Q4. A 13 yo presents with a 7-day history of a sore throat, headache, low-grade fever and a rash on his legs. This morning he started to have vague abdominal pain and blood in the stool, and thus decided to come to the ED. He denies any trauma or use of medications. The physical is unremarkable except for his legs (see image). Exam reveals marked tenderness and guarding in the right lower quadrant. The WBC is 11, BUN 28 and Cr 1.7. Based on this presentation, the next step is?
a. Appendectomy
b. Air contrast barium enema
c. Skin biopsy
d. Laparoscopy
e. IV antibiotics
f. Colonoscopy
g. Renal ultrasound
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