Welcome to episode 559 of the Divine Intervention Podcasts.

In today's podcast, we'll be continuing this series on the USMLA Step 3, 3137.

This is going to be series 6B.

Again, 51 or 54 had a lot of twists and turns and I felt compelled to discuss a bunch of

testing in principle so I figured we should do a 6b and do 55 to 60 all right so going to go

straight to 55 if you missed other parts of the series listen listen to them. Trust me, it's worth your while.

Okay, so patient information, age 64 years. It was a 64-year-old female coming to the office.

She says, I can't catch my breath even when I'm sitting still. So look at the HPI. She's been

shot of breath for 12 hours. Has a 15-year history COPD, Inguno hernia repair a week ago,

takes albuterol, no allergies, doesn't smoke or drink alcohol.

Okay, now look at her labs.

Her physical exam, what stands out? She's tachycardic, she's tekeepnic,

her O2 side is 86% on room air b my

is 23 her appearance she's in acute distress her intercostal and sternoclydo mastoid muscles are retracted

um honestly every other exact she her cardiac exam she's tachycardic, but every other thing

is fine.

And then we look at the rest of her labs, where D-Dimer is markedly elevated.

It's almost like 50x, the upper limit of normal.

Every other lab is fine.

Chest X-ray is fine.

So what's the most likely diagnosis, right?

So this should make perfect sense

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