Appendicitis Flashcards

1
Q

Define appendicitis?

A

Inflammation of the appendix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

aetiology of appendicitis?

A
  • Gut organisms invade the appendix wall after lumen obstruction
    eg. lymphoid hyperplasia
  • this leads to oedema, ischaemic necrosis and perforation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

epidemiology of appendicitis?

A
  • the most common surgical emergency (6% lifetime incidence)
  • can occur at any age
  • most common between 10-20
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

presenting complaints of appendicitis?

A
  • Periumbilical pain that moves to the right iliac fossa
  • anorexia
  • vomiting
  • constipation
  • diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is mcburneys point?

A
  • this is the point of pain for appendicitis

- (1/3 of the distance from the ASIS to the umbilicus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the general signs of appendicitis on physical examination?

A
  • tachycardia
  • fever
  • furred tongue
  • lying still
  • shallow breaths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the signs of the right iliac fossa?

A
  • guarding
  • rebound and percussion tenderness
  • pain on the right during a PR examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are specific signs seen with appendicitis?

A

Rovsing’s Sign - palpation of the LIF causing more pain in the RIF than the LIF
Psoas Sign - pain on extension of the hip
Cope Sign - pain on flexion and rotation of the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

some potential unusual presentions of appendicitis?

A
  • flank pain or RUQ pain
  • child might have vague pain but complete anorexia
  • confused elderly person with no pain
  • sometimes occurs in pregnancy (this is dangerous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

investigations for appendicitis?

A
- bloods 
these will show high WCC, high CRP
- pregnancy test 
for potential ectopic 
- USS 
- CT is unnecessary delay
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the management plan for appendicitis?

A
  • prompt appendicectomy
  • antibiotics
    piperacillin/tazobactam
  • laparoscopy is preferred in women and the obese due to diagnostic and therapeutic advantages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

possible complications of appendicitis?

A
  • perforation
  • appendix mass
    when the inflamed appendix becomes covered with omentum
  • Appendix abscess
    occurs if the appendix mass fails to resolve

mass and abscess can be treated with drainage and antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the prognosis for patients with appendicitis?

A

uncomplicated - most people recover with no long term problems

ruptured appendix - greater risk of complications and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly