Hepatitis C. Henderson: A Case Study

In general he is a not acutely ill appearing male. His neck veins were elevated to the angle of the jaw. He had no thyromegaly or lymphadenopathy. His lungs were clear to auscultation. His heart was regular rate and rhythm with an S3 and an S4. His PMI was laterally displaced by 1 cm. His abdomen was (full), slightly distended and had a positive fluid wave. He had no pitting edema in the abdominal exterior wall. His rectal exam was heme-negative. His extremities showed 4+ pitting edema up to his knees and in his feet

There are a number of individuals who may be suffering from an illness and not even be aware they have an illness. One example of such illness is Hepatitis C (HCV). Hepatitis C is a severe disease of the liver. It is caused by the Hepatitis C virus (Centers for Disease Control and Prevention (CDC), 2015). As a result, Hepatitis C has been termed a silent epidemic (CDC, 2015). This is because a lot of individuals have Hepatitis C and don’t even realize they have the infection (CDC, 2015). As the infection begins to progress over time, it could cause acute issues to the liver (CDC, 2015). Those issues could be things like damage to the liver, the liver could fail to function, cirrhosis, or even cancer of the liver (CDC, 2015). However, screening for Hepatitis C will allow an individual to benefit from treatments that are available, hence eliminating the disease from the body and preventing the liver from undergoing any further damage (CDC, 2015).

E.P. is an 88-year-old Caucasian male. He was admitted on 02/18/13. His code status is full code, and he declines to bring in his advanced directive. He reports that he is 68.5” tall, and his actual weight is 165 pounds. He and his wife are the sources of information, and they are reliable. His blood pressure is 124/62, taken on his right arm in a lying position, his oral temperature is 99.8, his right radial pulse is 74 beats per minute, his respiration rate is 16 breaths per minute and his pulse oximetry reading is 92 on room air. He is allergic to latex, cephalexin and sulfa drugs, with a reaction of hives, and to IV dye, with a reaction of moderate rash. He was

Hepatitis C typically has a slower and more insidious onset. The preicteric phase, the first of three phases, precedes jaundice that last from 1 - 21 days. When symptom do occur they can be so vague that people often don't realize what is truly going on. People actually may mistake these symptoms as a mild case of the influenza virus as the symptoms of this phase often mimic the symptoms of the flu. The interic phase is characterized by the onset of jaundice that last 2 - 4 weeks. Urine often becomes dark and stool may be a abnormally light color, this is cause by the absence of bile in the stool. Bile pigment deposits in the skin can cause pruritus to occur. The liver often becomes enlarged and tender. During the third phase, the posticteric

After that the patient remain hemodynamically stable , hemoglobin minimally dropped to 12.2 during the course of her admission , and later she underwent resection of the tumor and the sixth segment of the liver , during surgery there was no evidence of spread of the tumor outside the liver .

Her sodium is 136, potassium is 3.6, BUN 21, creatinine 0.7, cardiac enzymes as mentioned were negative x3. Hemoglobin is 10.7, hematocrit is 31.0, platelet count is 343. INR 0.98.

Hepatitis C virus (HCV) is a small (~55 to 65 nm), spherical enveloped virus that can cause major illness. Hepatitis C was discovered after the intense investigations between 1982 and 1988 in Chiron corporation. Michael Houghton discovered the non-A and non-B hepatitis by using the molecular approach. Hepatitis C affects liver caused by the hepatitis virus; the virus can cause acute and chronic hepatitis infection ranging from a mild illness to severity, lifelong illness. Mostly patients are affected with acute infection; however, chronic hepatitis is caused by liver cirrhosis a severe scarring which can lead to liver failure. HCV affects more than 185 million people worldwide. The rate of chronic hepatitis is affected by race, gender, and viral immune response. Depending on the certain region, hepatitis C infections can be concentrated in certain populations or in general populations. The HCV have high genetic diversity which is characterized by regional variation which makes treating the infection more challenging. Hepatitis patients are often prescribed ribavirin and interferon; but current research is developing new therapeutic drugs which will be less toxic and can be targeted to each genotype. This review will provide the historical, and scientific aspects of hepatitis C virus.

