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A 62-year-old man presents for a routine initial visit in New York

62 years old | Male

Vignette:

A 62-year-old man presents for a routine initial visit in New York. He has occasional arthralgia or myalgia, and takes an ACE inhibitor and a thiazide diuretic for hypertension. A retired accountant and nonsmoker, he drinks 1 or 2 beers per week and denies current drug use. Physical examination is normal except for being overweight. Routine blood chemistries are normal, but a screening hepatitis C virus antibody test is positive. At follow-up, the patient is concerned about whether he will develop liver problems. He had heard on television that new oral medications are easier to take than older regimens that used injections and asks about the next diagnostic and treatment steps.

Summary:

arthralgia | myalgia | takes an ACE inhibitor | hypertension | alcohol | overweight

Dx:

Chronic Hepatitis Hepatitis Hepatitis C Acute Hepatitis Autoimmune hepatitis

Ref:

https://online.epocrates.com/diseases/12822/Hepatitis-C/Common-Vignette

Rank

Disease

Weight

1 Hepatocellular carcinoma 311.0
2 Chronic atrial fibrillation 304.0
3 Polyarteritis nodosa 248.0
4 Systemic lupus erythematosus 244.0
5 Chronic Hepatitis 235.0
6 Liver Cirrhosis 229.0
7 Gout 223.0
8 Hereditary hemochromatosis 222.0
9 Hepatic Encephalopathy 221.0
10 Non-ST-elevation myocardial infarction 203.0
11 Stable ischemic heart disease 203.0
12 Colorectal cancer 201.0
13 Pneumonia 199.0
14 Eclampsia 195.0
15 Sarcoidosis 190.0
16 Prinzmetal angina 190.0
17 Osteoarthritis 183.0
18 Henoch-Schonlein purpura 182.0
19 Endometrial cancer 182.0
20 Autoimmune hepatitis 177.0
21 Primary biliary cirrhosis 173.0
22 Primary sclerosing cholangitis 171.0
23 Alzheimer disease 168.0
24 Preeclampsia 168.0
25 Rheumatoid Arthritis 166.0
26 Fibromyalgia 166.0
27 Kidney stones 166.0
28 Non-alcoholic Fatty Liver Disease 164.0
29 Influenza 163.0
30 Thrombotic thrombocytopenic purpura 160.0
31 Biliary cirrhosis 159.0
32 Rocky Mountain spotted fever 158.0
33 Bruxism 156.0
34 Achilles tendinopathy 156.0
35 Achilles tendon rupture 156.0
36 Ischemic optic neuropathy 155.0
37 Acute bacterial meningitis in children 155.0
38 Chronic Kidney Diseases 154.0
39 Brucellosis 153.0
40 Balanitis 151.0
41 Acute Liver Failure 147.0
42 Acute Pancreatitis 145.0
43 Gallstone pancreatitis 145.0
44 Acne fulminans 144.0
45 Tetanus 141.0
46 Chronic Pancreatitis 141.0
47 Non-diabetic hypoglycemia 140.0
48 Erectile dysfunction 136.0
49 Acute viral meningitis 135.0
50 ST-elevation myocardial infarction 134.0
51 Graves Disease 132.0
52 Menopause 132.0
53 Hypertriglyceridemia 132.0
54 Acute Hepatitis 131.0
55 posteriorischemic optic neuropathy 131.0
56 anterior ischemic optic neuropathy 131.0
57 Transient ischemic attack 131.0
58 Cushing syndrome 129.0
59 Abnormal uterine bleeding 129.0
60 pancreatic cancer 128.0
61 Campylobacter infection 125.0
62 Systemic vasculitis 124.0
63 Acute intermittent porphyria 124.0
