MSFinals-1400

MSFinals-1400

A 22-year-old man presents to the Student Health Service after a ‘flu like’ illness. He has noticed that his eyes have become yellow over the past two days and he has been off his food. On examination, there are no significant abnormal findings.
Investigations:
Investigation Result Normal value
Haemoglobin 140 g/l 135–175 g/l
White cell count (WCC) 6.4 × 109/l 4–11 × 109/l
Platelets 230 × 109/l 150–400 × 109/l
Sodium (Na+) 139 mmol/l 135–145 mmol/l
Potassium (K+) 4.9 mmol/l 3.5–5.0 mmol/l
Creatinine 80 μmol/l 50–120 µmol/l
Alanine aminotransferase (ALT) 25 IU/l 5–30 IU/l
Bilirubin 67 μmol/l 2–17 µmol/l
Lactate Dehydrogenase (LDH) 105 IU/l 100–190 IU/l
Urine bile salts +
Hepatic ultrasound scan – Normal
Which of the following is the most likely diagnosis?