Respiratory Diseases
The driver diagnosed with COPD may be certified if the driver has:
A) Hypoxemia at rest
B) FEV1>=65%
C) Chronic respiratory failure
D) History of continuing cough with cough syncope
B) Hypoxemia at rest, chronic respiratory failure, and cough syncope are all disqualifying
Levodopa/carbidopa may cause the driver to be disqualified because it is used for the treatment of what neurological condition?
A) Parkinson's Disease
B) Peripheral neuropathy
C) Isaac's Disease or Stiff Man Syndrome
D) Epileps
A) Although all of the conditions listed are disqualifying, levodopa/carbidopa is used to treat Parkinson's Disease
The following conditions are disqualifying except:
A) Multiple sclerosis
B) Congenital myopathies
C) Metabolic muscle diseases
D) Muscular dystrophies
A) Multiple sclerosis may or may not be disqualifying, depending on whether the driver has symptoms that interfere with safe driving. Congenital myopathies, metabolic muscle diseases, and muscular dystrophies are all disqualifying.
A driver with Meniere's Disease may be certified
A) True
B) False
B) Meniere's Disease is a disqualifying condition
A driver with bipolar disorder must meet a waiting period of ______________ following a nonpsychotic episode of major depression unaccompanied by suicidal behavior or a waiting period of __________________ following a nonpsychotic episode of major depression with suicidal behavior.
A) One year, two years
B) Six months, one year
C) Three months, six months
D) Three months, one year
B) Whatever the underlying medical condition, nonpsychotic episodes of major depression unaccompanied by suicidal behavior require a waiting period of six months and nonpsychotic episodes of major depression with suicidal behavior require a one year waiting period.
Pulse oximetry or ABG testing is indicated when the driver has an obstructive respiratory condition and results of spirometry testing are _________:
A) FEV1 <70% predicted
B) FEV1/FVC ratio less than 65%
C) FVC <80% predicted
D) FEF 25/75<80% predicted
Pulse oximetry or ABG testing is indicated if FEV1/FVC ratio is less than 65%
Transient ischemic attacks (TIA's) are automatically disqualifying for ________ months; after the minimum waiting period the certification depends on the interval history, general health, neurological examination, and compliance with the treatment program.
A) 3
B) 6
C) 9
D) 12
D) The minimum waiting period for TIA's is 12 months or one year
During the neurological examination the Medical Examiner should note the following:
A) Range of motion
B) Gait disorders, sensory or positional abnormalities
C) Prior fractures
D) Weight gain/loss
B) Range of motion and prior fractures should be noted on the musculoskeletal examination. Weight gain or loss is noted int he general examination.
A driver with a history of kidney disease with or without transplant:
A) Is medically disqualified
B) Must be assessed regarding the severity, stability, medications used, and medication side effects/adverse reactions
C) Should not be assessed for functional ability to operate a CMV safely
D) Should have the medical certificaton determination made by a renal specialist
B) Assessment for kidney disease must be ade on a case-by-case basis. Dialysis of any kind is disqualifying. The medical examiner may choose to test the driver for functional ability to operate a CMV safely. The medical certification decision must be made by the medical examiner.
Which of the following is true with respect to drivers with psychological disorders?
A) Drivers with chronic schizophrenia must be evaluated at least yearly by a qualified specialist such as a psychiatrist or psychologist who understands the function and demands of CMV driving.
B) The waiting period for a brief reactive psychosis or schizophreniform disorder is three months
C) Alcohol and drug dependency and abuse are profound risk factors in the presence of personality disorders
D) The waiting period following electroconvulsive therapy for treatment of depression is one year
C) Drivers with chronic schizophrenia are disqualified. The waiting period for a brief reactive psychosis or schizophreniform disorder is six months as is the waiting period for electroconvulsive therapy treatment.
A driver with asthma describes using an albuterol inhaler several times a day. He has not seen his primary care physician in several years but is still getting frequent refills on his inhaler. The driver has been hospitalized twice in the last eight months for asthma. The certification decision should be:
A) Do not certify
B) Certify for 3 months, pending driver follow up with personal physician and/or specialist
C) Certify one year
D) Certify 2 years
A) The driver should not be certified until evaluated by his personal physician and/or specialist
Episodic neurological conditions that are usually disqualifying include:
1) Epilepsy
2) Multiple sclerosis
3) Narcolepsy
4) Headaches
A) 1, 2, and 3 only
B) 1 and 3 only
C) 2 and 4 only
D) all of the above
B) Epilepsy and narcolepsy are usually disqualifying. Multiple sclerosis may be disqualifying but is not usually so. Headaches are occasionally, but not usually, disqualifying — disqualification would occur if there were symptoms or medication effects that interfere with safe driving.
A mild head injury has:
A) No dural penetration with LOC that lasts fewer than 30 minutes
B) Dural penetration with LOC that lasts fewer than 30 minutes
C) No dural penetration with LOC that lasts for more than 30 minutes but less than 24 hours
D) Dural penetration with LOC that lasts for more than 30 minutes but less than 24 hours
a) A mild head injury has no dural penetration and LOC that lasts fewer than 30 minutes
Levodopa/carbidopa may cause the driver to be disqualified because it is used for the treatment of what neurological condition?
