[613] | 1 | DVBCWLY3 ;ALB/RLC LYMPHATIC DISORDERS WKS TEXT - 1 ; 12 FEB 2007
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| 2 | ;;2.7;AMIE;**121**;Apr 10, 1995;Build 9
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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 | ;;B. Medical History (Subjective Complaints):
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| 9 | ;;
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| 10 | ;; Comment on:
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| 11 | ;;
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| 12 | ;; 1. If there are exacerbations/remissions, what is the state of the
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| 13 | ;; veteran's health, during remissions?
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| 14 | ;; 2. Current and past treatment history including date and type of
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| 15 | ;; last treatment, response, side effects.
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| 16 | ;; 3. If malignant neoplasm need diagnosis, date of diagnosis, dates of
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| 17 | ;; treatment, or if treatment ended, date of last treatment.
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| 18 | ;; 4. Current symptoms - lymphadenopathy, bleeding tendency, gastrointestinal
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| 19 | ;; symptoms, constitutional symptoms.
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| 20 | ;; 5. History of hospitalizations or surgery, reason or type of surgery,
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| 21 | ;; location and dates, if known.
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| 22 | ;; 6. Effects of condition on occupational functioning and daily activities.
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| 23 | ;;
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| 24 | ;;C. Physical Examination (Objective Findings):
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| 25 | ;;
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| 26 | ;; Describe the residuals of each body system affected and follow additional
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| 27 | ;; worksheets as appropriate. Comment on the following:
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| 28 | ;;
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| 29 | ;; 1. Lymphadenopathy.
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| 30 | ;; 2. Splenomegaly.
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| 31 | ;; 3. Hepatomegaly, jaundice.
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| 32 | ;; 4. Signs of bleeding.
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| 33 | ;; 5. Signs of anemia - Presence of Pallor (nail beds, mucosal surfaces and
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| 34 | ;; skin), tachycardia, systolic murmur.
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| 35 | ;; 6. Evidence of superior vena cava syndrome.
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| 36 | ;;
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| 37 | ;;D. Diagnostic and Clinical Tests:
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| 38 | ;;
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| 39 | ;; 1. Include results of all diagnostic and clinical tests conducted in
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| 40 | ;; the examination report.
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| 41 | ;;
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| 42 | ;;E. Diagnosis:
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| 43 | ;;
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| 44 | ;; 1. Is the disease active?
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| 45 | ;;
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| 46 | ;;
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| 47 | ;;
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| 48 | ;;Signature: Date:
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| 49 | ;;END
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