Exam (elaborations)
Surgery Acute Appendicitis Exam Questions and Answers
- Course
- Institution
Surgery Acute Appendicitis Exam Questions and Answers
[Show more]
Content preview
Surgery Acute Appendicitis ExamQuestions and Answers
What is the most common cause of an acute abdomen in the UK? - Answer-After non-
specific abdominal pain it is appendicitis.
NB: 10% of the population will develop acute appendicitis (most commonly between 10-
20 - but can happen at any age)
How does an acute appendicitis present? - Answer-1) Initially colicky peri-umbilical pain
-> moves to RIF (McBurney's point - 2/3rd umbilicus to ASIS) as peritoneum becomes
involved. Often aggravated by coughing, deep breathing & movement.
2) N&V, anorexia, change of bowel habits
3) Low-grade pyrexia may develop
4) Tachycardia may be sign of peritonitis
5) Localised tenderness, guarding, rebound tenderness/percussion tenderness in RIF
6) Rovsing's sign may be positive (palpation of LLQ increases pain felt in RLQ - irritates
the peritoneal lining)
7) Psoas sign (extension of R hip w/ pt on L side) in retrocoecal appendicitis
8) Obturator test (flex + internally rotate R hip) - also called Cope sign - positive if
appendix in close relation to obturator internus.
9) Localised tenderness on DRE may be only sign of retrocaecal or pelvic appendicitis.
10) Just after perforation, child may sit up in bed apparently better but tachycardic. Then
other signs of peritonitis develop.
NB: elderly may present without pain, but may have confusion and shock. deterioration
is rapid!
Why does the pain move from peri-umbilical location to RIF in appendicitis? - Answer-
Internal organs + visceral peritoneum have no somatic innervation.
Initial inflammation limited to the appendix wall is felt as referred pain to the peri-
umbilical region and is caused by activation of visceral c-fibres in the mid gut.
As the inflammation progresses and irritates the parietal peritoneum, somatic pain is felt
at McBurney's point (2/3 from umbilicus to ASIS) i.e. RIF.
What happens in the appendix wall during acute appendicitis? - Answer-Gut organisms
invade the appendix wall after lumen obstruction by lymphoid hyperplasia, faecolith or
filarial worms. This leads to oedema, ischaemic necrosis and perforation.
What may you see on blood test in acute appendicitis? - Answer-1) Neutrophil
leucocytosis
2) Elevated CRP
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lectknancy. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
72042 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now