Hepatitis C Case Study
Author/s[edit | edit source]
Sean Fizer, Patrick Fleming, Grant Idlewine, Kyle Kelley from the Bellarmine University Physical Therapy Program's Pathophysiology of Complex Patient Problems Project.
Abstract[edit | edit source]
100 word limit, non-structured description
Patient Characteristics[edit | edit source]
- Demographic Information: 52 year old female Medical Laboratory Scientist (occupation/vocation, gender, age, etc.)
- Medical diagnosis: Hepatitis C (diagnosed 6 years ago)
- Co-morbidities: Diabetes, Hypertension, Alcoholism
- Previous care or treatment
- Medication: Ribavirin BID
Examination[edit | edit source]
- Subjective :Upon examination the patient reported constant fatigue and muscle aches throughout the day, accompanied by mild pain in her right upper quadrant. She also reports intermittent nausea1,2. Her medical history shows that she has been diagnosed with Hepatitis C, Type II DM1, hypertension (HTN), and alcoholism1. A Fibro Test/Acti Test (FT-AT) was performed four years ago to determine the stage of liver fibrosis2,5, which concluded a Metavir fibrosis score of 2, meaning scarring has occurred and extends outside the areas in the liver that contain blood vessels6. The patient’s current treatment for the Hepatitis C and associated comorbidities consists of vitamin D supplements beginning 2 years after the diagnosis of Hepatisis C, Ribavirin2, Sofosbuvir3 and insulin. She began treatment with pegylated interferon treatment two years the Hepatitis C diagnosis, which was a 48 week treatment, but it was replaced with Sofosbuvir beginning in January of 20143.
The patient reported goals for her treatment are to achieve sustained viral responses (SVR) near 80%2, weight loss to improve her quality of life, improve fitness and decrease fatigue, and decrease the risk of osteoporis4. - Self Report Outcome Measures: http://www.ncbi.nlm.nih.gov/pubmed/22871087
- Physical Performance Measures (CV fitness?)
- Objective : Physical Examination Tests and Measures
Clinical Impression
[edit | edit source]
Summarization of Examination Findings[edit | edit source]
Working Diagnosis and Targeted Interventions
Intervention
[edit | edit source]
- http://cid.oxfordjournals.org/content/50/11/1505.long
This site looks like it may have a lot of the info we need; not just intervention. Boom! Already better than Pat's work. - Phases of Interventions (e.g. protective phase, mobility phase, etc.)
- Dosage and Parameters
- Rationale for Progression
- Co-interventions if applicable (e.g. injection therapy, medications)
Outcomes[edit | edit source]
Findings Over time
Discussion[edit | edit source]
Summary Statement which should include related findings in the literature, potential impact on clinical practices
Related Pages[edit | edit source]
Hepatitis A, B, C General Information
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
Center for Disease Control and Prevention. Hepatitis C Information for the public. http://www.cdc.gov/hepatitis/c/cfaq.htm (accessed 18 March 2015).
1. Poll R. Screening for and diagnosing hepatitis C. Practice Nursing [serial online]. 2015; 26(1):22-26. Available from: CINAHL with Full Text, Ipswich, MA. Accessed March 18, 2015.
2. Malnick S, Maor Y, Melzer E, Tal S. Chronic Hepatitis C in the Aged: Much Ado About Nothing or Nothing to Do?. Drugs & Aging [serial online]. May 2014; 31(5):339-347. Available from: CINAHL with Full Text, Ipswich, MA. Accessed March 18, 2015.
3. Sturm D, Gurevitz S, Davidson C, Fritchley A, Wagaman A. Chronic Hepatitis C Infection. Clinician Reviews [serial online]. November 2014; 24(11):24-32. Available from: Academic Search Complete, Ipswich, MA. Accessed March 18, 2015.
4. McKenna O, Blake C. Management of hepatitis C: the potential benefits of exercise. Physical Therapy Reviews [serial online]. December 2007;12(4):271-276. Available from: Academic Search Complete, Ipswich, MA. Accessed March 21, 2015.
5. Poynard T, Imbert-Bismut F, Benhamou Y, et al. Biomarkers as non-invasive assessment of hepatic fibrosis in chronic hepatitis C. Journal Of Gastroenterology & Hepatology [serial online]. December 3, 2004;19:S236-S245. Available from: Academic Search Complete, Ipswich, MA. Accessed March 22, 2015.
6. HCV Diagnostic Tools: Grading & Staging a Liver Biopsy. HCV Advocate website. http://www.hcvadvocate.org/hepatitis/factsheets_pdf/grade_stage.pdf. Published October 2007. Accessed March 22, 2015.
