Jellby, actually it depends. Though most PDFs are just a collection of objects that have a fixed position on the page, if the PDF was saved as a tagged PDF, then it can reflow. And it would've definitely taken care of bold and italics problem.
Also, 155 pages is a breeze, trust me. I had to work with 400+ pages, and it took me 3 days to properly format it. So put on some good music during it and you'll survive.
Have you tried selecting the text and copy-pasting it into Word ? I found that it keeps formatting even from web pages.
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