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Low-probability pulmonary embolism rule-out — SCE Respiratory MCQ

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EasyPulmonary Vascular DiseaseLow-probability pulmonary embolism rule-outSCE Respiratory

A 45-year-old woman with suspected PE has a Wells score indicating PE unlikely. D-dimer is below the age-adjusted threshold. Oxygen saturation is 98% and chest radiograph is normal. What is the most appropriate management?

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Correct answer: E — Exclude PE and consider alternative diagnoses

In low clinical probability PE with a negative D-dimer, PE can be excluded and alternative diagnoses considered. Anticoagulation or CTPA would expose the patient to unnecessary harm in this rule-out context. Thrombolysis and invasive angiography are reserved for very different high-risk scenarios.

Reference: NICE NG158 Venous thromboembolic diseases