View source for WBR1008

 {{WBRQuestion
|QuestionAuthor= {{VB}}
|ExamType=USMLE Step 2 CK
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|SubCategory=Dermatology
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Dermatology
|Prompt=A 42 years old female presents to her physician with following complaints:<br>
Abdominal pain which is severe and poorly localized since last 2 weeks, dark urine, altered sensation, sweating, restlessness and tremor, anxiety, agitation. She has also been hearing voices on and off which, tell her to harm her neighbor. She also experiences bouts of sudden uncontrolled weeping. 
On physical examination she has raised heart beat and slightly elevated blood pressure, but is otherwise unremarkable. 

After doing a thorough work up, she is diagnosed with a defect in heme metabolism. Which of these correctly represents her disease and the enzyme defect that she is suffering from? 
Shown below is an image depicting the heme metabolism:<br>

[[Image:Heme synthesis2.jpg|300px]]  
|AnswerA=Acute intermittent porphyria; porphobilinogen deaminase
|AnswerB=Congenital erythropoietic porphyria; uroporphyrinogen III synthase
|AnswerC=Variegate porphyria; protoporphyrinogen oxidase

|AnswerD=Acute porphyria; ALA synthase deficiency
|AnswerE=Acute porphyria; ALA dehydrogenase deficiency
|RightAnswer=A
|Approved=No
}}