NRCME Final Exam Practice Questions With Correct Answers 2023/2024 (Already GRADED A+)

NRCME Final Exam Practice Questions With Correct Answers 2023/2024 (Already GRADED A+) What is the waiting period and maximum certification period for driver on anticoagulants for cardiovascular cause? - Answer 1 month stabilized and 1 year with monthly INRs What is the waiting period and maximum certification period for driver on anticoagulants for neurlogical condition? - Answer None, driver is disqualified. 5 reasons to disqualify a driver with AAA - Answer 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 Maximum certification period for driver with AAA that is asymptomatic or <4cm, >4cm and <5cm but has clearance from cardiologist - Answer 1 year Maximum certification period for Acute DVT - Answer 1 year Maximum certification period for Chronic DVT - Answer 2 years Waiting period and maximum certification period for intermittent claudication if driver has no resting pain. - Answer 3 months for post-surgical repair and 1 year Waiting period and maximum certification for aneurysms of visceral, peripheral arteries or venous vessels - Answer 3 months post-surgical repair and 1 year with clearance from cardiologist Waiting period and maximum certification for peripheral vascular disease - Answer 3 months post-surgical repair and 1 year without resting pain Waiting period and maximum certification for pulmonary emboli - Answer 3 months with no pulmonary embolism and 1 year if asymptomatic Maximum certification period for superficial phlebitis - Answer 2 years Waiting period and maximum certification for thoracic aneurysm <3.5cm - Answer 3 months post surgical repair and 1 year True or false: having an ICD is automatic disqualification - Answer true Min waiting period for pacemaker implantation for sinus node dysfunction or AV block - Answer 1 month Min waiting period for pacemaker implantation for neurocardiogenic syncope or hypersensitive carotid sinus with syncope - Answer 3 months In order for a driver to receive maximum certification period of 1 year for pacemaker the driver must: - Answer Comply with pacemaker center scheduled function checks and provide documentation of pacemaker function checks at examination. Minimum waiting period for atrial fibrillation - Answer 1 month with adequate anticoagulation Minimum waiting period for atrial flutter - Answer 1 month post-isthmus ablation Minimum waiting period for AV nodal reentrant tachycardia, AV reentrant tachycardia and Wolff-Parkinson-White syndrome, Atrial tachycardia, Junctional tachycardia - Answer 1 month without symptoms Maximum certification period for SVT with adequate rate control, anticoagulation if indicated, and clearance from a cardiologist. - Answer 1 year Minimum waiting period for VT caused by coronary heart disease, right ventricular outflow VT, Idiopathic LV VT. - Answer 1 month after drug or other therapy Maximum certification for VT if patient is asymptomatic, NSVT with LVEF >40% and has clearance from a cardiologist - Answer 1 year Driver is to be disqualified if VT and the following: - Answer symptomatic, sustained VT, NSVT with LVEF <40% or diagnosis of hypertrophic cardiomyopathy, long QT interval syndrome or Brugada syndrome Waiting period and maximum certification for Acute MI is - Answer Waiting period 2 months post MI and maximum certification is 1 year What is required for initial certification following MI? - Answer In-patient post-MI echocardiogram showing LVEF 40% What are the requirements for certifying driver with history of MI? - Answer Asymptomatic, satisfactory ETT every 2 years, LVEF >/40%, no electrocardiogram ischemic changes and clearance by cardiologist Waiting period and maximum certification for angina in a driver without resting angina or change in angina pattern and 1 year with satisfactory ETT every 2 years and clearance by cardiologist - Answer 3 months NRCME Study Sheet 2023 With Correct Solutions GRADED A+ CHD risk-equivalent conditions include: - Answer DM, PVD, Framingham risk score predicting 20% CHD event risk over the next 10 years or being over 45 years of age with multiple risk factors for CHF Maximum certification of multiple CHD risk-equivalent is - Answer 1 year Waiting period and maximum certification for CABG if the driver is