Pulmonary Embolism USMLE Step 1 Practice Question
A 70-year-old man with unprovoked pulmonary embolism 6 months ago currently takes apixaban. He presents with HR 88 bpm, BP 138/82 mmHg, RR 16, SpO2 98% on room air, and afebrile. Prior CT pulmonary angiography confirmed segmental PE. He denies leg swelling, chest pain, or dyspnea. Bleeding risk assessment is low with normal platelet count and creatinine. He has no identifiable transient risk factors. He asks about optimal anticoagulation duration.
Answer choices
- ASwitch to aspirin after 6 months
- BDiscontinue anticoagulation after 6 months total
- CContinue anticoagulation indefinitelyCorrect answer
- DContinue anticoagulation for 3 more months then stop
- EDiscontinue after 12 months and recheck D-dimer
- FD-dimer and residual vein thrombosis guided discontinuation
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