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,   that only B, C, and D 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.