NRCME exam questions with complete solutions 2023

vision requirements - 20/40 each eye and 20/40 both eyes peripheral vision - 70 degrees Federal exemption for monocular vision: can certify for how long? - 1 year hearing requirements - whisper at not less than 5 feet better ear, or average hearing loss no greater than 40 dB at 500Hz, 1000Hz, 2000 Hz. name 4 otic conditions that are automatic DQs - Meniere's, uncontrolled vertigo, labyrinthine fistula, nonfunctioning labyrinth Max cert period for Syncope - 1 year (needs neurologist clearance) Post MI drivers can be certified for 1 year with all 5 of these criteria: (almost the same criteria for post CABG) (first 4 also apply for CHF drivers) - 1. Asymptomatic 2. Tolerating meds 3. Satisfactory ETT with workload capacity of 6 METs (has to have this biennially) 4. LVEF >=40% 5. No ST depression on ECG - for post CABG this one is replaced by completely healed sternal incision Stable angina: max cert period - 1 year minimum waiting period post CABG - 3 months Min waiting period for post heart transplant - 1 year Max cert period for post heart transplant - 6 months Min waiting period post PCI (percutaneous coronary intervention) - 1 week Min waiting period for pacemaker implantation for sinus node dysfunction - 1 month Min waiting period for pacemaker implantation for neurocardiogenic syncope or hypersensitive carotid sinus with syncope - 3 months Min waiting period post AAA repair - 3 months Max cert period for being on anticoagulation for a CV condition - 1 year 3 criteria for certification if patient on anticoagulation for a CV condition - 1. Stable on meds for 1 month 2. Provide copy of INR at exam 3. Have INR checked and monitored at least monthly True or false: driver on anticoagulation for CVA can be certified for max 1 year - False. Should not be certified due to high risk of bleeding 5 reasons to DQ a driver with AAA - 1. Symptomatic 2. AAA >5cm 3. AAA 4-5 cm and does not have clearance from a cardiologist 4. AAA increased in size 0.5cm in 6 months 5. Surgical repair was recommended but not done Max size of a thoracic aneurysm that can be certified - 3.5 cm Min waiting period for PE - 3 months True or false: having an ICD is automatic DQ - true True or false: dx of severe aortic stenosis is automatic DQ - true Max certification post aortic valve repair - 1 year Do not certify for moderate aortic stenosis if they have 1 of these 5 things - angina, CHF, A fib, LVEF <50%, thromboembolic disease How often to repeat echo for aortic stenosis? (answer for both mild and moderate AS) - Mild: 5 years moderate: 1-2 years Max certification for severe aortic regurgitation - 6 months and must be asymptomatic, normal LV function, LVEDD <=60mm, LVESD <=50mm Max cert period for balloon mitral valvotomy - 1 year Min waiting period for balloon mitral valvotomy - 4 weeks BP above which you must treat and do one time 3 month certificate - 160/100. For 140/90 and above up to this level, it says 3 month certificate but does not say must treat. BP above which you cannot certify until lowered below 140/90 - 180/110 - and then this patient can only be certified for 6 months