Appendicitis

Question 1

What is the percentage lifetime incidence of appendicitis?

Answer 1

6%

Question 2

Causes of obstruction can be? (4)

Answer 2

Faecolith
Lymphoid hyperplasia
Tumour
Worms (ascaris lumbicoides, schisto)

Question 3

How long does it take for central abdo pain to become localised in appendicitis?

Answer 3

12hrs approx

Question 4

What is murphy’s triad?

Answer 4

describes the three symptoms that happen in appendicitis in this precise order:

1) Pain
2) Fever
3) Vomiting

Question 5

What is Rovsing’s sign?

Answer 5

Pressing in the LIF = pain in RIF

Question 6

What is the psoas sign?

Answer 6

Pain on extending hip

Question 7

What are three surgical differentials for appendicitis?

Answer 7

Cholecystitis
Diverticulitis
Meckel’s diverticulitis

Question 8

What are three gynae differentials for appendicitis?

Answer 8

Cyst torsion/rupture/haemorrhage
Salpingitis/PID
Ruptured ectopic

Question 9

What are three medical differentials of appendicitis?

Answer 9

Mesenteric adenitis
UTI
Crohn’s

Question 10

Dx of appendicitis is mainly clinical, but what bloods would you run?

Answer 10

FBC
CRP
Amylase
G+S
Clotting

Question 11

For appendicitis type pain, what would you look for on urine dip

Answer 11

Ketones
White cells
B-HCG

Question 12

What is the definitive investigation for appendicitis?

Answer 12

Diagnostic lap

Question 13

Mx of appendicitis?

Answer 13

Fluids
Abx: cef 1.5g + met 500g IV TDS
Analgesia