UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0909
Question:
A 60 year old Hispanic male carpenter has been heavily drinking since he was 15. He drinks at least a pint of whiskey a day however he does not smoke or use drugs. He has long standing complaints of weakness, fatigue, anorexia and weight loss. His condition worsens and he develops extreme nausea, anorexia and abdominal pain. On physical exam, his liver is enlarged, palpable and firm. He has numerous spider nevi and palmar erythema. His laboratory results show a macrocytic anemia, elevated liver enzymes, elevated alkaline phosphatase and a negative alpha fetoprotein. What is the most likely condition?

a) primary biliary cirrhosis
b) hepatitis B
c) hepatocellular carcinoma
d) Laennec's cirrhosis
e) Gilbert's Syndrome