pls answer this nbme 3 q - asin

[ArchivalUser]

A 62 year old man is brought to the physician because of a 6 month history of increasingly severe dull back pain and a 14 kg (30 lb) weight loss despite a normal appetite. Recent x-ray films of the thoracolumbar spine showed no abnormalities. He has no history of trauma or serious illness. He takes no medications. He is 173 cm (5 ft 8 in) tall and weight 91 Kg (200 lb). BMI is 30 Kg/m2. The reminder of the examination shows no abnormalities. Test of the stool for occult blood is negative. A complete blood count, serum electrolyte levels and unrinalysis are within the reference range. Which of the following is the most appropriate step in diagnosis?

A. Mesenteric angiography
B. Measurement of serum CA 19-9 level
C. CT scan of the abdomen
D. Measurement of serum carcinoembryonic antigen (CEA) level
E. Laparoscopy
F. Upper endoscopy


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