Posted: July 25th, 2017

A 3-month-old female infant from South America is adopted. She has been exclusively breast-fed. The only known medical history is treatment with an antibiotic for a gastrointestinal infection prior to arrival in the USA; the specific antibiotic is not known. Three days after receiving the infant, the adoptive parents note that she no longer moves her left upper and lower extremities. Radiologic examination shows an intracranial hemorrhage without signs of head trauma. Laboratory studies show anemia and prolonged partial thromboplastin and prothrombin times. Her condition is most likely associated with a deficiency in which of the following?

A 3-month-old female infant from South
America is adopted. She has been exclusively
breast-fed. The only known medical history is
treatment with an antibiotic for a gastrointestinal
infection prior to arrival in the USA; the specific
antibiotic is not known. Three days after
receiving the infant, the adoptive parents note
that she no longer moves her left upper and
lower extremities. Radiologic examination
shows an intracranial hemorrhage without signs
of head trauma. Laboratory studies show anemia
and prolonged partial thromboplastin and
prothrombin times. Her condition is most likely
associated with a deficiency in which of the
following?
(A) γ-Aminobutyric acid (GABA)
decarboxylation
(B) Glutamic acid γ (gamma) carboxylation
(C) Heme synthesis
(D) Thymidine synthesis
(E) Xanthine oxidation