A 60-year-old male presents with acute onset unilateral leg swelling, pain, and erythema. He recently had abdominal surgery. Physical examination reveals a swollen, tender, and warm left calf. Which of the following is the most appropriate initial diagnostic and therapeutic step?

The correct answer to the question "A 60-year-old male presents with acute onset unilateral leg swelling, pain, and erythema. He recently had abdominal surgery. Physical examination reveals a swollen, tender, and warm left calf. Which of the following is the most appropriate initial diagnostic and therapeutic step?" is Option B: Obtain a lower extremity duplex ultrasound and initiate therapeutic anticoagulation..

The other options — A) Start oral warfarin and monitor INR., C) Administer a course of broad-spectrum antibiotics., D) Order a D-dimer test and if negative, reassure the patient. — are incorrect for this USMLE Exam Prep question. As explained above: The patient has signs and symptoms highly suggestive of deep vein thrombosis (DVT), especially post-surgery. A duplex ultrasound is the diagnostic test of choice. Given the high clinical suspicion, t…