MRCP2-1787

A 55-year-old woman presents with generalized itching and jaundice. She has been feeling fatigued for several months but has been too busy to see a doctor. She has a history of hypothyroidism and received a blood transfusion 10 years ago. On examination, she has xanthelasma, scratch marks, and jaundiced sclerae. Her BP is mildly elevated, and her BMI is 28. Investigations reveal elevated IgM, positive anti-mitochondrial antibodies, and abnormal liver function tests. What is the most likely diagnosis?