AME Risk Assessment & Mitigation 2 — Questions and Answers
Question 1: An AME discovers that a first-class applicant has a resting heart rate of 48 bpm with no symptoms. What is the most appropriate risk assessment approach?
- Deny certification immediately due to bradycardia
- Defer and request a cardiology evaluation to rule out pathological causes (Correct answer)
- Issue the certificate with no further action required
- Require a 24-hour Holter monitor before any consideration
Correct answer: Defer and request a cardiology evaluation to rule out pathological causes
Asymptomatic bradycardia at 48 bpm may be physiological (e.g., athletic heart) but requires cardiology evaluation to rule out pathological bradyarrhythmias before certification.
Question 2: Which HIMS AME tool is used to calculate the 5-year major adverse cardiovascular event risk for pilots with coronary artery disease?
- Framingham Risk Score
- ASCVD Pooled Cohort Equations
- FAA CAVI Protocol
- Duke Treadmill Score (Correct answer)
Correct answer: Duke Treadmill Score
The FAA uses the Duke Treadmill Score as part of the CAVI (Coronary Artery Disease in Flyers) protocol to assess MACE risk in pilots with known CAD.
Question 3: A pilot with Type 2 diabetes controlled by metformin alone wishes to renew their third-class certificate. What best describes the AME's risk mitigation role?
- Issue the certificate after confirming HbA1c is below 9% and no hypoglycemic agents are used (Correct answer)
- Deny all diabetic applicants regardless of medication regimen
- Refer the case to the FAA since diabetes is always disqualifying
- Issue the certificate only if the pilot agrees to not fly at night
Correct answer: Issue the certificate after confirming HbA1c is below 9% and no hypoglycemic agents are used
Pilots with Type 2 diabetes on metformin alone may be issued a certificate if HbA1c is acceptable and no hypoglycemia risk exists from medication class.
Question 4: When assessing a pilot's risk from obstructive sleep apnea (OSA), which parameter most directly correlates with aviation safety risk?
- Body mass index greater than 30
- Apnea-Hypopnea Index (AHI) and treatment compliance (Correct answer)
- Neck circumference exceeding 17 inches
- Daytime sleepiness score on Epworth scale alone
Correct answer: Apnea-Hypopnea Index (AHI) and treatment compliance
The AHI quantifies sleep apnea severity and treatment compliance (CPAP adherence data) is required evidence that the safety risk from excessive sleepiness is mitigated.
Question 5: A second-class applicant discloses a history of kidney stones treated 2 years ago with no recurrence. What is the primary risk mitigation concern for aviation?
- Chronic renal failure progression
- Incapacitation from acute renal colic during flight (Correct answer)
- Medication nephrotoxicity
- Hypertension secondary to renal damage
Correct answer: Incapacitation from acute renal colic during flight
The primary aviation safety concern with kidney stones is the risk of sudden incapacitating pain (renal colic) during flight, particularly at critical phases.
Question 6: Under the FAA's risk-based decision-making framework, which condition is evaluated using the concept of 'operational risk mitigation' for Special Issuance?
- Color vision deficiency with demonstrated OCA pass (Correct answer)
- A history of peptic ulcer treated 10 years ago
- Mild presbyopia corrected with bifocals
- A healed fracture of the non-dominant hand
Correct answer: Color vision deficiency with demonstrated OCA pass
Color vision deficiency requires demonstration that operational tasks can still be performed safely, assessed via the Operational Color Assessment (OCA) flight test as a mitigation measure.
Question 7: An AME is evaluating a pilot with a history of alcohol use disorder (AUD) who has been sober for 4 years. Which FAA program is designed to monitor and mitigate recidivism risk in this population?
- HIMS AME Protocol
- Human Intervention Motivation Study (HIMS) (Correct answer)
- Substance Abuse Professional (SAP) program
- Aviation Safety Action Program (ASAP)
Correct answer: Human Intervention Motivation Study (HIMS)
The FAA's HIMS (Human Intervention Motivation Study) program was specifically developed to monitor pilots recovering from alcohol use disorder and provides structured relapse risk mitigation.
AME Risk Assessment & Mitigation 2
An AME discovers that a first-class applicant has a resting heart rate of 48 bpm with no symptoms.
What is the most appropriate risk assessment approach?