appendicitis

Question 1

pathophysiology

Answer 1

pathogen trapped due to obstruction at point where appendix meets bowel

leads to infection and inflammation which can proceed to gangrene and rupture

rupture releases faecal contents and infective material into peritoneal cavity –> peritonitis

Question 2

presentation

Answer 2

abdo pain: starts centrally then moves to RIF 
tender McBurney;s 
loss appetite
N+V
fever
rovsing's sign 
gaurding 
rebound tenderness

Question 3

McBurney’s point

Answer 3

one third distance from ASIS to umbiliccus

Question 4

key differential diagnoses

Answer 4

ectopic pregnancy
ovarian cyst
meckel’s diverticulum
mesenteric adenitis

Question 5

abdo pain : F childbearing age

Answer 5

assume pregnant until proven otherwise with pregnancy test

serum HCG usually part of normal abdo pain blood panel inA&E

Question 6

appendix mass

Answer 6

occurs when omentum surrounds and sticks to inflammed appendix, forming RIF mass

manage conservatively with supportive treatment + antibiotics
appendicetomy once acute condition has resolved

Question 7

Mx

Answer 7

appendicectomy

Question 8

complications of appendicectomy

Answer 8

bleeding, infection, pain, scars
damage to bladder, bowel 
removal normal apendix
anaethetic risks 
VTE