113 lines
7.4 KiB
Mathematica
113 lines
7.4 KiB
Mathematica
DVBCWLL6 ;ALB/RLC LIVER, GALL BLADDER AND PANCREAS WKS TEXT - 1 ; 12 FEB 2007
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;;2.7;AMIE;**121**;Apr 10, 1995;Build 9
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;
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;
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TXT ;
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;;
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;;A. Review of Medical Records: This may be of particular importance when
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;; hepatitis C or chronic liver disease is claimed as related to service.
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;;
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;;B. Medical History (Subjective Complaints):
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;;
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;; 1. For Gall Bladder Disease (Including Gall bladder removal): Episodes of
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;; colic or other abdominal pain, distention, nausea, and / or vomiting.
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;; Include a statement on frequency of attacks (number within past year).
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;; Provide statement as to what x-ray (or other) evidence supports diagnosis
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;; of chronic cholecystitis. Include current treatment - type (medication,
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;; diet, etc.), duration, response, side effects. For Gall Bladder injury,
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;; refer to Stomach, Duodenum and Peritoneal Adhesions worksheet.
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;;
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;; 2. For Pancreatic conditions: Does veteran have steatorrhea, malabsorption,
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;; or malnutrition? Comment on whether veteran has attacks of abdominal
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;; pain. Include frequency of attacks (per year). Comment on whether veteran
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;; has diarrhea, weight loss. Is there evidence of continuing pancreatic
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;; insufficiency between acute attacks? Provide evidence (lab or other
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;; clinical studies) that abdominal pain is a consequence of pancreatic
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;; disease. Has veteran had pancreatic surgery? If so, describe. Include
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;; current treatment - type (medication, diet, enzymes, etc.), duration,
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;; response, side effects.
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;;
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;; 3. For Chronic Liver disease (including hepatitis B, chronic active
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;; hepatitis, autoimmune hepatitis, hemochromatosis, drug-induced hepatitis,
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;; etc., but excluding bile duct disorders and Hepatitis C): (a) Does
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;; veteran have "incapacitating episodes" (defined as periods of acute signs
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;; and symptoms with symptoms such as fatigue, malaise, nausea, vomiting,
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;; anorexia, arthralgia, and right upper quadrant pain with symptoms severe
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;; enough to require bed rest and treatment by a physician)? If so, provide
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;; frequency of episodes and total duration of episodes over the past
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;; 12-month period. Please include comment on whether this is veteran
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;; reported, and / or documented in the available records. (b) Include
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;; current treatment - type (medication, diet, enzymes, etc.), duration,
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;; response, side effects. (c) Comment on presence and severity (e.g.
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;; near-constant, debilitating, daily or intermittent), as appropriate, of
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;; fatigue, malaise, anorexia and weight loss, right upper quadrant pain and
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;; hepatomegaly. (d) Include a history of risk factors for the liver
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;; condition which the veteran is claiming service connection. For instance
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;; (as appropriate) is there a history of occupational blood exposure? IV
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;; drug use? Taking medications that are associated with liver disease?
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;; Include a history of alcohol use / abuse, past and present. Note presence
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;; or absence of extrahepatic manifestations of veteran's liver disease (e.g.
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;; vasculitis, kidney disease, arthritis.) Refer to additional worksheets
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;; as necessary. See and address 4. Cirrhosis of the liver when cirrhosis
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;; is a sequelae. See and address 7 (below) where veteran is status post
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;; liver transplant.
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;;
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;; 4. For Cirrhosis of the Liver, primary biliary cirrhosis, cirrhotic phase of
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;; sclerosing cholangitis, or as a sequelae of hepatitis from any cause:
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;; (a)Fully describe the following, indicating, as appropriate, the number
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;; of episodes, periods of remission, or whether the condition is refractory
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;; to treatment: (i) ascites, (ii) hepatic encephalopathy, (iii) hemorrhage
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;; from varicies (include comment on episodes of hemetemesis and/or melana,
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;; (iv) portal gastropathy (v) portal hypertension, (vi) jaundice. (b)
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;; comment on: (i) current treatment (s) (medications, diet, response, side
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;; effects, duration) (ii) Discuss presence, frequency (e.g., daily,
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;; intermittent, etc.) and severity of each of the following: weakness,
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;; anorexia, malaise, abdominal pain, weight loss (include amount and time
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;; frame), weight gain, and weakness. Note presence or absence of
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;; extrahepatic manifestations of veteran's liver disease (e.g.
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;; vasculitis, kidney disease, arthritis.) Refer to additional worksheets
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;; as necessary. See and address 3 (above) where cirrhosis is a sequelae
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;; of Chronic Liver disease (including hepatitis B, chronic active
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;; hepatitis, autoimmune hepatitis, hemochromatosis, drug-induced
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;; hepatitis, etc., but excluding bile duct disorders and Hepatitis C).
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;; See and address 7 (below) where veteran is status post liver transplant.
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;;
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;; 5. For Hepatitis C: (a) Does veteran have "incapacitating episodes" (defined
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;; as periods of acute signs and symptoms with symptoms such as fatigue,
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;; malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant
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;; pain with symptoms severe enough to require bed rest and treatment by a
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;; physician)? If so, provide frequency of episodes and total duration of
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;; episodes over the past 12-month period. Please include comment on whether
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;; this is veteran reported, and/ or documented in the available records.
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;; (b) comment on: (i) current treatment (s) (medications, diet, response,
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;; side effects, duration) (ii) Discuss presence, frequency (e.g., daily,
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;; intermittent, etc.) and severity of each of the following: weakness,
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;; anorexia, malaise, abdominal pain, weight loss (include amount and time
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;; frame), weight gain, and weakness. (c) Include a history of risk factors
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;; for the liver condition for which the veteran is claiming service
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;; connection. For instance (as appropriate) is there a history of
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;; occupational blood exposure? IV drug use? See established risk factors
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;; for Hepatitis C, below. Note presence or absence of extrahepatic
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;; manifestations of veteran's liver disease (e.g. vasculitis, kidney
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;; disease, arthritis.) Refer to additional worksheets as necessary.
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;; See and address 7 (below) where veteran is status post liver transplant.
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;;
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;; 6. For Liver Malignancy: Address presence or absence of symptomatolgy, etc.,
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;; as outlined in both: 3. (For Chronic Liver disease (including hepatitis B,
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;; chronic active hepatitis, autoimmune hepatitis, hemochromatosis,
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;; drug-induced hepatitis, etc., but excluding bile duct disorders and
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;; Hepatitis C) and 4. (For Cirrhosis of the Liver, primary biliary
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;; cirrhosis, cirrhotic phase of sclerosing cholangitis, or as a sequelae
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;; of hepatitis from any cause) above.
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;;
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;; 7. For Liver Transplant: Provide date of transplant. Describe current
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;; treatment(s) (medications, diet, response, side effects, duration).
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;; Please refer to additional AMIE worksheets to address conditions veteran
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;; has as a consequence of the transplant, treatment for the transplant, and
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;; as a consequence of any underlying disease that prompted the transplant
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;; in the first place (e.g. extrahepatic complications / manifestations of
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;; hepatitis C).
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;;
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;; 8. Effects of the condition on occupational functioning and daily activities.
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;;
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