73 lines
1.9 KiB
Mathematica
73 lines
1.9 KiB
Mathematica
DVBCWNW1 ;ALB/CMM NOSE, SINUS, ETC WKS TEXT - 1 ; 6 MARCH 1997
|
|
;;2.7;AMIE;**12**;Apr 10, 1995
|
|
;
|
|
;
|
|
TXT ;
|
|
;;A. Review of Medical Records:
|
|
;;
|
|
;;
|
|
;;
|
|
;;B. Medical History (Subjective Complaints):
|
|
;;
|
|
;; Comment on:
|
|
;; 1. Location and nature of the injury or disease.
|
|
;;
|
|
;;
|
|
;; 2. Interference with breathing through nose.
|
|
;;
|
|
;;
|
|
;; 3. Purulent discharge.
|
|
;;
|
|
;;
|
|
;; 4. Dyspnea at rest or on exertion?
|
|
;;
|
|
;;
|
|
;; 5. Treatments - type,(i.e., surgery, medications, oxygen,
|
|
;; respirator, etc.), frequency, duration, response, and side effects.
|
|
;;
|
|
;;
|
|
;; 6. If speech impairment (ability to communicate by speech,
|
|
;; ability to speak above a whisper, etc.).
|
|
;;
|
|
;;
|
|
;; 7. For chronic sinusitis, indicate which sinuses are affected and
|
|
;; whether pain and headaches are present. Describe severity and
|
|
;; frequency.
|
|
;;
|
|
;;
|
|
;; 8. If allergic attacks, frequency and baseline status between attacks.
|
|
;;
|
|
;;
|
|
;; 9. Other symptoms noted.
|
|
;;
|
|
;;
|
|
;; 10. Describe frequency and duration of periods of incapacitation
|
|
;; (defined as requiring bed rest and treatment by a physician).
|
|
;;
|
|
;;TOF
|
|
;;C. Physical Examination (Objective Findings):
|
|
;;
|
|
;; Provide:
|
|
;; 1. If there is nasal obstruction, indicate percent each nostril.
|
|
;;
|
|
;;
|
|
;; 2. Sinusitis - Describe tenderness, purulent discharge, or crusting.
|
|
;;
|
|
;;
|
|
;;D. Diagnostic and Clinical Tests:
|
|
;;
|
|
;; 1. If there is stenosis of larynx, order FEV-1 with flow-volume loop.
|
|
;; 2. If there is facial disfigurement, order COLOR PHOTOGRAPHS.
|
|
;; 3. Include results of all diagnostic and clinical tests conducted
|
|
;; in the examination report.
|
|
;;
|
|
;;
|
|
;;E. Diagnosis:
|
|
;;
|
|
;; Comment on whether the disease primarily involves or originates
|
|
;; from the nose, sinus, larynx, or pharynx.
|
|
;;
|
|
;;
|
|
;;Signature: Date:
|
|
;;END
|