DVBCWDM3 ;ALB/CMM DIGESTIVE, MISC. DISEASES WKS TEXT - 1 ; 5 MARCH 1997
;;2.7;AMIE;**164**;Apr 10, 1995;Build 2
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;
;; 1. State date of onset, and describe circumstances and initial
;; manifestations.
;; 2. Course of condition since onset.
;; 3. Current treatment, response to treatment, and side effects of
;; treatment.
;; 4. History of related hospitalizations or surgery, dates and location, if
;; known, reason or type of surgery.
;; 5. If there was hernia surgery, report side, type of hernia, type of
;; repair, and results, including current symptoms.
;; 6. If there was injury or wound related to hernia, state date and type of
;; injury or wound and relationship to hernia.
;; 7. History of neoplasm:
;;
;; a. Date of diagnosis, exact diagnosis, location.
;; b. Benign or malignant.
;; c. Types of treatment and dates.
;; d. Last date of treatment.
;; e. State whether treatment has been completed.
;;
;; 8. For tuberculosis of the peritoneum, state date of diagnosis, type(s)
;; and dates of treatment, date on which inactivity was established, and
;; current symptoms.
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following and fully describe current findings:
;;
;; 1. For hernia, state:
;;
;; a. Type and location (including side).
;; b. Diameter in cm.
;; c. Whether remediable or operable.
;; d. Whether a truss or belt is indicated, and whether it is well-
;; supported by truss or belt.
;; e. Whether it is readily reducible.
;; f. Whether it has been previously repaired, and if so, whether it is
;; healed and whether it is recurrent.
;; g. For inguinal and femoral hernias, also state (1) whether there is
;; a true hernial protrusion and (2) whether the hernia is readily
;; reducible.
;; h. For ventral hernia, also state (1) severity and extent of weakening
;; of muscular and fascial support of abdominal wall, (2) extent of
;; diastasis of recti muscles, and (3) whether diastasis is persistent.
;;
;; 2. For neoplasm, describe residuals of neoplasm and its treatment.
;; 3. For tuberculous peritonitis, describe any abnormal physical findings.
;;
;;D. Diagnostic and Clinical Tests:
;;
;;1. Include results of all diagnostic and clinical tests conducted in
;; the examination report.
;;
;;
;;E. Diagnosis:
;;
;; 1. For each diagnosis, state effects of the condition on occupational
;; functioning and daily activities.
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWDM3 2947 printed Dec 13, 2024@01:50:24 Page 2
DVBCWDM3 ;ALB/CMM DIGESTIVE, MISC. DISEASES WKS TEXT - 1 ; 5 MARCH 1997
+1 ;;2.7;AMIE;**164**;Apr 10, 1995;Build 2
+2 ;
+3 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;B. Medical History (Subjective Complaints):
+4 ;;
+5 ;; 1. State date of onset, and describe circumstances and initial
+6 ;; manifestations.
+7 ;; 2. Course of condition since onset.
+8 ;; 3. Current treatment, response to treatment, and side effects of
+9 ;; treatment.
+10 ;; 4. History of related hospitalizations or surgery, dates and location, if
+11 ;; known, reason or type of surgery.
+12 ;; 5. If there was hernia surgery, report side, type of hernia, type of
+13 ;; repair, and results, including current symptoms.
+14 ;; 6. If there was injury or wound related to hernia, state date and type of
+15 ;; injury or wound and relationship to hernia.
+16 ;; 7. History of neoplasm:
+17 ;;
+18 ;; a. Date of diagnosis, exact diagnosis, location.
+19 ;; b. Benign or malignant.
+20 ;; c. Types of treatment and dates.
+21 ;; d. Last date of treatment.
+22 ;; e. State whether treatment has been completed.
+23 ;;
+24 ;; 8. For tuberculosis of the peritoneum, state date of diagnosis, type(s)
+25 ;; and dates of treatment, date on which inactivity was established, and
+26 ;; current symptoms.
+27 ;;
+28 ;;C. Physical Examination (Objective Findings):
+29 ;;
+30 ;; Address each of the following and fully describe current findings:
+31 ;;
+32 ;; 1. For hernia, state:
+33 ;;
+34 ;; a. Type and location (including side).
+35 ;; b. Diameter in cm.
+36 ;; c. Whether remediable or operable.
+37 ;; d. Whether a truss or belt is indicated, and whether it is well-
+38 ;; supported by truss or belt.
+39 ;; e. Whether it is readily reducible.
+40 ;; f. Whether it has been previously repaired, and if so, whether it is
+41 ;; healed and whether it is recurrent.
+42 ;; g. For inguinal and femoral hernias, also state (1) whether there is
+43 ;; a true hernial protrusion and (2) whether the hernia is readily
+44 ;; reducible.
+45 ;; h. For ventral hernia, also state (1) severity and extent of weakening
+46 ;; of muscular and fascial support of abdominal wall, (2) extent of
+47 ;; diastasis of recti muscles, and (3) whether diastasis is persistent.
+48 ;;
+49 ;; 2. For neoplasm, describe residuals of neoplasm and its treatment.
+50 ;; 3. For tuberculous peritonitis, describe any abnormal physical findings.
+51 ;;
+52 ;;D. Diagnostic and Clinical Tests:
+53 ;;
+54 ;;1. Include results of all diagnostic and clinical tests conducted in
+55 ;; the examination report.
+56 ;;
+57 ;;
+58 ;;E. Diagnosis:
+59 ;;
+60 ;; 1. For each diagnosis, state effects of the condition on occupational
+61 ;; functioning and daily activities.
+62 ;;
+63 ;;Signature: Date:
+64 ;;END
