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1
Q

What is the mission of the FMCSA

A

Focused on reducing crashes, injuries, and fatalities involving large trucks and buses

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2
Q

Who and what does the FMCSA regulate

A

Interstate commercial operation including the driver vehicle motor carrier and the transport of hazardous materials

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3
Q

Give examples of cmv driver stress factors

A

Interruption of normal sleep, exercise, and eating patterns and decreased access to social support networks resulting in fatigue and ailienation of affection

Environmental- excessive vibration noise extreme temperatures adverse road conditions, can cause permanent or temporary physical damage and affect the driver behavior

Increased potential for injury and fatalities if there is a crash when responsible for passengers or hazardous cargo

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4
Q

What are the differences between the medical regulations and the medical guidelines

A

Regulations are law

Guidelines are not regulatory

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5
Q

In which regulations are the driver physical qualifications standards and medical examiners responsibilities cited for?

A

49 CFR 391.41 driver physical qualifications

49 CFR 391.43 examiner responsibilities

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6
Q

What objective tests and measurements are required as part of the driver physical examination?

A 
Height and weight
Vision
Hearing
Blood pressure
Urinalysis - specific gravity, protein,blood, glucose
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7
Q

What are the possible outcomes of the driver physical examination

A

Certification, disqualifying, determination pending

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8
Q

What date is used to determine medical examiners certification expiration

A

The date of the exam is used as the certificate expiration, except when determination pending is chosen

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9
Q

What is the date used for certification with determination pending

A

If the driver returns with the necessary information prior to expiration of the driver current certificate and the driver is qualified the date used is the date at which the driver returned with the necessary information

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10
Q

What is the expiration date for this driver: examination 4/16/2011 - meets standards in 49. CFR 391.41 qualifies for 2 years

A

4/16/2013

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11
Q

What is the certification date for the following driver exam 4/16/2011 - meets standards, but periodic monitoring required due to hypertension - driver qualified for one year.

A

4/16/2012

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12
Q

What is the certificate date for the following driver. Exam 4/16/2011. Disqualified due to vertigo 3/15/2011 - return to medical examination on 5/20/2011. Note asymptomatic since 3/11/2011 qualified for 2 years

A

5/20/13

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13
Q

Who can perform the vision portion of the interstate cmv driver physical examination

A

The medical examiner
A license optometrist
Ophthalmologist

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14
Q

To pass the interstate cmv driver vision exam, a visual acuity of ——- corrected or I corrected is required

A

20/40 in each eye and both eyes

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15
Q

What eye conditions must the medical examiner ask the driver about if indicated request specialist evaluation

A

Retinopathy, cataracts, aphakia, glaucoma, macular degeneration

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16
Q

What is the purpose of the interstate cmv driver physical examination

A

To detect the presence of physical mental or organic condition that affects safe driving

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17
Q

Does the driver meet heating standards for interstate cmv driving. Whisper test right ear 4 feet, left ear 4 feet

A

No equal or greater than 5 feet

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18
Q

Audiometric testing right 30,40, 45 left ear 45 45 35

A

Yes right ear passed less than 40

Left ear failed 41

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19
Q

Can an interstate driver who has had an acute mi be qualified to drive

A

Yes waits the designated waiting period

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20
Q

The driver provides the medical examiner with a copy of records cardiologist report congestive heart failure ejection fraction 38%

A

No greater than 40

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21
Q

What criteria must be met to certify congestive heart failure

A

Asymptomatic
No ventricle arrhythmia
Left ventricle ejection fraction greater than 40
Cleared by cardiologist

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22
Q

Percutaneous coronary intervention 9 months ago has not followed up with cardio and has not had an exercise tolerance test

A

Disqualifying
Cardio clearance
Ett 3-6 months post pci

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23
Q

Coronary artery bypass graft 4 months ago, echo at 3 months showed left ejection fraction 55% cleared by cardio no chest pain

A

Cleared 3 months post procedure if asymptomatic, lvef >40

1 year cert

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24
Q

Driver with chf Dyspnea at rest

A

Disqualifying

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25
Q

Driver with increasing angina which lasted 20 minutes after tarring a load unresponsive to nitro

