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 patient’s 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
