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