For a patient with hepatitis C, which physical exam finding is consistent with the disease?

For a patient with hepatitis C, splenomegaly is a notable physical exam finding that can occur as the disease progresses. Hepatitis C can lead to chronic liver disease, including cirrhosis, and portal hypertension. These complications often result in splenomegaly due to increased pressure in the portal venous system. The spleen can become enlarged as it filters more blood and reacts to increased pressure, resulting from liver fibrosis and structural changes in the liver.

Facial telangiectasias, while they can appear in various conditions, are not specific to hepatitis C and do not commonly indicate the disease's presence. Petechiae might occur due to thrombocytopenia (a decrease in platelets) or other conditions but are not reliable indicators for hepatitis C. Ascites, which is fluid accumulation in the abdominal cavity, typically develops in advanced liver disease but is not as universally present in hepatitis C patients as splenomegaly, especially in earlier stages. Therefore, splenomegaly serves as a more definitive finding associated with the pathological changes seen in hepatitis C infection.