🏥 USMLE Exam Prep

A 40-year-old obese female presents to the emergency department with unilateral leg swelling and pain. A D-dimer test is positive, but a Wells score for deep vein thrombosis (DVT) risk is 1 (low probability). What is the most appropriate next step in management?

A Initiate therapeutic anticoagulation immediately.
B Perform a compression ultrasonography of the affected leg.
C Repeat the D-dimer test in 24 hours.
D Discharge the patient with instructions to return if symptoms worsen.

✓ Correct Answer: Option B

In a patient with a low pretest probability for DVT but a positive D-dimer, a definitive imaging study like compression ultrasonography is required to rule out DVT, as D-dimer alone cannot exclude it.

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