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Routine: DVBCWSM1

DVBCWSM1.m

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DVBCWSM1 ;ALB/CMM RESPIRATORY, MISC. DISEASES WKS TEXT - 1 ;7 Oct 2000

 ;;2.7;AMIE;**34**;Apr 10, 1995

 ;

 ;

TXT ;

 ;;A. Review of Medical Records:

 ;;

 ;;B. Medical History (Subjective Complaints):

 ;;     Comment on:

 ;;

 ;;     1. Fever and/or night sweats.

 ;;     2. Weight loss or gain.

 ;;     3. Daytime hypersomnolence.

 ;;     4. Hemoptysis.

 ;;     5. Describe current treatment such as anticoagulant, tracheostomy, CPAP,

 ;;        oxygen, or antimicrobial therapy.

 ;;     6. If malignant disease, state initial treatment date, site of original

 ;;        tumor, type of tumor, types of treatment used, and date treatment is

 ;;        expected to end. If treatment has been completed, state date treatment

 ;;        was completed.

 ;;

 ;;C. Physical Examination (Objective Findings):

 ;;     Address each of the following as appropriate to the condition being

 ;;     examined and fully describe current findings:

 ;;

 ;;     1. Pulmonary Hypertension, RVH, cor pulmonale, or congestive heart failure.

 ;;     2. Residuals of pulmonary embolism.

 ;;     3. Respiratory Failure.

 ;;     4. Evidence of chronic pulmonary thromboembolism.

 ;;     5. If ankylosing spondylitis, is there restriction of the chest excursion

 ;;        and dyspnea on minimal exertion?

 ;;     6. Describe all residuals of malignancy including those due to treatment.

 ;;

 ;;D. Diagnostic and Clinical Tests:

 ;;

 ;;1. Pulmonary Function Tests, if indicated. The FEV-1,FVC, and FEV-1/FVC should

 ;;   be included. Both pre- and post-bronchodilatation pulmonary function

 ;;   test results should be reported. If post-bronchodilatation testing is not

 ;;   conducted in a particular case, please provide an explanation of why not.

 ;;   A DLCO may or may not be done routinely as part of pulmonary function

 ;;   testing at a particular facility. If there is a disparity between the results

 ;;   of different tests, please indicate which tests are more likely to

 ;;   accurately reflect the severity of the condition.

 ;;

 ;;TOF

 ;;     DLCO note: If the DLCO was not done as a routine part of pulmonary

 ;;     function testing, the examiner should use his or her judgment, based on

 ;;     the specific condition (e.g., whether it is obstructive, interstitial,

 ;;     etc.) and other available information about the condition, as to whether

 ;;     a DLCO test is needed. If it may provide useful information about the

 ;;     severity of the condition, it should be requested and reviewed before

 ;;     the examination report is submitted. If the examiner determines that

 ;;     the DLCO test is not needed, a statement as to why not (e.g., there are

 ;;     decreased lung volumes that would not yield valid test results) should be

 ;;     included in the report. Such a statement could avoid a remand from BVA when

 ;;     the test is not done. However, in the case of BVA remand in which DLCO

 ;;     is requested, the DLCO MUST be done unless there is a medical

 ;;     contraindication.

 ;;

 ;;     2. If sleep apnea is suspected, order Sleep Studies.

 ;;     3. Chest X-ray if necessary to document sarcoidosis or other parenchymal

 ;;        disease.

 ;;     4. Include results of all diagnostic and clinical tests conducted in

 ;;        the examination report.

 ;;

 ;;E. Diagnosis:

 ;;

 ;;

 ;;Signature:                             Date:

 ;;END