Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Routine: DVBCWHI3

DVBCWHI3.m

Go to the documentation of this file. 
DVBCWHI3 ;ALB/RLC HIV-RELATED ILLNESS WKS TEXT - 1 ; 12 FEB 2007

 ;;2.7;AMIE;**121**;Apr 10, 1995;Build 9

 ;

 ;

TXT ;

 ;;A.  Review of Medical Records:

 ;;

 ;;B.  Medical History (Subjective Complaints):

 ;;

 ;;    Comment On:

 ;;

 ;;    1.  Recurrent opportunistic infections - type.

 ;;    2.  Constitutional symptoms - recurrent, refractory, any currently present.

 ;;    3.  Diarrhea.

 ;;    4.  Debility.

 ;;    5.  Progressive weight loss.

 ;;    6.  Other symptoms - lymphadenopathy, fever, cough, dyspnea, headaches,

 ;;        difficult or painful swallowing, vision loss, etc.

 ;;    7.  Periods of remissions in symptomatology - frequency, average duration,

 ;;        date of last remission.

 ;;    8.  Depression or memory loss.

 ;;    9.  Treatment, type duration, response, side effects.  Is this an approved

 ;;        medication?

 ;;    10. Describe the effects of the condition on the veteran's usual 

 ;;        occupation and daily activities.

 ;;    11. History of hospitalizations or surgery, reason or type of surgery,

 ;;        dates and location, if known.

 ;;    12. History of malignant neoplasm.

 ;;

 ;;        a.  Date of diagnosis.

 ;;        b.  Diagnosis.

 ;;        c.  Type of treatment, dates.

 ;;        d.  Last date of treatment.

 ;;

 ;;C.  Physical Examination (Objective Findings):

 ;;

 ;;    Address each of the following and fully describe, follow additional

 ;;    worksheets as appropriate:

 ;;

 ;;    1.  Secondary diseases affecting multiple body systems.  Describe.

 ;;    2.  HIV-related illnesses.  Describe.

 ;;    3.  Neoplasm related to HIV-related illness.  Describe.

 ;;    4.  T4 cell counts.

 ;;    5.  Hairy cell leukoplakia.

 ;;    6.  Oral candidiasis.

 ;;    7.  Side effects from the use of HIV-related medications.  Describe.

 ;;    8.  Lymphadenopathy.

 ;;    9.  Hepatomegaly.

 ;;    10. Splenomegaly.

 ;;    11. If evidence of memory loss or depression (refer for examination by

 ;;        mental health provider).

 ;;

 ;;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:

 ;;

 ;;    1.  Definitive diagnosis of AIDS.  (Use CDC Definition).

 ;;    2.  Active opportunistic infection or neoplasm.

 ;;

 ;;

 ;;

 ;;Signature:                             Date:

 ;;END