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[613]1DVBCWIW1 ;ALB/CMM INTESTINES (LARGE AND SMALL) WKS TEXT - 1 ; 5 MARCH 1997
2 ;;2.7;AMIE;**12**;Apr 10, 1995
3 ;
4 ;
5TXT ;
6 ;;A. Review of Medical Records:
7 ;;
8 ;;
9 ;;
10 ;;B. Medical History (Subjective Complaints):
11 ;;
12 ;; Comment on:
13 ;; 1. Weight gain or loss.
14 ;;
15 ;;
16 ;; 2. Nausea and/or vomiting.
17 ;;
18 ;;
19 ;; 3. Constipation, diarrhea (frequency, severity, duration, and
20 ;; episodic or not?).
21 ;;
22 ;;
23 ;; 4. For fistula - frequency, duration, and amount of fecal discharge.
24 ;;
25 ;;
26 ;;C. Physical Examination (Objective Findings):
27 ;;
28 ;; Address each of the following and fully describe current findings:
29 ;; 1. Malnutrition, anemia, other evidence of debility.
30 ;;
31 ;;
32 ;; 2. Abdominal pain - location, type, frequency, and duration.
33 ;;
34 ;;
35 ;; 3. Current treatment - type, duration, response, and side effects.
36 ;;
37 ;; 4. For fistula - location.
38 ;;
39 ;;
40 ;;D. Diagnostic and Clinical Tests:
41 ;;
42 ;; 1. Include results of all diagnostic and clinical tests conducted
43 ;; in the examination report.
44 ;;
45 ;;
46 ;;E. Diagnosis:
47 ;;
48 ;;
49 ;;Signature: Date:
50 ;;END
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