QuestionSBA
QuestionChoice
This patient is suffering from a deep vein thrombosis (DVT). Her Wells' score is 3: 1 point each for major surgery within the past 12 weeks, the symptomatic calf measuring >3cm more than the asymptomatic calf, and pitting oedema in the symptomatic calf. It is therefore likely that this patient has a DVT, and they should undergo a doppler ultrasound scan within 4 hours.
10001422
a
Venous doppler ultrasound
QuestionChoice
This is the gold-standard investigation to diagnose a pulmonary embolism (PE). This patient does not appear to be suffering from a PE as they do not have pleuritic chest pain, dyspnoea or haemoptysis.
10001425
d
CTPA
QuestionChoice
An x-ray would not be able to visualise a thrombus, and this is not a useful investigation for DVT.
10001426
e
X-ray of the leg
QuestionChoice
This could be an appropriate treatment but is not the most appropriate investigation.
10001424
c
Warfarin for 3 months
QuestionChoice
D-dimer is the best initial investigation for patients with a low risk of DVT (Wells' score <2). This patient has a high DVT risk, so a d-dimer would not be sufficient.
10001423
b
D-dimer
Concept
Chapter
2693
3927
deep vein thrombosis
Topic
157
Haematology
12831
A 60-year-old female presents to A&E with pain and swelling in her right leg. She had a hip replacement 5 weeks ago. On examination, her left calf measures 45cm whilst her right calf measures 41cm, and there is pitting oedema in her right shin. She has a history of stable angina. Her vital signs are normal.

Which of the following is the most appropriate next investigation?
a