Weight 291, pulse 82, respirations 18, temp 98.1, blood pressure 162/96, O2 sat 96% on room air. Alert male, in no acute distress. Pleasant and cooperative. Skin is warm, pink, and dry. Speech is clear. Answers questions

Hepatitis C is a significant public health problem in Australia with approximately 10000 new infections occurring annually1. In 25% of patients, acute Hepatitis C infection is followed by viral clearance, defined as undetectable levels of HCV RNA in the blood, with the remaining 75% progressing to chronic infection. Without intervention, those with chronic infection are at increased risk of hepatic fibrosis and progression to hepatic cirrhosis. There appears to be a significant variation in the reported rates of progression of chronic hepatitis C infection to cirrhosis, ranging from 4% to 20% in 20 years, depending on the sample population and method of acquisition of the virus2. The risk of development of hepatocellular cancer is about 2 – 4% per annum3. Current use of alcohol7, type 2 diabetes and those with the metabolic syndrome are more likely to progress to cirrhosis when infection with hepatitis C is present.

One’s doctor will then conduct a physical examination to look for an enlarged and tender liver or spleen, fluid in abdomen, yellowing of skin, increased body temperature, and swollen glands in one’s neck and underarms. Generally, people infected with hepatitis C do not have symptoms, but if they do, it includes pain or bloating in the belly area, fatigue, fever, itching, joint pain, sore muscles, dark urine and pale/clay-coloured stools, jaundice, loss of appetite, nausea and vomiting, and weight loss.

One case (50%) of the 2 cases is oncological patient had hepatocellular carcinoma (HCC) (Fig.75).

Hepatitis C has developed into a significant public health issue that poses challenges because of the nature of its gestation period. The disease is asymptomatic so persons that have the disease might appear healthy for years unaware that they have the infection. The difference in genotypes in relation to diagnosis also presents another challenge to doctors. However, with improved techniques of disease diagnosis, it will be easier to detect the disease in its early stages of development which will prevent severe damage to the liver that only occurs when the disease has advanced to worse states. Liver cirrhosis and hepatomas are common problems that occur in patients when the diagnosis is confirmed at late stages.

The majority of people with an acute Hepatitis C infection often do not know they have the virus and therefore do not get treated. However, if a person realizes that they may have been exposed to the virus – like a healthcare worker who gets a needle stick injury – an acute Hepatitis C infection can be identified early and medication can be administered. Chronic Hepatitis C is defined by the presence of the virus for 6 months or longer. Many people already have chronic Hepatitis C when they’re first diagnosed because they were unknowingly infected with the virus many years ago. Long term infection by the hepatitis C virus can result in liver scarring known as cirrhosis. This scarring can be treated with antiviral medications. People with little to mild scarring, otherwise known as early stage fibrosis, should still consider Hepatitis C treatment to avoid the long-term complications of the disease, even though they may not be at risk for many

The main reason hepatocellular carcinoma is considered is due to the occurrence of multiple symptoms in HCC patients is common, and may include pain, fatigue, weight loss, and obstructive syndromes such as ascites and jaundice which was evident in the patient (Sun & Sarna, 2008). Hepatocellular carcinoma is the most common type of primary liver cancer, and incidence of HCC is highest in Africa and Asia, where viral hepatitis is endemic. HCC is often diagnosed at advanced stages and prognosis is generally poor when the tumor is unresectable. This extremely guarded prognosis is frequently coupled with severe symptom occurrence including pain, fatigue, anorexia, and ascites (Zhu, 2003).

Blood pressure is 116/80, pulse 67, respirations 16, weight 237. Cardiovascular S1, S2. Regular rate and rhythm without murmur. Lungs are clear to auscultation. There is no