Review Question - QID 214460

A 47-year-old woman presents to the clinic with complaints of nausea for the past month. She reports feelings of nausea often following meals. Due to this, she has had decreased appetite for the past 3 weeks and reports a 5-lb. weight loss. The symptoms began shortly after a cruise trip to the Bahamas where she enjoyed the beach and local food. Her past medical history includes diabetes mellitus for which she is on insulin and an episode of urinary tract infection for which she is currently being treated with trimethoprim and sulfamethoxazole. She is sexually active with her husband and does not use any birth control. She endorses some breast tenderness, episodic epigastric pain, and some numbness and tingling of her bilateral toes. What is the most likely explanation for this patient’s symptoms?