Appendiceal disease

Question 1

Appendicitis pain starts in _____ (___pain) then moves to ___ (___pain)

Answer 1

starts in umbilical region - visceral pain >

RIF - parietal pain as irritates peritoneum

Question 2

Appendicitis is most common in which age groups

Answer 2

5-40yos

elderly

Question 3

Aetiology of appendicitis =

Answer 3

obstruction with a faecolith, bacterial, viral or parasitic

Question 4

Appendicitis causes ___ inflammation, ___ hyperplasia, __+__ build up
___ obstruction

Answer 4

mucosal inflam
lymphoid hyperplasia
mucus and exudate build up
venous obstruction

Question 5

Rovsing’s sign =

Answer 5

Press LIF = pain in RIF

appendicitis sign

Question 6

Psoas sign =

Answer 6

patient on side and R hip flexed illicits abdominal pain

appendicitis / psoas abscess

Question 7

Investigations for appendicitis

Answer 7

clinical findings
US
AXR
bloods - CRP and WCC mildly raised
urinalysis

Question 8

1st line for treatment of appendiceal mass:

Answer 8

antibiotics

if fails/complicated then = surgery

Question 9

Neoplasms of the appendix (3)

Answer 9

carcinoid (most common)
pseudomyxoma peritonei
adenocarcinoma

Question 10

Crypts of lieberkuhn stains for ____ in carcinoid tumour of apppenndix

Answer 10

chromagraffin

Question 11

appendectomy is possibly for tumours of the appendix if __

Answer 11

less than 1cm and not at the base

Question 12

hemicolondectomy is needed for appendiceal tumours if ___

Answer 12

more than 1cm +/ at the base