Cholestasis of pregnancy Quiz: Ace Your Exams
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A 37-year-old G4P3 woman at 30 weeks gestation presents to her obstetrician for routine evaluation. The patient states that she has been experiencing difficulty sleeping at night due to constant itching. She has no other symptoms that are bothering her at this time. She has a history of asthma that is well-controlled with an as-needed albuterol inhaler. Temperature is 37°C (98.6°F), blood pressure is 102/60 mmHg, pulse is 105/min, respiratory rate is 22/min, and oxygen saturation is 97% on room air. Physical examination demonstrates a gravid abdomen consistent with 30 weeks gestation, without tenderness to palpation. Cardiopulmonary examination is within normal limits. Laboratory results are detailed below. Which of the following findings is most likely to be seen on physical exam given the likely underlying diagnosis?
| Laboratory value | Result |
| Complete Blood Count | |
| Hemoglobin | 13.5 g/dL |
| Leukocyte count | 5500/mm3 |
| Platelet Count | 300,000/mm3 |
| Serum Chemistry | |
| Sodium | 142 mEq/L |
| Potassium | 4.2 mEq/L |
| Chloride | 95 mEq/L |
| Creatinine | 0.8 mg/dL |
| Alanine aminotransferase | 75 U/L |
| Aspartate aminotransferase | 68 U/L |
| Serum albumin | 4 g/dL |
| Serum total bilirubin | 2.2 mg/dL |
| Alkaline phosphatase level | 220 U/L |
| Total bile acids | 14 µmol/L |
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