| [613] | 1 | DVBCWCS1 ;ALB/CMM CUSHING'S SYNDROME WKS TEXT - 1 ; 5 MARCH 1997
 | 
|---|
 | 2 |  ;;2.7;AMIE;**12**;Apr 10, 1995
 | 
|---|
 | 3 |  ;
 | 
|---|
 | 4 |  ;
 | 
|---|
 | 5 | TXT ;
 | 
|---|
 | 6 |  ;;A.  Review of Medical Records:
 | 
|---|
 | 7 |  ;;
 | 
|---|
 | 8 |  ;;
 | 
|---|
 | 9 |  ;;
 | 
|---|
 | 10 |  ;;B.  Medical History (Subjective Complaints):
 | 
|---|
 | 11 |  ;;
 | 
|---|
 | 12 |  ;;    Comment on:
 | 
|---|
 | 13 |  ;;    1.  Date diagnosis established.
 | 
|---|
 | 14 |  ;;
 | 
|---|
 | 15 |  ;;
 | 
|---|
 | 16 |  ;;    2.  Weakness or fatigability.
 | 
|---|
 | 17 |  ;;
 | 
|---|
 | 18 |  ;;
 | 
|---|
 | 19 |  ;;    3.  Etiology ?  Iatrogenic?
 | 
|---|
 | 20 |  ;;
 | 
|---|
 | 21 |  ;;
 | 
|---|
 | 22 |  ;;    4.  Treatments (surgery, medication, etc.), dose, frequency, 
 | 
|---|
 | 23 |  ;;        response, side effects.
 | 
|---|
 | 24 |  ;;
 | 
|---|
 | 25 |  ;;
 | 
|---|
 | 26 |  ;;C.  Physical Examination (Objective Findings):
 | 
|---|
 | 27 |  ;;
 | 
|---|
 | 28 |  ;;    Address each of the following and fully describe current findings:
 | 
|---|
 | 29 |  ;;    1.  Muscle strength.
 | 
|---|
 | 30 |  ;;
 | 
|---|
 | 31 |  ;;
 | 
|---|
 | 32 |  ;;    2.  Vascular fragility.
 | 
|---|
 | 33 |  ;;
 | 
|---|
 | 34 |  ;;
 | 
|---|
 | 35 |  ;;    3.  Gastrointestinal.
 | 
|---|
 | 36 |  ;;
 | 
|---|
 | 37 |  ;;
 | 
|---|
 | 38 |  ;;    4.  Blood Pressure.
 | 
|---|
 | 39 |  ;;
 | 
|---|
 | 40 |  ;;
 | 
|---|
 | 41 |  ;;    5.  Striae.
 | 
|---|
 | 42 |  ;;
 | 
|---|
 | 43 |  ;;
 | 
|---|
 | 44 |  ;;    6.  Weight gain or loss (weigh patient).
 | 
|---|
 | 45 |  ;;
 | 
|---|
 | 46 |  ;;
 | 
|---|
 | 47 |  ;;    7.  Moonface.
 | 
|---|
 | 48 |  ;;
 | 
|---|
 | 49 |  ;;
 | 
|---|
 | 50 |  ;;    8.  Glucose metabolism.
 | 
|---|
 | 51 |  ;;
 | 
|---|
 | 52 |  ;;
 | 
|---|
 | 53 |  ;;    9.  After control, describe adrenal insufficiency, cardiovascular,
 | 
|---|
 | 54 |  ;;        psychiatric, skin, or skeletal complications or residuals.
 | 
|---|
 | 55 |  ;;
 | 
|---|
 | 56 |  ;;
 | 
|---|
 | 57 |  ;;D.  Diagnostic and Clinical Tests:
 | 
|---|
 | 58 |  ;;
 | 
|---|
 | 59 |  ;;    Provide:
 | 
|---|
 | 60 |  ;;    1.  CT of brain or X-ray of sella turcica.
 | 
|---|
 | 61 |  ;;    2.  Serum and urine cortisol levels.
 | 
|---|
 | 62 |  ;;    3.  High and low dose dexamethasone suppression test.
 | 
|---|
 | 63 |  ;;    4.  X-rays if osteoporosis suspected.
 | 
|---|
 | 64 |  ;;    5.  Include results of all diagnostic and clinical tests conducted
 | 
|---|
 | 65 |  ;;        in the examination report.
 | 
|---|
 | 66 |  ;;
 | 
|---|
 | 67 |  ;;
 | 
|---|
 | 68 |  ;;E.  Diagnosis:
 | 
|---|
 | 69 |  ;;
 | 
|---|
 | 70 |  ;;    Comment on:
 | 
|---|
 | 71 |  ;;    1.  Is the disease active or in remission?
 | 
|---|
 | 72 |  ;;
 | 
|---|
 | 73 |  ;;
 | 
|---|
 | 74 |  ;;Signature:                             Date:
 | 
|---|
 | 75 |  ;;END
 | 
|---|