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Suspected pulmonary embolism — SCE Respiratory MCQ

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EasyPulmonary Vascular DiseaseSuspected pulmonary embolismSCE Respiratory

A 46-year-old woman has pleuritic chest pain 2 weeks after ankle surgery. HR is 112/min, SpO2 94% on air and CXR is normal. Wells score indicates PE is likely. Renal function is normal. What is the most appropriate investigation?

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Correct answer: C — CT pulmonary angiography

When PE is clinically likely, NICE recommends immediate imaging with CTPA where suitable, rather than using D-dimer to exclude disease. V/Q scanning is useful when CTPA is contraindicated or preferred for specific reasons, but renal function is normal here. Echocardiography is not definitive for stable suspected PE and symptom improvement does not exclude PE.

Reference: NICE NG158