Pulmonary Embolism USMLE Step 1 Practice Question
A 55-year-old woman with metastatic breast cancer on active chemotherapy presents with acute left calf swelling and erythema. Vital signs: BP 128/82, HR 102, RR 18, Temp 37.2°C, SpO2 98% on room air. She denies fever or recent trauma. Compression ultrasound confirms left popliteal deep vein thrombosis. D-dimer is elevated at 2.8 μg/mL. Which of the following is the most likely etiology of her thrombosis?
Answer choices
- AHypercoagulability from malignancyCorrect answer
- BInherited thrombophilia unmasked by chemotherapy
- CInfection from neutropenia-related cellulitis
- DImmobility from prolonged chemotherapy infusion
- EVascular injury from central venous catheter
- FDirect endothelial damage from extravasation of chemotherapy agents
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