A 62-year-old woman with COPD on postoperative day 4 following total hip replacement presents with acute dyspnea, pleuritic chest pain, and tachycardia. Vital signs show HR 112 bpm, BP 138/88 mmHg, RR 22/min, SpO2 88% on room air, and temperature 37.2°C. Chest X-ray reveals a wedge-shaped opacity. D-dimer is elevated at 2.8 µg/mL. She denies leg swelling. Which anatomic site is the most likely source of thromboembolism?

  1. A)Left atrial appendage
  2. B)Portal venous system
  3. C)Deep veins of the lower extremityGABARITO
  4. D)Pulmonary veins
  5. E)Coronary sinus

Explicação

Deep veins of the lower extremity is correct. Most pulmonary emboli arise from thrombi in the deep venous system of the legs or pelvis, especially after orthopedic surgery or prolonged immobility. Sudden dyspnea with pleuritic pain in this setting is classic. Ver explicação completa e trilha adaptativa →

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