Hepatic Disorders and Infections in Pregnancy MCQs

This patient has signs of pelvic inflammatory disease, and since distinguishing diagnostic clues are not provided here, the answer should pertain to the most common causes, which include Chlamydia and gonococcal infection. Infections of the cervix may present as an erythematous, edematous, and friable cervix, but most often are without obvious signs or symptoms. Early signs and symptoms of a chlamydial infection in women tend to be mild and include pain during urination, frequent urination, and low-grade fever. Later symptoms can be more intense and include nausea, fatigue, and abnormal discharge from the vagina. Other symptoms include abdominal pain, lower back pain, irregular menstrual bleeding or spotting, and pain during sex. Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 816

Also know Management of Intrahepatic Cholestasis – Medical Management The most troublesome feature of intrahepatic cholestasis is pruritus (and pruritus is due to bile acid in blood): Pruritus can be managed temporarily with antihistamines and topical emollients Ursodeoxycholic acid (10-15 mg/kg/d in 2 divided doses) relieves pruritus decreasing in the concentration of bile acid in blood and it also improves biochemical abnormalities. In patients of intrahepatic cholestasis of pregnancy – there is increased perinatal mortality. Hence fetal surveillance is done with biweekly NST. Conventional antepartum testing, does not predict fetal mortality as there is sudden death in choletasis due to acute hypoxia, hence delivery is recommended at 37-38 weeks. Reference : COGDT 10/e, pg 382; Williams Obs 24/e, pg 1085 Mgt of High Risk Pregnancy - S S Trivedi Manju Puri, pg 358

The earliest manifestation of end-organ damage in chronic hypertension is typically (B): Renal impairment. Chronic hypertension can lead to changes in kidney function and structure over time. These changes may be detectable through alterations in renal function tests, such as elevated serum creatinine levels or proteinuria. This early renal impairment often precedes other manifestations of end-organ damage such as hepatic, visual, or pulmonary complications Reference : Arias 5 th edition pg no 179