Medical Standards/Regulations vs Medical Guidelines - ANSWER-Medical Standards/Regulations - are mandatory
Medical Guidelines - are advisory / at
... [Show More] medical examiner discretion
Outcomes (3 results) and maxed interval - ANSWER-1. Certified - max is 2 years
2. Disqualified
3. Determination pending - 45 days
Minimal Retention Period for Medial Records - ANSWER-3 years
T/F Driver must carry valid ME Certificate - ANSWER-True
T/F Motor carrier does not have to maintain a copy of the ME certification - ANSWER-False - they must maintain a copy of the ME certificate
Minimal Vision Requirements - ANSWER--Visual Acuity: 20/40 in each eye or both eyes (corrected or uncorrected)
-FOV: at least 70 degrees in the horizontal meridian of EACH eye
-Color: standard red, yellow, green
Monocular Vision Definition - ANSWER-Vision worse than 20/40 in at least one eye (corrected or uncorrected)
THIS IS DISQUALIFYING
T/F - one ear passing is ok - ANSWER-True
Minimum Hearing Requirements - ANSWER-Forced whisper in at least one ear at 5 feet; no less
OR
hearing loss no more than 40 db at 500, 1000, 2000 hz
Hear loss no more than what db and frequencies? - ANSWER-No more than 40 db @ 500, 1000, 2000 hz
Audiometer should be calibrated to what standard - ANSWER-ANSI - American National Standards Institute
Waiting period for Acute Vestibulopathy - ANSWER-2 months - symptom free
Chronic Vestibulopathy - ANSWER-Certify after waiting period of 2 months - symptom free
BPPV - ANSWER-Certify after waiting period of 2 months - symptom free
Uncontrolled Vertigo - ANSWER-DO NOT CERTIFY
Meniere's Disease - ANSWER-DO NOT CERTIFY
Nonfunctioning Labyrinth - ANSWER-DO NOT CERTIFY
Nonfunctioning Fistula - ANSWER-DO NOT CERTIFY
Stage 1, 2, 3 of HTN - ANSWER-Stage 1: 140-159/90-99
Stage 2: 160-179/100-109
Stage 3: 180 + / 110 +
Stage 1 HTN Certification Results - ANSWER-1 year max
3 month extension given if uncontrolled
Stage 2 HTN Certification Results - ANSWER-3 month then 1 year if controlled under 140/90
Stage 3 HTN Certification Results - ANSWER-Disqualify until controlled then only 6 month max intervals
T/F 3 month cert can only be given once a year - ANSWER-TRUE
Hypertrophic Cardiomyopathy - ANSWER-DISQUALIFIED
Restrictive Cardiomyopathy - ANSWER-DISQUALIFIED
Implantable Cardiac Defibrillator - ANSWER-DISQUALIFIED
CABG - ANSWER-Waiting period - 3 months (for incision to heal)
ETT after 5 years d/t risk of graft closure
MI - ANSWER-Waiting period - 2 months
needs cardiology clearance
Med tolerance w/o SE
EF > 40%
pass ETT and every 2 years after
T/F - passing EF is >40% - ANSWER-True
Percutaneous Coronary Intervention - ANSWER-Waiting period - 1 week
Needs cardio clearance
Tolerated meds w/o SE
ETT within 3-6 months
then ETT every 2 years
Unstable Angina - ANSWER-DISQUALIFY
Heart Transplant - ANSWER-Waiting period - 1 year w/o symptoms
Med tolerance
Cardio Clearance
Max interval CERT is 6 months
Max Cert for any heart condition except heart transplant is? - ANSWER-1 year
Heart Transplant is 6 months
Angina - ANSWER-Stable - asymptomatic and no change in pain pattern
Waiting period - 3 months
Needs med tolerance
No orthostatic changes in pressure
ETT every 2 years
CHF - ANSWER-IF secondary to hypertrophic or restrictive DISQUALIFY
if idiopathic dilated cardiomyopathy:
Needs cardio clearance
Asymptomatic
No Ventricular arrhythmia
Annual cardiac visits with holter and ecg
THEN CERTIFY
Anticoagulants - ANSWER-Needs Monthly INR records
