This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': "Which of the following is not a component of Reynolds' Pentad in toxic cholangitis ? \nSelect and explain. \nA. Right upper quadrant pain, B. Confusion, C. Septic shock, D. Markedly elevated transaminases", 'role': 'user'}, {'content': 'Answer: D \nExplanation: None', 'role': 'assistant'}]