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Review Question - QID 214797

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QID 214797 (Type "214797" in App Search)
A 24-year-old G2P1 woman at 7 weeks' gestation presents for her prenatal checkup. The patient mentions that in addition to mild bouts of nausea and vomiting, she has recently started to have intense cravings for ice for the past month. Inquiring further, the physician learns that she consumes large amounts of ice and only drinks cold beverages. Physical examination is remarkable for the absence of papillae on the surface of the patient’s tongue. Which of the following is most likely responsible for the patient’s symptoms?