DOT exam emedhome
A driver is taking Celexa for the treatment of what he calls a "mild depression." He
reports he
has not considered or attempted suicide. The examiner should: - ANSWER-Temporarily
disqualify the driver until he obtains written clearance for the depression and
the medication from the treating provider.
The following statements are true concerning hearing requirements of commercial
drivers
EXCEPT:
a. Hearing aids may not be worn during the forcedwhisper test.
b. Either the forced whisper or audiometry tests may be performedfirst.
c. The forced whisper test is passed if one ear perceives the forced whisper at 5 feet.
d. Administration of both tests is only necessary if the first test is failed. - ANSWER-
Hearing aids may not be worn during the forcedwhisper test.
A driver with a history of diabetes, who is taking Metformin, provides a note from his
primary care provider that lists his A1c level as 10. His exam is essentially normal
including laboratory analysis, except he is very overweight. The medical examiner
should certify the driver for how long? - ANSWER-Certify the driver for 1 year.
A driver has had his second spontaneous pneumothorax on the same side 3 months
ago. There has
been no surgical intervention. The FVC is 68%. The correct determination in thiscase is:
- ANSWER-Do not certify until the condition has been corrected surgically.
The driver reports a suicide attempt 6 months earlier, following the break-up of his
marriage. He noted
seeing a psychiatrist and he takes Citalopram daily and he reports he feels fine now and
is moving on with
his life. He provides a release from his doctor that he may return to work without
restrictions. The
medical examiner should? - ANSWER-Disqualify the driver.
A driver with an Abnormal Aortic Aneurysm (AAA) can be certified: - ANSWER-For 1
year if between 4 and 5 cm, asymptomatic, with a recommendation from a
cardiovascular
specialist who understands the functions and demands of commercial driving.
Which of the following is false concerning additional information the driver is to provide
for any "yes"
responses on the history section of the examination form? - ANSWER-Must list only
prescription medications, not vitamins or supplements.
,Upon examination of a 46-year-old male smoker, you detect an irregularly irregular
heart rhythm.
The rate is 140 bpm. This is unknown to the driver and he denies any symptoms of
lightheadedness,
shortness of breath, dizziness, palpitations, nor any cardiac history. What would you
do? - ANSWER-a. Disqualify and refer to his PMD or cardiologist for further evaluation
Which 3 cardiac condition is disqualifying? - ANSWER-HOCM
Torsades
Brugada syndrome
You must review and discuss with the driver any "yes" answers to include any illness or
injury in
the last how many years. - ANSWER-years
A driver was discharged from the hospital 10 weeks ago, after an MI. He is
asymptomatic and has a
note from the cardiologist that he had a satisfactory in office ETT the week prior to your
examination
and that he may drive. His pre-discharge ECHO shows an EF of 45%. His examination
is normal.
What is the max certification period? - ANSWER-1 year
Concerning the medical certificate, can you give a copy to the current or prospective
employer? - ANSWER-No they must get it from the driver
Which of the following is an assessment of L4 nerve root pathology? - ANSWER-
Patellar reflex
What indicators will you need to refer a driver for PFT? - ANSWER-history of COPD,
symptoms of wheezing, cigarette smoking in drivers 35 years or older
How soon may a driver be certified after coronary artery bypass grafting (CABG)
surgery? - ANSWER-.3 months with clearance by cardiologist, resting echocardiogram
with an LVEF >40% after
CABG, and asymptomatic status with no angina.
A driver presents for his DOT physical. He notes occasional lower back pain. A lateral
pulsation is
palpated approximately 2 inches superior of the umbilicus. Auscultation in this area
reveals an
obvious bruit. What is the most important next step? - ANSWER-.Arrange for immediate
transport to an Emergency Department
, Arriving for a recertification exam, a 48 year-old male non-smoker is 5'4", 275lbs. His
supervisor calls
you ahead of time stating he recently went off the side of the road crashing into a guard
rail. There
were no injuries and the truck sustained only minor damage. When the medical
assistant goes to
bring him back, he is found asleep, snoring in the waiting room and she needs to wake
him by gently
shaking him by the shoulder. She reports this to you. When you arrive in the exam room
the patient
appears to be nodding off while sitting on the exam table. Upon further questioning, he
admits that
his wife frequently elbows him because of his snoring and that he gasps and snorts in
his sleep.
When asked, he denies nodding off while driving. His exam is notable for obesity,
Mallampati 4
oropharynx, HTN controlled with 2 medications, otherwise normal. Appropriate next
steps: - ANSWER-disqualify and refer to PMD for sleep study
Physical qualifications for vision regulations include all but: - ANSWER-Field of vision of
at least 85 degrees in the horizontal meridian in each eye
A 69-year-old male driver had a femoral-popliteal bypass 4 months ago, with resolution
of chronic
leg pain due to claudication. His surgeon clears him for driving. He is on coumadin with
INRs
consistently in the therapeutic range since discharge. what is the max certification? -
ANSWER-meets standards, qualified for one year
Drivers must have the following physical abilities except:
a. Grip strength.
b. Upper body strength.
c. Ability to lift 70 lbs. frequently.
d. Balance and flexibility - ANSWER-ability to lift 70 pounds frequently
A driver returns to work after a two-week absence due to a respiratory illness. He
presents a note
from his physician that he was unable to work as a truck driver because of the illness
and is now
cleared for returning to work. His medical certificate expires in 3 months. Thedriver:
a. Should be allowed to return to work based on his physician's note.
b. Should undergo a new commercial driver examination.
c. May only be qualified for one year.
d. Can return to work at the discretion of the motor carrier - ANSWER-. Should undergo
a new commercial driver examination.
