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INTRODUCTION

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CASE LEARNING OBJECTIVES

  • List modes of transmission and risk factors for hepatitis C

  • Identify the signs and symptoms of hepatitis C

  • Create treatment goals for treatment of hepatitis C

  • Develop a nonpharmacological and pharmacological treatment and monitoring plan for hepatitis C

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PATIENT PRESENTATION

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Chief Complaint

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"I was referred to you to get started on triple therapy for my hepatitis C."

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History of Present Illness

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Victoria Smith is a 42-year-old Caucasian female with no complaints. She is feeling well and is at the clinic because the liver doctor wants her to be worked up for hepatitis C treatment. She has not been treated in the past for the hepatitis C infection. She states that she contracted the hepatitis C infection when she used heroin in the 1980s.

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Past Medical History

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Diabetes 2011

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Hypertension 2010

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Hyperlipidemia 2009

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Anxiety

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Depression

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Surgical History

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None

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Family History

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Mother had HTN and type 2 diabetes, died at age 72

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Father had a 35 pack-year history of smoking and died of lung cancer at the age of 63

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She has one sister and does not know her medical history

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Social History

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She was married but now divorced for 12 years. She has two sons who live in the same city as her. She currently works at a law firm.

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Tobacco/Alcohol/Substance Use

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She used intravenous drugs including heroin and cocaine starting in her teens and quit in 2001. She was a social drinker and quit in 1993. She does not smoke tobacco.

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Allergies/Intolerances/Adverse Drug Events

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Sulfa: hives

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Seasonal allergies to pollen

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Medications (Current)

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Amlodipine 10 mg daily

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Acetaminophen 500 mg, 2 tablets 3 times a day PRN body aches

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Lovastatin 20 mg daily

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Metformin 1,000 mg, 2 tablets twice daily

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Calcium 500 mg with vitamin D 200 international units, take 1 tablet 3 times daily

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Glimepiride 2 mg tablet, take 1 tablet once daily

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Multivitamin one tablet PO daily

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Review of Systems

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Complains of fatigue frequently.

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Physical Examination

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General
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The patient is not in acute distress. She is an obese Caucasian female.

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Vital Signs
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BP 132/92 mm Hg, P 84, RR 20, T 37.1°C

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Weight 254 lb (115.5 kg)

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Height 69 ...

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