BOF: 71
A 78 year old male presents with a
history of falls and backache. On examination he is noted to have a blood
pressure of 110/70 lying and 80/50 standing. He looks pale and has a
tachycardia with a pulse rate of 110 beats per minute , his JVP is elevated ,
there is a 3rd heart sound heard on auscultation with s systolic
murmur at the apex and there are bilateral basal crepitations heard on
auscultation of his lungs .
Investigations
Hb 8.5 g/dL
WBC 7.5 x109/L
Platelets 180
ESR 102 mm in 1st hour
Sodium 132 mmol/L
Potassium 4.2 mmol/L
Urea 16 mmol/L
Calcium 2.9 mmol/L
Phosphate 1.9 mmol/L
Alkaline phosphatase 140U/L
Albumin 19g/L
Urine protein ++++
In this patient which one of the
following investigations would you arrange in order to diagnose the underlying
cause of the condition?
a)
Renal biopsy
b)
Sural nerve biopsy
c)
Rectal biopsy
d)
Bone marrow examination
e)
Short synacthen test
