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Pulmonary embolism exclusion — ABFM Board MCQ

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HardRespiratoryPulmonary embolism exclusionABFM Board

A 48-year-old woman has pleuritic chest pain and dyspnea after a 9-hour flight. Heart rate is 104/min, oxygen saturation is 95%, and Wells score is low. D-dimer is negative using an age-appropriate assay. Which of the following is the most appropriate next step?

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

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Correct answer: E — No imaging for pulmonary embolism

In a low pretest probability patient, a negative high-sensitivity D-dimer excludes pulmonary embolism and imaging is not required. Testing strategy should follow pretest probability.

Reference: ACEP Clinical Policy: Suspected Pulmonary Embolism