An Asymptomatic 48-Year-Old Caucasian Female with a History of Hypothyroidism Is

question 254

Multiple Choice

An asymptomatic 48-year-old Caucasian female with a history of hypothyroidism is being evaluated for abnormal liver function tests.  She has no other medical problems.  She takes thyroxine for the hypothyroidism.  She takes no herbal medication.  She never smoked or used IV drugs, and rarely drinks alcohol.  Her family history is unremarkable.  Her blood pressure is 120/80 mmHg, pulse is 72/min, temperature is 36.7C (98F) and respirations are 14/min.  The physical examination is normal, except for mild, painless hepatomegaly.  The initial lab test results are as follows:
What is the most appropriate next step in the management of this patient?

• A)Check gamma-glutamyl transferase
• B)Measure antinuclear antibodies and anti-smooth muscle antibodies
• C)Order antimitochondrial antibody tests
• D)Perform endoscopic retrograde cholangiopancreatography (ERC
• E)Test for alpha-1 antitrypsin deficiency

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Definitions:

Classical Conditioning

A learning process that occurs through associations between an environmental stimulus and a naturally occurring stimulus, leading to a learned response.

Stimulus

A signal or piece of data that elicits or influences a physiological or psychological response or activity.

Operant Conditioning

A learning theory which posits that behavior can be changed through the use of consequences, such as rewards or punishments.

Stimulus

Any event or situation that evokes a response from an organism in psychology and biology.