FREE NRCME Medical Conditions and Guidelines Questions and Answers

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Which of the following is a medical examiner required to inquire about from a driver with diabetes mellitus?

Correct! Wrong!

Explanation:
While all of the questions are recommended to ask, the only question that is necessary is to see if the driver has glycosuria (dip stick urinalysis). It is recommended, though, to ask about carrying rescue glucose while driving, using incretin mimetic, and routinely monitoring his or her blood glucose level.

All but which of the following are respiratory conditions that interfere with oxygen exchange and could result in gradual or sudden incapacitation?

Correct! Wrong!

Explanation:
Asthma, carcinoma, and chronic bronchitis are all respiratory conditions that interfere with oxygen exchange and could result in gradual or sudden incapacitation. Mitral regurgitation is actually a heart condition, not a respiratory condition.

Types of vertigo and dizziness with incapacitating symptoms can interfere with all but which of the following?

Correct! Wrong!

Explanation:
Types of vertigo and dizziness with incapacitating symptoms interfere with cognitive abilities, judgment, attention, concentration, and sensory or motor functions. However, it does not necessarily interfere with staying awake.

Which of the following is not a concern that predisposes commercial drivers to an increased risk of cardiovascular disease?

Correct! Wrong!

Explanation:
Obesity and a sedentary lifestyle increase the risk of cardiovascular diseases. Driving stressors can lead to increased neurosympathetic and adrenocortical catecholamine and cortisol release. Also, exposed to environmental stressors that are detrimental to the cardiovascular system. However, the long hours and rotating work schedules do not predispose a driver to increased risks of cardiovascular disease.

Which of the following is true in regard to an implantable cardioverter-defibrillator?

Correct! Wrong!

Explanation:
ICDs do treat arrhythmias, but they do not prevent them. So, the driver remains at risk for syncope. The management of the underlying disease is in fact not effective enough for the driver to meet cardiovascular qualification requirement. Lastly, combination ICD/pacemaker devices are also ineffective in preventing incapacitation of cardiac and arrhythmia events.

When conducting a vision examination, a driver must have at least what distant visual acuity in each eye with or without correction?

Correct! Wrong!

Explanation:
The driver must have at least 20/40 distant visual acuity in each eye with or without correction. 20/20 and 20/10 are higher standards than necessary. Lastly, 20/60 is not a high enough acuity standard.

Which of the following is not true in regard to antidepressant therapy?

Correct! Wrong!

Explanation:
Guidelines recommend a case-by-case assessment of drivers treated with antidepressant medication. With long-term use of antidepressants, most drivers tend to develop a tolerance to the sedative effects. First-generation antidepressants, which include tricyclics such as amitriptyline and imipramine, have consistently been shown to interfere with safe driving. Lastly, second-generation antidepressants, including fluoxetine and venlafaxine, have fewer side effects and are generally safe.

Which of the following colors is not necessary to be able to distinguish and recognize in traffic signals and devices?

Correct! Wrong!

Explanation:
Due to specifically the colors of a stoplight and most road signs, it is necessary for a driver to be able to recognize the colors amber, red, and green. Blue is not a necessary color to recognize in traffic signals and devices.

Which of the following is not true about the risk of headaches?

Correct! Wrong!

Explanation:
The symptoms of headaches, vertigo, and dizziness are typically inconsequential, but they still constitute a problem for a driver. Headache and chronic “nagging” pain may be present to such a degree that certification for driving is inadvisable. Also, medication used to treat headaches may further interfere with safe driving. Lastly, disorders with incapacitating symptoms, even if periodic or in the early stages of disease, warrant the decision to not certify the driver.

An implantable cardioverter-defibrillator is:

Correct! Wrong!

Explanation:
An implantable cardioverter-defibrillator is An electronic device that treats cardiac arrest, ventricular fibrillation, and ventricular tachycardia through the delivery of rapid-pacing stimuli or shock therapy. A pacemaker is an implantable device designed to treat bradycardia. Also, supraventricular tachycardia is a type of arrhythmia that is usually not considered a risk for sudden death. Lastly, ventricular arrhythmia is a type of arrhythmia categorized as ventricular fibrillation and ventricular tachycardia and is responsible for the majority of instances of sudden cardiac death.

If a medical examiner uses the number 1 during the physical examination, the medical examiner is indicating which of the following parts of the body system?

Correct! Wrong!

Explanation:
1 refers to General Appearance, 3 refers to Ears, 5 refers to Heart, and 7 refers to Abdomen and viscera.

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