Card 11 / 30: A 65 year old woman has abnormal liver function tests. She has been experiencing nausea and abdominal pain over the last 7 days. She does not take anti-coagulants. A right upper quadrant ultrasound is normal. Her laboratory tests are as follows: White blood cell count: 12,500 Glucose: 80 mg/dl Amylase: 100 U/l LDH: 305 U/l Lipase: 25 U/l Iron: 250mcg/dl Total iron binding capacity (transferring): 350 mcg/l Ferritin: 100 ng/ml Total bilirubin 7.5 mg/dl (Direct bilirubin 7.1 mg/dl) Alkaline phosphatase 90 U/l ALT 145 U/l AST 295 U/l PT 25 (INR 3.1) Albumin 3.6 g/dl Which of the following is the most likely explanation for these findings?
A) Chronic hepatitis B
B) Alcoholic hepatitis
C) Hepatitis A
D) Primary biliary cirrhosis
E) Primary sclerosing cholangitis

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