Pulmonary Embolism USMLE Step 1 Practice Question
A 63-year-old man with recurrent unprovoked deep venous thromboses presents with months of progressive exertional dyspnea and fatigue. Vital signs show BP 128/82 mmHg, HR 92 bpm, RR 20/min, SpO2 94% on room air, and normal temperature. Physical examination reveals a loud P2, lower extremity edema, and clear lung fields. Right heart catheterization demonstrates elevated pulmonary artery pressure (55 mmHg systolic). CT pulmonary angiography shows no acute emboli. Which diagnosis best explains these findings?
Answer choices
- APleural effusion
- BChronic thromboembolic pulmonary hypertensionCorrect answer
- CPulmonary edema due to left sided heart failure
- DCommunity acquired pneumonia
- EPrimary pulmonary hypertension due to BMPR2 mutation
- FIdiopathic pulmonary arterial hypertension without thromboembolism
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