Appendicitis

Question 1

is it a surgical emergency?

Answer 1

yes

Question 2

more common in children or adults

Answer 2

children

Question 3

histology

Answer 3

Acute neutrophilic inflammation, mucosal ulceration, pus in lumen, acute inflammation must involve muscle coat, thickened wall

Question 4

cause

Answer 4

unknown
Gut organisms invade the appendix wall after lumen obstruction by lymphoid hyperplasia, faecolith (dehydration) or filarial worms. This leads to oedema, ischaemic necrosis and perforation. Hygiene hypothesis may cause impaired ability to prevent invasion.
Tumours (rare)

Question 5

symptoms

Answer 5

epigastric pain 
anorexia 
low grade fever 
tenderness in RIF 
Rovsing

Question 6

WCC

Answer 6

increases

Question 7

describe epigastric pain

Answer 7

RIF - Mc Burneys point

classic periumbilical pain that moves to RIF

Question 8

where is McBurneys point

Answer 8

1/3 of the way between ASIS and umbilicus

Question 9

what is rovsings

Answer 9

pain in RIF when LIF palpated

Question 10

complications pneumonic thing

Answer 10

PRAFS

Question 11

complications

Answer 11

Peritonitis 
Rupture 
Abscess 
Fistula 
Sepsis 
Liver abscess

Question 12

where do tumours of the appendix originate from (which cells)

Answer 12

enterochromaffin cells

Question 13

surgery

Answer 13

laparoscopic appendectomy

Question 14

treatment

Answer 14

IV fluids and antibiotics - metronidazole and cefuroxime

Question 15

first line investigation

Answer 15

US

Question 16

in carcinoma of the appendix, where to the tumours originate form

Answer 16

enterochromaffin cells