A 64-Year-Old Man Comes to the Emergency Department Due to Severe

question 30

Multiple Choice

A 64-year-old man comes to the emergency department due to severe abdominal pain, nausea, and vomiting.  He has a history of hypertension, myocardial infarction, and systolic heart failure.  His blood pressure is 100/60 mm Hg, pulse is 116/min and irregular, and respirations are 24/min.  Examination shows a soft, mildly distended, and tender abdomen.  Laboratory results are as follows: CT scan of the abdomen reveals distal ileal wall thickening and lack of enhancement with intravenous contrast.  Decreased activity of which of the following enzymes best explains the acid-base disorder in this patient?

• A)Enolase
• B)Lactate dehydrogenase
• C)Pyruvate carboxylase
• D)Pyruvate dehydrogenase
• E)Pyruvate kinase