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DOT Exam Oakstone Course > Examination Scenarios > Flashcards

Examination Scenarios Flashcards

1
Q

what four things should the urine chemistry strips check for?

A

protein, glucose, specific gravity, blood

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2
Q

Max certification time for a driver with diabetic nephropathy?

A

two years
Nephropathy can be disqualifying. In order to qualify:
-etiology must be known
-tx shown to be effective
-tx plan doesn’t interfere with safe driving

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3
Q

What is typically the first sign in the development of diabetic nephropathy?

A

Persistent proteinuria is the first sign of nephropathy.

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4
Q

What is the major predictor for prognosis of coronary heart dz?

A

left ventricular function

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5
Q

You don’t have to disqualify all drivers who have autonomic neuropathy. What renders a pt with autonomic neuropathy ineligible for certification?

A

1.cardiovascular autonomic neuropathy that causes
Resting tachycardia
Orthostatic bp

  1. Other organ autonomic responses that may interfere with driving ability
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6
Q

There are six grades of murmurs. Describe them.

A

Grade I: must strain to hear the murmur
grade II: can hear faint murmur without straining
grade III: can easily hear a moderately loud murmur
grade IV: can easily hear a moderately loud murmur that has a thrill
grade V: can hear the murmur when only part of the stethoscope is touching the skin
grade VI: can hear the murmur with a stethoscope close to the skin; stethoscope doesn’t have to be touching the skin to hear the murmur

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7
Q

When do the guidelines for aortic regurgitation NOT apply?

A

The guidelines for aortic regurgitation do not apply when the cause is due to an acute condition such as infective endocarditis.

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8
Q

Risk of recurrent thrombosis is decreased by ___% with adequate anticoagulant therapy.

A

80%

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9
Q

Aortic regurgication is not always ______; it can be developed or acquired.

A

congenital

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10
Q

A driver has a diagnosis of COPD. Their pulmonologist has placed them on continuous 2l NC oxygen and has written a note saying the driver is appropriate for commercial driving. For what period of time can you certify them?

A

None. Guidelines indicate that drivers who need continuous oxygen cannot be certified. The use of oxyen while driving is prohibited.

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11
Q

Under what circumstances can a driver who takes insulin be certified?

A

The treating clinician, which may include but is not limited to an endocrinologist, may fill out form MCSA-5870 and forward to the FMCSA medical examiner to be determined for certification.

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12
Q

A driver must first perceive a forced, whispered voice IN ONE EAR at not less than _____ feet, OR not have an average hearing loss IN ONE EAR greater than _____ decibels at 500 hertz (Hz), 1,000 Hz and 2,000 Hz.

A

Five feet
40 decibels

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13
Q

Which portion of the urinalysis is recorded as a quantitative number?

A

Specific gravity

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14
Q

How do you confirm that a driver has elevated blood pressure?

A

Take the blood pressure more than once during a visit, then ask them to come back for additional testing on a different day. A 1-time reading of an elevated blood pressure does qualify for a diagnosis of hypertenstion.

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15
Q

How do you convert from International Organization for Standardization (ISO) to the American National Standards Institute (ANSI) standard?

A

When switching from ISO to ANSI, at 500 Hz, subtract 14, at 1000 Hz, subtract 10, and at 2000 Hz, subtract 8.5.

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16
Q

A driver has a vision exemption due to monocular vision. How often must the driver renew the exemption?

A

the exemption is good for a maximum of 2 years.

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17
Q

_________ deficits are at the highest risk for seizure while cerebellum and brainstem deficits are the least likely to cause seizure.

A

cortical

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18
Q

Name the only congenital myopathy that can be treated.

A

centronuclear

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19
Q

There are 2 exemption programs, the ________vexemption and the ________ exemption.

A

diabetes
vision

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20
Q

What classes of drugs are used to treat benign positional vertigo?

A

Benzodiazepines
Anticholinergics
sympathmomimetics

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21
Q

What is a symptom of cataracts?

A

The slow, progressive opacification of the crystalline lens of the eye distorts the optical passage of light to the retina resulting in diminished visual acuity.

22
Q

How long does a driver need to be symptom free when the driver has a diagnosis of chronic peripheral vestibulopathy?

A

Driver can be certified if free of sxs for 2 months.

23
Q

In general, the risk for subsequent unprovoked seizures is greatest in the first _______ following the acute insult.

A

2 years

24
Q

A driver had a subarachnoid hemorrhage without risk of seizure. How long can the driver be certified?

A

A driver can be certified a minimum of 1 year after a subarachhoid hemorrhage as long as they are seizure free and off anticonvulsant medication.

25
Q

A driver who has come in for a physical was previously diagnosed with stage 3 hypertension. The driver’s current blood pressure is <140/90, and he is on medication. For how long can the driver be certified?

A

As long as the driver is on medication and it is well tolerated and the blood pressure is under 140/90, they can be certified for a maximum of 6 months.

26
Q

A driver who previously had high blood pressure related to pheochromocytoma had surgery to correct the pheochromocytoma. How long must the driver wait before she can be certified?

A

There is a minimum 3-month wait after post-surgical correction of a condition that has caused secondary hypertension.

27
Q

The majority of abdominal aortic aneurysms (AAAs) occur in the _______ and ______ decades of life and occur more frequently in males than in females by a ____ ratio.

A

Sixth, seventh
3:1

28
Q

What is the maximum time a driver can be certified if the driver is taking anticonvulsants?

A

The driver can be certified for 2 years as long as the medication is well tolerated and not used to prevent seizures.

29
Q

A driver had a mild insult with early seizures. How long is the wait for the driver before being certified?

