111 lines
7.3 KiB
Mathematica
111 lines
7.3 KiB
Mathematica
DVBCWLL3 ;ALB/RLC LIVER, GALL BLADDER AND PANCREAS WKS TEXT - 1 ; 19 FEBRUARY 1999
|
|
;;2.7;AMIE;**86**;July 22, 2004
|
|
;
|
|
;
|
|
TXT ;
|
|
;;
|
|
;;A. Review of Medical Records: This may be of particular importance when
|
|
;; hepatitis C or chronic liver disease is claimed as related to service.
|
|
;;
|
|
;;B. Medical History (Subjective Complaints):
|
|
;;
|
|
;; 1. For Gall Bladder Disease (Including Gall bladder removal): Episodes of
|
|
;; colic or other abdominal pain, distention, nausea, and / or vomiting.
|
|
;; Include a statement on frequency of attacks (number within past year).
|
|
;; Provide statement as to what x-ray (or other) evidence supports diagnosis
|
|
;; of chronic cholycystitis. Include current treatment - type (medication,
|
|
;; diet, etc.), duration, response, side effects. For Gall Bladder injury,
|
|
;; refer to Stomach, Duodenum and Peritoneal Adhesions worksheet.
|
|
;;
|
|
;; 2. For Pancreatic conditions: Does veteran have steatorrhea, malabsorption,
|
|
;; or malnutrition? Comment on whether veteran has attacks of abdominal
|
|
;; pain. Include frequency of attacks (per year). Comment on whether veteran
|
|
;; has diarrhea, weight loss. Is there evidence of continuing pancreatic
|
|
;; insufficiency between acute attacks? Provide evidence (lab or other
|
|
;; clinical studies) that abdominal pain is a consequence of pancreatic
|
|
;; disease. Has veteran had pancreatic surgery? If so, describe. Include
|
|
;; current treatment - type (medication, diet, enzymes, etc.), duration,
|
|
;; response, side effects.
|
|
;;
|
|
;; 3. For Chronic Liver disease (including hepatitis B, chronic active
|
|
;; hepatitis, autoimmune hepatitis, hemochromatosis, drug-induced hepatitis,
|
|
;; etc., but excluding bile duct disorders and Hepatitis C): (a) Does
|
|
;; veteran have "incapacitating episodes" (defined as periods of acute signs
|
|
;; and symptoms with symptoms such as fatigue, malaise, nausea, vomiting,
|
|
;; anorexia, arthralgia, and right upper quadrant pain with symptoms severe
|
|
;; enough to require bed rest and treatment by a physician)? If so, provide
|
|
;; frequency of episodes and total duration of episodes over the past
|
|
;; 12-month period. Please include comment on whether this is veteran
|
|
;; reported, and / or documented in the available records. (b) Include
|
|
;; current treatment - type (medication, diet, enzymes, etc.), duration,
|
|
;; response, side effects. (c) Comment on presence and severity (e.g.
|
|
;; near-constant, debilitating, daily or intermittent), as appropriate, of
|
|
;; fatigue, malaise, anorexia and weight loss, right upper quadrant pain and
|
|
;; hepatomegaly. (d) Include a history of risk factors for the liver
|
|
;; condition which the veteran is claiming service connection. For instance
|
|
;; (as appropriate) is there a history of occupational blood exposure? IV
|
|
;; drug use? Taking medications that are associated with liver disease?
|
|
;; Include a history of alcohol use / abuse, past and present. Note presence
|
|
;; or absence of extrahepatic manifestations of veteran's liver disease (e.g.
|
|
;; vasculitis, kidney disease, arthritis.) Refer to additional worksheets
|
|
;; as necessary. See and address 4. Cirrhosis of the liver when cirrhosis
|
|
;; is a sequelae. See and address 7 (below) where veteran is status post
|
|
;; liver transplant.
