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Biochemistry, cell biology, and genetics

Lysosomal storage diseases by accumulated material

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SAMPLE QUESTION

A 14-month-old girl is evaluated for loss of developmental skills. She smiled and reached for toys during early infancy but later lost head control and stopped reaching. Sudden sounds produce an exaggerated startle, and she recently had her first seizure. Examination shows generalized hypotonia and a cherry-red macular spot. The liver and spleen are not enlarged.

Deficiency of which lysosomal enzyme best explains this presentation?