**Core Concept**
Acute yellow fatty liver is a rare and potentially life-threatening condition characterized by the accumulation of lipid droplets in hepatocytes, leading to liver dysfunction. This condition is often associated with the ingestion or exposure to certain toxic substances.

**Why the Correct Answer is Right**
Acute yellow fatty liver is most commonly caused by poisoning with **tetracycline antibiotics**, particularly doxycycline and minocycline. These antibiotics interfere with mitochondrial protein synthesis, leading to the accumulation of lipid droplets in hepatocytes. This results in liver dysfunction, including elevated liver enzymes, jaundice, and in severe cases, liver failure.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because **carbon tetrachloride poisoning** primarily causes centrilobular necrosis and fatty change, but it is not the primary cause of acute yellow fatty liver.

**Option B:** This option is incorrect because **acetaminophen toxicity** primarily causes centrilobular necrosis and not typically leads to the characteristic lipid droplet accumulation seen in acute yellow fatty liver.

**Option C:** This option is incorrect because **alcohol abuse** primarily causes steatosis, steatohepatitis, and fibrosis, but it is not the primary cause of acute yellow fatty liver.

**Clinical Pearl / High-Yield Fact**
It is essential to recognize that certain medications, including tetracycline antibiotics, can cause acute yellow fatty liver, and prompt recognition and discontinuation of the offending agent can prevent progression to liver failure.

**Correct Answer:** D. Tetracycline antibiotics.