NRCME DOT Respiratory, neuro Questions and Complete Solutions Graded A+

  Spirometry testing should be performed on... - Answer: all smokers equal to or 35yo Pts with COPD Spirometry testing includes - Answer: FEV1, FVC, and ratio ABG testing should be performed when... (4) - Answer: 1. FEV1 65% 2. FVC 65% and restrictive lung dz OR 60% 3. FEV1/FVC 65% 4. Pulse ox pO2 92% Disqualify driver if ABG results are... (3) - Answer: 1. ABG PaCO2 45mmHg 2. ABG PaO2 65mmHg if 5,000 ft altitude 3. ABG PaO2 60mmHg if 5,000 ft altitude Chest X-ray (CXR) should be performed for the evaluation of... (5) - Answer: mitral stenosis, hypersensitivity pneumonitis, spontaneous pneumothorax, a positive PPD, or other significant respiratory abnormalities. Sleep study should be considered if driver has... (4) - Answer: a history suggestive of obstructive sleep apnea (OSA), Epworth Sleepiness scale 10, previously diagnosed sleep disorder, previous sleep study apnea/hypoapnea index of 5 but 30. Drivers with suspected or untreated sleep apnea should not be certified until... - Answer: etiology is confirmed and treatment has been shown to be stable, safe, and effective. Sleep apnea waiting period - Answer: 1 month after starting CPAP 3 months after surgical tx Sleep apnea max cert interval - Answer: 1 year Respiratory conditions which should not be certified (5) - Answer: untreated symptomatic obstructive sleep apnea, restless leg syndrome associated with excessive daytime sleepiness (EDS), narcolepsy, hypoxemia at rest, use of supplementary oxygen. Asthma or COPD max cert interval - Answer: 2 years Pneumothorax cert interval - Answer: 2 years (asx and resolution confirmed) Pulmonary TB certification qualifications - Answer: not contagious, has completed streptomycin therapy without affecting hearing or balance, and is compliant with treatment. Do not drive within ? hours of taking antihistamine - Answer: 12 Neuro do not certify conditions (8) - Answer: 1. epilepsy, 2. Meniere's disease, 3. dementia, 4. Parkinsonism, 5. cerebellar ataxia, 6. severe traumatic brain injury, 7. arteriovenous malformation (AVM) not surgically treated. 8. severe HAs which interfere with safe driving Epilepsy can be certified if... - Answer: sz free and off medication x 10 years Single unprovoked sz waiting period - Answer: 5 years seizure free and off anticonvulsant medication, Epilepsy diagnosed and waiting period - Answer: diagnosed when a driver has 2 or more unprovoked seizures. The waiting period for epilepsy is 10 years seizure free and off anticonvulsant medication. Definition of severe TBI - Answer: dural penetration and LOC 24hrs Definition of moderateTBI - Answer: no dural penetration and LOC 30min-24hrs Definition of mild TBI - Answer: no dural penetration and LOC 30min Severe TBI max cert - Answer: do not certify Moderate TBI without seizure waiting period Moderate TBI with a seizure waiting period - Answer: 2 years 5 years Moderate TBI without a seizure max cert interval Moderate TBI with a seizure max cert interval - Answer: 1 year, 1 year Mild TBI without seizure waiting period Mild TBI with seizure waiting period - Answer: none 2 years (same as moderate without) Mild TBI without seizure max cert interval Mild TBI with seizure max cert interval - Answer: 2 years 1 year vertigo or acute/chronic vestibulopathy waiting period and max cert interval - Answer: 2 months, 2 years TIA waiting period - Answer: 1 year TIA max cert - Answer: 1 year CVA waiting period - Answer: 1 year CVA max cert - Answer: 1 year Where does the CVA or subarachnoid hemorrhage need to occur to be considered low seizure risk? waiting period? max cert interval? - Answer: cerebellar or brainstem 1 year 1 year Where does the CVA or subarachnoid hemorrhage need to occur to be considered high seizure risk? - Answer: cortical or subcortical 5 years 1 year Single, unprovoked sz waiting period and max cert - Answer: 5 years 1 year surgical procedures involving dural penetration max cert - Answer: do not certify Aseptic meningitis waiting period - Answer: none, etiology confirmed and tx finished Bacterial or viral meningitis without seizures , waiting period - Answer: 1 year Bacterial or viral meningitis without seizures , max cert interval - Answer: 2 year Bacterial meningitis with seizures, waiting period - Answer: 5 years Bacterial meningitis with seizures, max cert - Answer: 2 year Viral meningitis with seizures, waiting period - Answer: 10 years Viral meningitis with seizure, max cert - Answer: 2 year Infratentorial meningioma waiting period - Answer: 1 year Infratentorial meningioma max cert interval - Answer: 1 year acoustic neuroma waiting period - Answer: 1 year acoustic neuroma max cert interval - Answer: 1 year Pituitary adenoma waiting period - Answer: 1 year Pituitary adenoma max cert interval - Answer: 1 year Benign spinal or extra-axial tumors waiting period - Answer: 1 year Benign spinal or extra-axial tumors max cert - Answer: 1 year Benign supratentorial tumors waiting period - Answer: 2 year Benign supratentorial tumors max cert - Answer: 1 year