<prompt> A 50 year old lady presented with history of pain upper abdomen, nausea, and decreased appetite for 5 days. She had undergone cholecystectomy 2 years back. Her bilirubin was 10 mgd1, SGPT 900 1UL SGOT 700 IUL and serum alkaline phosphatase was 280 IUL. What is the most likely diagnosis ?Acute pancreatitisAcute cholangitisAcute viral hepatitisPosterior penetration of peptic ulcer  <response>: Answer is C Acute viral Hepatitis Prodromal symptoms of nausea and anorexia, presence of pain in upper abdomen together with characteristic laboratory features elevated bilirubin, elevated SCOT and SGPT500 with SGPT SGOT, and elevated alkaline phosphates to 3 times normal suggest the diagnosis of viral hepatitis. Diagnosis of Acute viral Hepatitis Prodromal Symptoms Anorexia, Nausea, Vomiting Fatigue, malaise, ahralgic, tuvalgia, Fever Clinical Jaundice and associated Signs Clinical Jaundice Also dark urine, clay coloured stool Tender Hepatomegaly Right upper abdomen paindiscomfo Characteristic Laboratory Parameters Bilirubin ASTALT Alkaline Phosphate Albumin Prothrombin time Elevated Elevated Normal to 3 times normal Usually normal Both fractions may be Elevated usually 500 IUL N30 to 120 1UL elevated ALTAST N3 to 13 KAU Note: ALT is synonymous with SGPIQ AST is synonymous with SGOT2 