🏥 USMLE Exam Prep

A 45-year-old woman presents to the ED with sudden-onset dyspnea, pleuritic chest pain, and a cough. She recently underwent knee surgery. Her EKG shows sinus tachycardia and non-specific ST-T wave changes. D-dimer is elevated. Which of the following is the most appropriate next diagnostic step?

A Chest X-ray
B Ventilation-perfusion scan (V/Q scan)
C CT pulmonary angiography (CTPA)
D Lower extremity Doppler ultrasound

✓ Correct Answer: Option C

Given high clinical suspicion for pulmonary embolism in a stable patient with an elevated D-dimer, CT pulmonary angiography is the most appropriate and sensitive diagnostic test to confirm or rule out PE.

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