Department of Alergy and Immunology Review of Systems Form

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DEPARTMENT OF ALERGY AND IMMUNOLOGY REVIEW OF SYSTEMS FORM Patient Name:___________________________ DOB:_______________ Date:_____________ *Please check off current symptoms your child is having. CONSTITUTION GU EYES HEMATOLOGIC BEHAVIORAL Activity change Difficulty urinating Eye discharge Enlarged lymph nodes Agitation Appetite change Painful urination Eye itching Bruises/Bleeds Behavior problem Chills Bed wetting Eye pain easily Confusion Crying Side pain Eye redness SKIN Decrease Sweating profusely Frequency Light sensitivity Color change concentration Fatigue Genital sore Visual disturbance Pallor Anxiety, Depression Fever Blood in urine Rash Hallucination Irritability Urgency MS Wound Hyperactive Unexpected Weight Urine decreased Joint pain Anxious change Vaginal bleeding Back pain NEUROLOGICAL Self-injury HENT Vaginal discharge Walking Sleep disturbance Congestion Vaginal pain Joint swelling Dizziness Suicidal ideas Dental Problems Muscle pain Facial Asymmetry Drooling GI Neck pain Headaches Ear Discharge Abdominal pain Neck stiffness Light Headedness Ear Pain Anal bleeding Numbness Facial Swelling Blood in stool RESPIRATORY Seizures Hearing Loss Constipation Apnea Speech difficulty Mouth sores Diarrhea Choking Syncope Nosebleeds Nausea Cough Tremors Runny nose Rectal Pain Breathing vibration Weakness noise Sneezing Vomiting Wheezing Sore Throat Ringing in ears CARDIOVASCULAR Trouble Swallowing Chest pain Voice change Skin discoloration Leg swelling Palpitations ***COMMENTS __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Patient Identification Office Use Only I attempted to obtain the patient’s (or representatives) signature on this If label is not available, please complete: Acknowledgement but did not because: ___It was emergency treatment Patient Name _________________________________ ___I could not communicate with the patient ___The patient refused to sign ___The patient was unable to sign because DOB: ______________ MR# ____________________ ___Other (please describe) Signature _______________________________________________ Page 1 of 1 PSV-Cln-119 |Revised:09/06/2016 .

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Two Cases of Intractable Auditory Hallucination Successfully Treated with Sound Therapy
ORIGINAL ARTICLE International Tinnitus Journal. 2010;16(1):29-31. Two cases of intractable auditory hallucination successfully treated with sound therapy Yutaka Kaneko, M.D. 1 Yasuhiko Oda, M.D. 2 Fumiyuki Goto, M.D. 3 Abstract We report two cases of patients with schizoaffective disorder with treatment-refractory auditory verbal hallucinations (AVHs) who were successfully treated with sound therapy, which is effective to treat tinnitus. AVHs in both patients were alleviated within about one month, and no recurrence was reported for 31 and 17 months after the sound the- rapy together with medication. Further studies may confirm the therapeutic value of sound therapy in patients with intractable AVHs. Keywords: auditory hallucinations, sound therapy. 1 Kaneko Otorhinolaryngology Clinic, Sendai, Miyagi, 2 Kunimidai Hospital (Psychiatry), Sendai, Miyagi, and 3 Department of Otorhinolaryngology, Hino Municipal Hospital, Tokyo, Japan Corresponding Author: Yutaka Kaneko, M.D. Kaneko Otorhinolaryngology Clinic 2-9-14 Kunimi,Aoba-ku,Sendai 981-0943,Japan Tel & Fax: +81-22-233-7722 E-mail: [email protected] International Tinnitus Journal, Vol. 16, No 1 (2010) www.tinnitusjournal.com 29 INTRODUCTION levomepromazine and olanzapine, together with fluvo- xamine maleate and sodium valproate during her hos- Auditory hallucinations (AHs) are generally defined pitalization for 3 years. She then received a psychiatric as false perceptions manifesting as “voices commenting” referral to our ear clinic for audiological evaluation and or “voices conversing” in patients with schizophrenia and treatment in August 2006. Her hearing level, calculated schizoaffective disorder. Auditory verbal hallucinations as the average across the frequencies 250, 500, 1000, (AVHs) are one of the major symptoms for the diagnosis and 2000 Hz, was 13.8 dB in the right ear and 18.8 dB of these disorders as well as the evaluation of psychotic in the left ear.
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In Diagnosis Must Be Based on Clinical Signs and Symptoms. in This Paper
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Bronson Healthcare Midwest Epic Review of Systems 10.3
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For Personal Use Only
Comments & Controversies p Coming to Ask more questions APA? suspected to be at risk for workplace MAY 2009 Visit us at booth The list of interview questions Dr. #1624 violence and for fi tness for duty. Mob- Henry Nasrallah suggested in “The bing seems to be more prevalent and hallucination portrait of psychosis: the consequences more dire for a vic- Probing the voices within” (From the A DOWDEN PUBLICATION • VOL. 8, NO. 5 Beyond threats tim who is feeling pressured to leave Editor, Current Psychiatry, May Risk factors for suicide his or her job when there is little hope in borderline personality 2009, p. 10-12) is a much-needed re- disorder of getting another one or is taking on ] SPECIAL REPORT minder of the clinical importance of Economic anxiety: First aid responsibilities previously held by oth- for the recession’s casualties patients’ verbal auditory hallucina- What is your patient’s ers who have been laid off. predicament? Knowing can tions. In 15 years of practice—much Mr. S experiences recurrent hypothermia inform clinical practice This brings to the forefront a very during treatment for multiple medical PLUS Editorial: Dr. Nasrallah problems and psychotic symptoms. of that inpatient psychiatry—I have Hallucination portrait of psychosis: important consideration for individu- Could antipsychotics be the cause? Probing the voices within Malpractice Rx cared for many patients with hallu- Smoking allowed: als who confront such assessment Is hospital policy a liability risk? Pearls cinations, and until recently I confess \DRiNK TWO 6 PACK challenges. Gathering collateral infor- clariﬁ es substance use ONLINE ONLY my interview was not as thorough as SEE PAGE 9 mation is critical for diagnostic accura- Dr.
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