Match each clinical presentation of suspected pulmonary embolism with the most appropriate next step in diagnostic testing according to current guidelines.
- A 42-year-old man with sudden-onset pleuritic chest pain, a Wells score of 6.5 (high probability), and normal renal function.Computed tomography pulmonary angiography (CTPA)
- A 65-year-old woman with suspected pulmonary embolism and a documented history of severe anaphylaxis to iodinated contrast media.Ventilation-perfusion (V/Q) scan
- A 28-year-old healthy man with mild dyspnea, clear lungs, and a Wells score of 1 (low probability).High-sensitivity D-dimer assay
- A 30-year-old pregnant woman in her second trimester presenting with acute dyspnea and a swollen, tender left calf.Lower extremity venous compression ultrasonography
Cevap
Each patient's clinical pre-test probability and specific contraindications determine the exact sequencing of their diagnostic workup.
The correct matches reflect the standard diagnostic algorithms for pulmonary embolism: D-dimer for low risk, CTPA for high risk without contraindications, V/Q scan for high risk with contrast allergy, and venous ultrasound for pregnant patients presenting with DVT symptoms.
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Diagnostic Workup and Test Sequencing for Pulmonary Embolism