NADME

Which driver exemptions exist?

Hearing and seizures

Which physical qualifications are non-discretionary?

Visón, hearing, epilepsy.

Where should the Medical Examination Report Form be provided to?

What is FMCSA guidance?

Recommendations to help medical examiners to make decisions. That are NOT law.

what are the regulations that affect commercial vehicle drivers?

Medical fitness for duty certification

Drug screening

Hours of service

Record keeping

Can you give someone younger than 21 a physical qualification exam?

Yes, but not a certificate

What is the FMCSA Medical programs division responsible for? (5 things)

Overseeing the:

national commercial driver certification process

medical review board

Relevant Medical research

Operates the national registry of certified medical examiners

Conducts the FMCSA medical exemption and certificate programs

What is the maximum number of hours a driver can drive in a single shift?

11 hours

Can a diabetic driver be treated with insulin?

Yes, if the driver meets the requirements in 49 CFR 391.46

A medical examiner’s responsibility include:

Health, education and counseling only including medication, side effects, how to read medication labels, and seeking care for serious illnesses

What can medical examiners not do? (3 things)

diagnose any suspected conditions

prescribe medications

develop a treatment plan

What is the Medical examiners responsibility when certifying a driver that only operates an intrastate commerce?

Know and follow the state regulations to qualify the driver

What would a medical examiner need to remain listed on the national registry? (3 things)

Keep your state license current and documented with NRCME

Complete a periodic refresher training every five years

Pass the recertification exam every 10 years

What is the alternative vision standard?

Monocular vision.

Has to see ophthalmologist or optometrist to show its stable.

How many days do you have to have stability of Monocular vision To certify?

45 days

When is the road test necessary for vision aspect?

Driver is trying to qualify for the alternative vision, standard monocular, and before operating a commercial motor vehicle vehicle

Is retinopathy a reason not to qualify someone ever?

No. Only severe non-proliferative retinopathy and severe proliferative retinopathy in insulin treated diabetes

What disease is characterized by slow onset of blindness caused by retinal degeneration of the photoreceptors?

Carcinoma associated retinopathy

What are two medications used to treat age related Macular Degeneration ?

Antioxidants and zinc

Vascular endothelial growth factor inhibitors

Five medication classes to treat glaucoma

Prostaglandin analogs

Beta agrenergic blocking agents

Carbonic anhydrate inhibitors

Alpha agonist

Cholinergic agents

Examples of prostaglandin analogs

Ends in -Prost (examples)

Latanaprost (xalatan)

Bimatoprost (lumigan)

Example of carbonic anhydride inhibitors for glaucoma

ends with -zolamide

Dorzalamide (Trusopt) - drops

Acetazolamide (Diamox) - oral

Example of alpha agonist for glaucoma

Ends in -onidine

Brimonidine (Alphagan)

Example of cholinergic agents for glaucoma

Pilocarpine (Carpine)

Three ways to treat dry eyes

Lubricant

NSAIDs (timolol)

Topical cyclosporine (restasis)

When getting vision testing by specialist, what information do you need?

name

telephone number

email address

license number

state is issuing the license

Sign and date report

How many years can you certify someone for visual?

Normal vision qualification standards two years

Alternative vision standard one year

What is a vision evaluation report (MCSA-5871)?

Form used by the ophthalmologist or optometrist when being evaluated under the Alternative Vision Standard.

How do you check for color?

Basically ANY color that is green, amber, and red.

What is visual degrees passing visual acuity?

At LEAST 70 degrees or greater.

When is the only time you can use “determination pending?”

When a driver has completed a vision evaluation and provided the vision evaluation report form to the medical examiner.

Never use determination pending without the form.

What is the federal standard for hearing?

Perceive force whispered voice in one ear not less than 5 feet

OR

Must not have average hearing loss in one year greater than 40 dB at 500, 1000, and 2000 Hz

What is a good hearing test?

Less than 40dB

Which calibration should you use if using audiometric devices?

American national standard (ANSI)

How to convert from ISO to ANSI?

ISO 500Hz minus 14dB

ISO 1000Hz minus 10dB

ISO 2000Hz minus 8.5dB

Add three readings and divide by 3

Federal exemption for hearing is only acceptable for which type of drivers?

Interstate drivers

Failed hearing test with hearing aids

Maximum certification period for drivers who use a hearing aid?

2 years

Maximum certification period for a driver who requires a federal hearing exemption?

2 years

Stages hypertension

Stage 1: 140/90 to 159/99

Stage 2: 160/100 to 179/109

Stage 3: 180/110 or higher

Blood pressure certification

Stage 1 = ONE year FREE (then subsequent year, if high, 3 months cert, then yearly if pass)

Stage 2 = THREE months temp cert first, then yearly if pass

Stage 3 = NOPE to certify, then 6 months forever if passed

When should you repeat BP??

Greater than 139/89

THIS IS A TRICK Question

Recheck vs treatment goal BP

DO NOT RECHECK if BP 139/89 or LESS

Acceptable blood pressure control is LESS than or EQUAL to 140/90

Define mild, moderate and severe sleep apnea per hour (apenic episodes)

Mild: 5

Moderate: 15

Severe: 30

Define hypopnea

Airflow drops by 30% or more

Reduced airflow 10 or more seconds

Blood O2 drops by 3-4%

Risk factors for sleep apnea

2+ meds for hypertension

Nocturnal arrhythmias

Atrial fibrillation

CHF

Stroke

Pulmonary hypertension

Motor vehicle accidents

Neck circumference for sleep apnea

17 inches men, 16 inches women

Mallampati score for sleep apnea

3-4

Physical exam sleep apnea

Large tongue (microglossia)

Large uvula

Narrow palate

Nasal Polyps