Wiki Lint Report — 2026-05-06

Auditor: Claude (automated)
Scope: Full wiki — all directories
Pages audited: ~127 markdown files
Previous lint: Lint Report 2026 05 03 (2026-05-03)
Auto-fixes applied this session: 3

Auto-Fixes Applied

Flags Requiring Human Review

🔴 Clinical / Safety

Flag 1 — BP completely undocumented
- Patient on losartan 50 mg q.d. (HTN / diabetic nephropathy per Hypertension)
- Zero BP readings anywhere in the vault
- Nifedipine confirmed NOT being taken (2026-05-06) — only monotherapy on losartan
- Cannot assess HTN control. No target BP, no onset date, diagnosis is PRESUMED
- Action: Obtain BP at next clinic visit. Document in Hypertension and Profile.

Flag 2 — Falls risk assessment absent
- Age 81 + pregabalin 75 mg q.d. (vestibular/proprioceptive effects) + residual anemia (Hb 11.9) + biothesiometry VPT 29–33V (moderate neuropathy, 2022) + no G-CSF
- No formal falls risk assessment documented (Timed Up and Go, Berg Balance, or equivalent)
- Action: TUG / FRAX / falls screen at next visit. Document in Preventive Care/ Preventive Schedule.

Flag 3 — Fructosamine recheck due
- Last value: 310 µmol/L (HIGH, 2026-04-22)
- Recommended interval: 4–6 weeks (preferred glycemic marker in AML; HbA1c unreliable)
- Due window: 2026-05-20 to 2026-06-03
- Action: Order fructosamine at or before next clinic visit (~Cycle 5 labs). Update Fructosamine.

Flag 4 — Renal function / Cr overdue
- Last Cr: 0.6 mg/dL (2026-04-06) — 30 days prior to this audit
- Patient on metformin (hold if eGFR < 30) and losartan (nephroprotective but monitor)
- Action: Cr/BUN/eGFR at next lab draw. Update Creatinine.

Flag 5 — Prednisolone indication never documented
- 15-day prednisolone course prescribed but indication field is "Unknown — inflammatory condition? AML-related?"
- Patient confirmed not taking it (2026-05-06 clinic note) — resolved by non-adherence, not documentation
- Corticosteroid with unlabeled indication in an AML patient on myelosuppressive therapy is a documentation failure
- Action: Clarify indication with prescribing provider. Update Prednisolone.

🟡 Documentation Gaps

Flag 6 — Oncology drug doses unknown (azacitidine, venetoclax, posaconazole, acyclovir)
- Azacitidine: mg/m² unknown (standard: 75 mg/m²/day × 5–7 days)
- Venetoclax: actual dose unknown; stated as "reduced" per posaconazole interaction but no mg value
- Posaconazole: dose and frequency both unknown
- Acyclovir: dose and frequency both unknown
- Root cause: No prescription PDFs for AML medications ingested
- Action: Obtain pharmacy printout or Rx from KIMS. Drop into raw/prescriptions/ and /ingest.

Flag 7 — 14 of 22 medication pages missing prescriber
- Prescriber field is "Unknown" for: cholecalciferol, insulin-degludec, insulin-glargine, linagliptin, losartan, magnesium-oral, menorease, metformin, nifedipine, pregabalin, pregmerve, serratiopeptidase, simvastatin, vitamin-e
- Action: Ingest prescriptions to populate. For Jothydev's DM medications, prescriber is likely Jothydev Kesavadev.

Flag 8 — Pregabalin indication is presumed, no DPN diagnosis formalized
- Pregabalin: indication "Neuropathic pain (presumed — diabetic neuropathy?)"
- No formal DPN diagnosis page exists. No NRS pain score, no current sensory exam
- Biothesiometry (2022) confirms subclinical DPN was already present at that time
- Action: Confirm indication with provider. Create wiki/conditions/diabetic-peripheral-neuropathy.md. Update Pregabalin.

Flag 9 — Serratiopeptidase indication and frequency unknown
- Indication: "Anti-inflammatory / mucolytic (presumed)" — unclear why prescribed in AML context
- Frequency: "Unknown (likely once or twice daily)" — explicit unknown in frontmatter
- Action: Obtain Rx. Confirm whether it should be continued during active chemo.

Flag 10 — Dual basal insulin regimen needs clarification
- Insulin Degludec (Tresiba, 10u q.d.) and Insulin Glargine (Lantus, 10u q.d.) both documented
- Patient confirmed NOT taking glargine (2026-05-06) — already moved to discontinued
- Documentation gap: When was the transition from Lantus → Tresiba, and was it intentional?
- Action: Confirm with provider. Update Insulin Degludec with clinical rationale for switch.

Flag 11 — Cycle 5 scheduling undocumented
- Cycle 4 Day 1: 2026-04-06. Estimated Cycle 5 window: May 4–17
- No scheduling confirmation, appointment letter, or Cycle 5 clinic note in vault
- ANC 1990 (Apr 27) was the gating factor; ANC now 2360 (May 4, normal) — likely cleared
- Action: Drop next clinic note or appointment letter into raw/clinic-notes/ and /ingest.

ℹ️ Structural / Low Priority

Flag 12 — jothydev-clinic-note-2022-11-25.md misclassified as condition
- File located in wiki/conditions/
- type: condition in frontmatter — incorrect. Content is a clinic visit note from Nov 2022.
- No wiki/clinic-notes/ directory exists in schema
- Action: Change type field to a neutral value (e.g., type: clinic-note) or leave in place as archival documentation. Not a structural blocker.

Flag 13 — wiki/_jobs/ directory undocumented in schema
- Directory present in wiki root but not defined in CLAUDE.md
- Action: Clarify purpose. If internal/system use, add a note to CLAUDE.md.

Flag 14 — wiki/summaries/ directory is empty
- Schema lists: new-provider-packet, medication-reconciliation, surgical-history-summary
- None of these have been generated
- Action: Optional — generate new-provider-packet.md on next provider introduction query.

Flag 15 — wiki/overview.md updated date should reflect May 4 data
- Body content references May 4 labs (Hb 11.9, Na 142) but updated frontmatter field may still read 2026-04-29
- Action: Minor — update updated: field to 2026-05-04 or 2026-05-06 on next write.

Broken Wikilinks

Result: ZERO broken wikilinks — all <a href="/wiki/links" class="wikilink">Links</a> in wiki/index.md and wiki/profile.md resolve to existing files.

Missing Directories

Result: All required schema directories present. No missing directories.

Stale Data Check (12+ months without update)

Preventive Care Overdue Items

Summary Statistics

Lint performed by Claude on 2026-05-06. Previous report: Lint Report 2026 05 03.