Open ended malnutrition query

Dear Dr. XXXX;

The dietitian note of 5/10/14 has a finding of severe protein calorie malnutrition in the context of chronic illness based on the physical findings: subcutaneous fat and muscle loss [12/16/13 58.06 kg (128 lb) to 05/08/14 52.572 kg (115 lb 14.4 oz)].

Can you please provide a diagnosis associated with the findings of the dietary consult (referenced above) in your next progress note?

Multiple choice malnutrition query

Dear Dr. XXXX;

The dietitian note of 5/10/14 has a finding of severe protein calorie malnutrition in the context of chronic illness based on the physical findings: subcutaneous fat and muscle loss [12/16/13 58.06 kg (128 lb) to 05/08/14 52.572 kg (115 lb 14.4 oz)].

Can the above findings be clarified as one of the following diagnoses?

 Mild protein calorie malnutrition

 Moderate protein calorie malnutrition

 Severe protein calorie malnutrition

 Finding without clinical significance

 Unable to determine

 Other: ______

MD signature: ______Date/time: ______

Sample heart failure yes/no query

Dear Dr. XXXX;

The ED provider documented “systolic congestive heart failure for a year.” The progress note of 5/14 states, "CAD, CHF: LVEF 15% on MR cardiac, continue PTA carvedilol, eplerenone, furosemide, and lisinopril ... Decreased left ventricular systolic performance moderately severe.”

Do you agree with the ED provider’s finding of systolic heart failure?

 Yes

 No

 Unable to determine

 Other: ______

MD signature ______Date/time: ______

Sample linking, yes/no query

Dear Dr. XXXX;

Is there a relationship between “peripheral neuropathy” and “diabetes” documented in the history and physical in this patient who “uses a walker to ambulate and his gait is worsened by his chronic gout as well as peripheral neuropathy”?

Yes

No

Unable to determine

Other: ______

MD signature ______Date/time ______

Sample GI bleed query, yes/no form

Dear Dr. XXXX;

Does the documentation “post-gastric bypass GI” in the ED notes in this patient whose Hgb dropped from 12.8 to 8.5 requiring 2 units PRBCs and an inpatient admission clarify the GI bleed as a complication of the gastric bypass?

Yes

No

Unable to determine

Other: ______

MD signature ______Date/time ______