Health Dictionary
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Hepatitis C physical examination
Introduction
Overview
Overview
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 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. However, patients with significant liver fibrosis have normal findings on physical examination.
| 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. Cryoglobulinemic vasculitis. |
| General appearance | Malnutrition can be a sign of advanced liver disease. Temporal wasting, spider nevi, scleral icterus, and terry nails. |
| 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
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.
- ↑ Kaplan, David E. (2020). “Hepatitis C Virus”. Annals of Internal Medicine. 173 (5): ITC33–ITC48. doi:10.7326/AITC202009010. ISSN 0003-4819.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-In-Chief: Javaria Anwer M.D.[2]