Review Question - QID 215148

A 7-week-old infant girl is brought to the physician by her mother with a 3-day history of lethargy, poor feeding, and infrequent bowel movements. Prior to 3 days ago, the patient was feeding normally. The patient was born at home at 38 weeks of gestation via spontaneous vaginal delivery without any complications. Apgar scores were 9 at 1 minute and 9 at 5 minutes. The patient has not seen a physician since birth, but her mother has not noted any developmental abnormalities until this week. Her temperature is 96.4°F (35.8°C), blood pressure is 78/44 mmHg, pulse is 110/min, and respirations are 40/min. Physical exam shows a lethargic, jaundiced infant with dry, mottled skin, a large anterior fontanelle, and a hoarse cry. Her face appears coarse, and there is macroglossia. Which of the following will most likely be seen on lab testing?