USMLE Q Bank Step 2 CK- 404




A 25 year old woman presents to her physician at 28 weeks of gestation with general itching for one week. Itching is worse at night and more prominent at soles and palms. She has no history of allergy or dermatological diseases. She is compliant with regular examinations and her pregnancy is uncomplicated. Her physical and obstetric examinations are unremarkable. Laboratory tests reveal normal full blood count, renal function tests and blood coagulations tests.

Her liver function tests are as follows:

ALT 47 IU/L

AST 55 IU/L

Alkaline phosphatase 356 IU/L

Total bilirubin 1.9

Bile acids 15 micromol/L

Serology for hepatitis is negative

What is the best treatment for this woman’s itching?

A- Hospitalization and induction of labor

B- Ursodeoxycholic acid and vitamin K

C- Diphenhydramine

D- No treatment and repeat liver function tests in a week




Answer:

This is a case of suspected primary biliary cirrhosis during pregnancy. It is safe to treat this pregnant woman with the routine treatment of primary biliary cirrhosis. Ursodeoxycholic acid and vitamin K is the main course of treatment and is safe for the fetus and the mother.

Correct answer is B



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