A 54-year-old man presents with pleuritic chest pain and dyspnoea. He has a recent history of lower limb immobilisation after Achilles tendon rupture....

Question

A 54-year-old man presents with pleuritic chest pain and dyspnoea. He has a recent history of lower limb immobilisation after Achilles tendon rupture. His Wells score suggests intermediate pre-test probability of pulmonary embolism. He is haemodynamically stable. What is the most appropriate next diagnostic step?

Accepted Answer

Order a CT pulmonary angiogram

Answer

Order a D-dimer assay

Answer

Order a ventilation-perfusion (V/Q) scan as first-line

Answer

Start anticoagulation without further imaging

Answer

Order lower limb venous Doppler ultrasound only

ca-mccqe1 MCQ (SBA): Pulmonary embolism work-up