20th February 2025

A patient with sickle cell disease is admitted to hospital with hip pain that is thought to be secondary to a vaso-occlusive crisis.

A patient with sickle cell disease is admitted to hospital with hip pain that is thought to be secondary to a vaso-occlusive crisis. They are admitted to hospital for analgesia. Three days after admission, they develop a cough and become slightly short of breath with a new oxygen requirement. Their observations are: heart rate 101, blood pressure 139/79, saturations 96% on 1L /min and respiratory rate 22. Examination identifies a regular tachycardic pulse, some crepitations in the right lower zone and a slightly increased work of breathing, but the patient is still able to converse with you in full sentences comfortably. You perform an ECG which shows a sinus tachycardia, send a d-dimer which is normal and arrange a chest x-ray which is suggestive of some right lower lobe infiltrates. Given the likely diagnosis, which of the following would NOT form part of the subsequent initial investigations for the patient:

Select the SINGLE most appropriate option from the list below. Select ONE option only.