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Postoperative venous thromboembolism — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Postoperative venous thromboembolismUSMLE Step 3

A 63-year-old man develops pleuritic chest pain and dyspnea 6 days after hip replacement. Heart rate is 112/min and oxygen saturation is 89%. Right calf is swollen and tender. Which of the following is the most likely diagnosis?

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Reveal the answer and explanation

Correct answer: E — Pulmonary embolism

Recent orthopedic surgery, unilateral calf swelling, hypoxemia, tachycardia, and pleuritic pain suggest pulmonary embolism.

Reference: CHEST venous thromboembolism guideline