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 patient comes to see you because he has  

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patient comes to see you because he has been weak and falling down frequently. During the interview, you note that he is suspicious and irritable. On physical examination, you note that his skin is pale, his tarsal plates are pale, and he has a loss of vibration sense over his legs and trunk. His legs show a symmetric weakness with decreased deep tendon reflexes. The leading theory for the pathophysiology of this disorder relates to which of the following?

A. Anamolous insertion of even-chain fatty acids into membrane lipids

B. Anomalous insertion of odd-chain fatty acids into membrane lipids

C. Increased vitamin A intake

D. Lack of methylmalonyl CoA

E. Lack of propionyl CoA


B12 deficiency - odd chain fatty acids accumulate and become incorporated into myelin sheets. B.



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