Respiratory

Question 1

49 CFR 391.41 b 5

Answer 1

Physical qualifications respiratory

Question 2

49 CFR 391. 43 f

Answer 2

Lung medical exam

Question 3

Lung examination

Answer 3

And normal chest wall expansion
Respiratory rate
Breath sounds -wheezing alveolar takes
Impaired respiratory function
Dyspnea
Cyanosis

Question 4

Indications for pulmonary function testing

Answer 4

COPD

Lung disease

Symptoms - sob, cough, chest tightness, wheezing

Smoking over the age of 35

Chronic respiratory failure

Question 5

PFT Includes the following:

Answer 5

Forced expiratory volume in first second of expiration FEV1

Forced viral capacity FVC

FEV1/FVC Ratio

Question 6

Indications for ABG

Answer 6

Airway obstruction 
PFT FEV1 <65% predicted 
FEV1/FVC Ratio less than 65%
FVC <60% indicating restrictive
Pulse ox <92%

Question 7

Don’t certify with ABG results

Answer 7

<65 mm hg altitudes below 5,000 ft
<60 mm hg altitudes above 5,000 ft
PaCO2 >45 at all altitudes

Question 8

Chest X-ray indications

Answer 8

Annual monitoring mitral stenosis
Respiratory abnormalities 
Hypersensitivity pneumonitis
Positive PPD test
Spontaneous pneumothorax

Question 9

Sleep apnea screening

Answer 9

Epworth
Berline
Stanford

Question 10

Objective tests for sleep apnea

Answer 10

Polysomnography
Napping tests
Maintenance of wakefulness test
Multiple sleep latency test

Question 11

Supplemental oxygen

Answer 11

Disqualifying

Question 12

Do not certify these respiratory conditions

Answer 12

Hypoxemia at rest

Untreated symptomatic obstructive sleep apnea

Narcolepsy

Primary idiopathic alveolar hypoventilation syndrome

Idiopathic central nervous system hypersomnolence

Restless leg syndrome with excessive daytime somnolence

Question 13

Sleep study indicated with following criteria 2 out of 3

Answer 13

BMI > 35

Neck size >17 in men / 16 in women

New/uncontrolled HTN

Sleep hx suggests sleep apnea

Epworth >10

Previously diagnosed

Previous sleep study >5 but less than 30

Question 14

Apnea definition

Answer 14

Airflow ceases more than 10 seconds

Question 15

Hyponea definition

Answer 15

Airflow decreases for >10 sec

Question 16

Mild sleep apnea

Answer 16

5+ episode/hr

Question 17

Moderate sleep apnea

Answer 17

15+ episode/hr

Question 18

Severe sleep apnea

Answer 18

30+ episode/hr

Question 19

Obstructive sleep apnea

Answer 19

> 30 episode/hr

Question 20

True or false: you can certify a driver for untreated or suspected sleep apnea

Answer 20

False

Question 21

Sleep disorders waiting/certification

Answer 21

Waiting 1 month

Minimum 3 month symptom free after surgery

Max 1 year certification

Question 22

COPD waiting/maximum

Answer 22

Waiting - no recommendations
Max cert 2 years
Has to be stable

Question 23

Pneumothorax

Answer 23

Waiting period - no recommendations

Certify- asymptomatic, confirmed resolution, meets pulmonary standards

Max 2 years

Question 24

Asthma waiting certification

Answer 24

Waiting none

Max certification 2 years

Question 25

Allergic reactions

Answer 25

Recommended to keep epipen in truck with driver

Question 26

Allergic rhinitis

Answer 26

No waiting period Can’t take antihistamine medication within 12 hours of driving

Question 27

Pulmonary hypertension

Answer 27

Can’t certify - dyspnea at rest, dizziness, hypotension, paO2 <65 mm

Question 28

Pulmonary TB waiting/certification

Answer 28

Waiting no timeframe | 2 years max certification

Question 29

Don’t certify TB if

Answer 29

Contagious Advanced TB not meeting PFT requirements Chronic TB not meeting PFT Hasn’t completed treatment Cranial nerve damage affect balance/hearing

Question 30

Atypical TB

Answer 30

No waiting period Max cert 2 years Can’t certify until tx completed

Question 31

Cor pulmonale can’t certify if

Answer 31

``` dyspnea dizziness hypotension partial pressure <65% FEV1 <65% ``` Certified after successful treatment

Question 32

A driver experienced a pneumothorax four weeks ago. The medical examiner tests the driver’s respiratory function and the FVC is 58% of predicted. What should the certification be?

Answer 32

Don’t certify pending further testing

Question 33

Pulse ox saturation =90%. Abg paO2 =60, paco2 =42 what is the determination

Answer 33

Certification depends on altitudes

Question 34

The Max certification interval for driver diagnosed with asthma is

Answer 34

2 years

Question 35

A spirometry should be performed on drivers who smoke and who are over the age ____ ?

Answer 35

35

Question 36

Which one is disqualifying: PaCO2 less than 45 Pa02 less than 70 at altitudes less than 5000 Pa02 less than 65 at altitudes above 5000 PaCO2 greater than 45

Answer 36

Greater than 45 paco2