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Question 1

What is the mission of the FMCSA

Answer 1

Focused on reducing crashes, injuries, and fatalities involving large trucks and buses

Question 2

Who and what does the FMCSA regulate

Answer 2

Interstate commercial operation including the driver vehicle motor carrier and the transport of hazardous materials

Question 3

Give examples of cmv driver stress factors

Answer 3

Interruption of normal sleep, exercise, and eating patterns and decreased access to social support networks resulting in fatigue and ailienation of affection

Environmental- excessive vibration noise extreme temperatures adverse road conditions, can cause permanent or temporary physical damage and affect the driver behavior

Increased potential for injury and fatalities if there is a crash when responsible for passengers or hazardous cargo

Question 4

What are the differences between the medical regulations and the medical guidelines

Answer 4

Regulations are law

Guidelines are not regulatory

Question 5

In which regulations are the driver physical qualifications standards and medical examiners responsibilities cited for?

Answer 5

49 CFR 391.41 driver physical qualifications

49 CFR 391.43 examiner responsibilities

Question 6

What objective tests and measurements are required as part of the driver physical examination?

Answer 6

Height and weight
Vision
Hearing
Blood pressure
Urinalysis - specific gravity, protein,blood, glucose

Question 7

What are the possible outcomes of the driver physical examination

Answer 7

Certification, disqualifying, determination pending

Question 8

What date is used to determine medical examiners certification expiration

Answer 8

The date of the exam is used as the certificate expiration, except when determination pending is chosen

Question 9

What is the date used for certification with determination pending

Answer 9

If the driver returns with the necessary information prior to expiration of the driver current certificate and the driver is qualified the date used is the date at which the driver returned with the necessary information

Question 10

What is the expiration date for this driver: examination 4/16/2011 - meets standards in 49. CFR 391.41 qualifies for 2 years

Answer 10

4/16/2013

Question 11

What is the certification date for the following driver exam 4/16/2011 - meets standards, but periodic monitoring required due to hypertension - driver qualified for one year.

Answer 11

4/16/2012

Question 12

What is the certificate date for the following driver. Exam 4/16/2011. Disqualified due to vertigo 3/15/2011 - return to medical examination on 5/20/2011. Note asymptomatic since 3/11/2011 qualified for 2 years

Answer 12

5/20/13

Question 13

Who can perform the vision portion of the interstate cmv driver physical examination

Answer 13

The medical examiner
A license optometrist
Ophthalmologist

Question 14

To pass the interstate cmv driver vision exam, a visual acuity of ——- corrected or I corrected is required

Answer 14

20/40 in each eye and both eyes

Question 15

What eye conditions must the medical examiner ask the driver about if indicated request specialist evaluation

Answer 15

Retinopathy, cataracts, aphakia, glaucoma, macular degeneration

Question 16

What is the purpose of the interstate cmv driver physical examination

Answer 16

To detect the presence of physical mental or organic condition that affects safe driving

Question 17

Does the driver meet heating standards for interstate cmv driving. Whisper test right ear 4 feet, left ear 4 feet

Answer 17

No equal or greater than 5 feet

Question 18

Audiometric testing right 30,40, 45 left ear 45 45 35

Answer 18

Yes right ear passed less than 40

Left ear failed 41

Question 19

Can an interstate driver who has had an acute mi be qualified to drive

Answer 19

Yes waits the designated waiting period

Question 20

The driver provides the medical examiner with a copy of records cardiologist report congestive heart failure ejection fraction 38%

Answer 20

No greater than 40

Question 21

What criteria must be met to certify congestive heart failure

Answer 21

Asymptomatic
No ventricle arrhythmia
Left ventricle ejection fraction greater than 40
Cleared by cardiologist

Question 22

Percutaneous coronary intervention 9 months ago has not followed up with cardio and has not had an exercise tolerance test

Answer 22

Disqualifying
Cardio clearance
Ett 3-6 months post pci

Question 23

Coronary artery bypass graft 4 months ago, echo at 3 months showed left ejection fraction 55% cleared by cardio no chest pain

Answer 23

Cleared 3 months post procedure if asymptomatic, lvef >40

1 year cert

Question 24

Driver with chf Dyspnea at rest

Answer 24

Disqualifying

Question 25

Driver with increasing angina which lasted 20 minutes after tarring a load unresponsive to nitro

