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[613] | 1 | DVBCWED1 ;ALB/CMM EAR DISEASE WKS TEXT - 1 ; 6 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 | ;;
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| 13 | ;;
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| 14 | ;;C. Physical Examination (Objective Findings):
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| 15 | ;;
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| 16 | ;; 1. Address each of the following and describe current findings,
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| 17 | ;; including abnormalities of size, shape, or form:
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| 18 | ;;
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| 19 | ;; a. Auricle.
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| 20 | ;;
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| 21 | ;;
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| 22 | ;; b. External canal.
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| 23 | ;;
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| 24 | ;;
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| 25 | ;;
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| 26 | ;; c. Tympanic membrane.
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| 27 | ;;
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| 28 | ;;
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| 29 | ;; d. The tympanum.
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| 30 | ;;
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| 31 | ;;
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| 32 | ;; e. The mastoid.
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| 33 | ;;
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| 34 | ;;
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| 35 | ;; f. All conditions secondary to ear disease, such as disturbance
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| 36 | ;; of balance, upper respiratory disease, hearing loss, etc.
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| 37 | ;;
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| 38 | ;;
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| 39 | ;; 2. State whether an active ear disease is present.
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| 40 | ;;
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| 41 | ;;
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| 42 | ;; 3. Infections of the middle or inner ear.
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| 43 | ;;
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| 44 | ;;
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| 45 | ;;D. Diagnostic and Clinical Tests:
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| 46 | ;;
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| 47 | ;; 1. Include results of all diagnostic and clinical tests conducted
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| 48 | ;; in the examination report.
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| 49 | ;;
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| 50 | ;;
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| 51 | ;;E. Diagnosis:
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| 52 | ;;
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| 53 | ;;
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| 54 | ;;Signature: Date:
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| 55 | ;;END
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