VTE, DVT & PE: ABFM practice questions

16 board-style questions on vte, dvt & pe in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 44-year-old woman presents with progressive left leg swelling, calf tenderness, and warmth over 4 days. She returned from a 12-hour international flight 8 days ago and is on combined oral contraceptive pills. Her left calf circumference is 4 cm greater than the right. There is pitting edema to the mid-shin. Her Wells score for DVT is calculated at 4 (calf swelling greater than 3 cm = 1, pitting edema = 1, recently bedridden/major surgery = 0, localized tenderness = 1, entire leg swollen = 1). What is the most appropriate next diagnostic step?

  1. Start therapeutic anticoagulation empirically without diagnostic testing
  2. CT venography of the pelvis and lower extremity
  3. Compression ultrasonography of the affected leg
  4. D-dimer level to exclude DVT

Sample question 2

A 48-year-old man was diagnosed with an unprovoked proximal deep vein thrombosis of the left popliteal and femoral veins 6 months ago. He has been on rivaroxaban 20 mg daily since diagnosis with no bleeding complications. Repeat compression ultrasonography shows complete resolution of the thrombus. He has no identifiable provoking risk factors (no surgery, immobilization, trauma, or malignancy). Thrombophilia workup is negative. He asks how long he should continue anticoagulation. What is the most appropriate recommendation?

  1. Consider extended (indefinite) anticoagulation with periodic reassessment of the risk-benefit balance
  2. Discontinue anticoagulation now; 6 months is adequate for a first unprovoked DVT
  3. Continue rivaroxaban for a total of 12 months, then discontinue
  4. Switch to aspirin 81 mg daily as a substitute for anticoagulation

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