1st

Question 1

TIA Minimum Waiting periods

Answer 1

1 year if not at risk of seizures (cerebellum or brainstem vascular lesions)
5 years if risk for seiners (cortical or subcortical deficits)

Question 2

Max cert for TIA (embolic thrombotic strokes, intracerebral and subarachnoid hemorrhage)

Answer 2

1 year

Question 3

DQ TIA (embolic thrombotic strokes, intracerebral and subarachnoid hemorrhage)

Answer 3

1. Not completed appropriate waiting periods
2. Use of oral anticoagulant therapy
3. Other high risk drug combination like CNS depressents
4. Residual intellectual physical impairments
5. Does not have clearance from a neurologist

Question 4

Nerve root of L4 is what refelx

Answer 4

Patellar

Question 5

Nerve root of s2 is what reflex

Answer 5

s2

Question 6

Do NOT certify pt with AAA if

Answer 6

4.0-<5.0 symptomatic, surgery recommended

>5.0 cm without repair and clarance

Question 7

Clear AAA if

Answer 7

<4.0 cm asx
4.0-<5.0 cm and asx with vascular specialist clearance
>5.0 cm if 3 month post-repair and clearance

Question 8

What is the waiting period for AAA post surgical repair

Answer 8

3 months

Question 9

AAA max cert

Answer 9

1 years

Question 10

Thoracic Aortic Aneurysm

Answer 10

Certify <3.5 cm and asx
DO NOT certify >3.5cm
Wait 3 months post repair and cleared by cardio

Question 11

Stage 1 HTN is

Answer 11

140/90-159/99

Question 12

Stage 2 HTN is

Answer 12

160/100-179/109

Question 13

Stage 3 hTN is equal to or greater than

Answer 13

180/110

Question 14

Stage 1 HTN with >140/90 certify for ?

Answer 14

1 year if they have no prior history of hon and no use of antihypertensive tx

Question 15

Stage 1 HTN already had a 1 year cert and still have bp >140/90 how long do you certify them for?

Answer 15

One time 3 months cert - if they have untreated hen and has not been prescribed antihypertensives

• possibly require a stress test

Question 16

When to not certify stage 1 HTN ?

Answer 16

1. Already had the 1 year cert, and 3 month certy and continued elevated bp >140/90
2. History of stage 3 HTN
3. B/p >180/110

Question 17

How long can a stage 1 be certified if HTN is controlled?

Answer 17

1 year

Question 18

How long can Stage 3 HTN be certified for if HTN is controlled and medications are well tolerated

Answer 18

6 months

Question 19

Stage 2 HTN defined as

Answer 19

160-179/100-109

Question 20

Max cert for patient with Stage 2 HTN?

Answer 20

One time 3 month cert if

• first exam no hx of HTN
• Has a hen dx tx with meds, tolerated without SE

Question 21

Stage 2 HTN patient with well controlled bp <140/09 what is the max cert they can get

Answer 21

1 year from the date of the original exam and if they don’t lower the b/p they will be DQ

Question 22

Do not certify Stage 2 HTN if

Answer 22

1. One mont 3 month cert and b/p is >140/90

2. Hx of stage 3 HTN and bp is >140/90

Question 23

Stage 3 HTN

Answer 23

DO NOT CERTIFY - regardless of history or treatment.

Question 24

When can Stage 3 HTN be certified

Answer 24

BP <140/90 , well tolerated treatment, and only certify for max 6 months

Question 25

Previous stage 3 comes in with Stage 1 or stage 2 HTN , how long does the ME certify for?

Answer 25

ME should determine appropriate use of 1 time 3 month cert. - only use if its a one time things and if something in their history explains this change in their blood pressure. - ME also has the option to not disqualify if they feel they are unacceptable risk and dq until bp <140/90.

Question 26

Common causes of Secondary HTn

Answer 26

pheochromocytoma, primary aldosteronism, renovascular disease, unilateral parenchymal disease

Question 27

How long can a patient be certified after surgical repair for secondary HTN?

Answer 27

- 1 year post surgical correction after a 3 month waiting period. B/p should be less than 140/90 - Annual medical exams

Question 28

What cardiac symptoms or diseases are DQ'ing?

Answer 28

Ischemic ECG Changes EF < 40% Inability to complete Exercise TT Angina at rest or with exertion Syncope poor medication tolerance Hypertrophic, restrictive, or dilated cardiomyopathy Pulmonary HTN Warfarin treated patient NOT being monitored or therapeutic INR Unrepaired or symptomatic vascular, cardiovascular, valvular, and congenital conditions Implantable defibrillator