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20054 Biochemistry

A 45-year-old man is admitted to the hospital for the evaluation of diplopia, weakness of his lower extremities, and gait difficulties. During the interview, the patient reveals that he has been forcing himself to vomit after almost every meal over the last 6 weeks. He denies associated eye pain and discomfo, headache, or dysphagia. He has never experienced such symptoms in the past. Examination of the patient demonstrates slight disorientation, veical nystagmus worse on downgaze, diffuse weakness of the lower extremities, bilateral dysmetria, and hypothermia. Laboratory analyses reveal mild dehydration and hypokalemia. The patient’s status has improved after an administration of a vitamin. The physiologically active form of this vitamin acts as a coenzyme for which of the following enzymes?

AGlycogen phosphorylase
BL-methylmalonyl-CoA mutase
CMethionine synthase
DPyruvate dehydrogenase
Biochemistry
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