Appendix

Question 1

Enumrate the different position of appendicx? (7) 📍

Answer 1

1- retrocecal 
2- paracecal
3-subcecal
4- plevic
5- pre-ileal
6- post-ileal
7- sub-ileal

Question 2

Most common appendix position?

Answer 2

Retrocecal (11 clock)

Question 3

MCq
Length normally of apendix range from ?

• 2-4 cm
• 4.5- 7
• 7.5 - 10 cm

Answer 3

7.7-10cm

Question 4

Name of the cell responsible fir carcnoid tumor?
A) kulchitsky cells
B) petute cell
C) macraoni cell

Answer 4

A

Question 5

Which from the following dietry factor have been attributed to acute appendicitis?
A) high fiber dier
B) low fiber diet
C) use of refined carbohydrate 
D) a+c

Answer 5

D) a+ c

Question 6

Appendicitis can bu occluded by?

Answer 6

Fecolith
Worms: Oxyuris vermicularis
Intestinal parasite
Lymphatic

Question 7

Complication of appendicitis?

Answer 7

• perforation
• pertionoits
• paracecal abscess
• apenducular mass
• plevic mass
• mucocele

Question 8

Risk factor of perforation following acute appendicitis?

اربعه خاصين بالمريض، اثين صفات للمرض

Answer 8

1- immunocobmrised
2- DM
3- old age
4- history of pervious abdominal surgery

5- plevic appendix
6- fecolith obstruction

Question 9

What the differential of acute appenditis in childern?

تذكري بجامه PGIMMH

Answer 9

P: pneumonia lobar 
G: gastroenteritis
I: intussception
M: mesenteric lymphadnitis 
M: meckel diverticulitus
H: henoch schonlein purupra هنوش سكولين بربرا

Question 10

Differential of acute appendicitis in adult ?
تذكري حبيبة
Hpuptt

Answer 10

H: hematoma of rectus sheath
P: pancreatitis 
U: urter colic 
P: perforated peptic upcer
T: Terminal ilium
T: resticular torsion

Question 11

Differenof acute appendicitis in female ? 📍

الحريم رومنسيات يحبون القصايد poem عددهم سته

Answer 11

P: Plevic inflammatory diseasse/ pyelonephritis
O: overian cyst hg or rupture
E: ectopic pregnancy / endomtrosis
M: mittleschemerz

Question 12

Ddx in elderly

يحبون الدبس مع انه مضر لهم

Answer 12

D: diverticulitis 
B: bowel obstruction
C: colon cancer
R: rotated testicle
M: mesentric infraction
A: aortic anueyrsm
N: مافي زياده بس حطي ببالك انهم يجون وذ نو تبكل بكتر

Question 13

During appendictony , tumpor of appendix was founf, it 4cm in size, How would manage?

1) leave it since it usually slow growing
2) appendictomy
3) take biobsy to see the milignancy or benign
4) right side hemicolectomy

Answer 13

4) right side hemicolectomy

Tumore <2 cm : appendictomy
Large tumor: right side hemi..

Question 14

Complication of appendictomy?

Wrap if hot تذكري

Answer 14

W: wound infection
R : respiratory atelecrasia
A: abscess
P: portal pyemia
I: ilius 
F: fistula ( in crohn px)
H: hernia ( richet hernia)
O: obstruction die to adhesion ( common late complication)
T: thrmposis in lung or leg

Question 15

Enumorate three type of appendiular tumor?

Answer 15

1- Carcinoid tumor
2- adenocarcinoma
3- goblet cell carcnoid carciomaw
4- signet ring carcinoma

Question 16

Alfardo score?

مان ترسلي

Answer 16

Migratory pan 
A- Anorexia
N- Nausa and vomiting
T- Tenderness
Repound tenderness
S : shift to left of netrophils
Luekocytosis امثر من عشر الالف
E elvated tempruture >37.3

If 5-6 : eqivoclunt do us or ct

Question 17

Enumorate 5 signs in acute appendix

Answer 17

1- rovasing sign 
2- psoas sign
3- obutrator sogn
4- rebound tenderness bumberg
5- mcburrny sign
6- pointing sign

Question 18

In rectal examination of px with acute appendicitis you founf boggy mass, the pc xomplain of tenus and diarrhia what could be the cause?
A- appendular mass
B- appendicular tumor
C- crohn
D- plevic abcess

Answer 18

D: plevic ansecc as in vesicolonic pouch

Question 19

In examining px with acute appendicitis you find 4cm mass in RLQ how would you manage?
A) apendictomy 
B) lapetactomy
C) ochsner sherren regmin
D) radiolgy gaudided drainge

Answer 19

C) consist of 
analgesic 
2 abx ( metrandizol , 3 generation cephlosporone)  
Iv fluid 
Correct electrolyte 
Antipyeetic - anti emtic 
Mark size of the mass
Mentor vital every four hour till t days

Question 20

After managing appendular mass concervitively, you should mentor 3 main if any develop , stop the concervayive. What are they?

Answer 20

• increase in pulse rate
• increase in size of mass
• Increase in abdominal pain

Question 21

Types of appendicitis oncision?

Answer 21

A- gridiron
B- lenz
C-rutherford morsion (for retro or oara cecal) or fixed appendix.

Question 22

What lapertory you would do?

Answer 22

CBs
Urineanalysis 
Pregnemcy test 
Electrolte 
Supine xeay for perforation
Us 
Ct ( liw dose)

Question 23

Typhlitis or leukaemic ileocaecal syndrome is a rare but
potentially fatal enterocolitis occurring in immunosuppressed
patients. …………. septicaemia can be rapidly progressive. Treatment is
with appropriate antibiotics and haematopoietic factors. Sur-
gical intervention is rarely indicated.

Write the name of bactrias?

Answer 23

Name of orgnism : Gram-negative or clostridial (especially Clostridium
septicum)