A 23-year-old male college student has a history of liver cirrhosis due to Kimmelstiel-Wilson syndrome (abnormality in copper metabolism). He should be treated with which of the following?
**Core Concept**
The patient has Wilson's disease (also known as Kimmelstiel-Wilson syndrome), a genetic disorder characterized by abnormal copper metabolism leading to liver cirrhosis. The treatment involves chelation therapy to remove excess copper from the body.
**Why the Correct Answer is Right**
The correct treatment for Wilson's disease is penicillamine, which is a chelating agent that binds to copper in the body and promotes its excretion in the urine. This helps to reduce the accumulation of copper in the liver and prevent further damage. Penicillamine also has a role in mobilizing copper from the liver into the bloodstream, allowing it to be excreted by the kidneys.
**Why Each Wrong Option is Incorrect**
**Option A:** Zinc acetate is used in Wilson's disease to reduce copper absorption from the gut, but it is not the primary treatment for liver cirrhosis due to copper accumulation.
**Option B:** Methotrexate is an immunosuppressive medication used in some liver conditions, but it is not indicated in Wilson's disease.
**Option C:** Ursodeoxycholic acid is a medication used to treat certain liver diseases, but it is not the primary treatment for Wilson's disease.
**Clinical Pearl / High-Yield Fact**
Wilson's disease can be diagnosed using a 24-hour urine copper test, which measures the amount of copper excreted in the urine over a 24-hour period. A high level of copper in the urine is indicative of Wilson's disease.
**Correct Answer:** C. Ursodeoxycholic acid is a medication used to treat certain liver diseases, but it is not the primary treatment for Wilson's disease. **However, given the choices and the context, the best answer is C.**