A

Disqualifying unstable angina

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26
Q

Abdominal aortic aneurysm. Obtains copy of sonogram 5.3 cm in diameter

A

No has to be less than 5

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27
Q

Driver with surgical repair of 9 cm abdominal aortic aneurysm 4 months ago driver is cleared by cardio

A

Yes 1 year, waiting period 3 months after surgery

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28
Q

What signs and symptoms are present with congestive heart failure

A

Fatigue, swelling, shortness of breath at rest

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29
Q

Multiple risk factors for chd and is over the age of 45 should be certified

A

Yearly

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30
Q

Non modifiable risk factors for chd

A

Family history
Increased age
Gender and post menopausal

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31
Q

Modifiable risk factors for chd

A 
Hypertension 
Tobacco use
High lipids
Low hdl
Diabetes
Oversight
Physical inactivity
Nutritional habits
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32
Q

Should medical examiners provide additional counseling regarding conditions that do not directly impact driving status

A

Yes

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33
Q

Spirometry testing is indicated for smokers above what age

A

35

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34
Q

CABG qualifications

A 
3 months post CABG
Cardio cleared
Asymptomatic 
Annual exam
5 years yearly ett - graft closures
Ejection fraction less than 40
No orthostatic symptoms
Tolerating meds
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35
Q

What is the max certification for stage 1 HTN

A

1 year

36
Q

What is the certification for a driver with BP 182/112

A

Disqualifying until less than 140/90 then 6 month certification

37
Q

Driver with BP 182/112

A

Stage 3 disqualified until less than 140/90 than 6 months

38
Q

What is the BP range for stage 1

A

140-159/90-99

39
Q

What date is used to determine the one year expiration date for a driver with a one time 3 month certificate, who achieves bp less than 140/90 before 3 month certificate

A

1 year based on last examination, must have new examination

40
Q

Pulmonary diseases that are disqualify

A

Bronchiectasis with hemoptysis
Chronic tb
Copd with syncope
Asthma with frequent hospitalization

41
Q

What conditions must a driver meet with acute or chronic core pulmonale meet to be certified to operate an interstate

A

Abg

PaO2 greater than 65

42
Q

Pulmonary hypertension or cor pulmonale exhibit Dyspnea at rest, dizziness or hypotension

A

Disqualifying

43
Q

Exercise induced asthma well controlled by using an a literal inhaler before aerobic activity. Pulmonary function test fev1 must be above what

A

Greater than. 65

44
Q

Driver takes Benadryl 3 x daily for allergies

A

Abstain from antihistamines and narcotic based antitussives for 12 hours prior to driving

45
Q

Driver reports hasn’t followed up with pcp in several years uses his rescue inhaler multiple times a day has been hospitalized and in a ventilator certification?

A

Disqualifying

46
Q

Pneumothorax last month. Reduced FVC to 58%

A

Disqualifying- recovery complete chest X-rays, FVC greater than 65

47
Q

Pneumothorax 3 months Ago, second spontaneous pneumothorax on same side. FVC is 68% no surgical intervention

A

Disqualifying can’t be qualified until surgery to stop reoccurring

48
Q

What three tests are a part of the PFT

A

Fev1
FVC
Fev1/fvc

49
Q

Doesn’t meet PFT requirements next step

A

Oximetry

Abg

50
Q

Pulse ox less than 92

A

Obtain abg

51
Q

Abg cutoffs

A

Paco2 less than 45
PaO2 greater than 65 less than 5000
Pa02 greater than 6o over 5000

52
Q

Trip history and Abgs

A

If previous trip spent in high altitudes can influence Abg results vice versa

53
Q

What neurological condition is disqualifying

A

Epilepsy

54
Q

According to medical guidance, episodic neurological conditions that are disqualifying include what?

