Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
106 Cards in this Set
- Front
- Back
|
Max time for any DOT certification |
2 years |
|
|
Vision disqualifications |
> 20/40 in each eye Field of vision <70 degrees Monocular vision Using 1 contact for distance and 1 for near vision Telescopic lenses (for Mac Deg) |
|
|
Certification criteria for Stage 1 HTN |
*Stage 1 (>140/90): 3 month cert until BP <140/90. Once BP is controlled may do 1 year certification |
|
|
Certification criteria for Stage 2 HTN |
*Stage 2 (>160/100): 1 time 3 month cert, DQ if not under 140/90 after that. Once BP is controlled may do 1 year cert |
|
|
Certification criteria for Stage 3 HTN |
*Stage 3 (>180/110): Cannot certify until BP is under 140/90, then may cert for 6 months |
|
|
Which 2 conditions have a federal exemption program? |
DM with insulin use Monocular vision |
|
|
Monocular vision |
DQ, unless applied for the exemption program, then may cert 1 year |
|
|
Hearing requirements |
Whisper test of at least 5ft OR audiometric showing hearing loss not less than 40dB at 500, 1000, and 2000 Hz *Can do either test, only do 2nd test if pt fails 1st one. DQ if fails both tests |
|
|
Meniere's Disease |
DQ |
|
|
BPPV |
DQ if uncontrolled Need to be asx for 2 months |
|
|
Labyrinthine Fistula |
opening between inner and middle ear DQ |
|
|
Anticoagulant therapy |
Need to be stable for 1 month Max cert 1 year need monthly INR results |
|
|
AAA requirements |
3 month wait after surgical repair, max cert 1 yr (if <4cm and asx or if 4-5cm, asx and clearance from cardio) DQ if any size with sx or if recommended for surgical repair, if >5cm, or if size has increased more than 0.5cm in 6 months |
|
|
Thoracic Aneurysm |
3 month wait after surgical repair, max cert 1 yr with cardiac clearance. Can certify if <3.5cm |
|
|
Acute DVT |
max cert 1 year if successfully treated and with no residual DVT present |
|
|
Chronic Thrombotic Venous Disease |
Max cert 2 years DQ if having any symptoms |
|
|
Claudication |
DQ if pain at rest, otherwise max cert 1 year, with 3 month wait after surgery |
|
|
Superficial phlebitis |
May cert up to 2 years, but rule out DVT during exam |
|
|
Pulmonary Embolism |
Min wait 3 months without additional PE, max cert 1 year. DQ if symptomatic |
|
|
ICD or ICD/pacemaker |
DQ- still at risk for syncope May cert if pacemaker alone: min wait 3 months, max cert 1 year |
|
|
SVT and A-fib |
may cert 1 year if HR controlled, on tx to prevent emboli, and has cardiac clearance. |
|
|
V fib and V tach |
min 1 month waiting period after therapy started. max cert 1 year. May cert if asx with clearance from cardio DQ if symptomatic, sustained VT, or LVEF <0.40 |
|
|
ECHO requirements |
LVEF > 40% and no pulmonary HTN (pulmonary artery pressure >50% of systolic BP) |
|
|
Exercise Tolerance Test (ETT) |
workload capacity > 6 metabolic equivalents, HR >85% of predicted max (unless on BBs), have a rise in systolic BP of >20mmHg without angina, and have no significant ST depression |
|
|
Acute MI |
min wait 2 months, max cert 1 year if asx, tolerates meds, satisfactory ETT, resting LVEF >40%, and no ischemic changes on EKG |
|
|
Angina |
Min wait 3 months no symptoms at rest. Max cert 1 year Certify if stable, asx, tolerates meds, and has a satisfactory ETT. Do not cert if unstable angina within last 3 months |
|
|
Max cert if CHD risk factors (DM, PVD, and age >45) |
1year |
|
|
CABG |
Min wait 3 month post op CABG max cert 1 year Certify if asx, tolerates meds with no orthostatic sx, LVEF>40%, has cardio examination, and sternum is healed. |
|
|
What does pt need if 5 years post op CABG |
Annual ETT, +/- imaging stress test |
|
|
CHF |
Max cert 1 year certify if asx, tolerates meds, LVEF>40%, has ETT results >6 metabolic equivalents Needs annual clearance from cardio with echo and holter monitering |
|
|
PCI |
min wait 1 wk if elective for stable angina. max cert 1 year (initial cert for 6 months, then may recert for 1 year if ETT is satisfactory @ 3-6 months postop) Certify if asx @ exam, tolerates meds, with no injury to the vascular access site |
|
|
Ebstein anomaly |
Max cert 1 year if asx Patients need annual cardiac clearance with ECHO |
|
|
Heart transplant |
min wait 1 year max cert 6 months, with cardio eval every 6 months |
|
|
Cardiomyopathies |
If enlarged heart suspected, do not certify until cardio eval Do not cert if dx with hypertrophic or restrictive cardiomyopathy |
|
|
Syncope |
