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
Which of the following is not a component of Reynolds' Pentad in toxic cholangitis? 
Select and explain. 
A. Right upper quadrant pain, B. Confusion, C. Septic shock, D. Markedly elevated transaminases
D: Markedly elevated transaminases
Answer: D: Markedly elevated transaminases 
Explanation: 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.