A 27 year-old female comes to your office and reports a ‘migraine attack’, sore throat and dark urine color. She is 2 months pregnant. She takes acetaminophen 500 mg twice daily as needed for pain in her back. She has not been taking folate or any other vitamin supplements. She takes propylthiouracil for hyperthyroidism. On further questioning, she reveals she also has abdominal pain and swelling of the legs. On physical examination, you notice yellow eyes and skin along with abdominal tenderness in the right upper quadrant. Her temperature is 101 °F (38.3 °C), heart rate is 108 beats/min, blood pressure is 100/70 mm Hg, respirations are 19 breaths/min, and oxygen saturation is 98% on room air. What is the next best step in the management of this patient?
