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Question category: Haematology

A 28 year old female who is 32 weeks pregnant presents with headache, nausea and vomiting and upper abdominal pain. On examination she appears jaundice and there is tenderness in the right upper quadrant. She is hypertensive at 140/80 mmHg. Bloods reveal a macrocytic anaemia, thrombocytopenia, deranged LFTs and elevated LDH. There is a reticulocytosis and red cell fragmentation on blood film. What is the most likely diagnosis?

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