Review Question - QID 210951

A 57-year-old man presents to the emergency department with fatigue. He states that his symptoms started yesterday and have been worsening steadily. The patient endorses a recent weight loss of 7 pounds this past week and states that he feels diffusely itchy. The patient has a past medical history of alcohol abuse, obesity, asthma, and IV drug use. His current medications include metformin, atorvastatin, albuterol, and fluticasone. In addition, the patient admits to smoking and drinking more than usual lately due to the stress he has experienced. His temperature is 98.7°F (37.1°C), blood pressure is 130/75 mmHg, pulse is 90/min, respirations are 15/min, and oxygen saturation is 98% on room air. A physical exam is notable for an ill-appearing man. The patient's skin appears yellow. An abdominal exam is notable for right upper quadrant tenderness. Cardiac and pulmonary exams are within normal limits. Laboratory values are ordered as seen below:

Hemoglobin: 14 g/dL
Hematocrit: 42%
Leukocyte count: 5,500 cells/mm^3 with normal differential
Platelet count: 70,000/mm^3

Partial thromboplastin time: 92 seconds
Prothrombin time: 42 seconds
AST: 1110 U/L
ALT: 990 U/L

Which of the following is most likely to be found in this patient's history?