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Hepatic, Biliary, and Pancreatic Disorders

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All EXCEPT which of the following liver-related changes are physiologic in pregnancy?

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a. Asterixis

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b. Palmar erythema

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c. Spider angiomas

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d. Elevated serum alkaline phosphatase levels

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What is the underlying pathophysiology of intrahepatic cholestasis of pregnancy?

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a. Acute hepatocellular destruction

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b. Incomplete clearance of bile acids

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c. Microvascular thrombus accumulation

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d. Eosinophil infiltration of the liver

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Which of the following clinical features are characteristic of intrahepatic cholestasis of pregnancy?

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a. Maculopapular rash

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b. Nausea and vomiting

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c. Generalized pruritis

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d. Serum transaminase levels > 500 U/L

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Which of the following viral infections has been associated with a marked increase in the risk for intrahepatic cholestasis of pregnancy?

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a. Hepatitis C

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b. Hepatitis B

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c. Cytomegalovirus

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d. Human immunodeficiency virus

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A 42-year-old primigravida presents at 35 weeks’ gestation with several new complaints. Most bothersome is yellowing of her sclera. After performing a thorough history, physical, and laboratory evaluation, you make a diagnosis of intrahepatic cholestasis of pregnancy. Approximately what percentage of women with this condition will develop jaundice?

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a. < 1%

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b. 10%

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c. 50%

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d. > 90%

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A 42-year-old primigravida presents at 35 weeks’ gestation with several new complaints. Most bothersome is yellowing of her sclera. After performing a thorough history, physical, and laboratory evaluation, you make a diagnosis of intrahepatic cholestasis of pregnancy. Referring to the patient, which of the following medications is most appropriate to initiate?

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a. Hydroxyzine

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