Hepatitis B physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hepatitis B}} | {{Hepatitis B}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{JM}} | ||
==Overview== | ==Overview== | ||
For the majority of patients with acute and chronic hepatitis B, the physical examination is normal. | For the majority of patients with acute and chronic [[hepatitis B]] ([[HBV]]), the physical examination is normal.<ref name="pmid19399815">{{cite journal| author=Rotman Y, Brown TA, Hoofnagle JH| title=Evaluation of the patient with hepatitis B. | journal=Hepatology | year= 2009 | volume= 49 | issue= 5 Suppl | pages= S22-7 | pmid=19399815 | doi=10.1002/hep.22976 | pmc=PMC2881483 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399815 }} </ref> | ||
==Physical Examination== | ==Physical Examination== | ||
The aim of the initial physical examination is to | The aim of the initial physical examination is to check for signs of [[chronic liver disease]], which include the following:<ref name="pmid19399815">{{cite journal| author=Rotman Y, Brown TA, Hoofnagle JH| title=Evaluation of the patient with hepatitis B. | journal=Hepatology | year= 2009 | volume= 49 | issue= 5 Suppl | pages= S22-7 | pmid=19399815 | doi=10.1002/hep.22976 | pmc=PMC2881483 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399815 }} </ref> | ||
===Skin=== | ===Skin=== | ||
*Jaundice | *[[Jaundice]] | ||
*Palmar erythema | *[[Palmar erythema]] | ||
*Spider angiomata | *[[Spider angiomata]] | ||
*Gynecomastia | *[[Gynecomastia]] | ||
===HEENT=== | ===HEENT=== | ||
*Icterus | *[[Icterus]] | ||
===Abdomen=== | ===Abdomen=== | ||
*Hepatomegaly | *[[Hepatomegaly]] | ||
*Shrunken liver | *Shrunken [[liver]] | ||
*Splenomegaly | *[[Splenomegaly]] | ||
*Ascites | *[[Ascites]] | ||
*Caput medusae | *[[Caput medusae]] | ||
===Extremities=== | ===Extremities=== | ||
*Peripheral edema | *[[Peripheral edema]] | ||
*Dupuytren's contracture | *[[Dupuytren's contracture]] | ||
===Neurologic=== | ===Neurologic=== | ||
*Asterixis | *[[Asterixis]] | ||
*Neurologic manifestations in cases of HBV progression to hepatic encephalopathy include a wide spectrum of cognitive impairment and motor system abnormalities, | *[[Neurologic]] manifestations in cases of HBV progression to [[hepatic encephalopathy]] include a wide spectrum of [[cognitive]] impairment and [[motor system]] abnormalities.<ref name="pmid25042402">{{cite journal| author=Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD et al.| title=Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study Of Liver Diseases and the European Association for the Study of the Liver. | journal=Hepatology | year= 2014 | volume= 60 | issue= 2 | pages= 715-35 | pmid=25042402 | doi=10.1002/hep.27210 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25042402 }} </ref> | ||
===Extrahepatic Manifestations=== | ===Extrahepatic Manifestations=== | ||
*Arthritis-dermatitis syndrome:<ref name="pmid15481347">{{cite journal| author=Han SH| title=Extrahepatic manifestations of chronic hepatitis B. | journal=Clin Liver Dis | year= 2004 | volume= 8 | issue= 2 | pages= 403-18 | pmid=15481347 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15481347 }} </ref> | *[[Arthritis-dermatitis syndrome]]:<ref name="pmid15481347">{{cite journal| author=Han SH| title=Extrahepatic manifestations of chronic hepatitis B. | journal=Clin Liver Dis | year= 2004 | volume= 8 | issue= 2 | pages= 403-18 | pmid=15481347 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15481347 }} </ref> | ||
**Urticaria | **[[Urticaria]] | ||
**Petechiae | **[[Petechiae]] | ||
**Palpable purpura | **[[Purpura|Palpable purpura]] | ||
**Arthralgia | **[[Arthralgia]] | ||
**Arthritis of small joints | **[[Arthritis]] of small joints | ||
*[[Neuropathy]] | |||
==Gallery== | |||
Refer to the [[Cirrhosis physical examination|Cirrhosis image gallery]] for images of the physical findings listed above. | |||
== References == | |||
{{Reflist|2}} | |||
{{WH}} | |||
{{WS}} | |||
:[[ | [[Category:Gastroenterology]] | ||
[[Category:FinalQCRequired]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Hepatology]] | |||
Latest revision as of 22:05, 29 July 2020
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Hepatitis B |
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Hepatitis B physical examination On the Web |
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American Roentgen Ray Society Images of Hepatitis B physical examination |
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Risk calculators and risk factors for Hepatitis B physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jolanta Marszalek, M.D. [2]
Overview
For the majority of patients with acute and chronic hepatitis B (HBV), the physical examination is normal.[1]
Physical Examination
The aim of the initial physical examination is to check for signs of chronic liver disease, which include the following:[1]
Skin
HEENT
Abdomen
- Hepatomegaly
- Shrunken liver
- Splenomegaly
- Ascites
- Caput medusae
Extremities
Neurologic
- Asterixis
- Neurologic manifestations in cases of HBV progression to hepatic encephalopathy include a wide spectrum of cognitive impairment and motor system abnormalities.[2]
Extrahepatic Manifestations
- Arthritis-dermatitis syndrome:[3]
- Urticaria
- Petechiae
- Palpable purpura
- Arthralgia
- Arthritis of small joints
- Neuropathy
Gallery
Refer to the Cirrhosis image gallery for images of the physical findings listed above.
References
- ↑ 1.0 1.1 Rotman Y, Brown TA, Hoofnagle JH (2009). "Evaluation of the patient with hepatitis B." Hepatology. 49 (5 Suppl): S22–7. doi:10.1002/hep.22976. PMC 2881483. PMID 19399815.
- ↑ Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD; et al. (2014). "Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study Of Liver Diseases and the European Association for the Study of the Liver". Hepatology. 60 (2): 715–35. doi:10.1002/hep.27210. PMID 25042402.
- ↑ Han SH (2004). "Extrahepatic manifestations of chronic hepatitis B." Clin Liver Dis. 8 (2): 403–18. PMID 15481347.