NRCME UPDATED EXAM SCRIPT QUESTIONS AND
ANSWERS RATED A+
✔✔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
✔✔Max cert period for diabetic patients - ✔✔Technically 2 years, but 1 year is
RECOMMENDED. What the hell.
✔✔The rule for DQ if they have history of hypoglycemic reactions - ✔✔1 episode in 12
months resulting in seizure, LOC, etc; or 2 episodes in 5 years that are as above or also
include loss of position sensation, orthostatic hypotension, etc.
✔✔Max cert period for asthma - ✔✔2 years
✔✔Must DQ COPD patients if 1 of 3 things: - ✔✔1. hypoxemia at rest
2. chronic resp failure
3. Continuing cough with cough syncope
✔✔if FEV1 on pulm function testing is < (blank) % of predicted, then must also test ABG
- ✔✔65%
✔✔Max cert period for CPAP - ✔✔1 year (1 month waiting period after starting CPAP or
3 months after surgery)
✔✔Should instruct drivers to refrain from driving for how many hours after cold or cough
medicines? - ✔✔12 hours
✔✔How many of these rules are stupid and arbitrary as hell? - ✔✔I'm gonna say 40%
✔✔Max cert period for pulmonary hypertension - ✔✔1 year
✔✔4 reasons to DQ a pulmonary hypertension patient - ✔✔1. dyspnea at rest
2. dizziness
3. hypotension
4. PaO2 <65mmHg
, ✔✔Name 3 reasons you should check PFTs/ spirometry prior to certifying - ✔✔1. Hx of
specific lung disease (asthma, CF, COPD)
2. symptoms of SOB, cough, chest tightness, wheezing, etc
3. Smokers over age 35
✔✔If pulse oximetry is less than blank, you have to do ABG - ✔✔92% (you would do the
pulse ox if FEV1 <65% of predicted or FEV1/FVC ratio <65%)
✔✔Apnea-hypopnea index of [blank] or more episodes per hour is diagnostic of OSA -
✔✔30
✔✔Min waiting period for diagnosis of epilepsy or viral encephalitis with early seizures -
✔✔10 years
✔✔Min waiting period for dx of bacterial meningitis with early seizures or single
unprovoked seizures - ✔✔5 years with no seizures and no seizure meds (or for single
unprovoked seizure, they can be cleared by a neurologist sooner)
✔✔Min waiting period for acute seizure secondary to acute structural insult to CNS -
✔✔2 years
✔✔Max certification for acute seizure secondary to acute structural insult to CNS - ✔✔1
year
✔✔Min waiting period for TBI with early seizures, stroke with risk for seizures,
intracranial bleed with risk for seizures - ✔✔5 years
✔✔Min waiting period for TIA or stroke with no risk for seizures - ✔✔1 year
✔✔Min waiting period for vertigo/ dizziness caused by dx of BPV or peripheral
vestibulopathy - ✔✔2 months
✔✔6 neuromuscular conditions that are automatic DQ - ✔✔1. congenital myopathies
2. metabolic muscle diseases
3. motor neuron diseases
4. muscular dystrophies
5. neuromuscular junction disorders
6. peripheral neuropathies
✔✔Max certification for single unprovoked seizure - ✔✔1 year
✔✔Max certification for embolic/ thrombotic stroke - ✔✔1 year and they have to be
cleared by neuro
ANSWERS RATED A+
✔✔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
✔✔Max cert period for diabetic patients - ✔✔Technically 2 years, but 1 year is
RECOMMENDED. What the hell.
✔✔The rule for DQ if they have history of hypoglycemic reactions - ✔✔1 episode in 12
months resulting in seizure, LOC, etc; or 2 episodes in 5 years that are as above or also
include loss of position sensation, orthostatic hypotension, etc.
✔✔Max cert period for asthma - ✔✔2 years
✔✔Must DQ COPD patients if 1 of 3 things: - ✔✔1. hypoxemia at rest
2. chronic resp failure
3. Continuing cough with cough syncope
✔✔if FEV1 on pulm function testing is < (blank) % of predicted, then must also test ABG
- ✔✔65%
✔✔Max cert period for CPAP - ✔✔1 year (1 month waiting period after starting CPAP or
3 months after surgery)
✔✔Should instruct drivers to refrain from driving for how many hours after cold or cough
medicines? - ✔✔12 hours
✔✔How many of these rules are stupid and arbitrary as hell? - ✔✔I'm gonna say 40%
✔✔Max cert period for pulmonary hypertension - ✔✔1 year
✔✔4 reasons to DQ a pulmonary hypertension patient - ✔✔1. dyspnea at rest
2. dizziness
3. hypotension
4. PaO2 <65mmHg
, ✔✔Name 3 reasons you should check PFTs/ spirometry prior to certifying - ✔✔1. Hx of
specific lung disease (asthma, CF, COPD)
2. symptoms of SOB, cough, chest tightness, wheezing, etc
3. Smokers over age 35
✔✔If pulse oximetry is less than blank, you have to do ABG - ✔✔92% (you would do the
pulse ox if FEV1 <65% of predicted or FEV1/FVC ratio <65%)
✔✔Apnea-hypopnea index of [blank] or more episodes per hour is diagnostic of OSA -
✔✔30
✔✔Min waiting period for diagnosis of epilepsy or viral encephalitis with early seizures -
✔✔10 years
✔✔Min waiting period for dx of bacterial meningitis with early seizures or single
unprovoked seizures - ✔✔5 years with no seizures and no seizure meds (or for single
unprovoked seizure, they can be cleared by a neurologist sooner)
✔✔Min waiting period for acute seizure secondary to acute structural insult to CNS -
✔✔2 years
✔✔Max certification for acute seizure secondary to acute structural insult to CNS - ✔✔1
year
✔✔Min waiting period for TBI with early seizures, stroke with risk for seizures,
intracranial bleed with risk for seizures - ✔✔5 years
✔✔Min waiting period for TIA or stroke with no risk for seizures - ✔✔1 year
✔✔Min waiting period for vertigo/ dizziness caused by dx of BPV or peripheral
vestibulopathy - ✔✔2 months
✔✔6 neuromuscular conditions that are automatic DQ - ✔✔1. congenital myopathies
2. metabolic muscle diseases
3. motor neuron diseases
4. muscular dystrophies
5. neuromuscular junction disorders
6. peripheral neuropathies
✔✔Max certification for single unprovoked seizure - ✔✔1 year
✔✔Max certification for embolic/ thrombotic stroke - ✔✔1 year and they have to be
cleared by neuro
