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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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