Hepatitis C

Question 1

What is the typical history associated with hepatitis C?

Answer 1

Often asymptomatic initially. Fatigue, anorexia, nausea. Right upper quadrant pain. History of IV drug use, unprotected sex, or blood transfusions before 1992.

Question 2

What are the key physical examination findings in hepatitis C?

Answer 2

Often normal in early stages. Jaundice and hepatomegaly in advanced disease. Signs of chronic liver disease: ascites, spider angiomas, palmar erythema.

Question 3

What investigations are necessary for diagnosing hepatitis C?

Answer 3

Elevated liver enzymes (ALT, AST). Positive anti-HCV antibodies. HCV RNA PCR for viral load. Genotype testing for treatment planning.

Question 4

What are the non-pharmacological management strategies for hepatitis C?

Answer 4

Avoid alcohol and hepatotoxic drugs. Maintain a healthy diet and weight. Educate on avoiding sharing needles and safe sex practices.

Question 5

What are the pharmacological management options for hepatitis C?

Answer 5

Direct-acting antivirals (DAAs) for chronic hepatitis C (e.g., sofosbuvir, ledipasvir). Treatment based on genotype and stage of liver disease.

Question 6

What are the red flags to look for in hepatitis C patients?

Answer 6

Severe abdominal pain, persistent vomiting. Signs of acute liver failure: confusion, severe jaundice, bleeding tendencies. Signs of chronic liver disease: ascites, variceal bleeding.

Question 7

When should a patient with hepatitis C be referred to a specialist?

Answer 7

Chronic hepatitis C with elevated liver enzymes or viral load. Signs of cirrhosis or liver failure. Coinfection with hepatitis B or HIV. Prior unsuccessful treatment attempts.

Question 8

What is one key piece of pathophysiology related to hepatitis C?

Answer 8

Caused by hepatitis C virus (HCV), an RNA virus. Transmitted via blood, sexual contact. Virus infects hepatocytes, leading to liver inflammation, fibrosis, and potential cirrhosis or hepatocellular carcinoma.