A 4-Day-Old Girl Is Brought to the Office for a Routine

A 4-day-old girl is brought to the office for a routine newborn visit.  She was born at 39 weeks gestation via normal spontaneous vaginal delivery to a gravida 5 para 4 woman.  The patient has been breastfed exclusively but has had increasing difficulty feeding over the past 24 hours.  Her parents say that she is "too sleepy to feed" and has been vomiting.  The infant has 3 healthy, living siblings and a brother who died in infancy from "low sugar in his blood."  Physical examination shows tachypnea and signs of dehydration.  The patient is responsive to painful stimuli only.  After acute treatment and stabilization, urine testing reveals significantly elevated levels of methylmalonic acid.  Which of the following sets of laboratory values would most likely result from this patient's condition?

A) A
B) B
C) C
D) D
E) E

Correct Answer:

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