BOF 65

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BOF: 65

A 62 year old male presents with a history of transient weakness of his right arm and leg. He is a mild hypertensive and is on a thiazide diuretic. He smokes 10 cigarettes a day. on examination you note that he has moderate enlargement of the spleen but apart from this there are no abnormalities detected. Neurological examination is normal.

Investigations

Hb 14.2 g/dL

Red cell count 8.6 x10¹² /L

MCV 68 fl

WBC 18 x10⁹ \L

Platelets 550 x10⁹ \L

In this patient which of the following investigations would you arrange to make a definitive diagnosis?

a)      Measure red cell volume

b)      Bone marrow examination

c)      MR angiogram of the brain

d)     Non invasive vascular assessment of the carotid vessels

e)      Transthoracic echocardiogram

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