input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 46-year-old man comes to the physician with a 1-week history of yellowish discoloration of his eyes, generalized fatigue, and pruritus. He was diagnosed with ulcerative colitis 7 years ago. At the time of diagnosis, a pANCA test was also positive. Physical examination shows scleral icterus and multiple scratch marks on the trunk and extremities. Abdominal examination is unremarkable. Serum studies show a total bilirubin concentration of 3.2 mg/dL, direct bilirubin concentration of 2.5 mg/dL, and alkaline phosphatase level of 450 U/L. Magnetic resonance cholangiopancreatography shows focal areas of intrahepatic bile duct strictures alternating with areas of dilation. Histologic examination of a liver biopsy specimen is most likely to show which of the following findings?   (A) Periductal concentric scarring and fibrosis   (B) Periportal lymphocytic infiltration and piecemeal necrosis   (C) Irregular ductal glands lined by atypical and pleomorphic cells   (D) Ductopenia and fibrotic degeneration of periportal hepatocytes
output: ['(A) Periductal concentric scarring and fibrosis <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Periductal concentric scarring and fibrosis  (B) Periportal lymphocytic infiltration and piecemeal necrosis  (C) Irregular ductal glands lined by atypical and pleomorphic cells  (D) Ductopenia and fibrotic degeneration of periportal hepatocytes <> possible answers', '  A 46-year-old man comes to the physician with a 1-week history of yellowish discoloration of his eyes, generalized fatigue, and pruritus. He was diagnosed with ulcerative colitis 7 years ago. At the time of diagnosis, a pANCA test was also positive. Physical examination shows scleral icterus and multiple scratch marks on the trunk and extremities. Abdominal examination is unremarkable. Serum studies show a total bilirubin concentration of 3.2 mg/dL, direct bilirubin concentration of 2.5 mg/dL, and alkaline phosphatase level of 450 U/L. Magnetic resonance cholangiopancreatography shows focal areas of intrahepatic bile duct strictures alternating with areas of dilation. Histologic examination of a liver biopsy specimen is most likely to show which of the following findings? <> context']