asymptomatic, LVEF >/40%, healed sternum and cleared by cardiology - Answer 3 months after CABG and 1 year 5 years post-CABG, what routine tests need to be completed - Answer Annual ETT and imaging stress test if indicated What is the maximum certification period for driver with heart failure who is asymptomatic, has ETT >6 METS and LVEF >/40% - Answer 1 year Heart failure disqualifications are: - Answer Symptomatic, asymptomatic with LVEF </ 50% and has ventricular arrhythmias or asymptomatic with LVEF <40% Driver with heart failure should obtain - Answer ETT every 2 years, annual evaluation and clearance from cardiologist, echocardiogram and holter monitoring What is the waiting period and maximum certification for PCI if patient is asymptomatic and vascular access site is healed? - Answer 1 week and initial certification of 6 months followed by 1 year if ETT is satisfactory What follow up testing is required in driver undergoing PCI? - Answer ETT 3 to 6 months post-PCI and bring results to 6 month follow up appointment (if inconclusive, imaging stress test may be indicated) Define Ebstein anomaly - Answer Congenital heart disease resulting in downward displacement of the tricuspid valve. What is the maximum certification of Ebstein anomaly if the driver is asymptomatic, has mild tricuspid anomaly, mild cardiac enlargement and mild ventricular dysfunction. - Answer 1 year What disqualifies a driver with Ebstein anomaly? - Answer Moderate or severe anomaly, intracardiac lesion, shunt, symptomatic arrhythmia, accessory conduction pathway What follow up testing is required in driver with Ebstein anomaly? - Answer Annual cardiac clearance and echocardiogram Waiting period and maximum certification period for heart transplantation in driver who is asymptomatic, has cardiac clearance and no signs of transplant rejection - Answer 1 year and 6 months NRCME Study Sheet 2023 With Correct Solutions GRADED A+ What myocardial diseases are disqualifying: - Answer hypertrophic cardiomyopathy and restrictive cardiomyopathy Maximum certification for syncope in driver who has been treated as is now asymptomatic, is at low risk for recurrence and has cardiac clearance. - Answer 1 year Follow up evaluation for drivers with syncope - Answer Annual evaluation by cardiologist Maximum certification for aortic regurgitation if the driver has mild aortic regurgitation that is asymptomatic or moderate aortic regurgitation that is asymptomatic with normal LV function, normal or mild LV enlargement - Answer 1 year Follow up evaluation for drivers with mild or moderate aortic regurgitation - Answer Echocardiogram every 2 to 3 years Waiting period and maximum certification for severe aortic regurgitation if the driver is asymptomatic, normal LV function, minimal LV dilation (LVEDD </60mm and LVESD </50mm) - Answer 3 months if post-aortic valve repair and 6 months if not surgically repaired or 1 year if repaired What disqualifies a driver with severe aortic regurgitation - Answer Symptomatic, unable to achieve workload > 6MET on Bruce protocol, LVEF <50%, LVEDD >70mm or LVES >55mm Follow up evaluation for drivers with severe aortic regurgitation - Answer Echocardiogram every 6 to 12 months if LVEDD <60mm or LVESD <50mm or every 4-6 months if LVEDD =60mm or LVESD =50mm Waiting period and maximum certification of aortic stenosis in driver with mild aortic stenosis and is asymptomatic, moderate aortic stenosis that is asymptomatic or severe aortic stenosis that has been surgically repaired - Answer 3 months postsurgical repair and 1 year What disqualifies a driver with aortic stenosis - Answer If moderate aortic stenosis and angina, heart failure, atrial fibrillation, LV dysfunction with EF<50% or thromboembolism. If severe aortic stenosis regardless of symptoms. Follow up evaluation for drivers with aortic stenosis - Answer Echocardiogram every 5 years if mild aortic stenosis and every 1 to 2 years if moderate aortic stenosis Follow up evaluation for drivers following aortic valve repair - Answer Twodimensional echocardiogram with Doppler prior to discharge and follow up based on aortic regurgitation severity Waiting period and maximum certification for mitral regurgitation if driver has mild or moderate mitral regurgitation if asymptomatic, normal LF size and function and