DOT CERTIFICATION

DOT CERTIFICATION LTCCS - CORRECT ANSWER-large truck crash causation study, , reported in 2006 #1 cause of fatalities with big trucks? - CORRECT ANSWER-driver fatigue DOT organization - CORRECT ANSWER-all subcategories are separate entities and require different things What is covered in NRCME training? - CORRECT ANSWER-federal motor carrier safety administration (FMCSA) How long does NRCME certification last? - CORRECT ANSWER-10 years with a 5 year update class once a driver is certified, what is the longest it lasts? - CORRECT ANSWER-2 years SPE - CORRECT ANSWER-skill performance evaluation Three copies of driver's certificate: who gets them and who has original for how long? - CORRECT ANSWER-driver, employer get copies examiner keeps original for 3 years Non discretionary standards - CORRECT ANSWER-immediately DQ the driver, examiner MUST follow standards discretionary guides/recommendations - CORRECT ANSWER-limits steered by recommendations and examiners judgement list the non discretionary DQers - CORRECT ANSWER-Hx of epilepsy, failed hearing exam, failed Vx exam, active insulin dependent DM who oversees medical certification process? - CORRECT ANSWER-office of medical programs how many X more is mortality rate for passenger vehicle vs large truck, in a crash between the two? - CORRECT ANSWER-passenger vehicle 5X more likely to die where are physical standards for drivers listed? - CORRECT ANSWER-49 CFR 391.41 define CMV - CORRECT ANSWER-commercial motor vehicle: any self propelled or towed MV used on a highway in interstate commerce to transport passengers or property...10k lbs or more, 8+ passengers for $$, 15+ passengers not for $$, hazardous materials where is CMV defined? - CORRECT ANSWER-40 CFR 390.5 where are medical examiner qualifications found? - CORRECT ANSWER-49 CFR 391.43 Where are general qualifications for CMV drivers found? - CORRECT ANSWER-49 CFR 391.11 list non-discretionary standards - CORRECT ANSWER-loss of limb, limb impairment, CV condition, respiratory dysfunction, HTN, RA/OA/orthopedic/muscular, mental disorder, drug use, alcoholism "average" driver demographics - CORRECT ANSWER-male, 40+, sedentary, obese, smoker, poor eating habits "average" driver medical health - CORRECT ANSWER-less healthy than average citizen, 2+ medical conditions, CV disease list 9 occupational stressors for CMV drivers - CORRECT ANSWER-type of route, schedule, finances, vehicle, road conditions, environmental, type of cargo when can a driver on insulin be certified? - CORRECT ANSWER-if he/she has FMCSA waiver - 49 CFR 391.64 OR federal exemption program FMCSA definition of "severe hypoglycemia" - CORRECT ANSWER-seizure, LOC, need assistance from others, impaired cog fxn if severe hypoglycemia, ask if driver has had reactions how frequently? - CORRECT ANSWER-1+ in last 12 months 2+ in last 5 years what happens if driver has loss of proprioception? what about peripheral neuropathy? - CORRECT ANSWER-DQ and DQ what if DM patient has resting tachycardia or orthostatic HOTN? - CORRECT ANSWER-DQ what if driver has silver wire, cotton patches? - CORRECT ANSWER-qualify but recommend ophthalmologist yearly what if driver has unstable retinopathy where neovascularization extends into vitreous? - CORRECT ANSWER-DQ driver uses telescopic lenses? - CORRECT ANSWER-DQ what if driver on incretin mimetics? what about other oral hypoglycemics? - CORRECT ANSWER-certify for one year DM exemption requires a driver to: - CORRECT ANSWER-annual endocrinology visit, annual optho visit, DM education, glucose monitoring forced whisper test - CORRECT ANSWER-hear a forced whisper at no less than 5ft audiometric testing limits - CORRECT ANSWER-average hearing loss no greater than 40 decibels can driver wear hearing aids during forced whisper test? - CORRECT ANSWER-yes audiometer should be calibrated to what standard? - CORRECT ANSWER-American National Standards Institute (ANSI) Z24.5-1951 driver wears a hearing aid. can you do in office whisper test? what about audiometry test? - CORRECT ANSWER-yes for whisper, no for audiometry how to calculate hearing loss? - CORRECT