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Pulmonary embolism — MCCQE Part 1 MCQ

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HardChest PainPulmonary embolismMCCQE Part 1

A 38-year-old woman 3 weeks postpartum has pleuritic chest pain, haemoptysis, oxygen saturation 91%, tachycardia and a swollen tender calf. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Start anticoagulation while arranging urgent diagnostic imaging for pulmonary embolism

Start anticoagulation while arranging urgent diagnostic imaging for pulmonary embolism is the single best answer because the age, timing, examination findings and investigations in the vignette fit Pulmonary embolism better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Thrombosis Canada VTE guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Thrombosis Canada VTE guidance