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Old 10-28-2011
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Question pruritus + high Bilirubin

A 32-year-old pregnant female, at 30 weeks of gestation, is seen in your office because of intense pruritus. Her laboratory tests show a total bilirubin 3.0 mg/dl; Alkaline phosphatase 200 IU/L; AST 120 IU/L, ALT 110 IU/L; PT 12 seconds; Platelet count 100,000/cmm; Hb 12.3 mg/dl, and markedly elevated serum bile acids. Her viral serologies are negative. On examination, she has no edema and her BP is 130/84 mm Hg. What is the most likely diagnosis in this patient?

a. Normal physiological changes in pregnancy.
b. Intrahepatic cholestasis of pregnancy.
c. Acute fatty liver of pregnancy.
d. Primary sclerosis cholangitis.
e. Primary biliary cirrhosis.
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b. Intrahepatic cholestasis of pregnancy.
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B.Intrahepatic cholestasis of Pregnancy.
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b. Intrahepatic cholestasis of pregnancy.
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I'm Predictable In The Unpredictable Future !
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Old 10-28-2011
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B.intrahepatic chole of pregnancy.

Akua
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b. Intrahepatic cholestasis of pregnancy.
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yes the answer is B. you guys are so clever....
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i thought this was the easiest of all
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Old 12-08-2011
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Unknown mechanism, possibly due to hormonal effect of estrogen and progesteron, so commonly seen in the third trimester and symtoms relieved after delivery

Increase of AST/ALT, ALP, serum bile acid, and persistent pruritis, especially at night.
May linked to several complications such as prematurity..

Often treated with UDCA
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Gastroenterology-, ObGyn-, Step-2-Questions

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