A) Parkinson's Disease
B) Peripheral neuropathy
C) Isaac's Disease or Stiff Man Syndrome
D) Epilepsy
A) Although all of the conditions listed are disqualifying, levodopa/carbidopa is used to treat Parkinson's Disease
Which of the following is true with regard to Adult Attention Deficit Hyperactivity Disorder?
A) The maximum certification interval is two years.
B) The driver should be disqualified if the driver has another psychological disorder, such as depression.
C) Risk related to adult ADHD include comorbid antisocial or borderline personality disorders and a high incidence of substance abuse
D) Treatment with amphetamines and amphetamine derivatives is disqualifying
C) The maximum certification interval is one year. As long as other psychological conditions are stable, a driver with adult ADHD may be certified. Treatment with amphetamines and amphetamine derivatives is not disqualifying.
Spirometry testing should be performed on drivers who smoke who are over _________ years of age:
A) 30
B) 35
C) 40
D) 45
B) Spirometry is recommended for current smokers over 35 years of age
The maximum certification period for a driver with diagnosis of autonomic neuropathy is:
A) Do not certify
B) Six months
C) One year
D) Two years
D) As long as the autonomic neuropathy does not cause orthostatic hypertension, resting tachycardia, or other organ autonomic neuropathy that interferes with driving ability, the driver may be certified for two years. Note that while FMCSA guidelines state that drivers with neurological conditions should be certified for a maximum of one year, FMCSA guidelines for several neurological conditions indicate a maximum certification interval of two years. Since these inconsistencies appear in the FMCSA guidelines themselves, this leaves medical examiners with unclear guidelines for those conditions.
A Skill Performance Evaluatioin (SPE) certificate:
A) Is valid for one year from the date of issuance
B) May be renewed 60 days prior to expiration
C) Is required when the severity of a fixed deficit of an extremity includes the loss or impairment of a hand, arm, foot or leg
D) Is issued by the medical examiner
C) A SPE certificate is valid for 2 years, may be renewed 30 days prior to expiration, and is required for a fixed deficit of an extremity includes of loss or impairment of a hand, arm, foot or leg. A SPE certificate is issued by the FMCSA, not the medical examiner. The medical examiner determines that the driver is otherwise medically qualified and meets the criteria for a SPE.
The Medical Examiner should recommend do not certify if the driver has the following:
A) Acute otitis media
B) Ménière's disease
C) A history of TIA's three years ago
D) Multiple sclerosis
B) Meriere's disease is disqualifying
Categories of risk associated with psychological disorders include:
1) The mental disorder including symptoms and/or disturbances in performance that are in integral part of the disorder and may pose hazards fro driving
2) The type of treatment provider who is treating the condition.
3) Psychopharmacology, as many psychotropic medications can comprise performance to the degree that CMV driving would be hazardous
4) Physical disorders which may be compromised by the mental disorder and may increase risk of CMV accidents
A) 1, 2, and 3 only
B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) All of the above
B) Type of treatment provider is unrelated to driving risk. Physical disorders are not noted by the FMCSA to increase risk related to psychological disorders.
An apnea/hypoapnea index of more than _________ episodes per hours is diagnostic for sleep apnea
A) 20
B) 25
C) 30
D) 35
C) An apnea/hypoapena index of more than 30 episodes per hour is diagnostic for sleep apnea
The maximum period for which a driver with a neurological condition should be certified is:
A) two years
B) Three months
C) Six months
D) One year
D) The maximum certification interval for a driver with a neurological condition is one year. Note that while FMCSA guidelines state that drivers with neurological conditions should be certified for a maximum of one year, FMCSA guidelines for several neurological conditions indicate a maximum certification interval for two years. Since these inconsistencies appear in the FMCSA guidelines themselves, this leaves medical examiners with unclear guidelines for these conditions.
Examples of adapting clinical evaluation of the musculoskeletal system to ensure applicability when assessing CMV driver fitness for duty could include all of the following except:
A) Using resistive force or a dynamometer to have the driver demonstrate grip strength
B) Nerve conduction study testing
C) Have the driver simulate the range of motion and coordination of hands and legs required for steering and changing gears when operating a CMV and/or have the driver demonstrate shoulder joint mobility, arm and leg muscle strength. Required to enter and exit the cab, and other driver-related duties.
D) Have driver perform activities that demonstrate the ability to maneuver and maintain balance while under the trailer and having the driver demonstrate cervical range of motion sufficient to look in either side mirror of an oversized CMV
B) Nerve conduction study testing is not a clinical evaluation of musculoskeletal function
Which of the following conditions are disqualifying?
1) Acute or chronic vestibulopathy after a one-month symptom free interval.
2) Nonfunctioning labyrinths after a three-month free interval.
3) Labyrinthe fistula after a six month symptom free interval.
4) Meniere's disease After a one-year symptom free interval.
A) 1, 2 and 3 only
B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) all of the above
E) Nonfunctioning labyrinths labyrinthine fistula, and Ménière's disease are all disqualifying and there is no symptom free interval that allows certification. The waiting period for acute and chronic vestibulopathy is two months symptom free.
Drivers with schizophreniform disorder, brief reactive psychosis, schizoaffective disorder, or delusional disorder may be certified after a _____________________ waiting period for a brief reactive psychosis or schizophreniform disorder and after a _________________ waiting period for any other psychotic disorder.
A) Six weeks, three months
B) Three months, six months
C) Six months, one year
D) One year, two years
C) The waiting period is six on this for a brief reactive psychosis or schizophreniform disorder and one year for any other psychotic disorder