Review Question - QID 109104

A 3-month-old boy is brought to his pediatrician’s office to be evaluated for seizures and failure to thrive. The patient’s mother says that he is unable to hold his own head up and does not seem to follow the movement of her fingers. On physical exam the patient is hypotonic. Initial serum studies show elevated lactate levels and further studies show elevated alanine and pyruvate. The patient’s mother says that one of her brothers had severe neurological impairments and died at a young age. Which of the following amino acids should most likely be increased in this patient’s diet?