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Discussion Module 6- Pathophysiology

Mike is a 23-year-old white male admitted for severe depression. He has a history of bipolar disorder and is currently taking valproate (Depakote) 500 mg XR daily. His psychiatrist ordered LFT’s to follow the valproate therapy. LFT’s were abnormal: ALT 1178 u/L, AST 746 u/L. the patient was asymptomatic. He denies fever, abdominal pain, nausea, vomiting or jaundice. He denies using other medication or alcohol but admits using illicit IV drugs starting about 8 weeks ago and continuing to present. He never had a blood transfusion.

Meds:  valproate (Depakote), clonazepam 1 mg prn, fluoxetine (Prozac) 40 mg qd.

Lab work: Direct bili 1 mg/dL, alk phos 188 u/L, anti-HCV negative on hospital day 1, positive on day 3. HCV-RNA PCR positive. Hep A, B, and D markers negative.

Diagnosis: Acute Hepatitis C.


Please elaborate on:

1)What is the pathophysiology of Hepatitis C?; 2) What additional diagnoses would you make for Mike?; 3) What impact would the medications have on his liver function?; 4) Who would be involved in Mike’s care and why?