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Hepatic, Biliary, and Pancreatic Disorders

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

a. Asterixis

b. Palmar erythema

c. Spider angiomas

d. Elevated serum alkaline phosphatase levels

What is the underlying pathophysiology of intrahepatic cholestasis of pregnancy?

a. Acute hepatocellular destruction

b. Incomplete clearance of bile acids

c. Microvascular thrombus accumulation

d. Eosinophil infiltration of the liver

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

a. Maculopapular rash

b. Nausea and vomiting

c. Generalized pruritis

d. Serum transaminase levels > 500 U/L

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

a. Hepatitis C

b. Hepatitis B

c. Cytomegalovirus

d. Human immunodeficiency virus

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?

a. < 1%

b. 10%

c. 50%

d. > 90%

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?

a. Hydroxyzine

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