🏥 USMLE Exam Prep

A 45-year-old woman presents to the emergency department with acute onset dyspnea and pleuritic chest pain. She recently had a long-haul flight. Her vital signs show HR 110/min, RR 24/min, BP 100/60 mmHg, O2 sat 92% on room air. ECG shows sinus tachycardia. Her Wells score for pulmonary embolism is 6. Which of the following is the most appropriate next step in management?

A Administer intravenous unfractionated heparin immediately.
B Order a D-dimer test.
C Perform a CT pulmonary angiography (CTPA).
D Initiate supplemental oxygen and observe.

✓ Correct Answer: Option C

A high Wells score indicates a high probability of PE. In such cases, direct imaging with CTPA is the most appropriate next step to confirm the diagnosis and guide immediate treatment.

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