Tracked across five visits, a composite restaurant manager with hepatitis C moves from a reactive screen to primary care treatment and the follow-up a cure still needs in NU572's closing case. Searches like "nu 572 unit 10 assignment example", "nu572 unit 10 sample" and "nu572 unit 10 example" land here.
From a Reactive Antibody to a Documented Cure: An Adult Primary Care Case of Hepatitis C Treated in the Practice
[Student Name]
Purdue University Global
NU572: AGNP I - Primary Care of the Adolescent and Adult
Unit 10 Adult Primary Care Case Study
[Instructor Name]
[Date]
The patient is a composite; values, regimen choices and dates are bracketed.
Visit 1: Screening
Data: Mr. [C.], 43, a restaurant manager, seen for a physical. Never tested for hepatitis C. Screening offered under the recommendation for adults 18 to 79 (US Preventive Services Task Force, 2020). Antibody reactive; reflex HCV RNA [1.2 million] IU/mL. Interpretation: current infection, not a past, cleared exposure. Decision: return in one week for a pretreatment evaluation in the practice. What he was told: "The test shows an active hepatitis C infection. It is curable with pills, usually in eight to twelve weeks, and we can treat it here."
Visit 2: Pretreatment Evaluation
Data. History: injection drug use in his twenties, in recovery for [18] years; two beers most nights. No prior hepatitis C treatment. Exam: no signs of cirrhosis. Labs: platelets [236], AST [48], ALT [66], albumin [4.2], bilirubin normal, INR [1.0]. FIB-4 [1.1]. Hepatitis B: no surface antigen, no core antibody, no surface antibody [all negative]. HIV negative. eGFR [96]. Genotype not tested. Interpretation. The AASLD and IDSA simplified treatment pathway applies to treatment-naive adults without cirrhosis, and allows pangenotypic treatment without genotype testing (Bhattacharya et al., 2023). He qualifies: never treated, a FIB-4 below 3.25 with no clinical signs of cirrhosis, and no hepatitis B, HIV or pregnancy to complicate the regimen. Decision: start a pangenotypic regimen; check interactions first. What he was told: the treatment choice, how to take it, and why alcohol reduction matters for his liver.
Boxed note: hepatitis B before treatment. Direct-acting antivirals for hepatitis C can trigger hepatitis B reactivation in people with current or past hepatitis B infection, sometimes severe, and the FDA warns that all patients should be tested for hepatitis B before starting (U.S. Food and Drug Administration, 2016). His hepatitis B tests are negative, so reactivation is not a concern, but he is not immune.
Talking About His History
When asked how he thought he had been infected, he paused, looked at the floor and answered, "Probably from back then." He had not mentioned his past drug use at any visit in six years with the practice. The clinician did not press for detail. She told him most people living with this virus picked it up long before they learned of it, that eighteen years in recovery is an achievement, and that the infection is a medical problem with a cure, not a judgment. He said afterward that he had avoided testing for years because he expected to be lectured. That is part of why universal screening matters: it does not require a patient to disclose a risk before being offered a test.
What Would Have Sent Him to a Specialist
The simplified pathway has clear exits. Signs of cirrhosis, a FIB-4 above 3.25, or elastography showing advanced fibrosis would call for a different evaluation and often specialist involvement. So would prior hepatitis C treatment, hepatitis B coinfection, HIV, kidney failure, a liver transplant or pregnancy. None applied. Documenting that each exit was checked is what makes treatment in primary care defensible.
Visit 3: Starting Treatment
Data: medication list includes [omeprazole] [20 mg] daily for reflux. Interpretation: acid-reducing drugs lower the absorption of some direct-acting antivirals, notably velpatasvir. Decision: [sofosbuvir-velpatasvir], a single daily tablet for twelve weeks, with [omeprazole] taken four hours after the antiviral with food, or [glecaprevir-pibrentasvir] three tablets daily with food for 8 weeks; [the choice made with him]. Prescription sent with prior authorization. What he was told: take it at the same time every day; do not start new medicines or supplements without checking; call if he misses doses.
Visit 4: Adherence Check by Phone, Week 4
Data: taking every dose; mild headache and fatigue in the first week, now gone. Interpretation: adherent, tolerating treatment. Decision: no labs needed during treatment on the simplified pathway unless clinically indicated. What he was told: keep going; next check twelve weeks after the last dose.
Visit 5: SVR12
Data: HCV RNA undetectable twelve weeks after the last dose. ALT [28]. Interpretation: sustained virologic response, which is considered a cure (Bhattacharya et al., 2023). Decision: document cure. What he was told: "You are cured of hepatitis C."
