#february2020mccqe1
A 50-year-old woman is evaluated in the emergency department for a 4-day history of pain, swelling, and erythema of the left leg. There is no history of recent
immobilization, cancer, surgery, or deep venous thrombosis. On physical examination, temperature is 37.7°C (100.0°F), blood pressure is 132/82 mm Hg, pulse rate is 65/min, and respiration rate is 16/min. Examination of the left leg discloses warmth and circumscribed erythema and tenderness limited to the posterior tibial portion of the leg. The circumference of the left leg is 1 cm greater than the right when measured 10 cm below the tibial tuberosity. Localized tenderness along the distribution of the deep venous system and pitting edema are absent, as are venous varicosities.
Which of the following is the most appropriate next step in diagnosis?
(A) CT of the leg
(B) D-dimer assay
(C) MRI of the leg
(D) Venography
A 50-year-old woman is evaluated in the emergency department for a 4-day history of pain, swelling, and erythema of the left leg. There is no history of recent
immobilization, cancer, surgery, or deep venous thrombosis. On physical examination, temperature is 37.7°C (100.0°F), blood pressure is 132/82 mm Hg, pulse rate is 65/min, and respiration rate is 16/min. Examination of the left leg discloses warmth and circumscribed erythema and tenderness limited to the posterior tibial portion of the leg. The circumference of the left leg is 1 cm greater than the right when measured 10 cm below the tibial tuberosity. Localized tenderness along the distribution of the deep venous system and pitting edema are absent, as are venous varicosities.
Which of the following is the most appropriate next step in diagnosis?
(A) CT of the leg
(B) D-dimer assay
(C) MRI of the leg
(D) Venography
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