DOT Test Solution Graded A+

DOT Test Solution Graded A+ Driver with percutaneous coronary intervention (PCI) nine months ago; he or she has not followed up with cardiologist and has not had exercise tolerance test (ETT) since procedure. Medically disqualified. PCI need cardio clearance and follow up ETT 3-6 months post PCI Coronary artery bypass graft (CABG) surgery four months ago; echo at three months showed LVEF 55%; driver was cleared by cardiologist and has no chest pain. Medically qualified: According to current CVD recommendations, the driver who had had CABG surgery may be qualified at 3 months post-procedure if asymptomatic, LVEF greater than 40%, and meets all other recommendations (qualify with annual recertification). Driver with CHF having dyspnea at rest. Medically disqualified. According to current CVD recommendations, a driver with CHF with symptoms is not medically fit for duty. Driver has recently had increasing angina which lasted 20 minutes after tarping a load; he or she is unresponsive to nitroglycerin. Medically disqualified. According to current CVD recommendations, a driver with unstable angina is not medically fit for duty. What are the differences between the medical standards and the medical guidelines? A driver presents for examination with a history (last month) of a pneumothorax. The records provided by the driver indicate that the pneumothorax reduced the driver's forced vital capacity (FVC) to 58% of predicted forced vital capacity. Can this drive be certified? If not, when can he be? Do not certify. According to recommendations, this driver should not be certified until the medical examiner has verified that the recovery is complete, with x-rays, and the driver has a FVC greater than 65%. Missing fourth and fifth fingers of right hand; has strong hand grasp. Qualifying procedure? not require 49 CFR 391.4 for certification. The medical examiner can assess for adequate grip strength; however, if any question of ability exists, medical examiner may request a treating or specialist evaluation. Missing right foot since age two; uses prosthesis and runs marathons. Does Requires qualifying procedures under 49 CFR 391.4 for certification. Regardless of the driver's ability to adapt to other challenges, the driver must still demonstrate adequate skill in operating a CMV with his/her fixed deficit. Status post-crush injury to left arm; has atrophy and weakness in ulnar distribution. Requires 49 CFR 391.4 for certification. The driver must demonstrate adequate skill in operating a CMV with his/her fixed deficit, even if it is impairment and not loss of the extremity. Suffering from carpal tunnel syndrome; has weak hand grasp. Does not require 49 CFR 391.4 for certification. Only fixed deficits can be qualified using the alternate standard. Carpal tunnel syndrome can be treated or, left untreated, can worsen causing increased impairment. Certification occurs only if the weakness in grasp is a fixed deficit, after maximal treatment, preventing any future deterioration from carpal tunnel syndrome. When evaluating a driver with a psychological disorder that might interfere with safe operation of a CMV, what behaviors should an examiner look for? Any suspicious, evasive, threatening, or hostile behaviors. Signs of being easily distracted. Signs of flat affect or lack or emotional response. Displays of unusual or bizarre ideas, auditory or visual hallucinations, dishonesty, or a tendency to omit important information. What is the purpose of the Interstate CMV driver physical examination? the purpose of the CMV exam is to detect the presence of physical, mental, or organic conditions of such character & extent as to affect driver ability to operate a CMV safely. This examination is for public safety determination & considered by FMCSA to be a "medical fitness for duty" exam. What is the mission of FMCSA? involving large trucks & buses. The FMCSA is focused on reducing crashes, injuries & fatalities Who and what does FMCSA regulate? The FMCSA regulates interstate commercial operation, including driver, vehicle, motor carrier, & transport of hazardous materials. Give some examples of CMV driver stress factors. patterns Interruption of normal sleep, exercise, & eating Limited access to social support networks resulting in fatigue, obesity, and/or alienation of affection. Environment that may have excessive vibration, noise, & extremes temperature, and/or adverse road or traffic conditions can interfere with CMV driver ability to recognize a driving hazard, cause temporary or permanent physical damage to sensory perception or affect driver behavior. Increased potential for injury & fatalities should there be a crash when driver is responsible for passenger safety or hazardous cargo. What are possible outcomes of the CMV driver physical exam? Qualifications) or Disqualification Certification (with or without Joe came in for exam on 2/1/2011 - met standards in 49 CFR 391.41; qualifies for 2 year certificate. Expiration date 2/1/2013 (2 yrs from date of PE) Pat came in for exam on 2/1/2011 - met standards but periodic monitoring required due to hypertension - driver qualified 1 year. Expiration date 2/1/2012 (1 year from date of PE) Sandy came in for exam on 2/1/2011 - Disqualified due to not having results of post-CABG stress test for review. 2/15/2011 - Return to ME's office with test results (attached) - driver qualified 1 yr. Expiration date 2/1/2012 (1 year from date of initial PE, not follow-up date when driver returned with test results needed to complete PE.) Stan came in for exam on 2/1/2011 - Disqualified due to diagnosis of benign positional vertigo on 3/10/2011. 4/3/2011- Returns to ME's office for Certification Exam. (Note: asymptomatic since 3/8/2011 but periodic.) Driver qualified for 2 years. Expiration date 4/3/2013 (2 yrs from date of second visit to ME. Time and conditions of waiting periods should be completed before considering driver for certification.) ME explains to CMV Driver at initial visit that he needs be symptom-free for 2 months (waiting period). On 4/3/2011, ME performed a complete physical exam, including starting a new ME Report form, and determined CMV Driver could be certified for 2 years. Expiration date is 2 years from the date the exam was performed. Who can perform the vision portion of the interstate CMV driver physical examination? Examiner, Medical assistant, Ophthalmologist/Optometrist To pass the interstate CMV driver vision exam, a visual acuity of __________ corrected or uncorrected is required. M