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Intrahepatic cholestasis of pregnancy — USMLE Step 3 MCQ

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ModerateOB/GYN (prenatal care, contraception, screening)Intrahepatic cholestasis of pregnancyUSMLE Step 3

A 29-year-old pregnant patient at 32 weeks has intense pruritus of the palms and soles without rash. Bile acids are elevated and transaminases are mildly elevated. Which of the following is the most likely diagnosis?

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Correct answer: E — Intrahepatic cholestasis of pregnancy

Pruritus of palms and soles with elevated bile acids in late pregnancy indicates intrahepatic cholestasis of pregnancy.

Reference: SMFM intrahepatic cholestasis of pregnancy guidance