Appendicitis Flashcards

1
Q

Commonest emergency operation

A

Appendicitis

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2
Q

What is at the base of appendix

A

Convergence of the teniae coli

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3
Q

Blood supply to appendix

A

Appendicular artery, arises from ileocolic artery, part of superior mesenteric artery

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4
Q

Cause of appendicitis

A

Idiopathic, obstruction due to foacalith, bacterial, viral, parasites

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5
Q

Classic picture of appendicitis

A

Umbilical pain that migrates to right iliac fossa, nausea, vomiting, +/- constipation, vague localised pain that can’t be pinpointed early on, anorexia

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6
Q

What is the rosvings sign in appendicitis

A

Pressing on the left causes pain on right

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7
Q

Psoas sign in appendicitis

A

Patient keeps right hip flexed as this lifts inflamed appendix off psoas muscle

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8
Q

Obturator sign in appendicitis

A

If appendix is touching the obturator internus then flexing the hip and internally rotating causes pain

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9
Q

Pointing sign in appendicitis

A

Being able to pin-point a location indicates the appendix is touching the body wall and has progressively worsened in inflammation

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10
Q

Patient presents with constant vomiting and diarrhoea with pain around umbilicus. There’s no shifting of pain

A

Postileal appendicitis, rare

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11
Q

Patient presents with pain in right iliac fossa with diarrhoea and frequent micturition

A

Pelvic appendicitis

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12
Q

What type of appendicitis presents with very few signs

A

Retrocaecal appendicitis

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13
Q

Differential diagnosis of appendicitis

A
Gastroenteritis
Mesenteric lymphadenitis
Meckel's diverticulum
Intussusception
Henoch-Schonlein Purpura
Lobar pneumonia
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14
Q

Investigations for appendicitis

A

Mostly a clinical diagnosis
Ultrasound is useful in women and kids
Abdominal x-ray to rule out differentials
Bloods and urinalysis

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15
Q

Important blood markers in appendicitis

A

CRP, WCC

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16
Q

What score can be used to help assess appendicitis

A

Alvarado score - MANTRELS mnemonic

17
Q

Treatment of appendicitis

A

Analgesia - Relieve pain
Antipyretics
Antibiotics
Appendicectomy - Laparoscopy best

18
Q

Laparoscopy or laparotomy for appendicitis

A

Laparoscopy is first line

19
Q

What is an appendix mass

A

Inflamed appendix with similar history to appendicitis but a longer duration.

20
Q

First line for appendix mass

A

Antibiotics. Theatre if tachycardia, worsening pain, increase in size and/or vomiting

21
Q

What is appendix abscess

A

Pocket of pus collects at the appendix. Might be due to surgery or burst appendix

22
Q

Treatment of appendix abscess

A

Radiological drain