Area of examination	Comments or reason for examination
Abdomen	Evaluate for evidence of hepatic inflammation or hepatomegaly.
	Note whether ascites or splenomegaly is present.
Cardiovascular system	Known, currently symptomatic cardiovascular disease is a relative contraindication to treatment with the combination of pegylated interferon and ribavirin.
Extremities	Peripheral edema can be a sign of portal hypertension.
General nutrition	Malnutrition can be a sign of advanced liver disease.
HEENT	Check for thyroid abnormalities, because treatment can cause or exacerbate autoimmune thyroiditis.
	Note whether icterus is present.
Mental status	Check for evidence of psychosis or depression.
	The patient’s level of judgment and insight should be sufficient to understand and tolerate the treatment regimen and its possible side effects.
Respiratory system	Perform a general examination to exclude respiratory disease.
Skin	Note any signs of alcohol abuse or liver failure, such as damaged capillaries over the cheeks, dilated veins over the chest or abdomen (indicative of portal hypertension), spider nevi, and palmar erythema.
	Note the presence or absence of jaundice and gynecomastia.
	Look for cutaneous complications of long-term HCV infection, such as palpable purpura (associated with cryoglobulinemia) or blisters and vesicles (porphyria cutanea tarda).
Weight	Weight determines the dosage of pegylated interferon and ribavirin.