Endocrine Diseases, Miscellaneous

(Benign and Malignant Neoplasms, Hyperpituitarism,
Hyperaldosteronism, and Pheochromocytoma)

Name:	SSN:
Date of Exam:	C-number:
Place of Exam:

A. Review of Medical Records:

B. Medical History (Subjective Complaints):

Comment on:

1. Date of diagnosis and how established.
2. Fatigability.
3. Headaches.
4. Changes in vision.
5. Neurologic, cardiovascular, or gastrointestinal symptoms.
6. Treatments (surgery, medications, hormones), including dose, frequency, response, side effects. For malignancy, provide date of completion of treatment for malignancy.
7. Weight gain or loss.
8. Excessive thirst, frequency of urination.
9. Describe the effects of the condition(s) on the veteran's usual occupation and daily activities.

C. Physical Examination (Objective Findings):

Address each of the following and fully describe current findings:

1. For hypoparathyroidism, thyroid surgery scar?
2. For diabetes insipidus, signs of dehydration?
3. For Addison's disease, muscle strength, blood pressure, skin pigmentary changes. Number of crises (with peripheral vascular collapse) or episodes (less acute and severe than crisis - no peripheral vascular collapse).
4. For pluriglandular syndromes, see examinations for glands affected.
5. Describe all residuals of benign or malignant neoplasm, including those related to treatment.
6. Is the disease active or in remission?
7. For hyperparathyroidism, history of kidney stones. History of demineralization of skeleton.

D. Diagnostic and Clinical Tests:

Provide, as appropriate:

1. Blood and urinary calcium.
2. X-ray of bones to confirm decalcification.
3. Glucose tolerance test, if necessary.
4. Antidiuretic hormone level.
5. Serum and urine electrolytes.
6. Urine specific gravity.
7. Serum cortisol.
8. Serum creatinine.
9. Serum glucose.
10. ACTH test.
11. Include results of all diagnostic and clinical tests conducted in the examination report.

E. Diagnosis:

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