Sideroblastic anemia Quiz: Ace Your Exams

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A 25-year-old woman presents to the emergency department because of abdominal pain, nausea, and confusion. The symptoms began around four-days ago following a binge-drinking episode. Her pain is currently rated as a 6 out of 10 in severity. Furthermore, she has been experiencing poor sleep quality, increased forgetfulness, and a tingling sensation in the lower extremities. The patient has had several similar episodes in the past, which would last for a week and subsequently resolve spontaneously. Past medical history is otherwise noncontributory. Temperature is 37.2°C (99.0°F), pulse is 105/min, respirations are 15/min, and blood pressure is 130/68 mmHg. Physical examination reveals diffuse abdominal pain that is not exacerbated with palpation. No rebound tenderness or localizing signs are present. Serum lipase and liver function tests are within normal limits. A urine sample is obtained and is shown below:


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This patient’s condition is most likely a result from a defect in which of the following?  

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