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A 17-year-old female was diagnosed with phenylketonuria (PKU) as a newborn. She marries a man with no family history of PKU and becomes pregnant but does not receive genetic testing or consistent prenatal care. The neonate is small, microcephalic, and has elevated levels of phenylalanine. Which of the following best explains these findings?

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Adult Lab Normals
Pediatric Lab Normals