Pulmonary Embolism (Imaging) — SCE Respiratory MCQ

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HardRadiologyPulmonary Embolism (Imaging)SCE Respiratory

A 60-year-old with suspected PE has intermediate pretest probability and a positive age-adjusted D-dimer. What is the most appropriate initial imaging study?

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Correct answer: D — CT pulmonary angiography with IV contrast

The best answer is “CT pulmonary angiography with IV contrast”. CT pulmonary angiography with IV contrast is supported by the decisive clinical findings and the cited specialist guidance. The alternatives remain plausible in related respiratory presentations but do not fit the stated threshold, sequence or physiology. The remaining choices—“V/Q scan for all patients”, “Noncontrast chest CT, within a respiratory pathway”, “Lower-extremity venous ultrasound principally”, “Echocardiography, with clinical reassessment”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: NICE NG158 venous thromboembolic diseases: https://www.nice.org.uk/guidance/ng158/chapter/Recommendations