Review Question - QID 215052

A 27-year-old gravida 2 para 1 woman at 30 weeks' gestation is brought to the emergency department by ambulance with a 1-day history of progressive nausea, vomiting, and abdominal pain. Her partner says that she has been lethargic and confused since waking up this morning. The patient has no significant medical history, and her previous pregnancy was complicated only by hyperemesis gravidarum requiring 2 emergency department visits. This past weekend, the couple returned from visiting family in Panama. However, her partner says that they received all recommended vaccinations prior to traveling. On exam, temperature is 100°F (37.8°C), blood pressure is 102/76 mmHg, pulse is 122/min, and respirations are 23/min. The patient is oriented only to person. There is scleral icterus and significant jaundice. Abdominal exam reveals right upper quadrant pain and hepatomegaly without rebound tenderness. Murphy sign is negative. Laboratory values are as follows:

Hemoglobin: 11.2 g/dL
Hematocrit: 33.6%
Leukocyte count: 18,000/mm^3
Platelet count: 250,000/mm^3

Serum:
Na+: 138 mEq/L
Cl-: 102 mEq/L
K+: 4.2 mEq/L
HCO3-: 32 mEq/L
Creatinine: 1.2 mg/dL
Alkaline phosphatase: 602 U/L
Aspartate aminotransferase (AST): 4,130 U/L
Alanine aminotransferase (ALT): 6,280 U/L
Bilirubin, total: 6 mg/dL

What is the most likely explanation for this woman's presentation?