Last change
on this file since 771 was 613, checked in by George Lilly, 15 years ago |
initial load of WorldVistAEHR
|
File size:
1.6 KB
|
Line | |
---|
1 | DVBCWHI1 ;ALB/CMM HIV-RELATED ILLNESS WKS TEXT - 1 ; 6 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. Recurrent opportunistic infections.
|
---|
14 | ;;
|
---|
15 | ;;
|
---|
16 | ;; 2. Recurrent constitutional symptoms.
|
---|
17 | ;;
|
---|
18 | ;;
|
---|
19 | ;; 3. Diarrhea.
|
---|
20 | ;;
|
---|
21 | ;;
|
---|
22 | ;; 4. Debility.
|
---|
23 | ;;
|
---|
24 | ;;
|
---|
25 | ;; 5. Progressive weight loss.
|
---|
26 | ;;
|
---|
27 | ;;
|
---|
28 | ;; 6. Remissions in any symptomatology.
|
---|
29 | ;;
|
---|
30 | ;;
|
---|
31 | ;; 7. Depression or memory loss.
|
---|
32 | ;;
|
---|
33 | ;;
|
---|
34 | ;; 8. Treatment - Is this an approved medication?
|
---|
35 | ;;
|
---|
36 | ;;
|
---|
37 | ;; 9. Describe the effects of the condition on the veteran's usual
|
---|
38 | ;; occupation and daily activities.
|
---|
39 | ;;
|
---|
40 | ;;
|
---|
41 | ;;C. Physical Examination (Objective Findings):
|
---|
42 | ;;
|
---|
43 | ;; Address each of the following and fully describe:
|
---|
44 | ;; 1. Definitive diagnosis of AIDS. (Use CDC Definition.)
|
---|
45 | ;;
|
---|
46 | ;;
|
---|
47 | ;; 2. Secondary diseases affecting multiple body systems - describe.
|
---|
48 | ;;
|
---|
49 | ;;
|
---|
50 | ;; 3. HIV-related illnesses - describe.
|
---|
51 | ;;
|
---|
52 | ;;
|
---|
53 | ;; 4. Neoplasm related to HIV-related illness. Describe.
|
---|
54 | ;;
|
---|
55 | ;;
|
---|
56 | ;; 5. T4 cell counts.
|
---|
57 | ;;
|
---|
58 | ;;
|
---|
59 | ;; 6. Hairy cell leukoplakia.
|
---|
60 | ;;
|
---|
61 | ;;
|
---|
62 | ;; 7. Oral candidiasis.
|
---|
63 | ;;
|
---|
64 | ;;
|
---|
65 | ;; 8. Use of HIV-related medications.
|
---|
66 | ;;
|
---|
67 | ;;
|
---|
68 | ;; 9. Lymphadenopathy.
|
---|
69 | ;;
|
---|
70 | ;;
|
---|
71 | ;;D. Diagnostic and Clinical Tests:
|
---|
72 | ;;
|
---|
73 | ;; Provide:
|
---|
74 | ;; 1. T4 Cell counts.
|
---|
75 | ;; 2. Include results of all diagnostic and clinical tests conducted
|
---|
76 | ;; in the examination report.
|
---|
77 | ;;
|
---|
78 | ;;
|
---|
79 | ;;E. Diagnosis:
|
---|
80 | ;;
|
---|
81 | ;;
|
---|
82 | ;;Signature: Date:
|
---|
83 | ;;END
|
---|
Note:
See
TracBrowser
for help on using the repository browser.