64 Celiac Disease 122.0
65 Cataract 122.0
66 Adrenal Suppression 121.0
67 Type 2 Diabetes mellitus 120.0
68 Leiomyomas 120.0
69 Anemia of chronic disease 119.0
70 Glomerulonephritis 118.0
71 Secondary hypogonadism 118.0
72 Granulomatosis with polyangiitis 117.0
73 Aortic Dissection 117.0
74 Papilledema 117.0
75 Analgesic nephropathy 116.0
76 Diabetic Kidney Disease 115.0
77 Malaria 114.0
78 Gastritis 113.0
79 Viral pharyngitis 113.0
80 Adrenocortical carcinoma 113.0
81 Obstructive Sleep Apnea 110.0
82 Primary Myelofibrosis 109.0
83 Psoriasis 108.0
84 Migraine headache in adults 108.0
85 Renal Cell Carcinoma 107.0
86 Chronic heart failure 106.0
87 STI HIV Pharyngitis 105.0
88 Lactose intolerance 104.0
89 Hyperparathyroidism 104.0
90 Alcoholic hepatitis 104.0
91 Hypothyroidism 102.0
92 Chronic Myeloid Leukemia 102.0
93 Chronic bacterial prostatitis 101.0
94 Acute Cholecystitis 101.0
95 Liver Abscess 101.0
96 Amebic Liver Abscess 101.0
97 Laryngeal Cancer 101.0
98 Foreign body ingestion 101.0
99 Hiatus hernia 101.0
100 Acute Clonorchiasis 100.0
101 Cellulitis 100.0
102 Gallbladder cancer 100.0
103 Androgenetic alopecia 100.0
104 Insomnia in adults 100.0
105 Carpal Tunnel Syndrome 100.0
106 Alcoholic Fatty Liver 100.0
107 Deep venous thrombosis 100.0
108 Primary hypogonadism 100.0
109 Oropharyngeal cancer 98.0
110 Gingivitis 96.0
111 Systemic sclerosis 95.0
112 Dermatophyte infections 95.0
113 Breast Cancer 95.0
114 COVID19 94.0
115 Multiple Myeloma 94.0
116 Gallstones 94.0
117 Choledocholithiasis 94.0
118 Hyperaldosteronism 94.0
119 Stevens-Johnson syndrome 93.0
120 Anthrax 91.0
121 Salmonella infection 91.0
122 Labyrinthitis 91.0
123 Gastroesophageal reflux disease 91.0
124 Diabetic Ketoacidosis 89.0
125 Osteomalacia 88.0
126 Ischemic stroke 87.0
127 Chronic Milk-alkali syndrome 86.0
128 Acute Lymphoblastic leukemia in children 85.0
129 Acute Myeloid Leukemia in children 83.0
130 Psoriatic arthritis 83.0
131 Emphysematous cholecystitis 83.0
132 Acromegaly 83.0
133 Listerial gastroenteritis 82.0
134 Kawasaki disease 82.0
135 Lung Cancer 82.0
136 Diabetic Neuropathy 82.0
137 Alcoholic Liver Disease 82.0
138 Alcoholic Liver Cirrhosis 82.0
139 Hemorrhagic stroke 81.0
140 Acute Bacterial Prostatitis 81.0
141 Autosomal Recessive Polycystic Kidney Disease 81.0
142 Hereditary Angioedema 80.0
143 Chronic pelvic pain in women 80.0
144 Stroke 80.0
145 Hepatorenal Syndrome 78.0
146 Intra-abdominal abscess 78.0
147 Diabetes Mellitus 78.0
148 Acute respiratory failure 75.0
149 Crohn Disease 74.0
150 Addison Disease 74.0
151 Insect bites and stings 74.0
152 Varicose veins 74.0
153 Animal bites 72.0
154 Achalasia 70.0
155 Ovarian and fallopian tube torsion 69.0
156 End Stage Renal Disease 68.0
157 Candidal intertrigo 68.0
158 Clostridium difficile infection 68.0
159 Rosacea 68.0
160 Ulcerative Colitis 67.0
161 Acute disseminated encephalomyelitis 67.0
162 Shigellosis 66.0
163 Renal Artery Stenosis 65.0
164 Anaphylaxis 65.0
165 Acute Lymphocytic Leukemia in Adults 64.0