max cert 1 year Can certify if treated for symptomatic disease, is asx, tolerates meds, is at low risk for future syncope and has clearance from a specialist. |
|
|
Murmurs |
max cert 1 year, do not cert if symptomatic Min wait 3 months after surgical valve repairs, 1 month after balloon valvuloplasty |
|
|
DQ for diabetes |
If requiring insulin use, unless pt is part of Diabetes exemption program. |
|
|
General DM guidelines |
Max cert 2 yrs, however 1 yr may be more reasonable d/t progressive nature of disease |
|
|
When not to certify with DM |
*if hx of hypoglycemia resulting in seizure, LOC, or impaired cognitive fxn within the last 12 months
*if 2 or more hypoglycemic reactions within last 5 years *if loss of position sensation, pedal sensation, or has resting tachycardia *if orthostatic hypotension, peripheral neuropathy, or proliferative retinopathy |
|
|
Requirements for DM exemption program |
Driver must check blood glucose before driving and every 2-4 hours while driving. (generally safe if between 100-400) Must carry a glucose source with them. Driver must have 5 yr medical hx to review. Other medical issues must be corrected before applying |
|
|
DM with insulin use |
Min wait 1 month after starting insulin, 2 months if newly diagnosed with no prior tx. |
|
|
Drug and Alcohol testing |
May be done during the visit. All drivers should be tested initially unless only driving on private property. If + drug test or BAC > 0.04 pt is to be removed from driving and referred to a SAP |
|
|
When to do drug and alcohol testing |
For preemployment, post accident, if supervisor suspicion, can be random, and for return to duty after violation of drug and alcohol standards. |
|
|
Does the driver need another examination if he tested positive for drugs/alcohol and completed a SAP? |
No |
|
|
Alcoholism/Drug abuse cert guidelines |
Max cert 2 years DQ if current clinical dx of Alcoholism DQ if driver uses Schedule I controlled subtances, amphetamines, narcotics, methadone, or marijuana |
|
|
HTN guidelines |
Always confirm BP with second reading. Do not cert if driver already has a one time 3 month cert and BP is still not under 140/90, if stage 3 HTN with BP still over 140/90, or if BP is > 180/110 regardless. If a 3 month cert is given, expiration of reexamination cert is using the original exam date. |
|
|
Secondary HTN |
Min 3 month waiting period post-surgical correction Max cert 1 year |
|
|
How long does a driver need to wait after taking antihistamines or any other sedating medication? |
12 hours |
|
|
Allergic Rhinitis |
Max cert 2 years. Do not cert if sx affect vision, uncontrollable sneezing, or sinusitis with severe HA |
|
|
Asthma |
Max cert 2 years Do not cert if symptomatic, continual, uncontrolled or if FEV1 <65% and PaO2 <65mmHg |
|
|
COPD |
Max cert 2 years Do not cert if hypoxemia at rest, chronic respiratory failure, or if hx of continuing cough with cough syncope. Spirometry should be done in all smokers over 35 |
|
|
Pulmonary TB |
Do not cert until determined to not be contagious and until tx is affective, safe, and stable. max cert 2 years |
|
|
Chest wall deformities |
max cert 2 years Do not cert if hypoxemia at rest, chronic respiratory failure, or hx of chronic cough with cough syncope Get FEV1 if difficulty breathing at rest. -- Get ABGs if FEV1 <65% predicted |
|
|
Cystic Fibrosis |
Max cert 2 years Do not cert if hypoxemia at rest, chronic respiratory failure, or hx of chronic cough with cough syncope, if spirometry requirements not met. |
|
|
Interstitial Lung Disease |
max cert 2 years Do not cert if hypoxemia at rest, chronic respiratory failure, or hx of chronic cough with cough syncope Get FEV1 if difficulty breathing at rest. -- Get ABGs if FEV1 <65% predicted |
|
|
Pneumothorax |
Cert requires CXRs showing complete recovery. Max cert 2 years DQ if more than 2 episodes on 1 side with no surgical intervention to prevent recurrence. |
|
|
Anticonvulsant therapy for something other than seizures |
Should not certify until it is shown to be safe and effective, with no side effects. Max cert 2 years |
|
|
Anticonvulsant therapy for seizures/epilepsy |
Automatic DQ |
|
|
Guidelines for insult to the brain without risk for seizures |
Min 1 year seizure free and off anticonvulsant medications Max cert 1 year |
|
|
guidelines for moderate brain insult without early seizures or mild insult with early seizures |
min 2 years seizure free and off anticonvulsant medications Max cert 1 year |
