes in BP that are disqualified
resting tachycardia and/or orthostatic hypotension
119
certification with afib
1 year if rate controlled
120
a good exercise tolerance test is greater than ___ METS
6
121
only stage of HF that can qualify for certification
Stage 1
122
if suspected substance abuse
contact employer and disqualify
123
types of antidepressants that are disqualifying
1st generations: TCA
124
non-sedating anxiolytics are qualifying if...
- half life less than 5 hours;
- low dose;
- short term therapy for less than 2 weeks
125
monitoring for Ebstein anomaly
ECHO yearly
126
___ lbs is normal grasp and prehension.
58 lbs
127
The patient on CPAP has to have been on it for at least ____ before being certified
1 month without symptoms
128
driver cannot drink alcohol up to ___ hours before driving
4 hours
129
minimally acceptable use of CPAP for certification
70% nights
130
A driver who has a history of ____ or
more episode(s) of spontaneous pneumothorax
requires ______ before
qualifying
2; surgery
131
A driver who is otherwise qualified when
| accompanied by an SPE can be certified for
2 years
132
A driver with a hx of bacterial meningitis with seizures but has been seizure and med free for more than 5 years can qualify for ___ year certification
2
133
Autonomic neuropathy
Can certify
134
how long does a newly diagnosed diabetic need to be on insulin before being able to be examined?
2 months
135
An A1C is equivalent to a blood glucose of
240
136
Modafinil (Provigil) is used for
nacrolepsy
