Approach to chronic abdominal pain (pediatrics) Quiz: Ace Your Exams

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A 15-year-old girl presents to a clinic for evaluation of abdominal pain and intermittent bloody diarrhea for the past 3 months. The pain is described as generalized, severe, and crampy. The pain is not diurnal or related to food consumption. She reports sores in her mouth and unexpected weight loss over the past few months. The patient has not had a fever, rash, or mucoid stool. Menstrual cycles are regular, and she is not sexually active. Past medical, surgical, and family history are non-contributory. Temperature is 37°C (98.6°F), pulse is 80/min, respirations are 15/min, blood pressure is 117/76 mm Hg, and oxygen saturation is 97% on room air. On exam, she has ulcers over the buccal mucosa and tender nodules over her legs as shown in the image below. The abdomen is tender about the umbilicus and over the left lower quadrant, and there is no distention or rigidity. Cardiopulmonary exam is within normal limits. Which of the following laboratory tests should be ordered as part of this patient’s workup? 



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