Her CXR and ECG are normal. What is the single most appropriate inv?

A 50yo woman returned by air to the UK from Australia. 3days later she presented with sharp

chest pain and breathlessness. Her CXR and ECG are normal. What is the single most

appropriate inv?

a. Bronchoscopy

b. Cardiac enzymes

c. CT

d. MRI

e. Pulse oximetry

f. V/Q scan

g. CTPA

Ans. The key is G. CTPA. [Prolonged plane journey is a recognized risk factor for thromboembolism and hence pulmonary embolism also! Sharp chest pain and breathlessness after 3 days of plane journey is highly suggestive of pulmonary embolism the investigation of choice for which is CTPA].