USMLE step 2 Mcq 217:A 42 year old female decides to become a mother. During her pregnancy she develops pruritis

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Question:
A 42 year old female decides to become a mother. During her pregnancy she develops pruritis. Other than the itching, her pregnancy and delivery are uncomplicated. However, even after the birth of her healthy baby boy, the pruritis continues. Two years later she develops jaundice. Her past medical history is unremarkable. On physical examination, she is found to have hepatosplenomegaly. Evaluation has ruled out gallstones. Her laboratory results show an elevated alkaline phosphatase (four times normal) and an elevated bilirubin. She is found to have mitochondrial antibodies. What condition should be included in the differential diagnosis?

a) primary biliary cirrhosis
b) hepatitis B
c) hepatocellular carcinoma
d) Laennec's cirrhosis
e) hepatitis A


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