166 Aortic coarctation 64.0
167 Diabetic Amyotrophy 64.0
168 Hyperthyroidism 63.0
169 Urinary Tract Obstruction 63.0
170 Osteomyelitis 63.0
171 Hemolytic uremic syndrome 63.0
172 Hyperosmolar Hyperglycemic state 63.0
173 Infectious mononucleosis 62.0
174 Non-small cell lung cancer 62.0
175 Asthma 62.0
176 COPD Exacerbation 62.0
177 Common cold(adults) 61.0
178 Chronic liver disease 61.0
179 Guillain-Barre syndrome 61.0
180 Chronic fatigue syndrome 60.0
181 Hypercalcemia 60.0
182 Gastroparesis 60.0
183 Mallory-Weiss syndrome 60.0
184 Osteoporosis 58.0
185 Mitral Stenosis 57.0
186 Gastroenteritis 57.0
187 Acne conglobata 56.0
188 Gram-negative folliculitis 56.0
189 Excoriated acne 56.0
190 Acute bacterial meningitis in adults 56.0
191 Wilson disease 54.0
192 Typhoid infection 54.0
193 Food poisoning 54.0
194 Acute bacterial meningitis in neonates 54.0
195 Drowning 54.0
196 Hypoparathyroidism 54.0
197 Umbilical hernia 53.0
198 Acute Myeloid Leukemia in adults 52.0
199 Familial Mediterranean fever 52.0
200 Ankylosing spondylitis 52.0
201 Eosinophilic gastroenteritis 52.0
202 mucosal Eosinophilic gastroenteritis 52.0
203 Muscle Layer Eosinophilic gastroenteritis 52.0
204 subserosal eosinophilic gastroenteritis 52.0
205 Acute fatty liver of pregnancy 52.0
206 Mesenteric ischemia 51.0
207 Bell palsy 50.0
208 Cholera 50.0
209 Open Angle Glaucoma 50.0
210 Tuberculous Peritonitis 50.0
211 Pyogenic Liver Abscess 50.0
212 Renal and perinephric abscess 50.0
213 Psoas Abscess 50.0
214 Benign Prostatic Hyperplasia 50.0
215 Peyronie Disease 50.0
216 Priapism 50.0
217 Dry eye 50.0
218 Acute pyelonephritis in adults 50.0
219 Liver disease 50.0
220 Infertility in women 50.0
221 Irritable Bowel Syndrome 49.0
222 Amphetamine use disorder 49.0
223 Secondary hyperparathyroidism 49.0
224 Erythema nodosum 48.0
225 Viral Gastroenteritis 48.0
226 Bacterial gastroenteritis 48.0
227 Autosomal Dominant Polycystic Kidney Disease 47.0
228 Cryptococcosis 47.0
229 Sialadenitis 47.0
230 Parkinson disease 46.0
231 Gestational diabetes mellitus 46.0
232 Autoimmune Pancreatitis 45.0
233 Male factor infertility 45.0
234 Simple kidney cyst 44.0
235 Psychogenic polydipsia 43.0
236 Extrahepatic Cholestasis 42.0
237 Intrahepatic Cholestasis 42.0
238 Pseudohypoparathyroidism 41.0
239 Unstable angina 41.0
240 Central retinal artery occlusion 41.0
241 Acetaminophen overdose 41.0
242 Musculoskeletal lower back pain 41.0
243 Cystic Fibrosis 40.0
244 Bladder Cancer 40.0
245 Graves ophthalmopathy 40.0
246 Anaplastic thyroid cancer 36.0
247 Churg-Strauss Syndrome 36.0
248 Klebsiella pneumoniae liver abscess 36.0
249 Acne vulgaris 36.0
250 Heparin-induced thrombocytopenia 36.0
251 Milk-alkali syndrome 36.0
252 Acute Milk-alkali syndrome 36.0
253 Chronic pyelonephritis 36.0
254 Prolactinoma 35.0
255 Stable angina 34.0
256 Amyloidosis 34.0
257 Candidiasis 34.0
258 Candida Balanitis 34.0
259 Oropharyngeal and esophageal candidiasis 34.0
260 Vulvovaginal candidiasis 34.0
261 Oral candidiasis 34.0
262 Rotator Cuff Tears 34.0
