Achieving the exact intended goal is not an easy thing and it
requires a skill called “Accuracy”, which enables individuals to accomplish
their missions in a perfect and effective way. In the field of medicine, this
is what a physician does all the time while treating his patients by pinpointing
the correct diagnosis depending on an ambiguous information and a medical
history. Even though there is an inaccurate medical history, the physician
should build up a connection with his patients to take out the accurate
information for diagnosing and curing the patients. As a future doctor, I would
say that success is all about the way of getting the accurate information,
which prevent any medical error that can be fatal.
v Background and history:
After meeting the
patient, he gave me the consent then I started interviewing him by asking him questions relevant to his
medical history. The patient was so cooperative by giving full answers
and even adding more information, such as mentioning the blood type. The
patient will be named YYY for the sake of confidentiality. YYY is a male from
Saudi Arabia, married, ages 53-year-old, used to work as a chemical engineer in
an industry in Al-jubail industrial
city, but currently lives in Dammam city.
The reason that made YYY show up to King Fahad University Hospital is a slight pain in
his stomach and noticing that his urine is darker than usual, as well as the
changing of his skin color. Before he presents to the hospital, he expected these
symptoms to be normal or caused by contaminated food and dehydration. As long
as YYY was able to live his life normally, he evaluated the pain 3 out of 10
which means there is a mild pain (considering 10 is severe pain and 0 means no pain at all). The
pain increases by exercising or making a lot of movements and decreases by
sleeping or having rests.
The physician has done 2
blood tests, anti-HCV antibodies
testing and HCV RNA testing, for detection of Hepatitis C Virus (HCV)
and unfortunately both were
positive, so he was diagnosed to be infected with hepatitis C in a late
v Past history:
YYY had the cleft
lip and palate defect, so he had undergone a cleft lip surgery, the surgeon
trimmed the tissues and sutured the lip together. After that, he had to make a
speech improvement since he was young. At the age of 10, he has done alveolar
bone graft, which is adding
bone to the gum ridge. After he completed 27-year-old, he decided to do
a double jaw surgery to match the jaws because there was a 1.2cm distance
between his maxilla and mandible.
YYY is married and
has 3 lovely daughters and one son. YYY has one parent alive, his father
unfortunately died by a car accident in 1994, but the mother is alive, she is 74-year-old.
YYY’s mother is diabetic and she is a carrier of sickle cell anemia. He has 5
brothers and 8 sisters, all of them are healthy but some are carriers of sickle
cell anemia, none are affected.
YYY and his family live
in a satisfying place in a supportive environment and having a stable life
until two of his daughter got married, they no longer live with them. They do
not exercise at summer, but they walk around the house during winter since the
weather is cold. In addition, they do not have a strict healthy diet but their
diet is considered healthy since they always eat from home and rarely junk food
Drug and allergy history:
YYY does not have
any allergies against any kind of food, animals, or drugs. He also never drinks
alcohol, but he is a heavy smoker, smokes one packet a day of Davidoff brand.
The doctor prescribed for him a
combination of ribavirin and pegylated interferon. This dual therapy has side
effects including nausea, muscle aches and hair loss. The physician ordered YYY to use his drugs regularly and
not be afraid after noticing these symptoms.
v Biological aspects:
“Hepatitis C is a liver disease caused
by the hepatitis C virus: the virus can cause both acute and chronic hepatitis,
ranging in severity from a mild illness lasting a few weeks to a serious,
lifelong illness” (World Health Organization,
2018). Hepatitis C is serious because it is
rarely eliminated from the body but not because it attacks the liver acutely.
When it persists, it leads to cirrhosis or other liver diseases in a large
number of those infected.
– Causes of hepatitis C
This type of hepatitis does not spread by
food, water, or casual contact and there are no vaccines available. its transmission
is blood-borne and it mostly involves exposure to infected syringes, needles, or
unscreened blood products for HCV. It can also be transmitted through any
activity that involves blood exposure, such as, the passage of the virus from
the mother to the child perinatally and unprotected sexual contact. Individuals
who received blood transfusion before 1992 have a high risk of acquiring this
disease, because the blood donated before that time was not screened for the
HCV. The pathophysiological effects of this disease in our body can include poor
ability of filtering toxins and hindering the ability of bile production,
therefore fatty acids won’t be broken down properly.