1. what possible conditions did this young woman have and why did it manifest at this time

2. would any members of her family have a similar disease

3. what enzyme defect did she have

4. what other confiramatory test if any could be done

A few days after a laparotomy for “intestinal obstruction,” a young nurse from South Africa became emotionally disturbed and appeared to be hysterical.For longer than 1 week before the operation, she had taken barbiturate capsules to help her sleep.When first seen, she complained of severe abdominal and muscle pain and general weakness. Her tendon reflexes were absent, and she was vomiting and constipated.Her urine was dark in color on standing and gave a brilliant pink fluorescence when viewed in ultraviolet light. Within 24 hours, she was completely paralyzed, and within 2 days she died.