<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 37-year-old woman comes to the office complaining of fatigue and itchiness for the past 2 months. She tried applying body lotion with limited improvement. Her symptoms have worsened over the past month, and she is unable to sleep at night due to intense itching. She feels very tired throughout the day and complains of decreased appetite. She does not smoke cigarettes or drink alcohol. Her past medical history is noncontributory. Her father has diabetes and is on medications, and her mother has hypothyroidism for which she is on thyroid supplementation. Temperature is 36.1C 97F, blood pressure is 12575 mm Hg, pulse is 80min, respiratory rate is 16min, and BMI is 25 kgm2. On examination, her sclera appears icteric. There are excoriations all over her body. Abdominal and cardiopulmonary examinations are negative.Laboratory testComplete blood countHemoglobin 11.5 gdLLeukocytes 9,000mm3Platelets 150,000mm3Serum cholesterol 503 mgdLLiver function testSerum bilirubin 1.7 mgdLAST 45 ULALT 50 ULALP 130 UL 2070 ULWhich of the following findings will favor primary biliary cirrhosis over primary sclerosing cholangitis?? A: Elevated alkaline phosphatase and gamma glutamyltransferase, B: P-ANCA staining, C: Beads-on-a-string appearance on MRCP, D: Anti-mitochondrial antibody, E: Onion skin fibrosis on liver biopsy,  <response>: This is a multiple choice question asking about the diagnosis between primary biliary cirrhosis and primary sclerosing cholangitis. The patient is a 37-year-old woman with fatigue, itching, jaundice, and elevated liver enzymes. Primary biliary cirrhosis typically presents with fatigue, pruritus, and elevated alkaline phosphatase. Anti-mitochondrial antibodies are present in 95 of patients. Primary sclerosing cholangitis often presents with fatigue, pruritus, and elevated alkaline phosphatase as well, but is associated with inflammatory bowel disease. MRCP would show a beads on a string appearance. p-ANCA may be positive. Liver biopsy would show onion skin fibrosis around bile ducts.Therefore, the presence of anti-mitochondrial antibodies would favor the diagnosis of primary biliary cirrhosis over primary sclerosing cholangitis.D: Anti-mitochondrial antibody 