Hepatitis C physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with hepatitis C typically have a | Patients with hepatitis C typically have a normal[[physical exam]]. In patients with advanced disease, physical exam signs of liver [[cirrhosis]] may be apparent. | ||
==Physical Exam== | ==Physical Exam== | ||
Patients with acute and chronic hepatitis C usually have a | Patients with acute and chronic hepatitis C usually have a normal physical exam. Patients with more advanced disease manifest findings observed in patients with liver [[cirrhosis]]. A complete [[physical exam]] is important to assess patients with hepatitis C to guide the optimal choice of therapy. | ||
<center>'''Findings in patients with chronic HCV'''<ref name="pmid15053407">{{cite journal| author=Ward RP, Kugelmas M, Libsch KD| title=Management of hepatitis C: evaluating suitability for drug therapy. | journal=Am Fam Physician | year= 2004 | volume= 69 | issue= 6 | pages= 1429-36 | pmid=15053407 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15053407 }} </ref></center> | <center>'''Findings in patients with chronic HCV'''<ref name="pmid15053407">{{cite journal| author=Ward RP, Kugelmas M, Libsch KD| title=Management of hepatitis C: evaluating suitability for drug therapy. | journal=Am Fam Physician | year= 2004 | volume= 69 | issue= 6 | pages= 1429-36 | pmid=15053407 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15053407 }} </ref></center> | ||
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| align="center" style="background:#f0f0f0;"|'''Comments''' | | align="center" style="background:#f0f0f0;"|'''Comments''' | ||
|- | |- | ||
| Abdomen||Evidence of hepatic inflammation or hepatomegaly, signs of cirrhosis may be present including ascites (shifting dullness), splenomegaly, caput medusae | | Abdomen||Evidence of hepatic inflammation or hepatomegaly, signs of cirrhosis may be present including ascites (shifting dullness), splenomegaly, and caput medusae | ||
|- | |- | ||
| Cardiovascular system|| | | Cardiovascular system||Underlying [[cardiovascular disease]] may affect the choice of therapy. 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 pitting edema]] can be a sign of [[portal hypertension]]. | ||
|- | |- | ||
| General appearance||Malnutrition can be a sign of advanced liver disease. | | General appearance||[[Malnutrition]] can be a sign of advanced liver disease. | ||
|- | |- | ||
| HEENT|| | | HEENT||[[Thyroid]] abnormalities; treatment can cause or exacerbate [[autoimmune thyroiditis]]. | ||
|- | |- | ||
| || | | ||[[Icterus]] | ||
|- | |- | ||
| Mental status|| | | Mental status||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|| | | Skin||Signs of [[alcohol abuse]] or liver failure, such as [[spider angioma]], dilated veins over the chest or abdomen (indicative of [[portal hypertension]]), and [[palmar erythema]]. | ||
|- | |- | ||
| || | | ||[[Jaundice]] and [[gynecomastia]]. | ||
|- | |- | ||
| || | | ||Cutaneous complications of long-term HCV infection, such as palpable purpura (associated with [[cryoglobulinemia]]) or [[blisters]] and [[vesicles]], associated with [[porphyria cutanea tarda]] | ||
|- | |- | ||
| Weight||Weight determines the dosage of pegylated interferon and [[ribavirin]] | | Weight||Weight determines the dosage of pegylated interferon and [[ribavirin]] | ||
Revision as of 15:17, 29 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
Patients with hepatitis C typically have a normalphysical exam. In patients with advanced disease, physical exam signs of liver cirrhosis may be apparent.
Physical Exam
Patients with acute and chronic hepatitis C usually have a normal physical exam. Patients with more advanced disease manifest findings observed in patients with liver cirrhosis. A complete physical exam is important to assess patients with hepatitis C to guide the optimal choice of therapy.
| Physical Exam | Comments |
| Abdomen | Evidence of hepatic inflammation or hepatomegaly, signs of cirrhosis may be present including ascites (shifting dullness), splenomegaly, and caput medusae |
| Cardiovascular system | Underlying cardiovascular disease may affect the choice of therapy. CVD is a relative contraindication to treatment with the combination of pegylated interferon and ribavirin. |
| Extremities | Peripheral pitting edema can be a sign of portal hypertension. |
| General appearance | Malnutrition can be a sign of advanced liver disease. |
| HEENT | Thyroid abnormalities; treatment can cause or exacerbate autoimmune thyroiditis. |
| Icterus | |
| Mental status | Evidence of psychosis or depression, which are important contraindications to treatment. |
| Respiratory system | Perform a general examination to exclude respiratory disease. |
| Skin | Signs of alcohol abuse or liver failure, such as spider angioma, dilated veins over the chest or abdomen (indicative of portal hypertension), and palmar erythema. |
| Jaundice and gynecomastia. | |
| Cutaneous complications of long-term HCV infection, such as palpable purpura (associated with cryoglobulinemia) or blisters and vesicles, associated with 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.
References
- ↑ Ward RP, Kugelmas M, Libsch KD (2004). "Management of hepatitis C: evaluating suitability for drug therapy". Am Fam Physician. 69 (6): 1429–36. PMID 15053407.