AME Risk Assessment & Mitigation 3 — Questions and Answers
Question 1: A pilot applicant reports taking a selective serotonin reuptake inhibitor (SSRI) for depression. Under the FAA's SSRI policy, which factor is NOT part of the risk mitigation criteria?
- Stable dose for at least 6 months
- Demonstrated clinical stability with no suicidal ideation
- Absence of certain disqualifying psychiatric diagnoses
- Pilot must hold an instrument rating (Correct answer)
Correct answer: Pilot must hold an instrument rating
The FAA's SSRI policy does not require an instrument rating; it focuses on stability of dose, absence of disqualifying diagnoses, and demonstrated clinical stability.
Question 2: When performing incapacitation risk analysis for a pilot with a single seizure 12 years ago and no recurrence, the AME should primarily assess:
- Whether the pilot has a valid driver's license
- Annual seizure recurrence probability and EEG findings (Correct answer)
- The pilot's altitude waiver history
- Duration of the initial seizure event
Correct answer: Annual seizure recurrence probability and EEG findings
The key risk metric for seizure history is the probability of recurrence per year, informed by EEG findings, neuroimaging, and etiology of the initial event.
Question 3: A commercial pilot is found to have moderate mitral valve regurgitation on echocardiogram but is asymptomatic. What best describes the AME's risk-based approach?
- Issue the certificate since the pilot is asymptomatic
- Defer to the FAA for Special Issuance evaluation with cardiology documentation (Correct answer)
- Deny permanently based on structural heart disease
- Restrict the pilot to daytime VFR only
Correct answer: Defer to the FAA for Special Issuance evaluation with cardiology documentation
Moderate valvular disease typically requires Special Issuance with complete cardiology evaluation including echocardiographic data to quantify hemodynamic risk.
Question 4: Which scenario best exemplifies the FAA concept of 'acceptable level of risk' in aviation medical certification?
- Certifying a pilot only when there is zero risk of in-flight incapacitation
- Certifying a pilot when the annual risk of incapacitation does not exceed 1% per flight hour
- Applying the 1% per year risk threshold for incapacitating events in single-pilot operations (Correct answer)
- Granting certification whenever a specialist clears the pilot for return to work
Correct answer: Applying the 1% per year risk threshold for incapacitating events in single-pilot operations
The FAA's '1% rule' holds that the risk of a sudden incapacitating event must not exceed approximately 1% per year for the pilot to be certified, especially in single-pilot operations.
Question 5: A pilot with controlled hypertension on lisinopril has a blood pressure reading of 138/88 mmHg in the office. What is the most appropriate risk mitigation step?
- Issue the certificate; reading is within acceptable limits for certification (Correct answer)
- Deny the certificate until blood pressure is below 120/80
- Request ambulatory blood pressure monitoring to rule out white-coat hypertension
- Require the pilot to switch to a beta-blocker before certification
Correct answer: Issue the certificate; reading is within acceptable limits for certification
Blood pressure up to 155/95 mmHg is within FAA acceptable limits for certification when medically treated, so 138/88 qualifies for certificate issuance.
Question 6: In evaluating psychiatric risk for aviation safety, the GAO and FAA both emphasize which ongoing mitigation strategy for certified pilots with mental health histories?
- Annual psychiatric hospitalization screening
- Continuous monitoring by a dedicated aviation psychiatrist
- Regular follow-up documentation and AME attestation at each renewal (Correct answer)
- Mandatory grounding during any new life stressor
Correct answer: Regular follow-up documentation and AME attestation at each renewal
Regular follow-up documentation at each medical renewal, with AME attestation of continued stability, is the FAA's primary longitudinal monitoring strategy for mental health risk.
Question 7: A pilot discloses use of a non-prescription antihistamine for seasonal allergies. From a risk mitigation standpoint, the primary concern is:
- Anaphylaxis risk from allergen exposure at altitude
- Sedative side effects impairing pilot performance and alertness (Correct answer)
- Drug interactions with oxygen at high altitude
- Increased infection risk due to immunosuppression
Correct answer: Sedative side effects impairing pilot performance and alertness
First-generation antihistamines cause CNS sedation and impaired psychomotor performance, which is the primary safety risk in pilot populations.
AME Risk Assessment & Mitigation 3
A pilot applicant reports taking a selective serotonin reuptake inhibitor (SSRI) for depression.
Under the FAA's SSRI policy, which factor is NOT part of the risk mitigation criteria?