Pulmonary Embolism USMLE Step 1 Practice Question
A 45-year-old man is brought to the emergency department with severe dyspnea, diaphoresis, and syncope. His blood pressure is 72/48 mmHg, heart rate is 130 bpm, and oxygen saturation is 82% on 100% oxygen via non-rebreather mask. Bedside echocardiography shows a dilated right ventricle with interventricular septal bowing into the left ventricle. CT angiography is unavailable. Which of the following is the most appropriate next step?
Answer choices
- APlace a bilateral lower extremity venous ultrasound
- BWait for CT angiography to become available
- CAdminister systemic thrombolysis with alteplaseCorrect answer
- DPerform urgent surgical embolectomy
- EStart unfractionated heparin and observe
- FInitiate inhaled nitric oxide and dobutamine infusion
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