NRCME Study Sheet. Questions and answers, 100% Accurate. Rated A

vision requirements - ✔✔Distant vision 20/40 each eye and 20/40 both eyes, Peripheral vision at least 70 degrees, Ability to recognize and distinguish betwen the colors of traffic signals and devices. If the driver pr ...

vision requirements - ✔✔Distant vision 20/40 each eye and 20/40 both eyes, Peripheral vision at least 70 degrees, Ability to recognize and distinguish betwen the colors of traffic signals and devices. If the driver presents a valid vision exemption, how long can he be certified? - ✔✔1 year The driver with a vision exemption must present what 2 things before receiving the medical examiner's certificate. - ✔✔Valid vision exemption and copy of the specialist eye examination report. When applying for a vision exemption, the driver should include a copy of the Medical Examination Report form and the medical examiner's certification with what marked? - ✔✔The "accompanied by" exemption checkbox and write "vision" to identify the type of exemption. If the driver is qualified by operation of 49 CFR 391.64 due to participation in the vision study program, what must the driver present to qualify for certification? - ✔✔Letter identifying the driver as a participant and copy of the specialist eye examination. How long can a driver who is qualified by operation of 49 CFR 391.64 be certified. - ✔✔1 year hearing requirements - ✔✔Whisper at not less than 5 feet in 1 ear, or average hearing loss no greater than 40 dB at 500Hz, 1000Hz, 2000 Hz in 1 ear. What is the waiting period for vertigo caused by benign positional vertigo or acute/chronic peripheral vestibulopathy? - ✔✔3 months Name 4 otic conditions that are automatic disqualification - ✔✔Meniere's, uncontrolled vertigo, labyrinthine fistula, nonfunctioning labyrinth Apnea-hypopnea index of [blank] or more episodes per hour is diagnostic of OSA - ✔✔30 3 requirements for a passing ETT - ✔✔1. increased SBP of at least 20 without angina 2. workload capacity >6 METs 3. no significant ST depression Examiners must retain records for how many years? - ✔✔3 Regulation that describes the physical qualifications of drivers. - ✔✔49 CFR 391.41 Regulation that describes the responsibilities of the medical examiner. - ✔✔49 CFR 391.43 Regulation that describes the process for conflict resolution when there is a disagreement between the primary care provider for the driver and the medical examiner for the motor carrier concerning driving qualifications. - ✔✔49 CFR 391.47 Regulation that describes the Skill Performance Evaluation (SPE) Certification Program. - ✔✔49 CFR 391.49 Regulation that describes limited exemptions for intra-city zone drivers. - ✔✔49 CFR 391.62 Regulation that describes grandfathering for certain drivers who participated in vision and diabetes waiver study programs. - ✔✔49 CFR 391.64 Regulation that includes regulations for medical review officers and substance abuse professionals, including drug and alcohol testing procedures. - ✔✔49 CFR 40 Define Stage I Hypertension - ✔✔BP greater than or equal to 140/90 What is the maximum certification period for stage I hypertension if this is the 1st examination at which the driver has BP equivalent to stage I hypertension and has no history of hypertension? - ✔✔1 year What is the maximum certification period for untreated known or inadequately controlled stage I hypertension? - ✔✔3 months What is the maximum certification period for blood pressure >140/90 and the following: follow-up 3 months certificate or history of stage III hypertension - ✔✔None, driver is disqualified Define Stage II hypertension. - ✔✔BP is ≥ 160 to <180 SYSTOLIC, and is ≥100 to < 110 Diastolic What is the maximum certification period for Stage II hypertension with blood pressure >140/90? - ✔✔3 months What is the maximum certification period for Stage II hypertension with blood pressure 180 Systolic and > 110 Diastolic What is the maximum certification period for Stage III hypertension with blood pressure >140/90? - ✔✔1 time certificate for 3 months in accordance with stage 1 or 2 HTN guidelines, as determined by a case by case basis. What is the maximum certification period for a driver with a history