Appendicitis

Question 1

What is the most common abdominal surgical emergency

Answer 1

Appendicitis

Question 2

General considerations
-Common between the ages of ___ to 35
-Most common between __-35
-Both sexes are affected ____

Answer 2

-10
-20
-equally

Question 3

What organ?
(a) Is found at the base of the cecum
(b) Its function is not clearly understood; thought to be involved in gestation/early life
with the development of gut flora.

Answer 3

Appendix

Question 4

What is located one third of the distance from the right anterior superior iliac spine to the umbilicus (navel).

Answer 4

McBurney’s Point

Question 5

________ typically manifests due to some sort of blockage of the lumen of the appendix.

Answer 5

Appendicitis

Question 6

The majority of luminal blockages are caused by what?

Answer 6

(a) Fecalith (most common)
(b) Immune response/expansion of lymph tissue
1) Viral infection
2) Vaccinations (i.e. rota-virus)
a) Typically only seen in young children

Question 7

True/FAlse
All women with progressively worsening abdominal pain should be evaluated with a beta-HCG and a pelvic exam regardless of reported sexual/medical history!

Answer 7

True

Question 8

Imaging/Radiology:
Gold standard for diagnosis of appendicitis is what?

Answer 8

CT scan of the abdomen

Question 9

Labs for suspected appendicitis

Answer 9

(a) CBC: Will likely show an increased White Blood Cell Count (WBC)
(b) Fecal Occult Blood Test
(c) UA: May have mild pyuria or hematuria on micro

Question 10

Antibiotic Selection:
Needs to cover gram negative and anaerobic bacteria.
Examples include

Answer 10

1) Ampicillin-sulfabactam (Unasyn) 3g IV every 6 hours.
2) Ertapenem (Invanz) 1g as a single dose.

Question 11

______ of individuals successfully treated for appendicitis with only antibiotics will have a subsequent episode of appendicitis requiring surgery within 3 months and over ____% will have a repeat episode of appendicitis and surgery within 12 months

Answer 11

29%
50%