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9577 Medicine

A two-month-old infant presents with irritability and lethargy. The parents state he was well until he rolled off the couch onto the floor on the previous day. On examination, he is inconsolable and afebrile. The fontanels are full and tense. He has a generalized tonic-clonic seizure in your office. The most impoant additional diagnostic study is:

ASerum calcium, phosphorus, and alkaline phosphatase levels
BViral cultures of nasopharyngeal swab
CRetinoscopic Exam
DSerum ammonia level
Medicine
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