🏥 USMLE Exam Prep

A patient presents with severe abdominal pain, neuropsychiatric symptoms, and port-wine-colored urine after starting phenobarbital. This constellation of symptoms is characteristic of acute intermittent porphyria (AIP), which results from a deficiency in which enzyme?

A Glucose-6-phosphate dehydrogenase
B Delta-aminolevulinate dehydratase
C Hydroxymethylbilane synthase
D Phenylalanine hydroxylase

✓ Correct Answer: Option C

AIP is caused by hydroxymethylbilane synthase deficiency, leading to accumulation of porphyrin precursors. Phenobarbital induces cytochrome P450, increasing heme synthesis demand and worsening symptoms.

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