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Diagnostic anchoring error in suspected PE — SCE Acute Medicine MCQ

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EasyPerioperative, Safety and End-of-Life CareDiagnostic anchoring error in suspected PESCE Acute Medicine

A 69-year-old woman presents with postoperative deterioration, treatment refusal or advanced illness. Relevant history includes recent surgery, frailty or a governance issue. On assessment, physiology and communication context require senior decision-making. Investigations show young patient labelled anxiety has hypoxaemia, tachycardia and PE risk factors. What is the most appropriate next step in management?

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

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Correct answer: D — Reassess objectively for pulmonary embolism using a validated pathway

The key discriminator is that young patient labelled anxiety has hypoxaemia, tachycardia and PE risk factors, which makes Reassess objectively for pulmonary embolism using a validated pathway the single best answer. Call critical care for escalation is less appropriate because it does not address the dominant acute risk in the vignette; Start anticoagulation after assessing bleeding risk would fit a different presentation or later stage of care. Give intravenous fluids with reassessment and Provide supportive care and close monitoring are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: NICE NG158