Dot Medical Examiners Test

Front 1

Loading and unloading of a truck is an example of "vigorous physical activity" and requires a driver to exert
A. 4 METS B. 5 METS C. 6 METS

Back 1

C

Front 2

FMCSA Medical examiners duties under 49 CFR 391.43 DO NOT INCLUDE:
a. determine medical fitness for duty
b. Make recommendations for specialist follow up
c. issue Medical Examiners Certificates to qualifying drivers

Back 2

B

Front 3

The Medical Examiners Certification date is dertermned by the
a. date of the initial physical exam
b. date of the follow up exam

Back 3

A

Front 4

If a driver reports symptoms of undiagnosed CVD (cardiovascular dz)
a. refer to a specialist for further testing prior to certifying
b. 3 mos temporary qualifying until seen by a specialist.
c. Give Rx for nitro to prevent any subsequent sx.

Back 4

A

Front 5

Dialysis?

Q qualify
DQ disqualify

Back 5

DQ

Front 6

Diabetic on injectable Byetta?
Q or DQ?

Back 6

Q (providing they meet all other criteria)

Front 7

When filling out the health history the driver must report illness or injury for _________ years prior?

Back 7

5 years

Front 8

SPE (skilled performance exam) is used for evaluating Fixed or progressive deficits?

Back 8

FIXED

Front 9

Which color is NOT required for a driver to see?
amber
green
blue
red

Back 9

blue

Front 10

Field of vision in both eyes would pass if:
a. 65 degrees
b. 80 degrees

Back 10

b.
must be at least 70 degrees

Front 11

Monocular vision?
Q
DQ

Back 11

DQ unless they have a waiver from the federal gov't and a note from their ophthalmologist. Not issuing these anymore so probably will never see one.

Front 12

T or F
A driver must successfully perceive a forced whisper at 5ft in both ears

Back 12

F only one ear

Front 13

Audiometric testing is administered at what hz?

Back 13

500, 1000, 2000

Front 14

A driver has "white coat htn" and brings readings from his home machine. These can be used to qualify him.
T or F

Back 14

F
Only readings taken during the exam count

Front 15

Stage 1 HTN =
a. 140/90
b. 160/90
c. 128/89

Back 15

A

Front 16

160-179/ 100-109 =
Stage 1 HTN
Stage 2 HTN
Stage 3 HTN

Back 16

Stage 2

Front 17

Urine tests for all but
a. SG
b. Glucose
c. pH
d. Blood

Back 17

C

(it also tests for protein)

Front 18

A driver with injuries may be qualified with a restriction in certain duties.
T or F

Back 18

F
Must be able to perform all duties

Front 19

The medical examiner is required to maintain a copy of the medical record for ________ years

Back 19

3 years

Front 20

________dB is an acceptable average hearing loss.

Back 20

40 dB

Front 21

An abdominal aortic aneurysm of less than ________ cm can be qualified for a year.

Back 21

4cm
(assuming asymptomatic)

Front 22

AAA 4-5 cm can be qualified if
a. they are stable for 2 years
b. they are asymptomatic
c. they are asymptomatic and have a cardiovascular specialist clearance

Back 22

C

Front 23

If a AAA increases more than ______cm in a _______month period then DQ regardless of size.

Back 23

0.5 cm in a 6 mos period

Front 24

Minimum waiting period for most surgeries is -

Back 24

3 mos

Front 25

A driver needs to be on Coumadin and monitored for ____ months before being cleared to drive.

Back 25

1 mos

Front 26

The only acceptable monitoring for coumadin is
a. INR
b. PT
c. APTT

Back 26

a INR

Front 27

Minimum monitoring for a driver on coumadin
a. once every 6 weeks.
b. once a month
c. once every 2 weeks

Back 27

b. once a month

Front 28

A driver on coumadin due to cerebrovascular disease
Q or DQ?

Back 28

DQ
too high of a risk of bleed

Front 29

Maximum certification for a driver being treated for acute dvt and no symptoms

Back 29

1 year

Front 30

Disqualify thoracic aneurysm > _______cm

Back 30

3.5 cm

Front 31

Pt has a combination ICD/pacemaker
Q or DQ

Back 31

DQ - this does not control the arrhythmia it only treats it when it happens.

Front 32

Pt has a pacemaker only and is 4 mos out from insertion. Rate is stable and other qualifying criteria are met. What else does driver need to qualify for one year certificate?

Back 32

Documentation of pacemaker checks and functioning pacemaker

Front 33

Hypertrophic cardiomyopathy
Q or DQ

Back 33

DQ

Front 34

LVEF <40% per echocardiogram
Q or DQ

Back 34

DQ

Front 35

A driver taking an exercise tolerance test (ETT) should be able to demonstrate all BUT:
a. exercise to a workload of 6 METS using Bruce protocol
b. obtain a heart rate < or equal to 85% of maximum predicted even if ON beta blockers
c. have a rise in systolic BP of >20mm Hg without any angina
d. Have no significant ST depression

Back 35

B. if on beta blockers heart rate doesnt need to go >85%

Front 36

Waiting period after acute MI?

