Appendicitis

Question 1

Physical exam findings indicative of appendicitis

Answer 1

N/V
Radiating pain in RLQ
Decreased appetite
Fever
Constipation

Question 2

Lab values indicative of appendicitis

Answer 2

elevated WBC, ANC, & CRP

Question 3

Diagnostic imaging for appendicitis

Answer 3

CT Scan ***
Ultrasound
MRI

Question 4

Common organisms involved in appendicitis

Answer 4

Bacteroides fragilis
Escherichia coli
Pseudomonas aeruginosa

Question 5

IV hydration

Answer 5

NS or LR
1x maintenance usually used but can commonly e 1.5x maintenance and fluid boluses if required

Question 6

Analgesia for mild pain

Answer 6

acetaminophen and ibuprofen

Question 7

Analgesia for moderate/severe pain

Answer 7

Opioids:
- morphine most common

AVOID: codeine and tramadol (CYP2D6 variation)

Question 8

Antibiotic treatment: Non-perforated appendix

Answer 8

Cefotetan
Cefoxitin

Question 9

Antibiotic treatment: Perforated appendix

Answer 9

Ampicillin-sulbactam
Piperacillin-tazobactam

Question 10

Antibiotic treatment duration for appendicitis

Answer 10

average of 5 days

Question 11

Criteria for discontinuation of IV antibiotics

Answer 11

afebrile
adequate PO intake
ambulating
benign abdominal exam