Best of Five 3.32

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BOF: 3.32

A 63-year-old male presents with a 6-day history of diarrhoea and lower abdominal pain. He is known to have COPD and has had several courses of antibiotics recently for what his GP thought were infective exacerbations.

On examination the patient looks unwell, he is febrile (temp 39° C) dehydrated, tachycardic and his blood pressure is low. His abdomen is distended and tender, no lumps palpable, bowel sounds are heard and not exaggerated.

Which of the following investigations would be most appropriate in this patient?

a)      Plain x-ray abdomen

b)      Stool microscopy and culture

c)      CT scan of the abdomen

d)      Colonoscopy

e)      Unprepared flexible sigmoidoscopy

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