Review Question - QID 214334

A 24-year-old woman presents to her primary care physician with complaints of leg numbness and tingling. She first noticed the numbness and tingling 4 months prior to presentation, and now occasionally has pain with the symptoms. The symptoms are associated with exercise, are not positional, and improve with rest. She moved into a new apartment 5 months ago. She denies chest pain, shortness of breath, abdominal pain and has had no changes in bowel or bladder function. She has a history of type I diabetes mellitus and irritable bowel syndrome. She is currently taking insulin and a multivitamin. Her temperature is 98.0°F (36.7°C), blood pressure is 160/100 mmHg, pulse is 70/min, and respirations are 18/min. On exam, her heart rate and rhythm are regular with a 2/6 systolic murmur heard at the left sternal border. Her lungs are clear to auscultation, and her abdomen is soft and nontender. She has no spinal tenderness, and a straight leg test is negative bilaterally. There is no lower extremity edema. Pin prick and vibratory sensation are intact with 1+ pulses in the dorsalis pedis arteries bilaterally. Her gait is normal, and she has a negative Romberg sign. Which of the following is most likely associated with this patient's condition?