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Evaluation

Does the patient have systemic lupus erythematosus?

What is the patient's gender?

Has the patient ever had a cataract?

Does the patient have retinal damage or optic atrophy?

Does the patient have a cognitive impairment (e.g., memory deficit, difficulty with calculation, poor concentration, difficulty in spoken or written language, impaired performance level)?

Does the patient have a major psychotic disorder?

Has the patient had seizures requiring therapy for at least 6 months?

How many separate cerebrovascular accidents has the patient had? (enter integer)

Has the patient had surgical resection of the central nervous system for causes other than malignancy?

Does the patient have a cranial or peripheral neuropathy (excluding optic)?

Does the patient have transverse myelitis?

What is the patient's estimated or measured glomerular filtration rate as percent of normal? (enter from 0 to 100)

percent

What is the patient's level of proteinuria excreted?

grams/day

Has the patient had end-stage renal disease (regardless of dialysis or transplantation)?

Does the patient have pulmonary hypertension (right ventricular prominence, or loud P2)?

Does the patient have pulmonary fibrosis on physical examination and/or chest radiograph?

Does the patient have a shrinking lung on chest radiograph?

Does the patient have pleural fibrosis on chest radiograph?

Has the patient had a pulmonary infarction?

Has the patient had a pulmonary resection for cause other than malignancy?

Does the patient have angina?

Has the patient ever had a coronary artery bypass?

How many myocardial infarctions has the patient had?

Does the patient have a cardiomyopathy with ventricular dysfunction?

Does the patient have cardiac valvular disease (either a systolic murmur > 3/6 or diastolic murmur)?

Has the patient had pericarditis for at least 6 months?

Has the patient have had a pericardiectomy?

Has the patient had claudication for at least 6 months?

Has the patient had minor tissue loss (pulp space) due to poor peripheral circulation?

How many peripheral sites have shown significant tissue loss (e.g., loss or resection of a digit or limb) due to peripheral vascular problems?

Does the patient have venous thrombosis with swelling, ulceration or venous stasis?

How many infarctions or resections of bowel performed involving jejunum, ileum or large bowel?

occurrences

Has the patient's spleen been removed?

Has the patient had an hepatic resection?

Has the patient had a cholecystectomy?

Has the patient ever had mesenteric artery insufficiency?

Has the patient had chronic peritonitis?

Has the patient had an esophageal stricture?

Has the patient ever had upper gastrointestinal tract surgery?

Has the patient had pancratic insufficiency, requiring enzyme replacement, or a pancreatic pseudocyst?

Does the patient have muscle atrophy or weakness?

Does the patient have a deforming or erosive arthritis (including reducible deformities, but excluding avascular necrosis)?

Does the patient have osteoporosis with fracture or vertebral collapse (excluding avascular necrosis)?

How many different bony sites have been affected by avascular necrosis?

Does the patient have osteomyelitis?

Does the patient have a scarring chronic alopecia?

Has the patient had extensive scarring or panniculum other than scalp and pulp space?

Has the patient had skin ulceration (excluding thrombosis) for more than 6 months?

Has or did the patient developed secondary amenorrhea before the age of 40?

Does the patient have diabetes mellitus sufficient to regard some manner of intervention (regardless of treatment)?

How many different malignant tumors has the patient had, excluding dysplasia?

Results

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