199) A 32 year old pregnant woman with 32 week gestation is evaluated in your office during a regular follow up visit. She denies any abdominal pain or vomiting or vaginal bleeding or headache. She denies any headache or pruritis. She feels healthy and is hoping for a normal delivery. Physical examination is consistent with 32 week gestation. Extremities do not reveal any edema. Laboratory investigations reveal a mild anemia at 12.0gm%. Rest of the lab results are normal except for elevated alkaline phosphatase at 280U/L ( Normal 40 to 120U/L) . The patient is very concerned. Most appropriate next step in managing this patient?
A) Ultrasound of the liver and gall bladder
B) Immediate Delivery
C) Ursodeoxycholic acid
E) Obtain Peripheral Smear
Filed under: USMLE Test Prep Tagged: | Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics