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
"I was referred to you to get started on triple therapy for my hepatitis C."
History of Present Illness
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.
Mother had HTN and type 2 diabetes, died at age 72
Father had a 35 pack-year history of smoking and died of lung cancer at the age of 63
She has one sister and does not know her medical history
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.
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.
Allergies/Intolerances/Adverse Drug Events
Seasonal allergies to pollen
Acetaminophen 500 mg, 2 tablets 3 times a day PRN body aches
Metformin 1,000 mg, 2 tablets twice daily
Calcium 500 mg with vitamin D 200 international units, take 1 tablet 3 times daily
Glimepiride 2 mg tablet, take 1 tablet once daily
Multivitamin one tablet PO daily
Complains of fatigue frequently.
The patient is not in acute distress. She is an obese Caucasian female.
BP 132/92 mm Hg, P 84, RR 20, T 37.1°C