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Gastroentrology > 2: Appendicitis > Flashcards

2: Appendicitis Flashcards

1
Q

What is appendicitis

A

Inflammation appendix

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2
Q

What age does appendicitis occur

A

10-30y

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3
Q

What is a risk factor for appendicitis

A

FH

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4
Q

Explain ethnicity for appendicitis

A

Appendicitis is most common in caucasians. However, in other ethnicities it is more likely to perforate

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5
Q

Explain symptoms of appendicitis

A
  • Starts as peri-umbilical pain that radiates to LIF
  • Associated nausea and vomiting
  • Pyrexia
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6
Q

What are the 4 signs associated with appendicitis

A
  1. Mcburney’s
  2. Rosving’s
  3. Psoas
  4. Obturator
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7
Q

What is mcburney’s sign

A

Rebound tenderness - when pressing over McBurney’s point

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8
Q

What is roving’s sign

A

Pain in RIF when palpating LIF

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9
Q

What is psoas sign

A

Pain in LIF, when extending right hip

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10
Q

what does a positive psoas sign indicate

A

Retrocaecal appendicitis

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11
Q

why does psoas sign occur

A

Due to appendix irritating the PSOAS muscle

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12
Q

what is obturator sign

A

Due to appendix irritating obturator internus

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13
Q

if present, what does obturator sign indicate

A

retrocaecal appendix

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14
Q

what causes obturator sign

A

appendix irritating obturator internus

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15
Q

explain pathophysiology of appendicitis

A

inflammation of the appendix secondary to obstruction of the lumen

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16
Q

what causes obstruction of the appendices lumen in the following

a. young patients
b. patients 30-60
c. patients >60

A

a. hyperplasia of lymphoid tissue
b. faecolith
c. appendicular or caecal tumour

17
Q

What blood tests are ordered for appendicitis

A

FBC

CRP

18
Q

Explain imaging in appendicitis

A

Appendicitis is a clinical diagnosis. However, imaging may be used to support a diagnosis

19
Q

What method of imaging is used for young children

A

AUS

20
Q

Why is AUS used for children

A
  • They have low body fat

- Avoid radiation

21
Q

What method of imaging is used in older patients

A

CT

22
Q

What scoring system is used to triage patients with appendicitis

A

Appendicitis Inflammatory Response (AIR) Scoring System

23
Q

What is used to manage appendicitis

A

Pre-Operative Antibiotics

Laparoscopic appendicectomy

24
Q

Why is the appendix sent for histology

A

Check for caecal or appendix tumour

25
Q

What are 3 complications of appendicitis

A
  1. Perforation
  2. Appendix mass = omentum adhere to appendix
  3. Pelvic abscess
26
Q

Describe blood supply to the appendix

A

Innervated by the appendicular artery a branch of the superior mesenteric artery

27
Q

What is a differential diagnosis for appendicitis in younger children

A

Mesenteric adenitis

28
Q

What is mesenteric adenitis

A

Inflammation of lymph nodes in mesentery

29
Q

What does mesenteric adenitis usually follow

A

Viral infection

Gastroentrology (18 decks)

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