input: 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
output: ['(B) Substance abuse <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Metabolic disorder  (B) Substance abuse  (C) Obesity  (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"]