A

There is a minimum wait of 2 years seizure free and off anticonvulsant medication following mild insult with early seizures.

30
Q

A driver who had a stroke 1 month ago presents to your office for a physical. This driver is at risk for seizures. How long is the wait before this driver can be certified?

A

There is a minimum wait of 5 years seizure free and off anticonvulsant medication following stroke with risk of seizures.

31
Q

Which types of headaches may interfere with the ability to drive a commercial motor vehicle safely?

A

migraines, tension-type headaches, cluster headaches, and post-traumatic head injury syndrome

32
Q

A driver who experiences migraine headaches presents to the office for a physical examination. What is the maximum time for which the driver can be certified?

A

If you, as the medical examiner, believe that the nature and severity of the medical condition of the driver does not endanger the health and safety of the driver and the public, then the driver can be certified for a maximum of 2 years.

33
Q

A driver has 1 unprovoked seizure. What is the timeframe between the first and second unprovoked seizure before the driver would receive a diagnosis with epilepsy?

A

A second unprovoked seizure, regardless of the elapsed time between seizures, would constitute a medical history of epilepsy, and the driver would no longer meet the physical requirements.

34
Q

What’s the minimum standard for central visual acuity?

A

20/40 in each eye and both eyes together

35
Q

A driver presents for a physical. When having vision tested using the Snellen chart, the driver can see 20/20 in the right eye, 20/50 in the left eye, and both eyes vision is 20/25. For how long can the driver be certified?

A

The driver cannot be certified, b/c 20/50 acuity disqualifies him.

Monocular vision occurs when the vision requirements are met in only one eye, with or without the aid of corrective lenses, regardless of cause or degree of vision loss in the other eye. Therefore, this driver would be disqualified since they did not pass the test in the left eye.

36
Q

What is the maximum time that a driver who passes the hearing test but wears hearing aids can be certified?

A

The driver who uses a hearing aid to qualify must wear a hearing aid while driving, but they can be certified for a maximum of 2 years.

37
Q

The driver who uses a hearing aid to qualify must wear a hearing aid while driving, but they can be certified for a maximum of 2 years.

A

1 year

Insidious onset of lower back pain does not guarantee abdominal aorta aneurysm is associated; 3-cm dilatation requires watchful waiting and a reduced certification time.

38
Q

A driver should be disqualified if the driver has a blood pressure of 164/90. True or false?

A

False. This driver would be given a 1-time certification for 3 months.

39
Q

A new driver with a blood pressure of 142/92 can be certified for how long?

A

One-year per recommendations.
All the following criteria have to be met:
-this is the first exam in which driver is found to have hypertension
-driver has no prior history of hypertension
-driver is not using any medication to control blood pressure

If all three of these criteria are met, may certify for one year.

40
Q

If a driver is required to start insulin, what circumstance would require the driver to have a 2 months period after starting insulin therapy?

A

He is newly diagnosed and not on prior treatment.

41
Q

While performing the forced whisper test, a driver can hear with the left ear at 5 feet (pass). With the right ear, the driver hears at 4 feet (fail). For how long can he be certified?

A

Recertification for 2 years if the 5-foot forced whisper test is performed at ≥5 feet in the better ear.

42
Q

To pass the DOT physical eye test, your eyesight needs to be at least _____on the Snellen eye chart, with or without corrective eyewear in each eye, and both eyes. Your peripheral vision needs to be _______degrees or better in both eyes.

A

20/40

70

43
Q

If a person underwent surgery to treat obstructive sleep apnea, what is the recommendation regarding certification?

A

3-month wait after surgery, then certified for 1 year

44
Q

Can a driver with a symptomatic hernia can be certified?

A

No. The risk for an incapacitating event is great.

45
Q

The number 1 cause of fatalities in the United States involving commercial motor vehicles is due to __________________.

A

driver fatigue

46
Q

A driver who is taking insulin for diabetes can be certified for how long?

A

Drivers taking insulin for diabetes cannot be certified unless there is an active diabetes waiver.

Three conditions have to be met in order for the medical examiner to certify the insulin-dependent commercial motor vehicle driver:
1. The insulin-dependent driver must be determined as stable by the treating clinician
2. Treating clinician must supply form MCSA-5870 to the medical examiner prior to the time the medical examiner examines the driver
3. The medical examiner must confirm the driver to be otherwise qualified and to not be at risk for an incapacitating event.
If all three conditions are met, then the medical examiner can certify the driver for up to one year.

47
Q

A driver has no history of hypertension and comes in for an initial physical examination. The driver’s blood pressure has a reading of 162/105. The driver can be certified for how long?

A

a 1-time certificate for 3 months

48
Q

When is a post-accident drug and alcohol test required?

A

-Any person sought medical treatment away from the scene
-The accident involves a loss of a human life
-The driver is cited for a moving violation

49
Q

A driver who has had an angioplasty 4 months ago and has had a satisfactory exercise stress test can be certified for how long?

A

1 year

50
Q

In crashes involving at least 1 large truck, the mortality rate for the occupants of the passenger vehicle is approximately ______ times greater than that of the occupants of the truck.

A

6

51
Q

An examiner must verify that a driver’s prehension and power grasp are adequate. A dynamometer is not required but, if used, what is the minimum grip strength that is recommended?

A

58 lbs

52
Q

A driver who previously had stage 1 hypertension and was certified for 1 year comes in for recertification. Upon exam, the driver has stage 2 hypertension. For how long can the driver be certified?

A

One time 3 months in order to get his BP under 140/90.

DOT Exam Oakstone Course (28 decks)

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