Answer 25

Disqualifying unstable angina

Question 26

Abdominal aortic aneurysm. Obtains copy of sonogram 5.3 cm in diameter

Answer 26

No has to be less than 5

Question 27

Driver with surgical repair of 9 cm abdominal aortic aneurysm 4 months ago driver is cleared by cardio

Answer 27

Yes 1 year, waiting period 3 months after surgery

Question 28

What signs and symptoms are present with congestive heart failure

Answer 28

Fatigue, swelling, shortness of breath at rest

Question 29

Multiple risk factors for chd and is over the age of 45 should be certified

Answer 29

Yearly

Question 30

Non modifiable risk factors for chd

Answer 30

Family history Increased age Gender and post menopausal

Question 31

Modifiable risk factors for chd

Answer 31

``` Hypertension Tobacco use High lipids Low hdl Diabetes Oversight Physical inactivity Nutritional habits ```

Question 32

Should medical examiners provide additional counseling regarding conditions that do not directly impact driving status

Answer 32

Yes

Question 33

Spirometry testing is indicated for smokers above what age

Answer 33

35

Question 34

CABG qualifications

Answer 34

``` 3 months post CABG Cardio cleared Asymptomatic Annual exam 5 years yearly ett - graft closures Ejection fraction less than 40 No orthostatic symptoms Tolerating meds ```

Question 35

What is the max certification for stage 1 HTN

Answer 35

1 year

Question 36

What is the certification for a driver with BP 182/112

Answer 36

Disqualifying until less than 140/90 then 6 month certification

Question 37

Driver with BP 182/112

Answer 37

Stage 3 disqualified until less than 140/90 than 6 months

Question 38

What is the BP range for stage 1

Answer 38

140-159/90-99

Question 39

What date is used to determine the one year expiration date for a driver with a one time 3 month certificate, who achieves bp less than 140/90 before 3 month certificate

Answer 39

1 year based on last examination, must have new examination

Question 40

Pulmonary diseases that are disqualify

Answer 40

Bronchiectasis with hemoptysis Chronic tb Copd with syncope Asthma with frequent hospitalization

Question 41

What conditions must a driver meet with acute or chronic core pulmonale meet to be certified to operate an interstate

Answer 41

Abg | PaO2 greater than 65

Question 42

Pulmonary hypertension or cor pulmonale exhibit Dyspnea at rest, dizziness or hypotension

Answer 42

Disqualifying

Question 43

Exercise induced asthma well controlled by using an a literal inhaler before aerobic activity. Pulmonary function test fev1 must be above what

Answer 43

Greater than. 65

Question 44

Driver takes Benadryl 3 x daily for allergies

Answer 44

Abstain from antihistamines and narcotic based antitussives for 12 hours prior to driving

Question 45

Driver reports hasn’t followed up with pcp in several years uses his rescue inhaler multiple times a day has been hospitalized and in a ventilator certification?

Answer 45

Disqualifying

Question 46

Pneumothorax last month. Reduced FVC to 58%

Answer 46

Disqualifying- recovery complete chest X-rays, FVC greater than 65

Question 47

Pneumothorax 3 months Ago, second spontaneous pneumothorax on same side. FVC is 68% no surgical intervention

Answer 47

Disqualifying can’t be qualified until surgery to stop reoccurring

Question 48

What three tests are a part of the PFT

Answer 48

Fev1 FVC Fev1/fvc

Question 49

Doesn’t meet PFT requirements next step

Answer 49

Oximetry | Abg

Question 50

Pulse ox less than 92

Answer 50

Obtain abg

Question 51

Abg cutoffs

Answer 51

Paco2 less than 45 PaO2 greater than 65 less than 5000 Pa02 greater than 6o over 5000

Question 52

Trip history and Abgs

Answer 52

If previous trip spent in high altitudes can influence Abg results vice versa

Question 53

What neurological condition is disqualifying

Answer 53

Epilepsy

Question 54

According to medical guidance, episodic neurological conditions that are disqualifying include what?

