Scope and Standards of RME

Question 1

What labs are required for a routine NAVMED 6470/13?

Answer 1

*White blood count (WBC) and Hematocrit (HCT)
*Mirco Urinalysis, via high power field.

Question 2

Are Actinic keratosis (AK) or basal cell carcinoma (BCC) disqualifying for rad work?

Answer 2

*Adequately treated AK or BBC is not.
*Medical provider may visually determine if AK is being adequately treated.
*Any pt w/ BCC requiring surgical removal i.e. shave biopsy and Mohs microscopic surg will not be considered PQ until the pathology results are obtained.

Question 3

What are the time requirements for RME Labs?

Answer 3

3 months prior to the physical exam.

Question 4

If an WBC or HCT is outside of facility lab ranges what must happen before the worker can be marked PQ?

Answer 4

*Repeat lab will be performed and hopefully WNLs.
*The local or attending provider will perform further clinical examinations to determine the reason for the abnormal finding and record a summary in block 14 with the basis of determination and NCD determination.

Question 5

If there was an issue with the CBC, who would you refer the patient to?

Answer 5

Family Med, Internal Med, Hematology.

Question 6

What is considered an UNSAT/postive result for a UA special study?

Answer 6

Equal or greater than 3 RBC/HPF

Question 7

If a micro-UA yields a positive result, what must a pt do to be cleared PQ for work?

Answer 7

Repeat the lab to prove to the value is in the same range,
Refer to urology.

Question 8

If there is an problem with a UA, were would you refer the patient to?

Answer 8

Urology or a board-certified physician with the appropriate expertise

Question 9

Can a mammogram be performed in lieu of manual breast exam?

Answer 9

No (Insert P-5055 section here)

Question 10

What are the requirements given for performing differential in response to an abnormal WBC?

Answer 10

NAVMED 6470/13, Instructions for Preparation

Question 11

IF you have an abnormal WBC, what would you do?

Answer 11

Order a CBC with diff as a repeat

Question 12

What are the standards for occupational exposure to ionizing radiation?

Answer 12

*Hx of Cancer
*Hx of rad therapy
*Hx of anemia
*Hx of leukemia
*Abnormal WBC, HCT
*Abnormal UA
*Internally deposited radionuclides
*Open lessions or wounds
* Polycythemia vera
*Rad exposure above table 1 limits