General Medicine

20 learning units • 100 chapter sections • 200 explained questions. Assess the patient, choose investigations and build a monitored management plan across adult medical specialties.

Original RAHBAR study material for the Year 4 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 08 / 20

Pulmonary Embolism & Pleural Disease

Use probability-based testing and distinguish thromboembolic and pleural emergencies from less urgent disease.

Answer all 10 questions, then submit to see your score and explanations. This is a self-study exercise; results are not saved.

Question 01. What does a positive D-dimer establish? A. Increased fibrin turnover without confirming PEB. Definite pulmonary embolismC. Exact clot locationD. A mandatory need for thrombolysis

Question 02. When is D-dimer most useful in suspected PE? A. As the sole test in every shocked patientB. To select anticoagulant dose directlyC. To grade pleural fluid acidityD. Within a validated lower-probability exclusion pathway

Question 03. Does absence of leg swelling rule out PE? A. NoB. Yes, in all adultsC. Only when chest pain is pleuriticD. Yes, if the pulse is fast

Question 04. What is the priority in suspected PE with shock? A. Routine clinic review after several weeksB. Waiting for a repeat D-dimer tomorrowC. Discharge if there is no feverD. Urgent resuscitation and specialist assessment

Question 05. What should influence anticoagulant selection? A. Only the patient's heightB. The chest-radiograph size aloneC. Renal function, bleeding risk and clinical contextD. Whether the patient prefers tablets of one colour

Question 06. Who may be considered for outpatient PE treatment? A. Carefully selected stable low-risk patients with adequate supportB. Every patient regardless of instabilityC. Only patients with shockD. Anyone with a positive D-dimer alone

Question 07. What helps guide safe pleural-fluid sampling? A. Ultrasound and a supervised procedural pathwayB. Blind puncture based only on an old filmC. A normal pulse aloneD. A routine ECG as the only localisation tool

Question 08. Why may an infected pleural collection require drainage? A. Antibiotics always remove every collection immediatelyB. Drainage is only cosmeticC. Source control may be needed in addition to antibioticsD. Fluid cannot contain organisms

Question 09. A patient has severe compromise with suspected tension pneumothorax. What should not delay emergency treatment? A. Waiting for a chest radiographB. Calling the emergency teamC. Immediate physiological assessmentD. Monitoring during resuscitation

Question 10. What determines duration of anticoagulation after PE? A. The same lifelong course for every patientB. D-dimer positivity alone indefinitelyC. Whether chest pain lasts one dayD. Provocation, recurrence and bleeding risks with review

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References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

Reference review: 27 September 2026. Consult current local protocols for prescribing, procedures and escalation.