This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: G.I.T, 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: Reynold's pentad of acute obstructive cholangitis(suppurative cholangitis) includes - persistent right upper quadrant pain,persistent fever,persistent jaundice,shock(toxicity) and altered mental status. Reference:SRB's manual of surgery,5th edition,page no:651.", 'role': 'assistant'}]