Question:medium
A patient with known carcinoma of the bladder presents with dyspnoea, clinical signs of deep vein thrombosis, and tachycardia. According to the Wells score, the risk of this patient developing pulmonary embolism is:
A patient with known carcinoma of the bladder presents with dyspnoea, clinical signs of deep vein thrombosis, and tachycardia. According to the Wells score, the risk of this patient developing pulmonary embolism is:
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Add up DVT signs, tachycardia and malignancy, then place the total in the 2 to 6 band.
Updated On: Jun 23, 2026
- High
- Medium (moderate)
- Low
- Cannot comment without D-dimer values
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The Correct Option is B
Solution and Explanation
Score-it-out approach. The original Wells PE rule gives points for specific features. This patient has clinical signs of DVT ($3$ points), a heart rate above $100$ ($1.5$ points) and an active cancer ($1$ point), so the running total is around $5.5$.
Banding: the three-level interpretation is low ($<2$), moderate ($2$ to $6$) and high ($>6$). A total near $5.5$ falls squarely in the moderate band.
Why the distractors fail: the figure never crosses $6$, ruling out high risk, and is far above $2$, ruling out low risk. D-dimer is an investigation ordered AFTER the Wells score sorts the patient, so it cannot be a prerequisite for stating the clinical probability. Hence the answer is moderate (medium) risk. Ref: Bailey and Love, Short Practice of Surgery, 27th edition, 2018.
Banding: the three-level interpretation is low ($<2$), moderate ($2$ to $6$) and high ($>6$). A total near $5.5$ falls squarely in the moderate band.
Why the distractors fail: the figure never crosses $6$, ruling out high risk, and is far above $2$, ruling out low risk. D-dimer is an investigation ordered AFTER the Wells score sorts the patient, so it cannot be a prerequisite for stating the clinical probability. Hence the answer is moderate (medium) risk. Ref: Bailey and Love, Short Practice of Surgery, 27th edition, 2018.
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