Annual Review

Good medical practice involves a clear history, physical examination and investigation in any out-patient review.

History from Alström person and family

General well-being
Psychology - adjustment to condition
Mobility
Eyesight and visual aids - Braille, IT
Hearing and appropriate hearing aids
Growth and development

Ask if there is any:

shortness of breath
tiredness
problems with passing water
heartburn
What treatments are being taken?

Examination

Observe mobility
Weight, height, blood pressure
Acanthosis
Condition of feet
Listen to heart and lungs

Investigation

blood:

urea and electrolytes
liver function tests
haemoglobin A1c and blood glucose
serum triglycerides and cholesterol
thyroid function
oestrogen or testosterone, FSH and LH

imaging:

bladder scan post micturition if urinary symptoms
ECG
echocardiogram

Respiratory Function

From seven years and older standard respiratory function tests:

Peak Flow
Forced Expiratory Volume in 1 second (FEV)
Forced Vital Capacity (FVC)
FEV1/FVC ratio
Digital oximetry at rest and after a five-minute walk