Pulmonary Embolism USMLE Step 1 Practice Question
A 48-year-old woman presents with acute dyspnea, tachycardia (HR 112/min), and tachypnea (RR 22/min). CT pulmonary angiography confirms pulmonary embolism. Vital signs: BP 128/82 mmHg, SpO2 98% on room air, temperature 37.2°C. Troponin and BNP are normal; echocardiography shows no right ventricular strain. She has a contraindication to anticoagulation due to hemorrhagic stroke 2 weeks prior. Which intervention is most appropriate for this hemodynamically stable patient?
Answer choices
- AAdminister half-dose systemic thrombolysis
- BInitiate full-dose enoxaparin despite the contraindication
- CPerform catheter-directed thrombolysis
- DPlace a retrievable inferior vena cava filterCorrect answer
- EStart low-dose aspirin
- FInitiate unfractionated heparin with close monitoring of bleeding risk
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