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 Best of Five 53

 

   

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BOF: 53

A 50-year-old man presents with malaise, weight loss, diarrhoea and pain in the joints. He is pigmented, has clubbing and lymphadenopathy. He has ascites and ophthalmoplegia.  Investigations show him to be anaemic. ECG shows a right bundle branch block and paracentesis abdominis reveals chylous ascites.

The investigation most likely to give a diagnosis would be:

a)      Lumbar puncture

b)      CT head

c)      Ascitic fluid cytology

d)      Small bowel biopsy

e)      Transoesphageal echocardiography

 

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