Question

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 5'9" 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 (jaundiced) 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 1. What are the risks or complications of HCV? 2. What advice would you give Mr. Collins about drinking alcohol? What dietary recommendations should be given to Mr. Collins, consider general needs of protein and fat? 3. Suppose Mr. Collins condition worsens and develops steatorrhea. Based on his EER with light activity recommend daily intakes of: (show calculations, get totals for this specific patient) 4. energx (kcals/day) b. protein (g/kg) c, total fat (% of kcals from fat) a.

Answer 1

1.      What are the most common etiologies of hepatitis C virus

Solution:-

Hepatitis C virus (HCV) has a place with the Flavivirus family. It is a solitary stranded, wrapped     RNA infection with a genome around 10,000 nucleotides in length. The infection is transmitted by percutaneous blood presentation. Hazardous medicinal services systems (counting dangerous infusion practices) and infusion sedate utilize were the main sources of new diseases in 2015.

Less frequently it is spread through sexual activity, prenatally, intranasal drug use, or after accidental blood contact (e.g., hem dialysis). Blood and blood products not screened for HCV have also been sources of infection. About 10% of people with HCV infection have no recognized risk factor. The prenatal (vertical) transmission rate is 2.4%, while the horizontal transmission rate is <1%.

2. What are the risks or complications of HCV

Solution:- Chronic hepatitis C (HCV) involves a range of complications affecting the liver and other organs throughout the body. After exposure to HCV, about 80% of people develop chronic infection and 60% to 70% of these people will develop chronic liver disease. About 20% to 30% of people with chronic HCV will develop cirrhosis over a 20- to 30-year period

Since the liver assumes such a vital job in the wellbeing of the body, when HCV debilitates liver capacity, there can be a scope of intricacies outside of the liver. In one investigation, 38% of subjects with endless HCV contamination had somewhere around one complexity outside the liver. Skin (dermatologic) complexities were normal, influencing 17% of individuals and musculoskeletal entanglements (joint and muscle torment) happened in 19% of individuals.

The major extra hepatic complications associated with HCV include:

Hematologic disorders

Immune system issue

Dermatologic disarranges

Diabetes mellitus

Eye illness

Kidney illness

Musculoskeletal scatters

2. Identify the physical symptoms that are consists with MR. Collins’s diagnosis

Long haul contamination with the hepatitis C infection (HCV) is known as incessant hepatitis C. Interminable hepatitis C is typically a quiet contamination for a long time, until the point when the infection harms the liver enough to cause the signs and side effects of liver malady.

- Bleeding effectively.

-Bruising easily.

-Fatigue.

-Poor appetite.

- Dark hued pee.

- Itchy skin.

- Weight misfortune.

- Swelling in your legs.

4. What advice would you give Mr. Collins’s Diagnosis?

Solution;- The combination of excessive alcohol use and infection from HCV can cause significant liver damage. It can lead to permanent scarring of the liver, known as cirrhosis. If you have been diagnosed with chronic HCV infection, you must refrain from drinking alcohol.