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: Pharmacology
Adequacy of D-penicillamine treatment in wilson is monitored by measuring the: 
Select and explain. 
A. 24 hour urinary copper, B. Serum ceruloplasmin, C. Disappearance of KF ring, D. Serum copper level in the fasting state
A: 24 hour urinary copper
Answer: A: 24 hour urinary copper 
Explanation: D-Penicillamine treatment in wilson disease: Adequacy of treatment is monitored by measuring 24-hour urinary copper excretion while on treatment. The most impoant sign of efficacy is a maintained clinical and lab improvement. Serum ceruloplasmin decrease after initiation of treatment. Ref: Journal of Hepatology 2012 vol. 56 / 671-685.