263 Multiple endocrine neoplasia 2A 33.0
264 Pharyngitis 33.0
265 Bacterial pharyngitis 33.0
266 Herpes pharyngitis 33.0
267 Middle East respiratory syndrome 32.0
268 Spontaneous bacterial peritonitis 32.0
269 Type 1 Diabetes mellitus 32.0
270 Hyperprolactinemia 32.0
271 Subdural hematoma 32.0
272 Discogenic low back pain 30.0
273 Painless thyroiditis 30.0
274 Tinea versicolor 30.0
275 Atypical pneumonia 30.0
276 Ruptured Tuboovarian abscess 29.0
277 Non-cholera Vibrio infections 27.0
278 Ichthyosis 27.0
279 Peritoneal dialysis associated peritonitis 26.0
280 Goiter 26.0
281 Diffuse nontoxic goiter 26.0
282 Toxic multinodular goiter 26.0
283 Cervical goiter 26.0
284 Acute heart failure 26.0
285 Giardiasis 25.0
286 Testicular cancer 25.0
287 Limited cutaneous systemic sclerosis 24.0
288 Obstructive cervical goiters 23.0
289 Aseptic meningitis 23.0
290 Fungal meningitis 23.0
291 Inflammatory Bowel Diseases 22.0
292 Acute pericarditis 22.0
293 Acute Bronchitis 21.0
294 Recurrent aphthous stomatitis 20.0
295 Intestinal Pseudo Obstruction 20.0
296 Sunburn 20.0
297 Epilepsy 20.0
298 Central diabetes insipidus 20.0
299 Penis Carcinoma 19.0
300 Pancreatic Pseudocyst 19.0
301 Adrenal crisis 18.0
302 Uveitis 18.0
303 Anterior uveitis 18.0
304 Intermediate uveitis 18.0
305 Posterior uveitis 18.0
306 Pan uveitis 18.0
307 Medullary thyroid cancer 18.0
308 Multiple endocrine neoplasia 2B 18.0
309 Acute cervical spine trauma 18.0
310 Short bowel syndrome 18.0
311 Bullous pemphigoid 17.0
312 Toxic thyroid adenoma 17.0
313 Common cutaneous drug reactions 16.0
314 Ascites 16.0
315 Intussusception 16.0
316 Hypogammaglobulinemia 15.0
317 Aortic stenosis 15.0
318 Central hypothyroidism 15.0
319 Pressure ulcer 15.0
320 Premenstrual syndrome 15.0
321 Premature labor 15.0
322 Sexual abuse and assault 15.0
323 Barrett esophagus 15.0
324 Fibrocystic breasts 15.0
325 Prostate cancer 14.0
326 Musculoskeletal sprains and strains 14.0
327 Phenylketonuria 14.0
328 Dyspepsia 13.0
329 Annular pancreas 12.0
330 Pheochromocytoma 12.0
331 Familial adenomatous polyposis syndrome 12.0
332 Acute epididymitis 11.0
333 Foodborne E coli infection 10.0
334 Acute otitis media 10.0
335 Multiple Sclerosis 10.0
336 Substernal goiter 8.0
337 Bed bugs 7.0
338 Herpes zoster 7.0
339 Alopecia areata 6.0
340 Thyroid lymphoma 6.0
341 Peutz-Jeghers Syndrome 6.0
342 Pulmonary Embolism 5.0
343 Paraneoplastic Syndromes 4.0
344 Peptic Ulcer 4.0
345 Duodenal Ulcer 4.0
346 Gastric Ulcer 4.0
347 Malt lymphoma 4.0
348 Chronic Lymphocytic Leukemia 3.0
349 Pityriasis rosea 3.0
350 Budd Chiari Syndrome 2.0
351 Chronic Renal vein thrombosis 2.0
352 Acute peptic ulcer 2.0
353 Gastric cancer 2.0
354 Chronic Clonorchiasis 2.0
355 Optic neuritis 1.0
356 Neuropapillitis 1.0
357 Acute atrial fibrillation 1.0
358 Chlamydia pneumoniae infection 1.0
359 Disseminated intravascular coagulation 1.0
360 Immune thrombocytopenia 0.0
361 Acute Cystitis(Men) 0.0
362 Hemorrhoids 0.0
363 Allergic rhinitis 0.0
364 Panic disorder in adults 0.0