input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 48-year-old woman comes to the emergency department because of a 1-day history of fever, vomiting, and abdominal pain. Two weeks ago, while visiting Guatemala, she had an emergency appendectomy under general inhalational anesthesia. During the surgery, she received a transfusion of 1 unit of packed red blood cells. Her temperature is 38.3°C (100.9°F) and blood pressure is 138/76 mm Hg. Examination shows jaundice and tender hepatomegaly. Serum studies show: Alkaline phosphatase 102 U/L Aspartate aminotransferase 760 U/L Bilirubin Total 3.8 mg/dL Direct 3.1 mg/dL Anti-HAV IgG positive Anti-HAV IgM negative Anti-HBs positive HBsAg negative Anti-HCV antibodies negative Abdominal ultrasonography shows an enlarged liver. A biopsy of the liver shows massive centrilobular necrosis. Which of the following is the most likely underlying cause of this patient's condition?"   (A) Acalculous inflammation of the gallbladder   (B) Virus-mediated hepatocellular injury   (C) Adverse effect of anesthetic   (D) Gram-negative bacteria in the bloodstream
output: ['(C) Adverse effect of anesthetic <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Acalculous inflammation of the gallbladder  (B) Virus-mediated hepatocellular injury  (C) Adverse effect of anesthetic  (D) Gram-negative bacteria in the bloodstream <> possible answers', '  A 48-year-old woman comes to the emergency department because of a 1-day history of fever, vomiting, and abdominal pain. Two weeks ago, while visiting Guatemala, she had an emergency appendectomy under general inhalational anesthesia. During the surgery, she received a transfusion of 1 unit of packed red blood cells. Her temperature is 38.3°C (100.9°F) and blood pressure is 138/76 mm Hg. Examination shows jaundice and tender hepatomegaly. Serum studies show:\nAlkaline phosphatase 102 U/L\nAspartate aminotransferase 760 U/L\nBilirubin\nTotal 3.8 mg/dL\nDirect 3.1 mg/dL\nAnti-HAV IgG positive\nAnti-HAV IgM negative\nAnti-HBs positive\nHBsAg negative\nAnti-HCV antibodies negative\nAbdominal ultrasonography shows an enlarged liver. A biopsy of the liver shows massive centrilobular necrosis. Which of the following is the most likely underlying cause of this patient\'s condition?" <> context']