Pulmonary embolism in pregnancy — MCCQE Part 1 MCQ

Correct answer: E — Investigate suspected pulmonary embolism using a pregnancy-adapted pathway and start anticoagulation if probability is high

Investigate suspected pulmonary embolism using a pregnancy-adapted pathway and start anticoagulation if probability is high is the single best answer because the age, timing, examination findings and investigations in the vignette fit Pulmonary embolism in pregnancy 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 SOGC VTE in pregnancy guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC VTE in pregnancy guidance