DVBCWAV1 ;ALB/CMM ARTERIES AND VEINS 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. Symptoms due to aortic aneurysm, other large or small artery ;; aneurysm, or arteriovenous aneurysm. ;; ;; ;; 2. Current and past treatment, including surgery - e.g., aortic ;; aneurysm grafting, varicose vein stripping, angioplasty of ;; peripheral vessels, etc. Date and response, side effects. ;; ;; ;; 3. Pain, cramping, claudication on exertion? standing? pain at ;; rest? Give frequency, severity, level of exercise that ;; precipitates pain, duration. ;; ;; ;; 4. Paresthesias or other abnormal sensations. ;; ;; ;; 5. Attacks of angioneurotic edema - severity, location, frequency, ;; duration? ;; ;; ;; 6. Cold sensitivity. ;; ;; ;; 7. If treated for malignancy, state type of treatment and dates, ;; including date of last treatment. Describe any residual ;; or recurrent symptoms if treated has been completed. ;; ;; ;; 8. Is exercise and exertion precluded by the condition? ;; ;; ;; 9. Is veteran confined to house or bed because of the condition? ;; ;; ;; 10. Describe the effects of the condition(s) on the veteran's ;; usual occupation and daily activities. ;; ;; ;;C. Physical Examination (Objective Findings): ;; ;; Address each of the following and fully describe current findings: ;; 1. Nutrition, general state of health. ;; ;; ;; 2. Renal, cardiac, or cerebral arteriosclerotic foci. ;; ;; ;; 3. Cardiac status - size, function. ;; ;; ;; 4. Evidence and size of aneurysm. ;; ;; ;; 5. Extremities: ;; a. Temperature. ;; ;; ;; ;; b. Evidence of superficial phlebitis. ;; ;; ;; ;; c. Ulceration or tissue loss. ;; ;; ;; ;; d. Edema (constant or intermittent, relieved by elevation?). ;; ;; ;; e. Scar. ;; ;; ;; ;; f. Color. ;; ;; ;; g. Eczema. ;; ;; ;; h. Tenderness. ;; ;; ;; 6. If there are attacks of blanching or flushing, or blanching, ;; rubor, and cyanosis, indicate their frequency and duration. ;; ;; ;; 7. If evidence or history of erythromelalgia - severity, frequency, ;; duration? ;; ;; ;; 8. If varicosities are present, indicate their size (diameter?), ;; location, appearance, and if deep circulation is involved. ;; ;; ;;D. Diagnostic and Clinical Tests: ;; ;; 1. X-rays, Doppler vascular studies, angiogram, etc., as ;; appropriate, and if indicated. ;; 2. Include results of all diagnostic and clinical tests conducted ;; in the examination report. ;; ;; ;;E. Diagnosis: ;; ;; ;;Signature: Date: ;;END