ANSWER-determine what decibels heard at 500Hz, 1000Hz, 2000Hz in one ear. Add the results and divide by three. Result = average hearing loss. Audiometric testing - results? - CORRECT ANSWER-qualify driver if less than 40dB hearing loss in good ear. both ears more than 40=DQ how to convert from International Organization for Standardization to ANSI? - CORRECT ANSWER-minus 14 from 500 minus 10 from 1000 minus 8.5 from 2000 which test to do first, whisper or audiometric? - CORRECT ANSWER-doesn't matter as long as one is passed, driver is qualified which otic diseases disqualify driver? - CORRECT ANSWER-BPPV w/ Sx in last 2 months menieres labyrinthine fistula nonfunctioning labyrinths Required vision tests? - CORRECT ANSWER-visual acuity (snellen/titmus), peripheral horizontal visual fields, color vision Snellen visual acuity - ft away from chart and standards? - CORRECT ANSWER-20 ft from chart, both eyes together and each eye must be 20/40 peripheral field of vision test? - CORRECT ANSWER-70 degrees what colors does driver need to distinguish between? - CORRECT ANSWER-green amber red driver has retinopathy - what to do? - CORRECT ANSWER-you can certify but driver must have annual medical exam, annual optho exam driver has unstable proliferative retinopathy - CORRECT ANSWER-DQ driver can only meet requirements for Vx in one eye - CORRECT ANSWER-DQ driver has contacts - one corrects for distance, one corrects for near acuity - CORRECT ANSWER-DQ Federal vision exempt program - CORRECT ANSWER-2 years monocular vision study - CORRECT ANSWER-49 CFR 391.64, grandfathered in, driver can be certified for 1 year you note HTN for first time in driver. what to do? - CORRECT ANSWER-certify for one year, after one year, certify for 3 months driver had stage 1 HTN, certified for 1 yr + 3 months, now what? - CORRECT ANSWER-DQ BP = 180/110 - CORRECT ANSWER-DQ, if driver gets BP down, can certify for 6 months at a time pending 3 month interval checkups first time stage 2 HTN, what to do? - CORRECT ANSWER-certify for 3 months...after this DQ if not lowered BP driver had stage 2 HTN, got a 3 month certification and got BP down. now what? - CORRECT ANSWER-certify for 1 year after the INITIAL check (3 months ago) name three neurologic standards, and choose the one that is nondiscretionary - CORRECT ANSWER-rheumatic/arthritic/ortho/muscular, epilepsy, mental...epilepsy is nondiscretionary driver is on anticoagulant therapy for cerebrovascular disorder - CORRECT ANSWERDQ driver has cerebrovascular disorder - when to qualify? - CORRECT ANSWERnormalized INR, recert q1yr, monthly INR monitoring TIA recurrence risk - CORRECT ANSWER-greatest in first few weeks following stroke, by one year post TIA, risk is 5% driver had TIA - CORRECT ANSWER-wait 1 year then recert if not on anticoagulants driver had stroke affecting cerebellum or brainstem - CORRECT ANSWER-1 year wait, then recertify if not on anticoagulants and able to obtain clearance from neurologist driver had stroke affecting cortical or subcortical region - CORRECT ANSWER-5 year wait period then recertify if not on anticoagulants and you're able to obtain clearance from neurologist intracerebral/subarachnoid bleed - CORRECT ANSWER-wait 1 year if in brainstem/cerebellum, wait 5 years if cortical/subcortical post moderate TBI (without early seizures, LOC 30m-24h) - CORRECT ANSWER-wait 2 years, cleared by neuro, yearly recertification post severe TBI (penetrates dura, LOC 24h+) - CORRECT ANSWER-DQ post moderate TBI with early seizures - CORRECT ANSWER-wait 5 years, no anticonvulsants, clearance by neuro post mild TBI with early seizures - CORRECT ANSWER-2 years wait, anticonvulsant free neuro reasons to DQ - CORRECT ANSWER-severe TBI, AV malfunction, dementia, parkinsons, cerebellar ataxia, frequent/severe HA how long to wait for benign supratentorial tumor? spinal tumor? - CORRECT ANSWERbenign supratentorial tumor and spinal tumor = 2 years post surgical removal. all other types = 1 year post surgical removal dementia? - CORRECT ANSWER-DQ always motor neuron disease? (ALS) - CORRECT ANSWER-DQ multiple sclerosis? - CORRECT ANSWER-DQ but driver can appeal