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 Best of Five 227

 

   

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BOF: 227

A 68-year-old male presents with a history of progressive tiredness and breathlessness. On examination there is pallor, his pulse rate is 60 beats per minute, regular rhythm, low volume, slow rising. The JVP is not elevated. His apex beat is at the 5th left intercostal space mid-clavicular line and it is heaving in nature. There is a systolic thrill in the 2nd right intercostal space just lateral to the sternum and there is a systolic murmur in the aortic area radiating to the neck. Investigations reveal:

Hb 7.0

MCV 68 fL

MCHC 28 g/dL

Upper GI endoscopy is normal

In further investigation of this patientís anaemia the most useful test would be:

a)      Colonoscopy

b)      Flexible sigmoidoscopy and barium enema

c)      Mesenteric angiography

d)      CT colography

e)      Capsule endoscopy

 

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