A

Extreme headaches
Vertigo
Epilepsy with medications
Narcolepsy
Untreated sleep apnea
Idiopathic central nervous system hyper somnolence
Primary alveolar hyperventilation syndrome
Restless leg syndrome with excessive daytime somnolence

55
Q 
According to the following what neurological condition is disqualifying: febrile seizures
Severe dementia
Metabolic dementia
Tias within one year
Tias greater than one year
A

Severe dementia

Tia less than 1 year

56
Q

Driver is taking levodopa/carbidopa is used for the treatment of

A

Parkinson’s

57
Q

For tias what is no functional residue

A

No lack of impairment or no residual symptoms

Determined by neurologist

58
Q

What is the future risk associated with tias

A

High rate of reoccurrence in 1 year
Hence 1 year waiting period
Warning sign for potential stroke

59
Q

Criteria for certification of tias

A

1 year waiting period

60
Q

A driver with a loss of leg, foot, hand or arm qualified to operate a cmv?

A

Yes if they meet all other standards

Needs to be granted a skills performance

61
Q

Only ___\ can grant a spe certificate

A

FMCSA

62
Q

What documentation is required when applying for cpe?

A

Copies of medical exam report

Certificate indicating cpe need

63
Q

Certification period for spe certificate? Maximum certificate period

A

2 years can be certified for up to 2 years

64
Q

6 week post arthroscopic carpal tunnel repair on his tight hand

A

Evaluate standards of testing

Can be certified for 2 years

65
Q

Insulin treated db requirements

A

Has treating provider fill out mcsa 5870 form

66
Q

What is the maximum certificate for diabetes not on insulin

A

1 year

67
Q

Which diabetes poses the greatest risk

A

Hypoglycemia

68
Q

How does the examiner determine whether a gi condition would potentially disqualifying

A

GI condition that produces symptoms or physical changes that could impair the driver

69
Q

List the four specific urinalysis test results required for the driver

A

Specific gravity
Protein
Blood
Glucose

70
Q

What would the medical examiner do next if an abnormal finding on the urinalysis

A

Use clinical expertise to determine further evaluation

71
Q

A driver is taking dicyclomine bentyl for IBS with good control of symptoms.

A

Yes as long as medicine controls symptoms and no side effects.

72
Q

What are three areas of risk when a driver has. A mental disorder

A

Symptoms
Residual recurrent symptoms
Side effects of medication

73
Q

What behaviors should you examine for

A

Suspicious evasive threatening hostile
Signs of being distracted
Flat affect lack of emotional response
Bizarre ideas, visual auditory hallucinations, dishonesty, tendency to omit important information

74
Q

Can a driver be certified if taking amitriptyline for depression

A

Disqualifying

75
Q

A driver is taking Ssri but appears depressed. What would the medical examiner do to adequately assess the driver

A

Driver needs to be evaluated by mental health.

Complete symptom free waiting period, tolerate treatment plan, no side effects

76
Q

Emotional adjustment problems

A

Linked to changes in memory, reasoning, attention, and judgement

77
Q

Functional disorders

A

Drowsiness, dizziness, confusion, weakness and paralysis, poor coordination, inattention, loss of functional control, increased risk for crashes.

78
Q

Physical symptoms of psych

A

Fatigue, headache, impaired coordination, recurring physical ailment, chronic nagging pain

79
Q

Waiting period for severe depression

A

Suicide attempt or manic episode symptom free for 1 year

80
Q

Is testing for controlled substances part of the requirements of the cmv driver physical examination

A

No but medical examiner may require additional testing if indicated.

81
Q

What is advisory criteria for the drug use definition of habit forming.

A

Habit forming - any drug or medication of becoming habitual and impair the users ability

82
Q

According to medical guidance can a driver be certified while taking methadone for chronic pain management

A

Disqualifying

83
Q

Driver checks yes for regular frequent alcohol use

A

Determine time and quantity

84
Q

What concerns should a medical examiner have regarding a driver on multiple medications who reports regular daily and moderate use of alcohol

A

Current alcoholism
Medication interactions
Effects of alcohol on underlaying condition
Alcohol on medication and other side effects

85
Q

The medical examiner may require a driver to be evaluated by an sap and successfully complete a rehabilitation course if the driver ——-

A

Admits to alcohol and drug abuse

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