Arrhythmias - ANSWER-For Certification pt needs:
EF>40%
waiting period of 1 month on tx / meds w/o symptoms
cardiac clearance
Annual cardiology visits
Afib and aflutter - ANSWER-Certify if asymptomatic
If on meds or cardioverted: 1 month waiting period and cleared by electrophysiologist
If risk for stroke needs anticoags and follow anticoag rules
Pacemaker for AV block or sinus node dysfunction - ANSWER-waiting period 1 month after implantation
annual cardiac eval
Pacemaker for Neurogenic syncope - ANSWER-waiting period 3 months w/o symptoms
Aneurysms (Abdominal) - ANSWER-Needs to be under 4.0 cm and asymptomatic'
If surgical intervention was done - 3 month waiting period
If 4.0 cm to 5.0 cm: needs cardio clearance and asymptomatic
IF 5.0 cm + or increase in 0.5 cm over the course of 6 months: Disqualify
Aneurysms (Throacic) - ANSWER-Needs to be under 3.5 cm
If surgical intervention was done - 3 month waiting period
IF greater than 3.5 cm or more than 0.5 cm over the course of 6 months: Disqualify
DVT - ANSWER-Certify if non resdiual DVT and monitor INF if anticoagulated
Aortic Stenosis - ANSWER-Needs to be asymptomatic and mild/moderated
If surgical intervention was done: 3 month waiting period
Otherwise DQ
Who should get spirometry testing? - ANSWER-All drivers with COPD and smokers at age of 35+
ABG should be obtained if? - ANSWER-FEV1 less than 65% predicted
FEV1/FVC ratio less than 65% predicted
FVC less than 60% predicted
OR
pulse ox less than 92%
ABG Disqualification Criterias - ANSWER-PO2 less than 65 mm hg (or if at more than 5000 ft elevation 60 mm hg)
OR
PaCO2 above 45 mm hg
CXR should be obtained for? - ANSWER-Significant Resp Abnormalities:
-Mitral Stenosis eval
-Hypersensitivity Pneumonitis
-Spontaneous Pneumothorax
-Positive PPD
Sleep Disorder Tests - ANSWER--Polysomnography
-Control sleep lab
-Maintenance Sleep Wakefulness test
-Napping test
-Multiple Sleep Latency Test
Indications for Sleep Studies - ANSWER-Needs 2 of 3 to meet indication criteria:
1. BMI >35
2. Neck Circumference > 17 in for men / >16 in for women
3. Uncontrolled / new onset HTN
4. HTN needing two meds for control
Absolute Indications for Sleep Studies - ANSWER--Hx or findings of OSA
-Epworth Sleepiness scale >10
-Previously diagnosed sleep disorder
-Previous sleep study apnea / hypoapnea >5 but <30
Sleep Apnea Definitions - ANSWER-Apnea: cessation of airflow for > or = to 10 sec
Hypopnea: decreased airflow (30/50%) > or = to 10 sec associated with oxygen desaturation (4 vs 3%) &/or arousal
Mild: 5+ episodes per hour
Moderate: 15+ episodes per hour
Severe: 30+ episodes per hour
Waiting Period for Sleep Apnea after starting CPAP? - ANSWER-1 month
Waiting period after Sleep Apnea after surgical intervention? - ANSWER-3 months
Max Cert and requirements for Sleep Apnea - ANSWER-Max Cert is 1 year
Pt must be symptom free, agree with uninterrupted therapy, and have yearly testing done
Antihistamine use - ANSWER-DQ if causing drowsiness within 12 hours of use
Untreated OSA/Sleep Apnea - ANSWER-DISQUALIFY
Restless leg syndrome with excessive daytime sleepiness - ANSWER-DISQUALIFY
Narcolepsy - ANSWER-DISQUALIFY
Hypoxemia at rest - ANSWER-DISQUALIFY
Use of supplemental O2 - ANSWER-DISQUALIFY
Max Cert for asthma or COPD - ANSWER-2 years
Max cert and indications for cert for Pneumothorax - ANSWER-Max cert: 2 years
Certify if - asymptomatic w/ resolution confirmed with CXR
Colds, influenza, and bronchitis - ANSWER-Certify when tx completed.
