A 49-Year-Old Man Comes to the Office Due to "Aching

A 49-year-old man comes to the office due to "aching bones."  He has a 2-month history of insidious-onset pain that is most pronounced in the back, pelvis, and lower extremities.  The pain is dull and increases after weight-bearing activities.  The patient has no prior medical conditions and takes no medications.  He emigrated from Central Africa 5 years ago and works overnight shifts as a cab driver.  Vital signs are within normal limits.  Physical examination shows normal muscle strength in the upper and lower extremities bilaterally.  A thorough laboratory evaluation establishes the diagnosis.  After discussing the likely cause of his condition, the patient starts spending more time outdoors in the sun.  Which of the following enzymatic steps will most likely be affected by this change in activity?

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

Correct Answer:

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