MSK, GI/GU and DM Flashcards
Max certification for fixed deficit of extremity
2 years
Which deficit is not certifiable
- impairment that affects torso
- no proof of SPE compliance
- progressive disease limb impairment
How to evaluate grip strength
dynanometer
sphygmomanometer
Biceps nerve
C5
C6
Brachioradialis nerve
C6
Triceps
C7
Patellar
L2-L4
Achilles
S1
Normal reflex grade
+2
Normal A1C
4-6
A1C target for T2 DM
<7
A1C DM diagnosis
> 6.5
Severe hypoglycemic reaction
seizure
LOC
need of assistance from another person
period of impaired cognitive function that occurred without warning
when not to certify driver with DM
- in last 12 months experienced severe hypoglycemic reaction
- in last 5 years had 2 or more disqualifying hypoglycemic reactions
- loss of position sense
- loss of pedal sense
- resting tachycardia
- orthostatic hypotension
- peripheral neuropathy
- proliferative retinopathy
A1C level indicator for poor glucose control
> 10
If driver has proteins in UA, what test next
finger stick
Example of incretin mimetic
Exenatide (byetta)
Incretin mimetic with what other medication increases risk for hypoglycemia
sulfonylurea
glipizide
glyburide
How to approve insulin therapy for driver
- visit PCP within 45 days prior to ME exam
- complete DM assessment form (MCSA-5870)
- need 3 months of electronic blood sugar records
Waiting period for driver with DM previously diagnosed and not on insulin treatment
1 month
Waiting period for newly diagnosed DM
2 months
Max certification for T2DM
1 year
BG within what reading is safe for CMV driving
100-400
Waiting period for driver with T1DM or T2DM converting to insulin therapy
3 months
Max certification for hernias
2 years
Max certification for nephropathy
2 years
When not to certify kidney issues
if on dialysis/renal replacement therapy
stage 5 not receiving renal replacement
Max certification for stage 1 and 2 kidney disease
2 years
max certification for stage 3 kidney disease
1 year
max certification for stage 4 kidney disease
6 months with normal EKG
BP <140/90
Max certification for stage 4 kidney disease with stage 2 HTN
3 months with normal EKG
Max certification for stage 5 CKD
NONE
Waiting period for renal transplant
3 months post-op
Recertification for renal transplant
recertify at 3 months, 6 months, and 12 months post-op, then annually