Drivers should not drive while contagious
and for at least 12 hours after taking sedating meds
Cert criteria for TB - ANSWER-Certify if not contagious, completed and compliant with tx w/o side effects
Epilepsy - ANSWER-DISQUALIFY
Meniere's Disease - ANSWER-DISQUALIFY
Dementia (organic etiology) - ANSWER-DISQUALIFY
Parkinsonism - ANSWER-DISQUALIFY
Cerebellar Ataxia - ANSWER-DISQUALIFY
Severe Traumatic Brain Injury - ANSWER-DISQUALIFY
AVM (untreated) - ANSWER-DISQUALIFY
Waiting period for 1 unprovoked Seizure - ANSWER-5 years
symptom free and off anticonvulsant meds
Waiting period for Epilepsy (2 or more unprovoked seizures) - ANSWER-10 years
symptom free and off anticonvulsant meds
Parkinsonism - ANSWER-DISQUALIFY
T/F: Driver with childhood febrile seizures should be disqualified - ANSWER-FALSE
Migraines, tension, an cluster headaches - ANSWER-DISQUALIFY IF interferes with vision / safe operation of truck
T/F: TIAs highest risk of recurrence is in the first year - ANSWER-TRUE
decreases to less than 5% after 1 year
TIA with treatment of anticoags - ANSWER-DISQUALIFY
TIA max cert? - ANSWER-1 year
CVA waiting period - ANSWER-1 year if not at risk for seizures (cerebellum or brainstem lesions)
5 years if at risk for seizures
*driver also must have neuro clearance and normal exam for cert
How is TBI classfied? - ANSWER-by depth of dural penetration and LOC
Mild, Mod, Severe TBI - ANSWER-Mild - NO dural penetration and LOC under 30 min
Moderate - NO dural penetration and LOC less than 24 hours but more than 30 min
Severe - Dural penetration and LOC more than 24 hours (high risk for seizures here)
Mild TBI WITH seizures or Mod TBI withOUT seizures waiting period? - ANSWER-2 years w/o seizure and off meds
Mod TBI WITH early seizures waiting period? - ANSWER-5 years w/o seizure and off meds
T/F; Drivers with aseptic meningitis should be disqualified - ANSWER-FALSE
Drivers with aseptic meningitis can be qualified
CNS infections waiting periods - ANSWER-Bacterial or Viral meningitis withOUT seizures: 1 year seizure free and off meds
Bacterial WITH seizures: 5 years seizure free and off meds
Viral WITH seizures: 10 years seizure free and off meds
CNS infection max cert? - ANSWER-2 years
Alzhiemer's Disease - ANSWER-DISQUALIFY
Pick's disease - ANSWER-DISQUALIFY
Untreated CNS tumors - ANSWER-DISQUALIFY
Waiting period for treated/surgically removed CNS tumors - ANSWER-1 year if it is:
-infratemporal meningioma
-acoustic neuromas
-pituitary adenomas
-benign spinal tumors
-benign extra-axial tumors
2 years if it is:
-benign supratentorial tumors
-malignant spinal tumors
Spinal tumor max cert - ANSWER-1 year
driver must have no neuro findings and negative imaging
Waiting period for BPPV - ANSWER-2 months sx free
Waiting period for chronic peripheral vestibulopathy - ANSWER-2 months sx free
Max cert for BPPV and Chronic peripheral vestibulopathy - ANSWER-2 years
Meniere's Disease - ANSWER-DISQUALIFY
Labyrinthine fistula - ANSWER-DISQUALIFY
Nonfunctioning labyrinths - ANSWER-DISQUALIFY
Skill Performance Evaluation (SPE) - ANSWER-Given by FMCSA not the ME and good for 2 years
Required for drivers with a fixed and stable impairment of an extremity not involving a torso.
T/F: peripheral neuropathy is usually disqualifying - ANSWER-TRUE but this is advisory not regulation
49 CFR 391.46 - ANSWER-Drivers must have a treating clinician for insulin
have the MCSA-5870 form filled within the last 45 days
Severe Hypoglycemia Definition - ANSWER-Needing assistance of another person, is accompanied by LOC, seizures, or coma
Dialysis of any type is... - ANSWER-DISQUALIFYING
3 categories of risk related to psychological disorders - ANSWER-1. the mental disorder and symptoms or performance issues integral to the disorder
2. residual symptoms after time-limited reversible episodes or the initial presentation of the full syndrome
3. psychotropic medication treatment that can compromise performance
BAC limit - ANSWER-0.04%
First generation antidepressants - ANSWER-Disqualify as they interfere with driving.
i.e.
amitriptyline
imipramine
clomipramine
phenelzine
49 CFR 391.41 - ANSWER-Physical qualification for drivers
49 CFR 391.43 - ANSWER-Instructions for medical examination; certificate of physical qualification.
Second Generation Antidepressants - ANSWER-Case by case basis
ie.e
fluoxetine
sertraline
norepinephrine
venlafaxine
bupropion
Lithium - ANSWER-Lithium is used for treatment of bipolar and depressive disorders. Studies suggest little evidence of lithium interfering with driver skill performance.
Benzo and barbs - ANSWER-interfere with safe driving
Drug and EtOH screening - ANSWER-not required but can be obtained for eval
Self-help groups - ANSWER-not required but does not fulfill the requirements for a substance abuse professiona
Alcoholism - ANSWER-DISQUALIFY
Methadone use - ANSWER-DISQUALIFY
Marijuana use - ANSWER-DISQUALIFY
Recert requirements of alcohol or drug abuser - ANSWER-SAP eval
complete SAP rehab program
The maximum certification interval for a driver with a history of drug abuse or alcoholism is - ANSWER-2 years
Recovering Alcoholism max cert - ANSWER-1 year
How many f/u drug tests for driver that is returning to duty after violating drug and etoh standards - ANSWER-6 drug screens in a year
Time frame for alcohol and drug testing after crash - ANSWER-8 hours for ETOH
32 hours for drugs [Show Less]