<prompt> A patient presents to the emergency room with malaise. The physician notices slight jaundice. Serum chemistries reveal marked elevation of both aspaate aminotransferase AST and alanine aminotransferase ALT, with the ASTALT ratio being 2.5. Alkaline phosphatase is near normal. Serum copper and serum iron are normal. Liver damage from which of the following diseases most likely accounts for these findings?Alcoholic hepatitisBiliary cirrhosisHemochromatosisHepatitis A  <response>: Elevated AST and ALT with a ASTALT ratio of greater than 1.5 is strongly suggestive of alcoholic hepatitis. Microscopic features of this condition include swollen and necrotic hepatocytes, neutrophil infiltration, Mallory hyaline bodies, fatty change, and fibrosis around the central vein. Biliary cirrhosis would be associated with elevated alkaline phosphatase. Hemochromatosis would be associated with elevated serum iron levels. In viral hepatitis, both AST and ALT are elevated, but the ratio is usually less than 1.5. Ref: Jarnagin W.R. 2010. Chapter 24. Liver Poal Venous System. In G.M. Dohey Ed, CURRENT Diagnosis Treatment: Surgery, 13e. 