Hepatitis C

HEPATITIS C 1.

CHIEF COMPLAINT •Hepatitis C

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HPI

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ROS

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SYMPTOMS •Fatigue •Malaise •Sleep inversion •Pruritus •Hepatic encephalopathy •Ankle edema •Ascites •Hematemesis •Melena

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HISTORY

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ALLERGIES

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PHYSICAL EXAMINATION •Necrotizing Vasculitis •Palmar erythema •Spider nevi •Dupuytren contracture •Asterixis •Leuconychia •Clubbing •Icteric sclera •Temporal muscle wasting •Fetor hepaticus •Enlarged parotid •Cyanosis •Gynecomastia •Paraumbilical hernia •Ascites •Caput medusae

•Hepatosplenomegaly •Abdominal bruit •Small testes •Ankle edema •Scant body hair 8.

SPECIFIC DATA LIKE GRADING ETC

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TESTS TO BE ORDERED •CBP •Alanine aminotransferase (ALT) •Hepatitis C antibody test •Anti-HCV •Recombinant immunoblot assay •Qualitative and quantitative assays for HCV RNA •Amplicor Hepatitis C Virus Test •CBC count with differential. •Liver function tests •Thyrotropin level •Ultrasonography of the liver •Liver biopsy

10. ASSESSMENT /PLAN •Surgical Care o Hepatic resection o LT 11. EDUCATION •Avoid alcohol •Use barrier protection during sexual intercourse. •Patients with hepatitis C should not donate blood or organs. 12. MEDICATION •PEG-IFN alfa •Ribavirin •Interferon alfa-2b •Interferon alfacon-1 •Pegylated interferon alfa-2b •Pegylated interferon alfa-2a 13. FOLLOW-UP