Appendicitis

Question 1

Appendicitis age

Answer 1

Any age

Mostly 10-20 yrs

Question 2

Appendicitis pathology

Answer 2

Gut organisms invade the appendix wall after lumen obstruction
- lymphoid
- hyperpasia
- faecolith
- filarial worms
Causes oedema, ischaemic necrosis, perforation.

Question 3

Appendicitis Complications

Answer 3

Perforation
Appendix mass
Appendix abscess

Question 4

Appendicitis Symptoms

Answer 4

Murphy's Triad 
Pain in RIF 
Anorexia 
Fever
Periumbilical pain that moves to right iliac fossa
Anorexia 
Constipation - sometimes diarrhorea

Question 5

Appendicitis Signs

Answer 5

Tachycardia 
Fever
Furred tongue 
Foetor (strong, foul smell)
Flushing 
Lying still
Coughing exacerbates pain 
Shallow breaths

Question 6

Appendicitis Special Testing

Answer 6

Cope Sign
Psoas Sign
Rovsing’s Sign

Question 7

Cope Sign

Answer 7

Pain on flexion and internal rotation of the right hip, if the appendix is close in relation to obturator internus.

Question 8

Psoas Sign

Answer 8

Pain on extending the hip, if the appendix is retrocaecal in position

Question 9

Rovsing’s Sign

Answer 9

When LIF is pressed, pain is greater in the RIF than in the LIF.

Question 10

Appendicitis Investigations

Answer 10

Bloods - neutrophil predominant leucocytosis is present in 80-90% of px
Ultrasound
CT

Question 11

Appendicitis Treatment

Answer 11

Appendicectomy 
Antibiotics 
Metronidazole
Cefuroxime
Laparoscopy - dy & tx