A driver is taking Celexa for the treatment of what he calls a "mild depression." He
reports he
has not considered or attempted suicide. The examiner should: - ANSWER-Temporarily
disqualify the driver until he obtains written clearance for the depression and
the medication from the treating provider.
The following statements are true concerning hearing requirements of commercial
drivers
EXCEPT:
a. Hearing aids may not be worn during the forcedwhisper test.
b. Either the forced whisper or audiometry tests may be performedfirst.
c. The forced whisper test is passed if one ear perceives the forced whisper at 5 feet.
d. Administration of both tests is only necessary if the first test is failed. - ANSWER-
Hearing aids may not be worn during the forcedwhisper test.
A driver with a history of diabetes, who is taking Metformin, provides a note from his
primary care provider that lists his A1c level as 10. His exam is essentially normal
including laboratory analysis, except he is very overweight. The medical examiner
should certify the driver for how long? - ANSWER-Certify the driver for 1 year.
A driver has had his second spontaneous pneumothorax on the same side 3 months
ago. There has
been no surgical intervention. The FVC is 68%. The correct determination in thiscase is:
- ANSWER-Do not certify until the condition has been corrected surgically.
The driver reports a suicide attempt 6 months earlier, following the break-up of his
marriage. He noted
seeing a psychiatrist and he takes Citalopram daily and he reports he feels fine now and
is moving on with
his life. He provides a release from his doctor that he may return to work without
restrictions. The
medical examiner should? - ANSWER-Disqualify the driver.
A driver with an Abnormal Aortic Aneurysm (AAA) can be certified: - ANSWER-For 1
year if between 4 and 5 cm, asymptomatic, with a recommendation from a
cardiovascular
specialist who understands the functions and demands of commercial driving.
Which of the following is false concerning additional information the driver is to provide
for any "yes"
responses on the history section of the examination form? - ANSWER-Must list only
prescription medications, not vitamins or supplements.
,Upon examination of a 46-year-old male smoker, you detect an irregularly irregular
heart rhythm.
The rate is 140 bpm. This is unknown to the driver and he denies any symptoms of
lightheadedness,
shortness of breath, dizziness, palpitations, nor any cardiac history. What would you
do? - ANSWER-a. Disqualify and refer to his PMD or cardiologist for further evaluation
Which 3 cardiac condition is disqualifying? - ANSWER-HOCM
Torsades
Brugada syndrome
You must review and discuss with the driver any "yes" answers to include any illness or
injury in
the last how many years. - ANSWER-years
A driver was discharged from the hospital 10 weeks ago, after an MI. He is
asymptomatic and has a
note from the cardiologist that he had a satisfactory in office ETT the week prior to your
examination
and that he may drive. His pre-discharge ECHO shows an EF of 45%. His examination
is normal.
What is the max certification period? - ANSWER-1 year
Concerning the medical certificate, can you give a copy to the current or prospective
employer? - ANSWER-No they must get it from the driver
Which of the following is an assessment of L4 nerve root pathology? - ANSWER-
Patellar reflex
What indicators will you need to refer a driver for PFT? - ANSWER-history of COPD,
symptoms of wheezing, cigarette smoking in drivers 35 years or older
How soon may a driver be certified after coronary artery bypass grafting (CABG)
surgery? - ANSWER-.3 months with clearance by cardiologist, resting echocardiogram
with an LVEF >40% after
CABG, and asymptomatic status with no angina.
A driver presents for his DOT physical. He notes occasional lower back pain. A lateral
pulsation is
palpated approximately 2 inches superior of the umbilicus. Auscultation in this area
reveals an
obvious bruit. What is the most important next step? - ANSWER-.Arrange for immediate
transport to an Emergency Department
, Arriving for a recertification exam, a 48 year-old male non-smoker is 5'4", 275lbs. His
supervisor calls
you ahead of time stating he recently went off the side of the road crashing into a guard
rail. There
were no injuries and the truck sustained only minor damage. When the medical
assistant goes to
bring him back, he is found asleep, snoring in the waiting room and she needs to wake
him by gently
shaking him by the shoulder. She reports this to you. When you arrive in the exam room
the patient
appears to be nodding off while sitting on the exam table. Upon further questioning, he
admits that
his wife frequently elbows him because of his snoring and that he gasps and snorts in
his sleep.
When asked, he denies nodding off while driving. His exam is notable for obesity,
Mallampati 4
oropharynx, HTN controlled with 2 medications, otherwise normal. Appropriate next
steps: - ANSWER-disqualify and refer to PMD for sleep study
Physical qualifications for vision regulations include all but: - ANSWER-Field of vision of
at least 85 degrees in the horizontal meridian in each eye
A 69-year-old male driver had a femoral-popliteal bypass 4 months ago, with resolution
of chronic
leg pain due to claudication. His surgeon clears him for driving. He is on coumadin with
INRs
consistently in the therapeutic range since discharge. what is the max certification? -
ANSWER-meets standards, qualified for one year
Drivers must have the following physical abilities except:
a. Grip strength.
b. Upper body strength.
c. Ability to lift 70 lbs. frequently.
d. Balance and flexibility - ANSWER-ability to lift 70 pounds frequently
A driver returns to work after a two-week absence due to a respiratory illness. He
presents a note
from his physician that he was unable to work as a truck driver because of the illness
and is now
cleared for returning to work. His medical certificate expires in 3 months. Thedriver:
a. Should be allowed to return to work based on his physician's note.
b. Should undergo a new commercial driver examination.
c. May only be qualified for one year.
d. Can return to work at the discretion of the motor carrier - ANSWER-. Should undergo
a new commercial driver examination.
