DVBCWHI1 ;ALB/CMM HIV-RELATED ILLNESS WKS TEXT - 1 ; 6 MARCH 1997
;;2.7;AMIE;**12**;Apr 10, 1995
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment On:
;; 1. Recurrent opportunistic infections.
;;
;;
;; 2. Recurrent constitutional symptoms.
;;
;;
;; 3. Diarrhea.
;;
;;
;; 4. Debility.
;;
;;
;; 5. Progressive weight loss.
;;
;;
;; 6. Remissions in any symptomatology.
;;
;;
;; 7. Depression or memory loss.
;;
;;
;; 8. Treatment - Is this an approved medication?
;;
;;
;; 9. Describe the effects of the condition on the veteran's usual
;; occupation and daily activities.
;;
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following and fully describe:
;; 1. Definitive diagnosis of AIDS. (Use CDC Definition.)
;;
;;
;; 2. Secondary diseases affecting multiple body systems - describe.
;;
;;
;; 3. HIV-related illnesses - describe.
;;
;;
;; 4. Neoplasm related to HIV-related illness. Describe.
;;
;;
;; 5. T4 cell counts.
;;
;;
;; 6. Hairy cell leukoplakia.
;;
;;
;; 7. Oral candidiasis.
;;
;;
;; 8. Use of HIV-related medications.
;;
;;
;; 9. Lymphadenopathy.
;;
;;
;;D. Diagnostic and Clinical Tests:
;;
;; Provide:
;; 1. T4 Cell counts.
;; 2. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;
;;E. Diagnosis:
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWHI1 1685 printed Nov 22, 2024@17:01:54 Page 2
DVBCWHI1 ;ALB/CMM HIV-RELATED ILLNESS WKS TEXT - 1 ; 6 MARCH 1997
+1 ;;2.7;AMIE;**12**;Apr 10, 1995
+2 ;
+3 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;
+4 ;;
+5 ;;B. Medical History (Subjective Complaints):
+6 ;;
+7 ;; Comment On:
+8 ;; 1. Recurrent opportunistic infections.
+9 ;;
+10 ;;
+11 ;; 2. Recurrent constitutional symptoms.
+12 ;;
+13 ;;
+14 ;; 3. Diarrhea.
+15 ;;
+16 ;;
+17 ;; 4. Debility.
+18 ;;
+19 ;;
+20 ;; 5. Progressive weight loss.
+21 ;;
+22 ;;
+23 ;; 6. Remissions in any symptomatology.
+24 ;;
+25 ;;
+26 ;; 7. Depression or memory loss.
+27 ;;
+28 ;;
+29 ;; 8. Treatment - Is this an approved medication?
+30 ;;
+31 ;;
+32 ;; 9. Describe the effects of the condition on the veteran's usual
+33 ;; occupation and daily activities.
+34 ;;
+35 ;;
+36 ;;C. Physical Examination (Objective Findings):
+37 ;;
+38 ;; Address each of the following and fully describe:
+39 ;; 1. Definitive diagnosis of AIDS. (Use CDC Definition.)
+40 ;;
+41 ;;
+42 ;; 2. Secondary diseases affecting multiple body systems - describe.
+43 ;;
+44 ;;
+45 ;; 3. HIV-related illnesses - describe.
+46 ;;
+47 ;;
+48 ;; 4. Neoplasm related to HIV-related illness. Describe.
+49 ;;
+50 ;;
+51 ;; 5. T4 cell counts.
+52 ;;
+53 ;;
+54 ;; 6. Hairy cell leukoplakia.
+55 ;;
+56 ;;
+57 ;; 7. Oral candidiasis.
+58 ;;
+59 ;;
+60 ;; 8. Use of HIV-related medications.
+61 ;;
+62 ;;
+63 ;; 9. Lymphadenopathy.
+64 ;;
+65 ;;
+66 ;;D. Diagnostic and Clinical Tests:
+67 ;;
+68 ;; Provide:
+69 ;; 1. T4 Cell counts.
+70 ;; 2. Include results of all diagnostic and clinical tests conducted
+71 ;; in the examination report.
+72 ;;
+73 ;;
+74 ;;E. Diagnosis:
+75 ;;
+76 ;;
+77 ;;Signature: Date:
+78 ;;END
