DVBCWTD1.m

DVBCWTD1 ;ALB/CMM THYROID DISEASES WKS TEXT - 1 ; 5 MARCH 1997

 ;;2.7;AMIE;**12**;Apr 10, 1995

 ;

 ;

TXT ;

 ;;A.  Review of Medical Records:

 ;;

 ;;

 ;;

 ;;B.  Medical History (Subjective Complaints):

 ;;

 ;;    Comment on:

 ;;    1.  Date diagnosis established.

 ;;

 ;;

 ;;    2.  Fatigability.

 ;;

 ;;

 ;;    3.  Mental assessment.

 ;;

 ;;

 ;;    4.  Neurologic, cardiovascular, or gastrointestinal symptoms.

 ;;

 ;;

 ;;    5.  Treatments (surgery, medications, hormones), including dose, 

 ;;        frequency, response, side effects.  For C-cell hyperplasia, 

 ;;        provide date of completion of any treatment for malignancy.

 ;;

 ;;

 ;;    6.  Symptoms due to pressure (on larynx, esophagus, etc.).

 ;;

 ;;

 ;;    7.  Cold or heat intolerance.

 ;;

 ;;

 ;;    8.  Constipation.

 ;;

 ;;

 ;;    9.  Weight gain or loss.

 ;;

 ;;

 ;;C.  Physical Examination (Objective Findings):

 ;;

 ;;    Address each of the following and fully describe current findings:

 ;;    1.  Thyroid size.

 ;;

 ;;

 ;;    2.  Pulse and blood pressure.

 ;;

 ;;

 ;;    3.  Eye and vision abnormalities.

 ;;

 ;;

 ;;    4.  Muscle strength.

 ;;

 ;;

 ;;    5.  Tremor.

 ;;

 ;;

 ;;    6.  Myxedema.

 ;;

 ;;

 ;;    7.  All other residuals of thyroid disease or its treatment.

 ;;

 ;;

 ;;D.  Diagnostic and Clinical Tests:

 ;;

 ;;    Provide:

 ;;    1.  T4, T3, TSH, and/or other thyroid function tests, if needed.

 ;;    2.  If thyroidectomy scar is disfiguring, order color photograph.

 ;;    3.  Thyroid scan, if indicated.

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

 ;;        in the examination report.

 ;;

 ;;

 ;;E.  Diagnosis:

 ;;

 ;;    Comment on:

 ;;    1.  Is the disease active or in remission? 

 ;;

 ;;

 ;;Signature:                             Date:

 ;;END

--- Routine Detail   --- with STRUCTURED ROUTINE LISTING ---DVBCWTD1   1858     printed  Feb 18, 2025@23:20:47                                                                                                                                                                                                    Page 2

DVBCWTD1  ;ALB/CMM THYROID DISEASES WKS TEXT - 1 ; 5 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.  Date diagnosis established.

 +9       ;;

 +10      ;;

 +11      ;;    2.  Fatigability.

 +12      ;;

 +13      ;;

 +14      ;;    3.  Mental assessment.

 +15      ;;

 +16      ;;

 +17      ;;    4.  Neurologic, cardiovascular, or gastrointestinal symptoms.

 +18      ;;

 +19      ;;

 +20      ;;    5.  Treatments (surgery, medications, hormones), including dose, 

 +21      ;;        frequency, response, side effects.  For C-cell hyperplasia, 

 +22      ;;        provide date of completion of any treatment for malignancy.

 +23      ;;

 +24      ;;

 +25      ;;    6.  Symptoms due to pressure (on larynx, esophagus, etc.).

 +26      ;;

 +27      ;;

 +28      ;;    7.  Cold or heat intolerance.

 +29      ;;

 +30      ;;

 +31      ;;    8.  Constipation.

 +32      ;;

 +33      ;;

 +34      ;;    9.  Weight gain or loss.

 +35      ;;

 +36      ;;

 +37      ;;C.  Physical Examination (Objective Findings):

 +38      ;;

 +39      ;;    Address each of the following and fully describe current findings:

 +40      ;;    1.  Thyroid size.

 +41      ;;

 +42      ;;

 +43      ;;    2.  Pulse and blood pressure.

 +44      ;;

 +45      ;;

 +46      ;;    3.  Eye and vision abnormalities.

 +47      ;;

 +48      ;;

 +49      ;;    4.  Muscle strength.

 +50      ;;

 +51      ;;

 +52      ;;    5.  Tremor.

 +53      ;;

 +54      ;;

 +55      ;;    6.  Myxedema.

 +56      ;;

 +57      ;;

 +58      ;;    7.  All other residuals of thyroid disease or its treatment.

 +59      ;;

 +60      ;;

 +61      ;;D.  Diagnostic and Clinical Tests:

 +62      ;;

 +63      ;;    Provide:

 +64      ;;    1.  T4, T3, TSH, and/or other thyroid function tests, if needed.

 +65      ;;    2.  If thyroidectomy scar is disfiguring, order color photograph.

 +66      ;;    3.  Thyroid scan, if indicated.

 +67      ;;    4.  Include results of all diagnostic and clinical tests conducted

 +68      ;;        in the examination report.

 +69      ;;

 +70      ;;

 +71      ;;E.  Diagnosis:

 +72      ;;

 +73      ;;    Comment on:

 +74      ;;    1.  Is the disease active or in remission? 

 +75      ;;

 +76      ;;

 +77      ;;Signature:                             Date:

 +78      ;;END