NRCME Endocrine and Metabolic Conditions 5

Question 1

A driver holds a Federal Diabetes Exemption and reports one episode of nocturnal hypoglycemia in the past year that required assistance. What must the NRCME examiner do?

Accepted Answer

Report the episode and defer renewal of the exemption pending FMCSA review

Answer

Any severe hypoglycemic episode requiring third-party assistance must be reported to FMCSA and may jeopardize exemption renewal.

Question 2

Which finding on a DOT physical would MOST likely prompt the NRCME examiner to screen for undiagnosed diabetes in an otherwise asymptomatic driver?

Accepted Answer

Urinalysis showing glucosuria

Answer

Glucosuria on urinalysis is a classic indicator of hyperglycemia and should prompt further evaluation for diabetes.

Question 3

A driver with well-controlled Graves' disease (hyperthyroidism) treated with methimazole has a resting heart rate of 102 bpm and mild tremor. What should the NRCME examiner do?

Accepted Answer

Disqualify until thyroid function is normalized and symptoms resolve

Answer

Active hyperthyroid symptoms including tachycardia and tremor indicate inadequate control, which poses a safety risk and warrants disqualification until stabilized.

Question 4

Under FMCSA guidelines, a driver using an oral hypoglycemic agent (e.g., metformin) with no insulin use and an A1c of 6.8% should be:

Accepted Answer

Certified under standard medical criteria if no hypoglycemia risk or other disqualifying conditions

Answer

Oral hypoglycemic agents not causing hypoglycemia do not trigger the insulin exemption requirement, and well-controlled diabetes on such therapy is certifiable.

Question 5

A driver with primary adrenal insufficiency (Addison's disease) on stable hydrocortisone and fludrocortisone replacement presents with normal electrolytes and no symptoms. Which concern is MOST important for the NRCME examiner?

Accepted Answer

Risk of adrenal crisis during sudden stress or illness while operating a CMV

Answer

Adrenal crisis—potentially causing sudden incapacitation—is the primary safety concern for CMV drivers with adrenal insufficiency.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Endocrine and Metabolic Conditions 5