DOT Medical Examiner Certification 2023 Solved 100% Correct

What are the 3 points of contact when entering/exiting a cab? - ANSWER--hands -arms -leg What is the minimum passing grip strength required when using a dynamometer? - ANSWER--58 lbs -26.3 kgs Can those with peripheral neuropathy be certified? - ANSWER--do not certify! -inform the patient they can submit an appeal which will require evaluation by a physiatrist or neurologist Can those with autonomic neuropathy be certified? - ANSWER--if they have resting tachycardia do not certify! -if no resting tachycardia they can be certified for up to 2 years once etiology is confirmed and treatment is safe/effective Can those who are taking nitroglycerin be certified? - ANSWER--only if angina is stable -requires cardiology evaluation Can those with menieres disease be certified? - ANSWER--no! What are 3 neurologic conditions that are always disqualifying? - ANSWER--myotonia -Isaac's syndrome -stiff person syndrome What 3 factors are considered as part of the Council for Psychiatric Disease and Commercial Driving? - ANSWER--psychopharmacology -counseling -mental disorders The sedative effects of psychotropic medications are compared to what blood alcohol content? - ANSWER--0.04 Which psychiatric condition is most likely to be disqualifying? - ANSWER--schizophrenia What are the elements of the CAGE assessment? - ANSWER--cut down (do you feel the need to?) -annoyed (are you annoyed by the response of others?) -guilt (do you feel guilty about drinking?) -eye opener (do you need one?) What should you do if a candidate is visibley drunk on exam? - ANSWER--contact FMCSA or employer -should not certify if you suspect alcoholism Can you certify a driver who is actively in a 12-step or recovery program? - ANSWER--yes! When should you submit a candidate to drug/alcohol testing? - ANSWER--not part of the standard DOT exam -only performed if required by the employer or another regulatory agency What is the 1st indication of diabetic nephropathy? - ANSWER--persistent proteinuria on urine dipstick -can certify for 2 years if etiology confirmed and treatment is safe and effective How often does a candidate with a hernia require examination? - ANSWER--requires at least biennial medical exam -must check for visceral/GU/abdominal hernia(s) on exam -if painful they require further evaluation but can then be certified for up to 2 years if appropriate What should you do with a candidate who has abnormal urine dipstick findings? - ANSWER--refer back to primary care for evaluation and treatment Can you certify a candidate who is using medial marijuana? - ANSWER--no! What should you do with a candidate who is using a disqualifying medication? - ANSWER--refer back to primary care -they can still be qualified if approved by primary care but the ultimate decision is left up to the medical examiner -can certify for any time period you deem appropriate Can a patient on anticoagulants be certified? - ANSWER--if taking for neurovascular condition then no! -if taking for cardiovascular condition then yes -requires monthly INR checks to maintain certification Can a patient with migraines be certified? - ANSWER--yes they can be certified for up to 2 years -depends on the severity of symptoms and any associated symptoms they are having (e.g. visual disturbances) -must tolerate treatment Can a patient taking antacids be certified? - ANSWER--yes -ensure there are no acute incapacitating events associated with the underlying disease (e.g. IBD) Can a patient taking anticonvulsants for seizures be certified? - ANSWER--no! Can a patient taking Provigil (modafinil) be certified? - ANSWER--yes but only for 1 year max and only after a 6 week monitoring period What 3 environmental factors are candidates exposed to? - ANSWER--whole body vibration -temperature extremes -excessive noise What are the ETT qualification standards? - ANSWER--workload 6 METS -% predicated max HR 85% -increase SBP 20 mmHg -no angina -no ECG changes What is the definition of pulmonary hypertension? - ANSWER--PAP 50% systemic SBP as determined per echo or cardiac cath Can you certify a patient with unstable angina? - ANSWER--no! refer to specialist What is the #1 prognostic indicator for CAD? - ANSWER--left ventricular function What is the #1 prognostic indicator for dysrhythmias? - ANSWER--underlying etiology Can you certify a patient with a dysrhythmia? - ANSWER--yes -must disqualify if it results in cerebral hypoperfusion or altered mental status What 3 factors must you consider in a patient with CHD? - ANSWER--severity of the defect -result of treatment -risk of sudden death or incapacitation What is the most common CHD you will see? - ANSWER--ebstein anomoly -usually associated with ASD -requires annual CV exam w/ echo When should you disqualify someone with pulmonary hypertension? - ANSWER--dizziness -hypotension -dyspnea at rest -PaO2 65 mmHg What are the requirements for certifying a candidate post aortic valve repair? - ANSWER--at least 3 months post op -asymptomatic -cleared by CV specialist -no thromboembolic complications What are the requirements for certifying a candidate post heart transplant? - ANSWER--no signs of transplant rejection (e.g. fever/dyspnea) -certification time = 6 months When should you disqualify a candidate who has mitral regurgitation? - ANSWER--symptomatic -6 METS -ruptured chordae -atrial fibrillation -left ventricular dysfunction -thromboembolism -pulmonary hypertension How greatly is the risk of recurrent thromboembolism reduced in a patient taking anticoagulant therapy? - ANSWER--80% When can you certify a patient with a history of DVT? - ANSWER--when etiology is confirmed and treatment is safe and effective What is the maximum certification period for a patient with superficial phlebitis? - ANSWER--max 2 years What is the waiting period for a patient post surgical repair for PVD? - ANSWER--3 month waiting period What is the waiting period for a patient post surgical repair for TAA? - ANSWER--3 month waiting period When is a TAA disqualifying? - ANSWER--size 3.5 cm What are the 2 criteria for certifying a patient with dilated CMP? - ANSWER--history of only non sustained VT -EF 40% Can you certify a patient with restrictive CMP? - ANSWER--no! What is a complication of TB therapy that you should be aware of? - ANSWER--CN8 damage -results in hearing/balance difficulty What are the 3 cardinal signs of COPD? - ANSWER--chronic cough -increased sputum production -dyspnea on exertion What are the 2 requirements per FMCSA to be eligible for medical examiner certification? - ANSWER--professional licensure -ability to perform physical exams What is the definition of interstate commmerce? - ANSWER--between a place in a state and a place outside that state -between two places in a states through another state -between two places in a state as part of commerce originating or terminating outside that state When is medical examination required for interstate drivers? - ANSWER--gross vehicle weight 10K lbs -between 9-15 passengers (including the driver) when driving for compensation -16 or more passengers (including the driver) whether or not driving for compensation -transportation of hazardous materials Who publishes the rules for drug and alcohol testing - ANSWER--department of transportaion (DOT) -they determine who gets tested and the procedures for doing so Do regulatory requirements take precedence over HIPPA? - ANSWER--yes! Who should get a copy of the driver certificate? - ANSWER--1 copy to the driver -1 copy to the motor carrier -keep 1 copy on file -no release form is required Which code includes the regulations for physical qualifications for drivers? - ANSWER--49 CFR 391.41 What is an SPE certification - ANSWER--special skills evaluation -alternative qualification standard -for those with FIXED msk deficits (not progressive!) of an extremity -driver must be otherwise qualified What are the 2 federal exemption programs - ANSWER--vision and diabetes -both require annual medical examination for maintenance of exemption What is the age requirement to become a CMV driver? - ANSWER--21 years old When are state regulations used instead of federal? - ANSWER--for intrastate commerce