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Biochemistry, cell biology, and genetics

Cell membranes, receptors, and transporters

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SAMPLE QUESTION

A 29-year-old woman reports double vision near the end of her workday and difficulty finishing meals because chewing becomes tiring. Her eyelids droop further during sustained upward gaze, and strength improves after rest. Sensation and tendon reflexes are preserved. Serum testing detects antibodies against the muscle acetylcholine receptor.

Which change most directly accounts for the failure of neuromuscular transmission?