What Ongoing Care Still Owes Him
Cure confers no immunity. He could be reinfected if exposed again. The plan addresses reinfection risk without assuming he is using drugs; if he ever does, testing for HCV RNA, not antibody, would be needed, since his antibody will stay positive for life.
Vaccination: hepatitis B vaccine series, since he is not immune; hepatitis A vaccine if not immune.
Alcohol: two beers most nights is above low-risk limits for liver health after hepatitis C. A brief conversation about cutting back, framed around protecting the liver he has just cleared.
Liver follow-up: without cirrhosis, no ongoing liver cancer surveillance is needed. If he had cirrhosis, surveillance ultrasound every six months would continue after cure.
Routine prevention resumes its normal schedule: blood pressure, colorectal screening at 45, and others.
Why Treat Him Here
Many people diagnosed with hepatitis C are never treated, often because a referral to a distant specialist is lost along the way. Each extra step between a diagnosis and a first dose is a place where patients fall out of care. Mr. [C.] works long, unpredictable hours, and a referral with a months-long wait might have ended his care before it began. Treating him in the practice he already knew, with a clinician he trusted, removed that step. The practice's part was modest: a clinician who had completed the simplified pathway training, a staff member who knew the prior authorization forms for the two regimens, and a phone call at week four. Those three pieces turned a positive screen into a cure without anyone else's calendar. The same pieces could serve the next patient the age-based screen finds, and there will be others, since many adults in their forties were never tested before 2020.
Reflection on the Case
The case shows what the move to universal screening and simplified treatment makes possible. A man with no symptoms and a history he would not have volunteered was found by an age-based screen and cured in primary care in about five months, without a specialist referral. The steps that made it safe, the fibrosis check, the hepatitis B test and the interaction review, were each small, and each is documented.
References
Bhattacharya, D., Aronsohn, A., Price, J., Lo Re, V., Heald, J., Demisashi, G., Durzy, E., Davis-Owino, A., & Tynes, S. (2023). Hepatitis C guidance 2023 update: American Association for the Study of Liver Diseases-Infectious Diseases Society of America recommendations for testing, managing, and treating hepatitis C virus infection. Clinical Infectious Diseases. Advance online publication. https://doi.org/10.1093/cid/ciad319
U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: FDA warns about the risk of hepatitis B reactivating in some patients treated with direct-acting antivirals for hepatitis C. https://www.fda.gov/drugs/drug-safety-and-availability
US Preventive Services Task Force. (2020). Screening for hepatitis C virus infection in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA, 323(10), 970-975. https://doi.org/10.1001/jama.2020.1123
How this NU572 Unit 10 example is structured
Visits run in order, and each carries the same four parts: data, interpretation, decision and what the patient was told. Repeating that pattern lets the reasoning be followed across months without losing the thread. The pretreatment visit carries the most weight, because the simplified treatment pathway published by AASLD and IDSA applies only to adults without cirrhosis and without prior treatment, and the case documents that he qualifies. A boxed note explains why hepatitis B status is checked before starting: direct-acting antivirals carry an FDA warning about hepatitis B reactivation. The treatment visit records an interaction check against his omeprazole, with the adjustment bracketed. The closing section is the part many case studies omit. Cure confers no immunity, so the plan addresses reinfection risk, vaccination against hepatitis A and B, alcohol and the liver, and routine adult prevention resuming its normal schedule.
Get an NU572 Unit 10 example written to your instructions
Whatever condition your prompt assigns, from hepatitis C to hypertension or depression, the closing case follows it across however many visits your section expects, in the note format it uses. Add the case details and grading criteria you were given. Your first sample is free and is returned inside 24-48h, matched to your instructions. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU572 Unit 10 questions, answered
Can primary care really treat hepatitis C?
For many patients, yes. The AASLD and IDSA simplified pathway supports treatment outside specialty care for adults without cirrhosis who have not been treated before, using pangenotypic regimens and limited monitoring. The case documents that the patient meets those conditions. Patients with cirrhosis, prior treatment failure or certain coinfections are typically referred, and a strong case study says where that line falls.
How many visits should the case study cover?
Enough to show screening, confirmation, a management decision and at least one follow-up, which is often four to six encounters. Some prompts set a number. What graders watch is continuity: each visit should begin from what the last one found, so the case reads as one patient's care over time rather than separate snapshots joined by dates.
Should the case include routine prevention alongside the main condition?
Usually a short section, yes. An adult followed across several visits will come due for vaccines, blood pressure checks and age-based screening, and ignoring them makes the case read as single-disease care. The sample handles them in a closing block so they do not crowd the main thread but are visibly addressed.