of Stage III hypertension but t exam his BP is at or less 140/90 and treatment is well tolerated? - ✔✔6 months What is the maximum certification period for Stage III hypertension with blood pressure >180/110? - ✔✔None, driver is disqualified. What is the waiting period and maximum certification period for surgical correction of secondary hypertension? - ✔✔3 months and 1 year post surgical correction What is the waiting period and maximum certification period for driver on anticoagulants for cardiovascular cause? - ✔✔1 month stabilized and 1 year with monthly INRs What is the waiting period and maximum certification period for driver on anticoagulants for neurlogical condition? - ✔✔None, driver is disqualified. 5 reasons to disqualify a driver with AAA - ✔✔1. Symptomatic 2. AAA >5cm 3. AAA 4-5 cm and does not have clearance from a cardiologist 4. AAA increased in size 0.5cm in 6 months 5. Surgical repair was recommended but not done Maximum certification period for driver with AAA that is asymptomatic or <4cm, >4cm and <5cm but has clearance from cardiologist - ✔✔1 year Maximum certification period for Acute DVT - ✔✔1 year Maximum certification period for Chronic DVT - ✔✔2 years Waiting period and maximum certification period for intermittent claudication if driver has no resting pain. - ✔✔3 months for post-surgical repair and 1 year Waiting period and maximum certification for aneurysms of visceral, peripheral arteries or venous vessels - ✔✔3 months post-surgical repair and 1 year with clearance from cardiologist Waiting period and maximum certification for peripheral vascular disease - ✔✔3 months post-surgical repair and 1 year without resting pain Waiting period and maximum certification for pulmonary emboli - ✔✔3 months with no pulmonary embolism and 1 year if asymptomatic Maximum certification period for superficial phlebitis - ✔✔2 years Waiting period and maximum certification for thoracic aneurysm <3.5cm - ✔✔3 months post surgical repair and 1 year True or false: having an ICD is automatic disqualification - ✔✔true Min waiting period for pacemaker implantation for sinus node dysfunction or AV block - ✔✔1 month Min waiting period for pacemaker implantation for neurocardiogenic syncope or hypersensitive carotid sinus with syncope - ✔✔3 months In order for a driver to receive maximum certification period of 1 year for pacemaker the driver must: - ✔✔Comply with pacemaker center scheduled function checks and provide documentation of pacemaker function checks at examination. Minimum waiting period for atrial fibrillation - ✔✔1 month with adequate anticoagulation Minimum waiting period for atrial flutter - ✔✔1 month post-isthmus ablation Minimum waiting period for AV nodal reentrant tachycardia, AV reentrant tachycardia and WolffParkinson-White syndrome, Atrial tachycardia, Junctional tachycardia - ✔✔1 month without symptoms Maximum certification period for SVT with adequate rate control, anticoagulation if indicated, and clearance from a cardiologist. - ✔✔1 year Minimum waiting period for VT caused by coronary heart disease, right ventricular outflow VT, Idiopathic LV VT. - ✔✔1 month after drug or other therapy Maximum certification for VT if patient is asymptomatic, NSVT with LVEF >40% and has clearance from a cardiologist - ✔✔1 year Driver is to be disqualified if VT and the following: - ✔✔symptomatic, sustained VT, NSVT with LVEF <40% or diagnosis of hypertrophic cardiomyopathy, long QT interval syndrome or Brugada syndrome Waiting period and maximum certification for Acute MI is - ✔✔Waiting period 2 months post MI and maximum certification is 1 year What is required for initial certification following MI? - ✔✔In-patient post-MI echocardiogram showing LVEF 40% What are the requirements for certifying driver with history of MI? - ✔✔Asymptomatic, satisfactory ETT every 2 years, LVEF >/40%, no electrocardiogram ischemic changes and clearance by cardiologist Waiting period and maximum certification for angina in a driver without resting angina or change in angina pattern and 1 year with satisfactory ETT every 2 years and clearance by cardiologist - ✔✔3 months CHD risk-equivalent conditions include: - ✔✔DM, PVD, Framingham risk score predicting 