NRCME (DOT) Exam Test Bank: Questions & Answers:
Well Elaborated With Explanations
CAD - ANSWERAt least annual examination, and be on board with cardiology,
tolerate and comply with meds. No need to disqualify right away.
Acceptable Echo -
LVEF >/= 40%
Pulmonary artery pressure <50% systemic systolic BP.
Acceptable exercise tolerance -
Achieve >6 mets through Bruce stage 2 or equivalent (medium work up to 50 lb
carrying)
Attain HR of >/=85% predicted maximum unless on beta blockers
Rise in systolic BP >/= 20 mm/hg without angina.
No ST segment depression
Post MI - ANSWERdrivers must wait 2 months minimum. 1 year maximum.
Must be asymptomatic.
Tolerate meds
Acceptable ETT after the MI, and biennial after that
LVEF >/=40 (REQUIRES ECHO)
Needs cardiology clearance
Angina - - ANSWERNeeds 3 month wait after angina.
Maximum of 1 year certification
Biennial ETT (Q2Y)
Cardiology clearance
Clearly delineate cardiac cause vs other cause. If this is transient and noncardiac,
treat the patient as if they do not have a condition. Not all chest pain is cardiac
angina.
CABG - - ANSWERSternum must be completely healed after this.
Minimum 3 month return
Maximum 1 year certification.
Annual ETT
Cardiology clearance.
PCI - - ANSWER1 week waiting time.
Maximum of 1 year clearance.
Cardiology clearance.
Biennial ETT
Pacemakers - ANSWERMinimum 1 month wait if sinus node dysfunction / AV block
Minimum 3 month wait if hypersensitive carotid sinus with syncope
Maximum cert of 1 year
Needs routine pacemaker checks. Patient needs documentation.
, SVT - ANSWERMinimum 1 month wait on anticoagulation and asymptomatic
1 month wait post isthmus ablation and diagnosis is atrial flutter
1 month wait if asymptomatic if AV reentrant tachycardia, WPW, atrial tachycardia,
junctional tachycardia
Maximum certification of 1 year.
Cardiology clearance + Annual cardiology visit.
Ventricular arrhythmias - ANSWERMinimum 1 month wait if coronary heart disease,
RV outflow V-tach, Idiopathic LV V-tach
Maximum 1 year cert.
Cannot be sustained, nonsustained requires LVEF >/=40%
CANNOT CERTIFY hypertrophic cardiomyopathy, Long QT, Brugada
Heart Failure - ANSWERUse NYHA classes (Only certify class 1)
Maximum 1 year certification.
Syncope - ANSWERRequires a 3 month waiting period.
Maximum cert of 1 year.
Ebstein Anomaly - ANSWERDownward tricuspid displacement)
Must be asymptomatic, everything about it must be mild.
Annual cardiology + echo
Cannot certify if there are comorbid issues.
Maximum of 1 year cert.
Heart Transplant - ANSWERWait period of 1 year post transplant.
Max 6 month certification.
Need cardiology evaluation every 6 months as well as medical examination.
Cardiomyopathies - ANSWERCannot certify drivers with hypertrophic or restrictive
cardiomyopathy.
AAA - ANSWERCertify if <4cm and asymptomatic
Certification is 4-5cm and asymptomatic and cardiology clearance.
Following surgical repair, 3 month wait.
Max cert of 1 year.
If it has increased in size by 0.5cm during the 6 month period, cannot certify.
Thoracic Aneurysm - ANSWER<5cm and asymptomatic required.
3 months after surgery wait period.
1 year max cert.
DVT - ANSWER1 year max cert
Meet anticoagulation guidelines.
Chronic Thrombotic Venous Disease - ANSWERMaximum cert of 2 years only if
asymptomatic.
Well Elaborated With Explanations
CAD - ANSWERAt least annual examination, and be on board with cardiology,
tolerate and comply with meds. No need to disqualify right away.
Acceptable Echo -
LVEF >/= 40%
Pulmonary artery pressure <50% systemic systolic BP.
Acceptable exercise tolerance -
Achieve >6 mets through Bruce stage 2 or equivalent (medium work up to 50 lb
carrying)
Attain HR of >/=85% predicted maximum unless on beta blockers
Rise in systolic BP >/= 20 mm/hg without angina.
No ST segment depression
Post MI - ANSWERdrivers must wait 2 months minimum. 1 year maximum.
Must be asymptomatic.
Tolerate meds
Acceptable ETT after the MI, and biennial after that
LVEF >/=40 (REQUIRES ECHO)
Needs cardiology clearance
Angina - - ANSWERNeeds 3 month wait after angina.
Maximum of 1 year certification
Biennial ETT (Q2Y)
Cardiology clearance
Clearly delineate cardiac cause vs other cause. If this is transient and noncardiac,
treat the patient as if they do not have a condition. Not all chest pain is cardiac
angina.
CABG - - ANSWERSternum must be completely healed after this.
Minimum 3 month return
Maximum 1 year certification.
Annual ETT
Cardiology clearance.
PCI - - ANSWER1 week waiting time.
Maximum of 1 year clearance.
Cardiology clearance.
Biennial ETT
Pacemakers - ANSWERMinimum 1 month wait if sinus node dysfunction / AV block
Minimum 3 month wait if hypersensitive carotid sinus with syncope
Maximum cert of 1 year
Needs routine pacemaker checks. Patient needs documentation.
, SVT - ANSWERMinimum 1 month wait on anticoagulation and asymptomatic
1 month wait post isthmus ablation and diagnosis is atrial flutter
1 month wait if asymptomatic if AV reentrant tachycardia, WPW, atrial tachycardia,
junctional tachycardia
Maximum certification of 1 year.
Cardiology clearance + Annual cardiology visit.
Ventricular arrhythmias - ANSWERMinimum 1 month wait if coronary heart disease,
RV outflow V-tach, Idiopathic LV V-tach
Maximum 1 year cert.
Cannot be sustained, nonsustained requires LVEF >/=40%
CANNOT CERTIFY hypertrophic cardiomyopathy, Long QT, Brugada
Heart Failure - ANSWERUse NYHA classes (Only certify class 1)
Maximum 1 year certification.
Syncope - ANSWERRequires a 3 month waiting period.
Maximum cert of 1 year.
Ebstein Anomaly - ANSWERDownward tricuspid displacement)
Must be asymptomatic, everything about it must be mild.
Annual cardiology + echo
Cannot certify if there are comorbid issues.
Maximum of 1 year cert.
Heart Transplant - ANSWERWait period of 1 year post transplant.
Max 6 month certification.
Need cardiology evaluation every 6 months as well as medical examination.
Cardiomyopathies - ANSWERCannot certify drivers with hypertrophic or restrictive
cardiomyopathy.
AAA - ANSWERCertify if <4cm and asymptomatic
Certification is 4-5cm and asymptomatic and cardiology clearance.
Following surgical repair, 3 month wait.
Max cert of 1 year.
If it has increased in size by 0.5cm during the 6 month period, cannot certify.
Thoracic Aneurysm - ANSWER<5cm and asymptomatic required.
3 months after surgery wait period.
1 year max cert.
DVT - ANSWER1 year max cert
Meet anticoagulation guidelines.
Chronic Thrombotic Venous Disease - ANSWERMaximum cert of 2 years only if
asymptomatic.
