MSFinals-3523

MSFinals-3523

A 29-year-old woman presents to the clinic with a complaint of intense itching that has developed over the past few weeks. She is currently 32 weeks pregnant and has had an uncomplicated pregnancy thus far. The patient reports that the itch is particularly bothersome on her palms and soles. She denies any recent illness or fever and states that she otherwise feels well. On examination, there is no evidence of a rash. Blood tests reveal elevated levels of bilirubin, ALT, AST, and ALP. What should be discussed with the patient?