Appendicitis Flashcards
Does fever present with appendicits?
low grade fever only, high grade fever does not fit with presentation (if rigors and high grade fever think pyelonephritis)
Why are 50% appendicitis presentations variable?
because the appendix does not have a fixed location, therefore this will vary from person to person
How to determine whether child is peritonitic?
ask them to jump. There is no way they would be able to do this if they are
Describe the typical presentation of pain in appendicitis
begins centrally, is colicky, and subsequently localises to RIF. When in RIF, the pain is constant
What are the signs and symptoms of appendicitis?
central to RIF pain, N/V, tenderness over McBurney’s point, fever, tachycardia, leukocytosis
Name two special tests for appendicitis
rovsing sign, obturator and psoas sign
Name five differentials for acute appendicitis
the attic: pneumonia
the upper floor: acute cholecystitis + perforated peptic ulcer
the ground floor: gastroenteritis, crohn’s disease, meckel’s diverticulum, intestinal obstruction
the basement: salpingitis, ectopic pregnancy, ruptured ovarian cyst
the backyard: ureteric colic, pylenephritis, ruptured AAA
What is the golden treatment for appendicitis?
appendectomy! due to high risk of recurrence
Three differentials for appendicitis?
Cholecystitis Diverticulitis Meckel's diverticulitis UTI Crohn's Gynae- torsion/ruptured cyst, ruptured ectopic pregnancy, PID
Imaging for appendicitis?
USS- to exclude gynae pathology, visualise inflammed appendix
CT
Two complications of appendicitis?
appendix abscess
perforation
