A 72-year-old female develops sudden onset dyspnea and pleuritic chest pain post-operatively from a total hip arthroplasty. She is tachycardic, tachypneic, and hypotensive (BP 90/60 mmHg). ECG shows sinus tachycardia with an S1Q3T3 pattern. A CT pulmonary angiography confirms massive pulmonary embolism. What is the most appropriate immediate management strategy?

The correct answer to the question "A 72-year-old female develops sudden onset dyspnea and pleuritic chest pain post-operatively from a total hip arthroplasty. She is tachycardic, tachypneic, and hypotensive (BP 90/60 mmHg). ECG shows sinus tachycardia with an S1Q3T3 pattern. A CT pulmonary angiography confirms massive pulmonary embolism. What is the most appropriate immediate management strategy?" is Option C: Administer intravenous alteplase..

The other options — A) Start subcutaneous enoxaparin., B) Initiate unfractionated heparin infusion., D) Prepare for placement of an inferior vena cava (IVC) filter. — are incorrect for this USMLE Exam Prep question. As explained above: This patient has a massive pulmonary embolism with hemodynamic instability (hypotension). Thrombolysis (e.g., alteplase) is indicated in this setting to rapidly dissolve the clot and restore pulmonar…