question: Q:A 58-year-old patient comes to the physician because of progressive pain and swelling of his left calf for the past 2 days. He has no personal or family history of serious illness. He does not smoke or drink alcohol. His last digital rectal examination and colonoscopy at the age of 50 years were normal. His vital signs are within normal limits. He is 183 cm (6 ft) tall and weighs 80 kg (176 lb); BMI is 24 kg/m2. Physical examination shows redness, warmth, and tenderness of the left calf. The circumference of the left lower leg is 4 cm greater than the right. Dorsiflexion of the left foot elicits pain in the ipsilateral calf. Laboratory studies show:
  Hemoglobin 15 g/dL
  Leukocyte count 9000/mm3
  Platelet count 190,000/mm3
  Erythrocyte sedimentation rate 12 mm/h
  Serum
  Urea nitrogen 18 mg/dL
  Creatinine 1.0 mg/dL
  Alkaline phosphatase 24 U/L
  Aspartate aminotransferase (AST, GOT) 12 U/L
  Alanine aminotransferase (ALT, GPT) 10 U/L
  Urine
  Protein negative
  RBC 1/hpf
  WBC none
  Compression ultrasonography with Doppler shows a non-compressible left popliteal vein with a visible 0.5-cm hyperechoic mass and reduced flow. In addition to initiating anticoagulation, which of the following is the most appropriate next step in management?"? 
  {'A': 'Colonoscopy', 'B': 'Inferior vena cava filter', 'C': 'X-ray of the chest', 'D': 'Abdominal ultrasound', 'E': 'Streptokinase therapy'},