question: Q:A previously healthy 5-year-old girl is brought to the emergency department by her parents because of a severe headache, nausea, and vomiting for 6 hours. Last week she had fever, myalgias, and a sore throat for several days that resolved with over-the-counter medication. She is oriented only to person. Examination shows bilateral optic disc swelling. Serum studies show:
  Glucose 61 mg/dL
  Aspartate aminotransferase (AST) 198 U/L
  Alanine aminotransferase (ALT) 166 U/L
  Prothrombin time 18 sec
  Which of the following is the most likely cause of this patient's symptoms?"? 
  {'A': 'Autoimmune destruction of beta cells', 'B': 'Acute viral hepatitis', 'C': 'Hepatic mitochondrial injury', 'D': 'Ruptured berry aneurysm', 'E': 'Ethylene glycol poisoning'},