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 BOF 58

 

   

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BOF: 58

A 72-year-old male presents with a history of longstanding diarrhoea and loss of weight.  He does not have any abdominal pain and has not lost his appetite.

In the past he has had a sigmoid colectomy for diverticulitis and subsequently has had further surgery for relief of adhesions following the initial operation.

He is hypertensive well controlled on a thiazide diuretic. He does not smoke and drinks 12 units of alcohol per week.

On examination he appears to have lost weight and looks pale. Apart from scars on his anterior abdominal wall from previous surgery, there are no abnormalities detected.

Investigations

Hb 7.6 g/dL

MCV 126 fl

WBC 3.8 x109 /L

Platelets 85 x109 /L

Sodium 139 mmol/L

Potassium 3.8 mmol/L

Urea 4 mmol/L

Vitamin B12 75 ng/L

Serum folate 14 mg/L

In this patient which one of the following tests is likely to indicate the cause of this patientís problem?

a)      Schilling test

b)      Glycocholic acid breath test

c)      Colonoscopy and terminal ileal biopsy

d)      Gastroscopy and distal duodenal biopsy

e)      Parietal cell antibody

 

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