20% CHD event risk over the next 10 years or being over 45 years of age with multiple risk factors for CHF Maximum certification of multiple CHD risk-equivalent is - ✔✔1 year Waiting period and maximum certification for CABG if the driver is asymptomatic, LVEF >/40%, healed sternum and cleared by cardiology - ✔✔3 months after CABG and 1 year 5 years post-CABG, what routine tests need to be completed - ✔✔Annual ETT and imaging stress test if indicated What is the maximum certification period for driver with heart failure who is asymptomatic, has ETT >6 METS and LVEF >/40% - ✔✔1 year Heart failure disqualifications are: - ✔✔Symptomatic, asymptomatic with LVEF 6MET on Bruce protocol, LVEF <50%, LVEDD >70mm or LVES >55mm Follow up evaluation for drivers with severe aortic regurgitation - ✔✔Echocardiogram every 6 to 12 months if LVEDD <60mm or LVESD <50mm or every 4-6 months if LVEDD =60mm or LVESD =50mm Waiting period and maximum certification of aortic stenosis in driver with mild aortic stenosis and is asymptomatic, moderate aortic stenosis that is asymptomatic or severe aortic stenosis that has been surgically repaired - ✔✔3 months post-surgical repair and 1 year What disqualifies a driver with aortic stenosis - ✔✔If moderate aortic stenosis and angina, heart failure, atrial fibrillation, LV dysfunction with EF<50% or thromboembolism. If severe aortic stenosis regardless of symptoms. Follow up evaluation for drivers with aortic stenosis - ✔✔Echocardiogram every 5 years if mild aortic stenosis and every 1 to 2 years if moderate aortic stenosis Follow up evaluation for drivers following aortic valve repair - ✔✔Two-dimensional echocardiogram with Doppler prior to discharge and follow up based on aortic regurgitation severity Waiting period and maximum certification for mitral regurgitation if driver has mild or moderate mitral regurgitation if asymptomatic, normal LF size and function and normal pulmonary artery pressure; severe mitral regurgitation that is asymptomatic; or surgical mitral valve repair, is asymptomatic and has cardiac clearance - ✔✔3 months if post-surgical commissurotomy and 1 year Disqualification for mitral regurgitation - ✔✔Symptoms, less than 6 METs on Bruce protocol, ruptured chordae or flail leaflet, atrial fibrillation, LV dysfunction, thromboembolism and pulmonary hypertension Follow up evaluation for drivers with mitral regurgitation - ✔✔Annual echocardiogram if moderate mitral regurgitation. ETT and echocardiogram every 6 to 12 months if severe mitral regurgitation. Waiting periods and maximum certification period for mitral stenosis in driver with mild mitral stenosis that is asymptomatic, moderate stenosis that is asymptomatic, or severe mitral stenosis and cardiac clearance - ✔✔4 weeks if post-percutaneous balloon mitral valvotomy or 3 months if post-surgical commissurotomy and 1 year Follow up evaluation for drivers with mitral stenosis - ✔✔Annual cardiac clearance with chest x-ray, electrocardiogram and two-dimensional echocardiogram with doppler Waiting period and maximum certification period for mitral valve prolapse - ✔✔3 months if postsurgical repair 1 year Follow up evaluation for drivers with mitral valve prolapse - ✔✔Echocardiogram annually and cardiac clearance Disqualification of drivers with mitral valve prolapse - ✔✔Symptomatic, ruptured chordae or flail leaflet, systemic emboli, atrial fibrillation, syncope or documented VT or severe mitral regurgitation or LV dysfunction Waiting period and maximum certification for pulmonary valve stenosis if driver has mild or moderate pulmonary valve stenosis or pulmonary valve stenosis corrected by surgical valvotomy or balloon valvuloplasty - ✔✔1 month if post-balloon valvulopasty or 3 months if post-surgical valvotomy and 1 year Disqualification of drivers with pulmonary valve stenosis - ✔✔Symptoms of dyspnea, palpitations or syncope; Pulmonary valve peak gradient >50mmHg in the presence of normal cardiac output; RV pressure >50% systemic pressure; Moderate or severe RV hypertrophy noted by echocardiography; Moderate or severe RV dysfunction noted on echocardiography; severe pulmonary valve regurgitation noted by echocardiography; Main pulmonary artery diamete