|
|
Guidelines if moderate brain insult with early seizures or stroke or hemorrhage with risk for seizures |
Min 5 years seizure free and off anticonvulsant medications Max cert 1 year |
|
|
Guidelines for severe brain insult with or without seizures |
Do not certify |
|
|
Systemic metabolic illness with seizures |
Max cert 2 years if underlying metabolic dysfunction has been corrected, unless at risk for recurrence |
|
|
Childhood febrile seizure |
Ok to certify, max 2 years, if seizure hx is limited to childhood. |
|
|
Timeline after first single unprovoked seizure |
5 years seizure free and off anticonvulsant meds |
|
|
Epilepsy |
DQ unless seizure free and off anticonvulsant medications for 10 years |
|
|
Headaches |
Use your clinical judgment based on headache severity and frequency. Max cert 2 years |
|
|
Use of antihistamines, benzos, or phenothiazines for dizziness/vertigo |
DQ, some antihistamines ok |
|
|
BPPV and peripheral vestibulopathy |
Min wait 2 months asx Max cert 2 years |
|
|
Meniere's Disease |
DQ |
|
|
Labyrinthine Fistula |
DQ |
|
|
CNS infections (Bacterial meningitis or viral encephalitis without early seizures) |
Min waiting period 1 year Max cert 2 years |
|
|
Bacterial meningitis with early seizures |
Min waiting period 5 years seizure free and off anticonvulsant meds |
|
|
Viral encephalitis with early seizures |
Min wait 10 years seizure free and off anticonvulsant meds |
|
|
Aseptic meningitis |
Ok to certify Max 2 years |
|
|
Autonomic Neuropathy |
Ok to cert (max 2 years) unless resting tachycardia or orthostatic hypotension |
|
|
Myotonia, Isaac's syndrome, or Stiff-man syndrome |
DQ |
|
|
Congenital myopathies |
DQ |
|
|
Metabolic muscle diseases |
DQ |
|
|
Motor neuron diseases |
DQ |
|
|
Muscular dystrophy |
DQ |
|
|
Neuromuscular junction disorder (Myasthenia gravis) |
DQ |
|
|
Peripheral neuropathy |
DQ |
|
|
CNS tumors |
Min wait 1 year post op tumor resection, must be seizure free and off of anticonvulsant meds. Max cert 1 year |
|
|
Benign supratentorial tumors and spinal tumors |
Min wait 2 years post op removal, must be seizure free and off of anticonvulsant meds. |
|
|
Dementia |
DQ |
|
|
Strokes and hemorrhages |
Min wait 1 year if not at risk for seizures (cerebellar or brainstem lesions) Min wait 5 years if at risk for seizures (cortical or subcortical lesions) Max cert 1 year |
|
|
TIA |
min wait 1 year max cert 1 year |
|
|
Anticoagulant therapy for TIA |
do not cert |
|
|
Moderate TBI without seizures and mild TBI with seizures |
Min wait 2 years seizure free and off meds max cert 1 year |
|
|
Moderate TBI with seizures |
Min wait 5 years max cert 1 year |
|
|
Mild TBI without seizures |
Max cert 2 years |
|
|
Severe TBI with or without early seizures |
DQ |
|
|
Parkinsons |
DQ |
|
|
Antidepressant therapy |
First generation (amytriptyline and imipramine) generally DQ, unsafe for driving. Second generation (SSRIs, SNRIs, Wellbutrin) generally safe Max cert 1 year |
|
|
Anxiolytic medications (Benzos) |
Can certify if half life less than 5 hours and if used for short term (<2 weeks) Otherwise do not certify |
|
|
Stimulant medications |
Ok if for ADHD (max cert 1 year) DQ if for Narcolepsy |
|
|
ECT for depression |
Min wait 6 months after treatment, must be symptom free, and cannot be undergoing maintenance ECT. |
|
|
Lithium Therapy |
May cert if no side effects, lithium levels in therapeutic range |
|
|
ADHD |
max cert 1 year Do not cert if prominent negative symptoms or active psychosis |
|
|
Bipolar Disorder |
Min wait 6 months after a major depressive episode with no suicidal thoughts. Min wait 1 year after a severe depressive episode, suicide attempt, or manic episode. Max cert 1 year |
|
|
Major Depression |
Min wait 6 months after a major depressive episode with no suicidal thoughts.
Min wait 1 year after a severe depressive episode, suicide attempt, or manic episode. Max cert 1 year |
|
|
How often should a pt with a mental health disorder get clearance from a Psychiatrist? |
At least every 2 years. |
|
|
Personality Disorders |
Max cert 1 year |
|
|
Schizophrenia related disorders |
Dx of schizophrenia: DQ Min 6 month wait sx free after brief reactive psychosis or schizophreniform disorder. Min 1 year wait sx free if any other psychotic disorder. Max cert 1 year |
|
|
Who needs a copy of the medical examiner's certificate |
1 copy to the driver and 1 to the motor carrier that employs the driver. |