Answer 54

Extreme headaches Vertigo Epilepsy with medications Narcolepsy Untreated sleep apnea Idiopathic central nervous system hyper somnolence Primary alveolar hyperventilation syndrome Restless leg syndrome with excessive daytime somnolence

Question 55

``` According to the following what neurological condition is disqualifying: febrile seizures Severe dementia Metabolic dementia Tias within one year Tias greater than one year ```

Answer 55

Severe dementia | Tia less than 1 year

Question 56

Driver is taking levodopa/carbidopa is used for the treatment of

Answer 56

Parkinson’s

Question 57

For tias what is no functional residue

Answer 57

No lack of impairment or no residual symptoms | Determined by neurologist

Question 58

What is the future risk associated with tias

Answer 58

High rate of reoccurrence in 1 year Hence 1 year waiting period Warning sign for potential stroke

Question 59

Criteria for certification of tias

Answer 59

1 year waiting period

Question 60

A driver with a loss of leg, foot, hand or arm qualified to operate a cmv?

Answer 60

Yes if they meet all other standards | Needs to be granted a skills performance

Question 61

Only ___\\ can grant a spe certificate

Answer 61

FMCSA

Question 62

What documentation is required when applying for cpe?

Answer 62

Copies of medical exam report | Certificate indicating cpe need

Question 63

Certification period for spe certificate? Maximum certificate period

Answer 63

2 years can be certified for up to 2 years

Question 64

6 week post arthroscopic carpal tunnel repair on his tight hand

Answer 64

Evaluate standards of testing | Can be certified for 2 years

Question 65

Insulin treated db requirements

Answer 65

Has treating provider fill out mcsa 5870 form

Question 66

What is the maximum certificate for diabetes not on insulin

Answer 66

1 year

Question 67

Which diabetes poses the greatest risk

Answer 67

Hypoglycemia

Question 68

How does the examiner determine whether a gi condition would potentially disqualifying

Answer 68

GI condition that produces symptoms or physical changes that could impair the driver

Question 69

List the four specific urinalysis test results required for the driver

Answer 69

Specific gravity Protein Blood Glucose

Question 70

What would the medical examiner do next if an abnormal finding on the urinalysis

Answer 70

Use clinical expertise to determine further evaluation

Question 71

A driver is taking dicyclomine bentyl for IBS with good control of symptoms.

Answer 71

Yes as long as medicine controls symptoms and no side effects.

Question 72

What are three areas of risk when a driver has. A mental disorder

Answer 72

Symptoms Residual recurrent symptoms Side effects of medication

Question 73

What behaviors should you examine for

Answer 73

Suspicious evasive threatening hostile Signs of being distracted Flat affect lack of emotional response Bizarre ideas, visual auditory hallucinations, dishonesty, tendency to omit important information

Question 74

Can a driver be certified if taking amitriptyline for depression

Answer 74

Disqualifying

Question 75

A driver is taking Ssri but appears depressed. What would the medical examiner do to adequately assess the driver

Answer 75

Driver needs to be evaluated by mental health. Complete symptom free waiting period, tolerate treatment plan, no side effects

Question 76

Emotional adjustment problems

Answer 76

Linked to changes in memory, reasoning, attention, and judgement

Question 77

Functional disorders

Answer 77

Drowsiness, dizziness, confusion, weakness and paralysis, poor coordination, inattention, loss of functional control, increased risk for crashes.

Question 78

Physical symptoms of psych

Answer 78

Fatigue, headache, impaired coordination, recurring physical ailment, chronic nagging pain

Question 79

Waiting period for severe depression

Answer 79

Suicide attempt or manic episode symptom free for 1 year

Question 80

Is testing for controlled substances part of the requirements of the cmv driver physical examination

Answer 80

No but medical examiner may require additional testing if indicated.

Question 81

What is advisory criteria for the drug use definition of habit forming.

Answer 81

Habit forming - any drug or medication of becoming habitual and impair the users ability

Question 82

According to medical guidance can a driver be certified while taking methadone for chronic pain management

Answer 82

Disqualifying

Question 83

Driver checks yes for regular frequent alcohol use

Answer 83

Determine time and quantity

Question 84

What concerns should a medical examiner have regarding a driver on multiple medications who reports regular daily and moderate use of alcohol

Answer 84

Current alcoholism Medication interactions Effects of alcohol on underlaying condition Alcohol on medication and other side effects

Question 85

The medical examiner may require a driver to be evaluated by an sap and successfully complete a rehabilitation course if the driver ——-

Answer 85

Admits to alcohol and drug abuse