Red Palms

"Everybody, look at your palms. Mine are slightly pink with Irish blood flowing because of Saint Patrick's Day." Our small group was making an interesting observation. Well, it is not that interesting since everyone in my small group had normal color palms. Reddened palms are a cardinal (no pun intended) sign of chronic liver disease, a symptom called palmer erythema. It is important to see normal color palms before thinking about pathology.

For some reason, the palms turn red and the face turns yellow with liver disease (jaundice). We may have some of the most advanced technology to assist us in our diagnostic algorithms, but there is limited use of such modalities without an adequate patient history and physical. If we overlook the obvious physical symptoms, in the case of liver disease, the general symptoms are clumped together into a "stigmata of chronic liver disease," we may be led on a wild goose chase.

Our first Metabolism and Nutrition exam will be on Thursday. I am in the thick of studying 569 pages worth of syllabus material that cover a myriad of topics, everything from gastrointestinal diseases to metabolism of nucleotides to GI physiology to liver disease to GI anatomy. And there is so much in between. Being confined in the library for the last few days has been far from exciting.

My only consolation was thinking, at least I'm not studying for boards. The second years have been madly preparing, spending all hours in the library, consuming gallons of caffeinated beverages and looking so tired. I guess a year from now- that will be us first years. Right now, we'll focus on our midterm.

Needless to say, I am thoroughly distracted, exhausted, overwhelmed thinking about the intricacies of bowel movements and defection and diseases that maybe causing diarrhea, abdominal pain or steatorhea (fat in the stool).

I guess studying GI motility and absorption and all those mechanisms makes going to the bathroom that much more interesting...ok- not really. I might just know way too much about poop for my own good.