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Postoperative pulmonary embolism — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Postoperative pulmonary embolismUSMLE Step 3

A 70-year-old man is on postoperative day 2 after hip arthroplasty. He has pleuritic chest pain and dyspnea. Oxygen saturation is 89% on room air, heart rate is 118/min, and blood pressure is 118/72 mm Hg. CT pulmonary angiography shows segmental pulmonary emboli. Which of the following is the most appropriate next step in management?

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Correct answer: E — Start therapeutic anticoagulation

Hemodynamically stable pulmonary embolism is treated with therapeutic anticoagulation; thrombolysis is generally reserved for instability.

Reference: CHEST venous thromboembolism guideline