KNOWLEDGE - Students should know:

  1. The approach to the patient with clinical jaundice.
  2. The five serologic types of hepatitis (A, B, C, D, and E), their primary mode of transmission, B, C, and D (and rarely E) can culminate in chronic hepatitis.
  3. Active and passive immunization is available for hepatitis A and B only.
  4. The common complications of cirrhosis and treatment of these.


SKILLS - Students should be able to:

  1. Obtain and record an accurate history in the patient with suspected liver disease.
  2. Perform an accurate physical examination in the patient with suspected liver disease; palpate for hepatosplenomegaly and appreciate the extrahepatic findings in chronic liver disease such as spider angiomata, gynecomastia, ascites, testicular atrophy, etc.
  3. Generate a differential diagnosis in the jaundiced patient.
  4. Develop a treatment plan for patients with chronic liver disease.






  1. Yamada, Tadataka.   Handbook of Gastroenterology . 2000, Chap 16 (The Medicine Education Office, 7604, has a copy of this reference.)
  2. Screening for Hepatitis C Virus Infe c tion : Re c ommendations from the U.S. Preventive Servi c es Task For c e   Ann Intern Med , Mar 2004; 140: I-62.
  3. Steven K. Herrine   Approa c h to the Patient with C hroni c Hepatitis C Virus Infe c tion
    Ann Intern Med , May 2002; 136: 747 - 757.