DVBCWIW3 ;ALB/RLC INTESTINES (LARGE AND SMALL) WKS TEXT - 1 ; 16 JAN 2007 ;;2.7;AMIE;**120**;Apr 10, 1995;Build 4 ; TXT ; ;;A. Review of Medical Records: ;; ;;B. Medical History (Subjective Complaints): ;; ;; Comment on: ;; ;; 1. Weight gain or loss. ;; 2. Nausea and/or vomiting. ;; 3. Constipation, diarrhea (frequency, severity, duration, and ;; episodic or not?). ;; 4. For fistula - frequency, duration, and amount of fecal discharge. ;; 5. Treatment-type, duration, response, side effects. ;; 6. Abdominal pain, distress, cramps - frequency, duration, location. ;; 7. For ulcerative colitis - number of attacks per year. ;; 8. Effects of condition on occupations functioning and activities of ;; daily living. ;; 9. History of trauma. ;; 10. History of hospitalizations or surgery - reason or type of surgery, ;; location and dates, if known. ;; 11. History of neoplasm: ;; ;; a. Date of diagnosis, diagnosis. ;; b. Benign or malignant. ;; c. Treatment, dates and response. ;; d. Last date of treatment. ;; ;;C. Physical Examination (Objective Findings): ;; ;; Address each of the following and fully describe current findings: ;; 1. Malnutrition, anemia, other evidence of debility. ;; 2. Abdominal pain - location. ;; 3. For fistula, location, presence of discharge. ;; 4. Ostomy present - type. ;; 5. Abdominal mass. ;; 6. Signs of anemia. ;; 7. Weight - gain or loss. ;; ;;D. Diagnostic and Clinical Tests: ;; ;; 1. If signs of anemia, obtain hemoglobin/hematocrit. ;; 2. Include results of all diagnostic and clinical tests conducted in ;; the examination report. ;; ;;E. Diagnosis: ;; ;; ;; ;;Signature: Date: ;;END