Question

Case Study - Hepatitis C Virus (HCV) 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 59" 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 (aundiced) 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. Points as listed be detailed and specific in your answers. 3. What dietary recommendations should be given to Mr. Collins, consider general needs of protein and fat? Also, consider interventions that will help him meet his needs. - 6 points 4. Suppose Mr. Collins condition worsens and develops steatorrhea. Based on the Nutrition Therapy recommendations in the text what are his kcal, protein and fat needs? (show all calculations, get totals for this specific patient)- 6 points a. energy (kcals/day) b. protein (g/kg) c. total fat (% of kcals from fat)

Answer 1

Dietary recommendation to mr collin are:

• include variety of vegetable and fruits to provide vitamins and minerals necessary for liver functioning. Moderate amount of Leafy green vegetables i.e. spinach, kale can lessen fatty acid composition in liver , not in excess as as they are the source of iron that is harmful for liver
• Complex carbohydrates like Whole grains such as oats, brown rice, barley etc.should be taken.
• Getting adequate amount of protein is important as it provide energy and keep a person feeling full. lean protein such as fish, skinless chicken,egg whites , turkey , tofu and beans
• low fat and non fat dietary products like
• healthy fats like those in nuts, avocadoes and olive oil
• certain foods like sugar, salt, saturated fats and foods rich in iron should be avoided.
• 
  
  4.a 2500 kcal energy
  b. protein 0.8 g/ kg
  c.total fats 20 gm/ day and 30% of calories from fat
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