This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': "True about wilson\\'s disease – \nSelect and explain. \nA. Increase in urinary copper and increased serum ceruloplasmin and copper, B. Increased serum ceruloplasmin levels with increased urinary copper, C. Elevated hepatic copper level and increased serum ceruloplasmin levels, D. Increased in urinary copper and decreased serum ceruloplasmin", 'role': 'user'}, {'content': "Answer: D \nExplanation: Diagnosis of Wilson disease \nDiagnosis includes the demonstration of a reduced ceruloplasmin level, increased urinary excretion of copper, the presence of Kayser-Fleischer rings in the cornea of the eyes, and an elevated hepatic copper level, in the appropriate clinical setting.\n\nCeruloplasmin\n\n\nSerum glycoprotein that contains six copper atoms.\nCopper incorporation into ceruloplasmin is impared in Wilson's disease.\n95% of homozygotes have levels < 20mg/dL (rarely are levels > 30 mg/dL).\nMay also be low in other hypoproteinemic states\nMay be low in 20% of asymptomatic heterozygotes\n\n\nSerum free copper (unbound copper)\n\n\nGreater than 25 mg in symptomatic pts (normal < 10)\n\n\nSlit lamp detection of Kayser Fleischer Rings\n24 hour urinary copper excretion\n\n\nMay exceed 100 mg/24 h-use metal free container\nFalse + with sign. Proteinuria (ceruloplasmin loss)\n\n\nLiver biopsy\n\n\n> 250 g/g copper dry weight in homozygotes (normal < 50).\nCholestatic diseases (PBC/PSC) may have elevated hepatic copper dry weight.", 'role': 'assistant'}]