MSK, GI/GU and DM

Question 1

Max certification for fixed deficit of extremity

Answer 1

2 years

Question 2

Which deficit is not certifiable

Answer 2

• impairment that affects torso
• no proof of SPE compliance
• progressive disease limb impairment

Question 3

How to evaluate grip strength

Answer 3

dynanometer

sphygmomanometer

Question 4

Biceps nerve

Answer 4

C5

C6

Question 5

Brachioradialis nerve

Answer 5

C6

Question 6

Triceps

Answer 6

C7

Question 7

Patellar

Answer 7

L2-L4

Question 8

Achilles

Answer 8

S1

Question 9

Normal reflex grade

Answer 9

+2

Question 10

Normal A1C

Answer 10

4-6

Question 11

A1C target for T2 DM

Answer 11

<7

Question 12

A1C DM diagnosis

Answer 12

> 6.5

Question 13

Severe hypoglycemic reaction

Answer 13

seizure
LOC
need of assistance from another person
period of impaired cognitive function that occurred without warning

Question 14

when not to certify driver with DM

Answer 14

• 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

Question 15

A1C level indicator for poor glucose control

Answer 15

> 10

Question 16

If driver has proteins in UA, what test next

Answer 16

finger stick

Question 17

Example of incretin mimetic

Answer 17

Exenatide (byetta)

Question 18

Incretin mimetic with what other medication increases risk for hypoglycemia

Answer 18

sulfonylurea
glipizide
glyburide

Question 19

How to approve insulin therapy for driver

Answer 19

• visit PCP within 45 days prior to ME exam
• complete DM assessment form (MCSA-5870)
• need 3 months of electronic blood sugar records

Question 20

Waiting period for driver with DM previously diagnosed and not on insulin treatment

Answer 20

1 month

Question 21

Waiting period for newly diagnosed DM

Answer 21

2 months

Question 22

Max certification for T2DM

Answer 22

1 year

Question 23

BG within what reading is safe for CMV driving

Answer 23

100-400

Question 24

Waiting period for driver with T1DM or T2DM converting to insulin therapy

Answer 24

3 months

Question 25

Max certification for hernias

Answer 25

2 years

Question 26

Max certification for nephropathy

Answer 26

2 years

Question 27

When not to certify kidney issues

Answer 27

if on dialysis/renal replacement therapy

stage 5 not receiving renal replacement

Question 28

Max certification for stage 1 and 2 kidney disease

Answer 28

2 years

Question 29

max certification for stage 3 kidney disease

Answer 29

1 year

Question 30

max certification for stage 4 kidney disease

Answer 30

6 months with normal EKG

BP <140/90

Question 31

Max certification for stage 4 kidney disease with stage 2 HTN

Answer 31

3 months with normal EKG

Question 32

Max certification for stage 5 CKD

Answer 32

NONE

Question 33

Waiting period for renal transplant

Answer 33

3 months post-op

Question 34

Recertification for renal transplant

Answer 34

recertify at 3 months, 6 months, and 12 months post-op, then annually