Jaundice is usually not associated with?

PGIMS Rohtak NO - 2017

Medical & Surgical Nursing

Medium

Appeared in: PGIMS Rohtak NO - 2017

Explanation

Acute infection with Hepatitis C virus (HCV) is frequently asymptomatic, with estimates suggesting up to 80% of newly infected individuals show no symptoms.
Jaundice is considered a rare manifestation of acute Hepatitis C infection.
When jaundice does occur in the context of Hepatitis C, it is more commonly a sign of advanced liver disease, such as decompensated cirrhosis, rather than the initial acute phase.
This contrasts with Hepatitis A and E, where jaundice is a hallmark symptom of the acute illness, and Hepatitis B, where it is also a common finding.

Option A: Jaundice is a common and characteristic sign of acute Hepatitis A infection, especially in adults. Its presence is expected.
Option B: Acute Hepatitis B infection frequently presents with jaundice. Although the onset is more insidious than Hepatitis A, jaundice is a common clinical feature.
Option D: Jaundice is a typical symptom of acute Hepatitis E infection, which is clinically similar to Hepatitis A. It is particularly dangerous in pregnant women, where it is associated with high mortality.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical presentation of different types of viral hepatitis, specifically the association with jaundice as background academic context rather than a clinical decision trigger.
A nurse should not rule out acute viral hepatitis, particularly Hepatitis C, just because a patient is not jaundiced. A high index of suspicion is needed for patients with risk factors (e.g., IV drug use, needlestick injury).
Nursing assessment for any suspected hepatitis should include checking for other signs like dark urine, pale stools, fatigue, nausea, and abdominal pain, and monitoring liver function tests (ALT, AST).
Patient education is crucial. For a patient diagnosed with any form of hepatitis, the nurse must teach them to avoid hepatotoxic substances like alcohol and certain medications (e.g., excessive paracetamol) to prevent further liver damage.

How to Approach the Question

First, understand the core of the question. It asks which type of hepatitis is LEAST likely to cause jaundice. This requires comparing the typical clinical presentations of the listed viruses.
Recall or look up the main symptoms of acute viral hepatitis. Jaundice is a classic sign, but its frequency varies.
Consider each option: Hepatitis A and E are known for causing acute, symptomatic illness where jaundice is common.
Consider Hepatitis B. Jaundice is also a frequent sign of acute infection.
Consider Hepatitis C. Recall that its main danger is its high rate of chronicity, often following an asymptomatic or very mild acute phase.
Based on this comparison, conclude that Hepatitis C is the most likely answer because its acute phase is often anicteric (without jaundice).

Concept Tested & Keywords

Concept Tested: Clinical presentation of different types of viral hepatitis, specifically the association with jaundice.
Stem keywords: Jaundice, Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis E
Lead-in keywords: not associated with
Negative lead-in flag: NOT

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