This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Misc., Subject name: Medicine
[{'content': 'Most likely precipitating cause for acute hepato-cellular failure is? \nSelect and explain. \nA. Oral lactulose, B. Large IV albumin infusion, C. Large carbohydrate meal, D. Upper GI bleeding', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Upper GI bleeding will provide the bacteria in the gut with lots of nutrition to multiply and this will lead to increase in production of ammonia.', 'role': 'assistant'}]