The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 57-year-old homeless man is brought to the emergency department because of several episodes of hematemesis in the past 24 hours. His vital signs include a temperature of 37.1°C (98.8°F), pulse of 95/min, and blood pressure of 85/60 mm Hg. On physical examination, he appears confused and unable to give a complete history. He is noted to have jaundice, palpable firm liver, mild splenomegaly, and shifting dullness consistent with the presence of ascites. Liver function tests are as follows: Serum aspartate aminotransferase (AST)  97 U/L Serum alanine aminotransferase (ALT) 40 U/L Serum albumin 2.5 g/dL Total bilirubin 3 mg/dL Prothrombin time 20 seconds Which of the following is the most likely cause of this patient's illness?   (A) Metabolic disorder   (B) Substance abuse   (C) Obesity   (D)  Hepatic venous outflow obstruction
['(B) Substance abuse <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Metabolic disorder \n (B) Substance abuse \n (C) Obesity \n (D)  Hepatic venous outflow obstruction <> possible answers', "  A 57-year-old homeless man is brought to the emergency department because of several episodes of hematemesis in the past 24 hours. His vital signs include a temperature of 37.1°C (98.8°F), pulse of 95/min, and blood pressure of 85/60 mm Hg. On physical examination, he appears confused and unable to give a complete history. He is noted to have jaundice, palpable firm liver, mild splenomegaly, and shifting dullness consistent with the presence of ascites. Liver function tests are as follows:\nSerum aspartate aminotransferase (AST)  97 U/L\nSerum alanine aminotransferase (ALT) 40 U/L\nSerum albumin 2.5 g/dL\nTotal bilirubin 3 mg/dL\nProthrombin time 20 seconds\nWhich of the following is the most likely cause of this patient's illness? <> context@"]