Pulmonary Embolism USMLE Step 1 Practice Question
A 42-year-old man with no prior thromboembolism presents with acute pleuritic chest pain and dyspnea. Vital signs show BP 138/82, HR 118, RR 22, SpO2 88% on room air, and temperature 37.2°C. Physical examination reveals normal lung sounds bilaterally. His Wells score is 2 points. Chest X-ray shows no infiltrate or pleural effusion. D-dimer is pending. Which of the following is the most appropriate next diagnostic step?
Answer choices
- ASerial troponin measurements
- BD-dimer assayCorrect answer
- CCT pulmonary angiography immediately
- DVentilation-perfusion scan
- EEmpiric anticoagulation
- FTransthoracic echocardiography
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