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Postoperative pulmonary embolism — SCE Acute Medicine MCQ

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ModeratePerioperative Medicine, End-of-Life Care and Patient SafetyPostoperative pulmonary embolismSCE Acute Medicine

A 66-year-old woman is assessed on the acute medical unit. She is day 5 after hemicolectomy with sudden dyspnoea and pleuritic pain. Oxygen saturation is 89% and chest radiograph is clear. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate investigation?

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

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Correct answer: A — CT pulmonary angiography

CT pulmonary angiography is the best answer because postoperative hypoxaemia with pleuritic pain and clear radiograph warrants PE imaging when stable. MRI brain with diffusion-weighted imaging is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Postoperative status increases VTE risk even with prophylaxis.

Reference: NICE NG158