A 78 yr old female with pruritus

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A 78yr old female came with the c/o itching all over the body since 5 to 6 months.
HOPI: 
Patient was apparently asymptomatic 6 months back.
Later developed pruritis all over the body.
Insidious in onset and gradually progressed to all over the the body.
Then she used ayurvedic body lotion for the pruritus, which was not subsided.
There is darkening and roughness of skin.
Associated with decreased appetite and weight loss.
Later on suggestion of a doctor for the yellowish discoloration of the conjunctiva, investigations were done showing tb levels of 5.
Later even usg was peformed showing distention of gallbladder with thickening of wall and calculi in the gallbladder.
K/C/O HTN since 30yrs and on regular medication and controlled BP.
N/k/c/o DM, Epilepsy, asthma, tb.
O/e:
Pt is c/c/c. 
Bp: 130/70mmhg
Pr:64bpm
Rs: bae+
Cvs: s1s2+
Cns: NAD.
P/A : Soft and non tender.
Bs: +
Ecg:
USG:
Chest x ray:
Investigations:
Surgery referal:


CECT ABDOMEN:
Rx: 
Tab. Levocitrezen 5mg od.

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