|
|
;;
|
|
;; 4. For Cirrhosis of the Liver, primary biliary cirrhosis, cirrhotic phase of
|
|
;; sclerosing cholangitis, or as a sequelae of hepatitis from any cause:
|
|
;; (a)Fully describe the following, indicating, as appropriate, the number
|
|
;; of episodes, periods of remission, or whether the condition is refractory
|
|
;; to treatment: (i) ascites, (ii) hepatic encephalopathy, (iii) hemorrhage
|
|
;; from varicies (include comment on episodes of hemetemesis and/or melana,
|
|
;; (iv) portal gastropathy (v) portal hypertension, (vi) jaundice. (b)
|
|
;; comment on: (i) current treatment (s) (medications, diet, response, side
|
|
;; effects, duration) (ii) Discuss presence, frequency (e.g., daily,
|
|
;; intermittent, etc.) and severity of each of the following: weakness,
|
|
;; anorexia, malaise, abdominal pain, weight loss (include amount and time
|
|
;; frame), weight gain, and weakness. Note presence or absence of
|
|
;; extrahepatic manifestations of veteran's liver disease (e.g.
|
|
;; vasculitis, kidney disease, arthritis.) Refer to additional worksheets
|
|
;; as necessary. See and address 3 (above) where cirrhosis is a sequaele
|
|
;; of Chronic Liver disease (including hepatitis B, chronic active
|
|
;; hepatitis, autoimmune hepatitis, hemochromatosis, drug-induced
|
|
;; hepatitis, etc., but excluding bile duct disorders and Hepatitis C).
|
|
;; See and address 7 (below) where veteran is status post liver transplant.
|
|
;;
|
|
;; 5. For Hepatitis C: (a) Does veteran have "incapacitating episodes" (defined
|
|
;; as periods of acute signs and symptoms with symptoms such as fatigue,
|
|
;; malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant
|
|
;; pain with symptoms severe enough to require bed rest and treatment by a
|
|
;; physician)? If so, provide frequency of episodes and total duration of
|
|
;; episodes over the past 12-month period. Please include comment on whether
|
|
;; this is veteran reported, and/ or documented in the available records.
|
|
;; (b) comment on: (i) current treatment (s) (medications, diet, response,
|
|
;; side effects, duration) (ii) Discuss presence, frequency (e.g., daily,
|
|
;; intermittent, etc.) and severity of each of the following: weakness,
|
|
;; anorexia, malaise, abdominal pain, weight loss (include amount and time
|
|
;; frame), weight gain, and weakness. (c) Include a history of risk factors
|
|
;; for the liver condition for which the veteran is claiming service
|
|
;; connection. For instance (as appropriate) is there a history of
|
|
;; occupational blood exposure? IV drug use? See established risk factors
|
|
;; for Hepatitis C, below. Note presence or absence of extrahepatic
|
|
;; manifestations of veteran's liver disease (e.g. vasculitis, kidney
|
|
;; disease, arthritis.) Refer to additional worksheets as necessary.
|
|
;; See and address 7 (below) where veteran is status post liver transplant.
|
|
;;
|
|
;; 6. For Liver Malignancy: Address presence or absence of symptomatolgy, etc.,
|
|
;; as outlined in both: 3. (For Chronic Liver disease (including hepatitis B,
|
|
;; chronic active hepatitis, autoimmune hepatitis, hemochromatosis,
|
|
;; drug-induced hepatitis, etc., but excluding bile duct disorders and
|
|
;; Hepatitis C) and 4. (For Cirrhosis of the Liver, primary biliary
|
|
;; cirrhosis, cirrhotic phase of sclerosing cholangitis, or as a sequelae
|
|
;; of hepatitis from any cause) above.
|
|
;;
|
|
;; 7. For Liver Transplant: Provide date of transplant. Describe current
|
|
;; treatment(s) (medications, diet, response, side effects, duration).
|
|
;; Please refer to additional AMIE worksheets to address conditions veteran
|
|
;; has as a consequence of the transplant, treatment for the transplant, and
|
|
;; as a consequence of any underlying disease that prompted the transplant
|
|
;; in the first place (e.g. extrahepatic complications / manifestations of
|
|
;; hepatitis C).
|
|
;;
|