This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: G.I.T, Subject name: Anatomy
A 50year old male presents with pain upper abdomen, Pruritus, jaundice and weight loss, elevated ANA, the likely diagnosis is 
Select and explain. 
A. Primary sclerosing cholangitis, B. Klatskin tumor, C. Secondary sclerosing cholangitis, D. Choledocholithiasis
A: Primary sclerosing cholangitis
Answer: A: Primary sclerosing cholangitis 
Explanation: Clinical features More common in males, mean age at presentation is 40-45 years. About 75% of patients are symptomatic at presentation with evidence of cholestatic liver disease such as jaundice, Pruritus and fatigue Symptoms of bacterial cholangitis are uncommon. Condition is characterized by relapses & remissions with quiescent periods. Median survival from the time of diagnosis ranges from 10 to 12 years Ref: Sabiston 20th edition Pgno : 1508-1509