1 | DVBCWDM1 ;ALB/CMM DIGESTIVE, MISC. DISEASES WKS TEXT - 1 ; 5 MARCH 1997
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2 | ;;2.7;AMIE;**12**;Apr 10, 1995
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3 | ;
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4 | ;
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5 | TXT ;
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6 | ;;A. Review of Medical Records:
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7 | ;;
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8 | ;;
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9 | ;;B. Medical History (Subjective Complaints):
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10 | ;;
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11 | ;; 1. Describe all hernia surgery and results.
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12 | ;;
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13 | ;;
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14 | ;; 2. For malignancy, state type of treatment, dates of treatment,
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15 | ;; including last date treatment if it has ended.
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16 | ;;
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17 | ;;
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18 | ;; 3. For peritoneal tuberculosis, state date of diagnosis, treatment,
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19 | ;; and date on which inactivity was established.
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20 | ;;
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21 | ;;
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22 | ;;C. Physical Examination (Objective Findings):
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23 | ;;
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24 | ;; Address each of the following and fully describe current findings:
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25 | ;; 1. For inguinal or ventral hernia, state whether reducible, how
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26 | ;; well supported by truss or belt, and whether irremediable or
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27 | ;; inoperable.
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28 | ;;
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29 | ;;
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30 | ;; 2. For ventral hernia, state size of hernia, extent of diastasis
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31 | ;; of recti muscles, status of muscles and fascia of abdominal wall.
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32 | ;;
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33 | ;;
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34 | ;; 3. All residuals of malignancy, including residuals from treatment.
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35 | ;;
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36 | ;;
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37 | ;;D. Diagnostic and Clinical Tests:
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38 | ;;
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39 | ;;1. Include results of all diagnostic and clinical tests conducted in
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40 | ;; the examination report.
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41 | ;;
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42 | ;;
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43 | ;;E. Diagnosis:
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44 | ;;
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45 | ;;
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46 | ;;Signature: Date:
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47 | ;;END
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