Heme synthesis disorders Quiz: Ace Your Exams
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A 30-year-old woman presents to the emergency department for evaluation of acute abdominal pain. The pain developed a day ago and has been constant, diffuse, and 7/10 in intensity. She has also experienced nausea, vomiting, a tingling sensation in the bilateral hands, as well as painless, dark-red urine. The patient had similar episodes in the past following the consumption of alcohol. Past medical history is significant for generalized anxiety disorder, depression, and pelvic inflammatory disease. She is currently sexually active with one male partner and does not use contraception. Temperature is 37.0°C (98.6°F), pulse is 103/min, respirations are 18/min, and blood pressure is 138/78 mmHg. Physical examination reveals a soft, nontender, and nondistended abdomen. Neurological examination shows decreased sensation in the bilateral hands. Which of the following is the most likely cause of this patient’s condition?
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