英文原文：
A 42-year-old woman has a two-week history of nausea and vomiting. She had bariatric surgery two months ago. She reports generalized weakness, fatigue, confusion, weakness of the lower extremities associated with numbness in both hands and feet, and blurry vision. Physical examination shows sinus tachycardia, horizontal nystagmus, and peripheral neuropathy with muscle weakness and decreased reflexes.The most appropriate next step is IV administration of
一名42歲的女性患者，噁心、嘔吐兩周。兩個月前她做過減肥手術。患者報告全身無力、疲乏、意識模糊、下肢無力伴手足麻木和視物模糊。查體可見竇性心動過速、水平眼震、周圍神經病變伴肌無力、反射減弱。