Back 36

2 mos

Front 37

After waiting period, certify post MI driver for one year if what criteria are met?

Back 37

The driver:

Is asymptomatic.
Tolerates medications.
Has a satisfactory exercise tolerance test (ETT).
Has a resting left ventricular ejection fraction (LVEF) greater than or equal to 40%.
Has no electrocardiogram ischemic changes.
Obtains clearance for cardiologist
Has biennial ETT

Front 38

Because of the risk of reocclusion over time, 5 years post-CABG surgery, the driver should obtain:

Back 38

Annual exercise tolerance test.
Imaging stress test, if indicated.

Front 39

Annual Holter Monitoring is recommended for which?

a. angina pectoris
b. hypertrophic cardiomyopathy
c. Congestive heart failure

Back 39

Heart failure along with echo, holter done yearly

(remember hypertrophic heart is an automatic DQ)

Front 40

Waiting period post PTCA -

Back 40

1 week... doesnt seem like a lot, but that's the regulation...
Would be more if there was an MI to go along with it, then it would be 2 month

Front 41

After PTCA there initial certification is for 6 mos pending results of a _________

Back 41

ETT

Front 42

Maximum certification for heart transplant following one year waiting period?

Back 42

every 6 mos w/ letter from transplant doctor

Front 43

Following a syncopal episode, the driver should not be qualified until:
a. symptom free for six months
b. they have a pacemaker
c. they have been referred and clear etiology to the cause of the syncope is determined

Back 43

C

Front 44

Which of the comments about spirometry are FALSE?

a. Spirometry should be performed on all smokers over 35 years old
b. If FEV1 is less than 65% of predicted, arterial blood gasses should be obtained
c. Spirometry should be performed on all asthmatics

Back 44

C this is a false statement

Front 45

Waiting period after starting CPAP machine?

Back 45

1 mos

Front 46

Waiting period after surgery for sleep apnea?

Back 46

3 mos - that's about standard for ALL surgeries

Front 47

Maximum certification for chronic sleep disorders even if treated?

Back 47

1 year

Front 48

When to DQ a driver with spontaneous pneumothorax?

A history of ______ or more spontaneous pneumothoraces on one side if no successful surgical procedure has been done to prevent recurrence.

Back 48

TWO

Front 49

If pulse oximetry is less than ______ % on room air, then ABG's must be obtained

Back 49

92

Front 50

For ABG's obtained at an altitude of less than 5,000 feet, disqualifying would be a
Pa(O2) of < _______
Pa( C02) of >
_______

Back 50

65 O2
45 CO2

Front 51

Dyspnea at rest:
a. obtain PFT's
b. obtain pulse oximetry
c. DQ

Back 51

C. DQ

Front 52

history of 2 unprovoked seizures (not including febrile) at ANY point in a driver's life
DQ or Q

Back 52

DQ like a Blizzard
This is epilepsy

Front 53

A driver with seizure maintained successfully on anticonvolescent medications for 5 years may qualify.

T or F

Back 53

NOOOOOOOOO
they have to be OFF all meds to qualify AND seizure free

Front 54

Waiting period after a history of single unprovoked seizure and off all meds

Back 54

5 years

Front 55

Childhood febrile seizures maximum recertify

Back 55

2 years

Front 56

Recommend to certify?

A. Acute and chronic peripheral vestibulopathy and has been symptomatic within the past 2 months.
B. Meniere's disease.
C. Labyrinthine fistula.
D. Nonfunctioning labyrinths.
E. Benign positional vertigo, asymptomatic for 2 mos

Back 56

E
rest of them are DQ

Front 57

Minimum waiting period for bacterial meningitis with early seizure?

Back 57

5 years

10 years for viral with early seizure

1 year for BOTH without early seizure

Front 58

Neurological waiting periods go to this link

Back 58

http://nrcme.fmcsa.dot.gov/mehandbook/neuro_waiting_sums_ep.aspx

Front 59

One or two year wait following surgery for these cerebral tumors?
Infratentorial meningiomas.
Acoustic neuromas.
Pituitary adenomas.
Spinal benign tumors.
Benign extra-axial tumors.

Back 59

1 year

Front 60

One year or two year wait following surgery for these cerebral tumors?
Benign supratentorial tumors.
Spinal tumors.

Back 60

two years

Front 61

Dementia of any severity
Q or DQ

Back 61

I can't remember.....

DQ of course

Front 62

Which of the following stroke areas are at an increased risk of seizure and require a 5 year waiting period?
a. Cerebellum and brainstem vascular lesions
b. Cortical and subcortical defecits

Back 62

B
(one year A)