Disability Examination Worksheets
Cushing's Syndrome
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A. Review of Medical Records: B.
Medical History (Subjective Complaints):
Comment on:
- Date diagnosis established.
- Current symptoms: weakness, fatigue, weight change, acne, mental changes, vision problems
- History of glucose intolerance?
- Etiology? Iatrogenic?
- Treatments (surgery, medication, etc.), dose, frequency,
response, side effects.
- Effects of the condition on occupational functioning and daily activities.
- History of hospitalizations or surgery, dates and location, if known, reason or type of surgery.
- History of neoplasm:
- Date of diagnosis, diagnosis.
- Benign or malignant.
- Types of treatment and dates.
- Last date of treatment.
C. Physical Examination (Objective Findings):
Address each of the following and fully describe current
findings:
- Muscle strength.
- Vascular fragility.
- Blood Pressure.
- Striae, skin thinning.
- Weight gain or loss, presence of obesity.
- Moonface, buffalo hump.
- Vision abnormalities, presence of abnormalities requires evaluation by vision specialist.
- After control, describe adrenal insufficiency, cardiovascular,
psychiatric, skin, or skeletal complications or residuals, follow appropriate worksheets.
D. Diagnostic and Clinical Tests:
Provide:
- CT of brain or X-ray of sella turcica, unless of record.
- Serum and urine cortisol levels, unless of record.
- High and low dose dexamethasone suppression test, unless of record.
- Imaging studies for size of adrenals, unless of record.
- Glucose tolerance test, if needed, to confirm glucose intolerance.
- X-rays if osteoporosis suspected.
- Include results of all diagnostic and clinical tests conducted in
the examination report.
E. Diagnosis:
Comment on:
1. Is the disease active or in remission?
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Reviewed/Updated Date: December 15, 2008 |
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