Intrahepatic cholestasis of pregnancy — MCCQE Part 1 MCQ

Correct answer: E — Diagnose intrahepatic cholestasis of pregnancy and arrange obstetric monitoring and treatment discussion

Diagnose intrahepatic cholestasis of pregnancy and arrange obstetric monitoring and treatment discussion is the single best answer because the age, timing, examination findings and investigations in the vignette fit Intrahepatic cholestasis of pregnancy better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to SOGC cholestasis of pregnancy guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC cholestasis of pregnancy guidance