Our newest adventures follow the gastrointestinal tract from top to bottom. Like the chocolate morsel in the animation we are developing an understanding of the chemical breakdown of foods in healthy and diseased individuals. At first, I thought there was no hope of grasping the workings of the liver and this complex array of tubes (If only it were as simple as the animation). Despite its complexity, there are occasional "aha moments" when the on-turning light above my head illuminates a concept I've known before, but never truly understood. Compared to days of confusion, those are usually what constitutes a good day.
We have not yet finished our systematic approach to the body. Looking back at my second year of medical school, however, I feel there has been a significant amount of progress. We are constantly developing a new vocabulary and a working knowledge that were non-existent only months prior. This process definitely has a steep learning curve and it is no wonder that doctors are considered to be among the top 1% of the world's most educated professionals. A daunting reality that is appropriate, considering we are expected to care for the life of another individual.
Board Prep Question of the Week
A 46-year-old female with a history of painful spasms of the fingers in the cold complains of 2 weeks of fatigue, pruritus, and abdominal pain. Her exam is notable for scleral icterus, right upper quadrant pain, and a liver span of 11cm. Her laboratory values are as follows:
Alkaline Phosphatase: 256
Total Bilirubin: 2.8
Direct Bilirubin: 1.9
An abdominal ultrasound shows no obstruction. A liver biopsy is taken and shows destruction of small interlobar bile ducts. What antibody test will likely be positive?
A. Anti-Scl 70
B. Anti-ds DNA
D. Anti-smooth muscle