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8572 Medicine

A 37-year-old factory worker develops increasing weakness in the legs; coworkers have noted episodes of transient confusion. The patient has bilateral foot drop and atrophy; mild wrist weakness is also present. Deep tendon reflexes are absent in the lower extremities. His CBC shows an anemia with hemoglobin of 9.6 g/dL; examination of the peripheral blood smear shows basophilic stippling. Which of the following is the most likely cause of this patient’s symptoms?

AAmyotrophic lateral sclerosis
BLead poisoning
COveruse syndrome
DMyasthenia gravis
Medicine
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