Hepatitis C physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
==Physical Exam== | ==Physical Exam== | ||
{| {{table}} | |||
{| {{table}}|Findings in patients with chronic HCV | |||
| align="center" style="background:#f0f0f0;"|'''Physical Exam''' | | align="center" style="background:#f0f0f0;"|'''Physical Exam''' | ||
| align="center" style="background:#f0f0f0;"|'''Comments''' | | align="center" style="background:#f0f0f0;"|'''Comments''' | ||
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| Abdomen||Evidence of hepatic inflammation or hepatomegaly, signs of cirrhosis may be present including ascites (shifting dullness), splenomegaly, caput medusae, etc. | | Abdomen||Evidence of hepatic inflammation or hepatomegaly, signs of cirrhosis may be present including ascites (shifting dullness), splenomegaly, caput medusae, etc. | ||
|- | |- | ||
| Cardiovascular system|| | | Cardiovascular system||Assess for underlying cardiovascular disease (CVD) since it may affect the choice of therapy since CVD is a relative contraindication to treatment with the combination of pegylated interferon and ribavirin. | ||
|- | |- | ||
| Extremities||Peripheral edema can be a sign of portal hypertension. | | Extremities||Peripheral edema can be a sign of portal hypertension. | ||
|- | |- | ||
| General | | General appearance||Malnutrition can be a sign of advanced liver disease. | ||
|- | |- | ||
| HEENT||Check for thyroid abnormalities, because treatment can cause or exacerbate autoimmune thyroiditis. | | HEENT||Check for thyroid abnormalities, because treatment can cause or exacerbate autoimmune thyroiditis. | ||
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| ||Note whether icterus is present. | | ||Note whether icterus is present. | ||
|- | |- | ||
| Mental status||Check for evidence of psychosis or depression | | Mental status||Check for evidence of psychosis or depression, which are important contraindications to treatment. | ||
|- | |- | ||
| Respiratory system||Perform a general examination to exclude respiratory disease. | | Respiratory system||Perform a general examination to exclude respiratory disease. | ||
|- | |- | ||
| Skin||Note any signs of alcohol abuse or liver failure, such as damaged capillaries over the cheeks, dilated veins over the chest or abdomen (indicative of portal hypertension), spider | | Skin||Note any signs of alcohol abuse or liver failure, such as damaged capillaries over the cheeks, dilated veins over the chest or abdomen (indicative of portal hypertension), spider angiomata, and palmar erythema. | ||
|- | |- | ||
| ||Note the presence or absence of jaundice and gynecomastia. | | ||Note the presence or absence of jaundice and gynecomastia. | ||
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Adapted from Ward RP, Kugelmas M, Libsch KD. Management of hepatitis C: evaluating suitability for drug therapy. Am Fam Physician. 2004;69(6):1429-36. | |||
==References== | ==References== | ||
Revision as of 06:41, 28 July 2014
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Hepatitis C |
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Diagnosis |
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Treatment |
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Hepatitis C physical examination On the Web |
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American Roentgen Ray Society Images of Hepatitis C physical examination |
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Risk calculators and risk factors for Hepatitis C physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical Exam
| Physical Exam | Comments |
| Abdomen | Evidence of hepatic inflammation or hepatomegaly, signs of cirrhosis may be present including ascites (shifting dullness), splenomegaly, caput medusae, etc. |
| Cardiovascular system | Assess for underlying cardiovascular disease (CVD) since it may affect the choice of therapy since CVD is a relative contraindication to treatment with the combination of pegylated interferon and ribavirin. |
| Extremities | Peripheral edema can be a sign of portal hypertension. |
| General appearance | Malnutrition can be a sign of advanced liver disease. |
| HEENT | Check for thyroid abnormalities, because treatment can cause or exacerbate autoimmune thyroiditis. |
| Note whether icterus is present. | |
| Mental status | Check for evidence of psychosis or depression, which are important contraindications to treatment. |
| Respiratory system | Perform a general examination to exclude respiratory disease. |
| Skin | Note any signs of alcohol abuse or liver failure, such as damaged capillaries over the cheeks, dilated veins over the chest or abdomen (indicative of portal hypertension), spider angiomata, and palmar erythema. |
| Note the presence or absence of jaundice and gynecomastia. | |
| Look for cutaneous complications of long-term HCV infection, such as palpable purpura (associated with cryoglobulinemia) or blisters and vesicles (porphyria cutanea tarda). | |
| Weight | Weight determines the dosage of pegylated interferon and ribavirin |
Adapted from Ward RP, Kugelmas M, Libsch KD. Management of hepatitis C: evaluating suitability for drug therapy. Am Fam Physician. 2004;69(6):1429-36.