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DOT Study > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

49 CFR 391.41 b 4

A

Cardiovascular physical qualifications

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2
Q

49 CFR 391.43 f

A

Cardiovascular medical examination

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3
Q

Minimally invasive cardiovascular procedures

A

Coronary steering

Arrhythmia ablation procedures

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4
Q

True or false: implantable defibrillators are disqualifying

A

True

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5
Q

True or false: OTC supplements may interfere with prescription medications and cause CV symptoms

A

True

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6
Q

Causes of ephedra

A

Tachycardia

Hypertension

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7
Q

Garlic, ginkgo, goldenseal can interact with the blood thinners causing?

A

Excessive bleeding

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8
Q

Licorice can cause

A

HTN

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9
Q

Additional tests for cardiovascular disease

A 
Electrocardiographs
Stress tests
Ejection fractions
Vascular studies
Labs
X-rays
Drug levels
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10
Q

Maximum certification for cardiovascular diseases

A

1 year

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11
Q

New York heart association (NYHA) classification

A

4 categories I-Iv

Iv more severe - limitations in physical activity/ decreased overall health

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12
Q

What test can be required for monthly monitoring

A

INR for anticoagulant

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13
Q

Non modifiable CVD risk factors

A

Age 45 high risk 60 higher risk

Makes high risk, post menopausal women high risk

Family hx- premature cvd 1degree relative- males less than 55, less than 65

Race - African highest risk

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14
Q

Modifiable CVD risk factors

A 
HTN
smoking
Cholesterol
High triglycerides 
Obesity
Sed. Lifestyle 
Diabetes
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15
Q

CHD risk equivalent conditions include

A

Diabetes

PVD

Framingham risk predicting 20% over next 10 years
Age over 45 yoa w/multiple risk factors

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16
Q

Qualifications to certify CHD

A

Asymptomatic
No ischemic changes on ecg
No incapacity
No exercise tolerance test abnormalities

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17
Q

Waiting period/certification for CHD

A

Waiting: none no certification until stable

Max. Cert. 1 yr

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18
Q

Exercise tolerance test

A

Exercise to a workload if >6 Mets through Bruce stage ii.

Heart rate >85% of predicted maximum (unless on beta blockers)

Rise in SBP >20 without angina

No ST depression or elevation and no marked t-wave abnormalities

No ventricle dysthymia’s

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19
Q

No certification for MI if:

A

recurrent angina

Post MI ejection fraction <40%

Abnormal ETT

Evidence of ischemia, arrhythmia

Ischemic changes at rest on ECG

Unable to tolerate current meds

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20
Q

Can certify MI when:

A 
2 months post MI
Cleared by cardiology
Passed ETT
no angina
EF >40%
Tolerating Current meds
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21
Q

Ejection fraction less than 40%

A

Disqualifying

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22
Q

Annual certification requirements for MI

A

ETT every 2 years

Cardiology examination

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23
Q

Percutaneous coronary intervention certification qualifications

A 
1 week post procedure 
Cardiology approval
Tolerating meds
Neg ETT 3-6 months after 
No rest angina
No ischemic changes on ecg
No incomplete healing or complications
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24
Q

Percutaneous coronary intervention waiting/ max cert

A

Waiting period 1 week

Max cert 1 year

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25
Q

Requirements for Percutaneous coronary intervention ETT

A

ETT 3-6 months after PCI

Every 2 years after

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26
Q

Certification qualifications coronary artery bypass graft surgery

A

3 months waiting

Left ventricle ejection fraction greater or equal to 40% after CABG
Cardio okay
Asymptomatic 
Tolerance to meds
ETT 5 years after
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27
Q

CABG waiting period/max. Cert.

A

Waiting 3 months

Max 1 year

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28
Q

Heart transplant requirements

A

Asymptomatic
Tolerates meds
Clearance from cardio
No signs of transplant rejection

