Mr. Collins is a 55-year-old physician\'s assistant with a history of chronic he
ID: 204292 • Letter: M
Question
Mr. Collins is a 55-year-old physician's assistant with a history of chronic hepatitis C. Past history was remarkable for a needle stick injury on the job that occurred two years ago. Following the injury, he initially experienced sporadic episodes of mild flu-like symptoms with fever, chills, and diaphoresis. Over the past six months, his complaints increased to include generalized muscle weakness, fatigue, and weight loss. Mr. Collins is 5'9 tall and weighs 150 pounds with a usual weight of 162. On examination he was noted to have hepatomegaly and be markedly pale with icteric (jaundiced) conjunctiva and skin Mr. Collins complains of a poor appetite. He generally eats two meals a day and prefers meat, potatoes, salted snacks, and an occasional beer. He dislikes sweets, and some vegetables and fruits. He states that he often has nausea and feels bloated after eating, but is unable to pass the gas. He feels most comfortable when his stomach is empty 1. What are the most common etiologies of hepatitis Cvirus (HV)? 2. What are the risks or complications of HCV? 3. Identify the physical symptoms that are consistent with Mr. Collins's diagnosis What adria would y advice would you give Mr. Collins about drinking alcohol? S. What general dietary recommendations should be given to Mr. Collins? Suppose Mr. Collins develops steatorrhea. Recommend daily energy (based on his EER; light activity), protein, and total fat intakes for him 6.Explanation / Answer
Answer 1
Hepatitis C virus (HCV) belongs to the Flavivirus family. It is a single-stranded, enveloped RNA virus with a genome about 10,000 nucleotides in length.The virus is transmitted by percutaneous blood exposure. Unsafe healthcare procedures (including unsafe injection practices) and injection drug use were the leading causes of new infections in 2015. Less frequently it is spread through sexual activity, perinatally, intranasal drug use, or after accidental blood contact (e.g., hemodialysis). Blood and blood products not screened for HCV have also been sources of infection. About 10% of people with HCV infection have no recognized risk factor. The perinatal (vertical) transmission rate is 2.4%, while the horizontal transmission rate is <1%.
Answer 2
Chronic hepatitis C (HCV) involves a range of complications affecting the liver and other organs throughout the body. After exposure to HCV, about 80% of people develop chronic infection and 60% to 70% of these people will develop chronic liver disease. About 20% to 30% of people with chronic HCV will develop cirrhosis over a 20- to 30-year period.Because the liver plays such a pivotal role in the health of the body, when HCV impairs liver function, there can be a range of complications outside of the liver.In one study, 38% of subjects with chronic HCV infection had at least one complication outside the liver. Skin (dermatologic) complications were common, affecting 17% of people and musculoskeletal complications (joint and muscle pain) occurred in 19% of people.
The major extra hepatic complications associated with HCV include:
Hematologic disorders
Autoimmune disorders
Dermatologic disorders
Diabetes mellitus
Eye disease
Kidney disease
Musculoskeletal disorders
Answer 3
Long-term infection with the hepatitis C virus (HCV) is known as chronic hepatitis C. Chronic hepatitis C is usually a silent infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.
-Bleeding easily.
-Bruising easily.
-Fatigue.
-Poor appetite.
-Dark colored urine.
-Itchy skin.
-Weight loss.
-Swelling in your legs.
Answer 4
The combination of excessive alcohol use and infection from HCV can cause significant liver damage. It can lead to permanent scarring of the liver, known as cirrhosis. If you’ve been diagnosed with chronic HCV infection, you should refrain from drinking alcohol.
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