Antenatal medicine: intrahepatic cholestasis: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Antenatal medicine: intrahepatic cholestasis

Sample item

A pregnant patient develops intense nocturnal pruritus of the palms and soles in the third trimester without a primary rash. Which test is most relevant?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Serum bile acids

Intrahepatic cholestasis of pregnancy commonly causes pruritus, particularly on palms and soles, with raised bile acids and sometimes abnormal liver tests. It requires obstetric monitoring because of fetal risk.

Option by option

  • A. D-dimer only

    D-dimer is not diagnostic for cholestasis.

  • B. Serum amylase only

    Amylase evaluates pancreatic disease.

  • C. Serum bile acids (correct)

    Correct. Bile-acid measurement is central to assessment.

  • D. Urine ketones only

    Ketones assess starvation or diabetic ketoacidosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Serum bile acids. Intrahepatic cholestasis of pregnancy commonly causes pruritus, particularly on palms and soles, with raised bile acids and sometimes abnormal liver tests.

Why is "D-dimer only" not the answer?

D-dimer is not diagnostic for cholestasis.

Why is "Serum amylase only" not the answer?

Amylase evaluates pancreatic disease.

Why is "Urine ketones only" not the answer?

Ketones assess starvation or diabetic ketoacidosis.

What concept does this question test?

It tests Antenatal medicine: intrahepatic cholestasis in OBG. It requires obstetric monitoring because of fetal risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antenatal medicine: intrahepatic cholestasis?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.