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29
Q

Heart transplant waiting/certification

A

Waiting 1 year

Max. Cert 6 months

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30
Q

Angina pectoris unstable

A

Certification not recommended

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31
Q

Angina pectoris stable

A

Can certify

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32
Q

Angina pectoris waiting/max. Cert

A

Waiting 3 months no rest angina, change in angina pattern

Max. Cert. 1 year

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33
Q

Angina pectoris certification qualifications

A

Stable angina

Asymptomatic

Tolerates meds

SBP not <95 no orthostatic drop >20 with standing

Passed ETT

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34
Q

Consideration with angina medications

A

Can potentially cause hypotension/orthostatic

35
Q

Angina pectoris monitoring requirements

A

Biennial ETT

Cardio clearance

36
Q

Can not certify which heart conditions

A

Hypertrophic cardiomyopathy

Restrictive cardiomyopathy

37
Q

Certification for CFH related to dilated cardiomyopathy

A

Asymptomatic
Tolerates meds
No ventricle arrhythmias

38
Q

CHF requirements for certification

A

LVEF greater than or equal to 40%

Cardiology eval with ekg and holter monitoring

39
Q

Syncope certification requirements

A

Has been treated for symptomatic disease

Asymptomatic

Tolerates meds

Low risk falls/syncope

Cardio/neurologist clearance

40
Q

Max cert for syncope

A

1 year

No waiting period recommendations

41
Q

Neurcardiogenic syncope qualifications to certify

A

Documented correct functioning pacemaker

Asymptomatic

42
Q

Neurocardiogenic syncope requirements for certification

A

Annual exam
Pacemaker checks
Asymptomatic

43
Q

Neurocardiogenic syncope waiting/max. Cert

A

Waiting 3 months after pacemaker implantation

Max cert. 1 year

44
Q

Hypertensive carotid sinus with syncope

A

Documented pacemaker functioning

Asymmetrical

45
Q

Hypertensive carotid sinus with syncope waiting/max cert

A

Waiting 3 months after pacemaker

1 year max cert

46
Q

Hypersensitive carotid sinus with syncope annual requirements

A

Annual exam
Pacemaker checks
Asymptomatic

47
Q

Line atrial fibrillation

A

Max cert 1 year

Annual exam

48
Q

Atrial fibrillation as cause of or risk for stroke

A

Anticoagulation adequate x1 month
INR monitored monthly
Rate Rhythm controlled
Cardio approved

49
Q

Atrial fibrillation with stroke risk max cert

A

1 year

50
Q

Atrial fibrillation after thoracic surgery

A

Anticoagulant 1 month
INR monitored monthly
Rate Rhythm controlled
Cardio ok

51
Q

Atrial fibrillation after thoracic surgery max cert.

A

1 year

52
Q

Atrial flutter

A 
Asymptomatic
Isthmus ablation performed 
Arrhythmia treated
Cleared by electrophysiologies street
Rate Rhythm controlled
53
Q

Atrial flutter waiting/max cert

A

Wait after isthmus ablation 1 month

1 year cert

54
Q

Underlying diagnosis coronary heart disease

A

No VT
LVEF >40%
Asymptomatic
Cleared cardio

55
Q

Coronary heart disease waiting/ max. Cert/ requirements

A

Wait: 1 month after drug therapy
Max. Cert. 1 month
Annual- cardiology exam

56
Q

Ventricular tachycardia

A

No sustained VT

No hx of no sustained VT with LVEF <40%

No syncope/near

57
Q

V tach certification frequency

A

1 yr with cardiology examination

58
Q

Do not certify cardiology conditions

A

Hypertrophic cardiomyopathy
Long Qt interval syndrome
Brigades syndrome

59
Q

Sinus node dysfunction and Av block

A

One month after pacemaker implant
Correct function documented
Underlying dz not disqualifying

60
Q

Sinus node dysfunction and av block waiting/max. Cert and annual requirements

A

Waiting 1 month after pacemaker

Max cert. 1 year

Annual exam. Pacemaker checks

61
Q

Implantable defibrillators

A

Disqualifying

62
Q

Aneurysm <4.0cm

A

Asymptomatic
3 months after surgical repair
Cleared by cardio
1 year certification

63
Q

Aneurysm > 4 but less than <5

A

Asymptomatic
Cleared by cardio
3 months after surgical repair
Max cert 1 year

64
Q

Don’t certify aneurysm

A

> 5cm

Increased in size o.5 during 6 months

Surgical repair recommended with no compliance

Symptomatic

65
Q

Thoracic aneurysm

A

<3.5
3 months after surgical repair
Cleared by cardio
1 year max cert

66
Q

Aneurysm / visceral and peripheral artery and venous vessels

A

3 months after surgical repair
Cleared by cardio
1 year max

67
Q

Peripheral vascular disease

A

No other cardiovascular consitions

68
Q

Don’t certify peripheral vascular disease if

A

Symptomatic
Pain at rest
3 months after revascularization

69
Q

DVT

A

Increased risk for developing long hours of sitting

Can be source for PE

Adequate treatment decreases recurrence by 80%

70
Q

Certify DVT requirements

A

No residual/acute DVT

Etiology confirmed and treated

1 year cert

Monitoring guidelines with anticoagulant

71
Q

True or false: you should certify a driver who has an underlying neurological condition and taking an anticoagulant with risk of bleeding?

A

False

72
Q

Superficial phlebitis and or varicose veins

A

Etiology confirmed with treatment
No DVT
2 year certification

73
Q

Mild Aortic stenosis

A

Echo every 5 years

74
Q

Moderate aortic stenosis

A

Asymptomatic

Echocardiogram 1-2 years

75
Q

Severe aortic stenosis

A

Surgically repaired
Waiting period met
Cleared by cardiology
2d echocardiogram prior to discharge

76
Q

After a heart transplant the minimum waiting period is ______ and the max certification period is ______

A

One year - 6 months

77
Q

For mild aortic stenosis an electrocardiography should be repeated every _____ years. For moderate aortic stenosis an echocardiogram should be repeated every _____

A

Five 1-2

78
Q

A driver underwent surgical repair of a 6cm abdominal aortic aneurysm 3 months ago. The driver may be certified for ?

A

1 year

79
Q

A driver with congestive heart failure recently had an echocardiogram demonstrating an ejection fraction of 44%. The driver may be certified for __— if the driver meets all other qualifications for chf

A

One year

80
Q

What are common symptoms of chf

A

Swelling in the legs, ankles or other body parts

81
Q

Guidelines for supraventricular tachycardia include. 1. Certification should be granted only after adequate anticoagulation is demonstrated for 3 months. 2. Certification for atrial flutter may be considered if the driver is one month following ismuths ablation.

A

2 only

82
Q

The waiting period for hypertrophic cardiomyopathy is

A

There is no waiting period. This is disqualifying

83
Q

Recommendations for ETT for drivers with coronary heart disease are?

A

3-6 months after Percutaneous coronary intervention

Every 2 years after

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