Azerbaijan Medical Residents Final Attestation Practice Questions - Azerbaijan Medical Residents Final Attestation Examination (Həkim-Rezidentlərin Yekun Attestasiyası) Exam

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A 64-year-old female presents with sudden-onset severe dyspnea and pleuritic right chest pain. CT pulmonary angiography (CTPA) confirms a saddle pulmonary embolism with right ventricular strain. Blood pressure is 125/80 mmHg, heart rate is 108 bpm, and high-sensitivity Troponin T and NT-proBNP are elevated. How is this patient stratified according to ESC pulmonary embolism guidelines, and what is the appropriate initial management?

Low-risk PE; outpatient treatment with oral paracetamol Intermediate-High risk PE; admission for therapeutic anticoagulation (LMWH or direct oral anticoagulant), close hemodynamic monitoring, and rescue reperfusion readiness if decompensation occurs High-risk (massive) PE; immediate bedside systemic thrombolytic bolus therapy regardless of stable blood pressure Non-thrombotic pleurisy; oral NSAID therapy for 5 days

Correct Answer:

Intermediate-High risk PE; admission for therapeutic anticoagulation (LMWH or direct oral anticoagulant), close hemodynamic monitoring, and rescue reperfusion readiness if decompensation occurs

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