A 44-year-old woman who recently lost her job because of absen- teeism, presents to her physician complaining of loss of appetite, fatigue, muscle weakness, and emotional depression. The physical examination reveals a somewhat enlarged liver that feels firm and nodular, and there is a hint of jaundice in the sclerae and a hint of alco- hol on her breath. The initial laboratory profi e included a hematolog- ical analysis that showed that she had an anemia with enlarged red blood cells (macrocytic). A bone marOw aspirate confirmed the suspi- cion that she has a megaloblastic anemia because it showed a greater than normal number of red and white blood cell precursors, most of which were larger than normal. Further analyses Tevealed that her serum folic acid level was 2.9 ng/ml. (normal = 6 to 15), her serum B, level was 153 pg/mL (normal 150 to 750), and her serum iron level was normal. The patient's megaloblastic anemia is most likely caused by which of the following? A. A decreased synthesis of methionine BA decreased conversion of dUMP to dTMP A decreuse in the synthesis of phosphatidvl choline D.Adecrease in the leels of succinyl CoA A decreased synthesis of aUTP
A 44-year-old woman who recently lost her job because of absen- teeism, presents to her physician complaining of loss of appetite, fatigue, muscle weakness, and emotional depression. The physical examination reveals a somewhat enlarged liver that feels firm and nodular, and there is a hint of jaundice in the sclerae and a hint of alco- hol on her breath. The initial laboratory profi e included a hematolog- ical analysis that showed that she had an anemia with enlarged red blood cells (macrocytic). A bone marOw aspirate confirmed the suspi- cion that she has a megaloblastic anemia because it showed a greater than normal number of red and white blood cell precursors, most of which were larger than normal. Further analyses Tevealed that her serum folic acid level was 2.9 ng/ml. (normal = 6 to 15), her serum B, level was 153 pg/mL (normal 150 to 750), and her serum iron level was normal. The patient's megaloblastic anemia is most likely caused by which of the following? A. A decreased synthesis of methionine BA decreased conversion of dUMP to dTMP A decreuse in the synthesis of phosphatidvl choline D.Adecrease in the leels of succinyl CoA A decreased synthesis of aUTP
Biochemistry
9th Edition
ISBN:9781319114671
Author:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.
Publisher:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.
Chapter1: Biochemistry: An Evolving Science
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Transcribed Image Text:A 44-year-old woman who recently lost her job because of absen-
teeism, presents to her physician complaining of loss of appetite,
fatigue, muscle weakness, and emotional depression. The physical
examination reveals a somewhat enlarged liver that feels firm and
nodular, and there is a hint of jaundice in the sclerae and a hint of alco-
hol on her breath. The initial laboratory profi e included a hematolog-
ical analysis that showed that she had an anemia with enlarged red
blood cells (macrocytic). A bone marrOw aspirate confirmed the suspi-
cion that she has a megaloblastic anemia because it showed a greater
than normal number of red and white blood cell precursors, most of
which were larger than normal. Further analyses revealed that her
serum folic acid level was 2.9 ng/ml. (normal
level was 153 pg/mL (normal
6 to 15), her serum B,,
150 to 750), and her serum iron level
was normal.
The patient's megaloblastic anemia is most likely caused by which of
the following?
A. A decreased synthesis of methionine
BA decreased conversion of dUMP to dTMP
A decreuse in the synthesis of phosphatidvl choline
D.Adecrease in the leels of succinvl CoA
EA decreased synthesis of dU TP
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