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exam 4 Acute care > Abdominal issues > Flashcards

Abdominal issues Flashcards

(80 cards)

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1
Q

What is the most common cause of appendicitis?

A

Obstruction of the appendix

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2
Q

What age group is most commonly affected by appendicitis?

A

Adolescents and young adults

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3
Q

Which gender is more frequently affected by appendicitis?

A

Male

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4
Q

What can untreated appendiceal obstruction ultimately lead to?

A

Necrosis and rupture

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5
Q

What is the classic triad of symptoms in appendicitis?

A

Periumbilical pain, nausea, RLQ pain

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6
Q

Where does pain typically begin in appendicitis?

A

Periumbilical area

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7
Q

What is the classic location for tenderness in appendicitis?

A

McBurney’s point

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8
Q

Positive psoas sign suggests the appendix is located where?

A

Retrocecal

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9
Q

Positive obturator sign indicates what location of the appendix?

A

Pelvic

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10
Q

Fever >38.3°C in appendicitis suggests what?

A

Perforation or abscess

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11
Q

Which imaging has the highest negative predictive value for appendicitis?

A

CT scan

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12
Q

Which lab test helps rule out pregnancy in appendicitis evaluation?

A

Beta-hCG

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13
Q

Which lab finding supports severe bacterial inflammation?

A

High band neutrophils (left shift)

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14
Q

What is the first step in managing confirmed appendicitis?

A

Laparoscopic appendectomy

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15
Q

When is drainage indicated in appendicitis?

A

In cases of perforation with abscess

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16
Q

What is the purpose of bowel rest in appendicitis management?

A

To prevent further distension and vomiting

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17
Q

What complication can follow appendiceal rupture?

A

Peritonitis

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18
Q

What is the feared chain of complications from untreated appendicitis?

A

Perforation → Peritonitis → Sepsis → Death

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19
Q

Which type of peritonitis occurs without GI tract perforation?

A

Primary peritonitis

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20
Q

What organism is commonly involved in peritonitis?

A

E. coli

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21
Q

What finding differentiates appendicitis from gastroenteritis?

A

Pain precedes vomiting

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22
Q

What exam finding most strongly suggests peritoneal irritation?

A

Guarding and rebound tenderness

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23
Q

What imaging finding warrants immediate surgery in appendicitis?

A

CT evidence of free air and perforation

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24
Q

Most likely complication of delayed appendicitis diagnosis?

A

Intra-abdominal abscess

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25
Empiric antibiotics for perforated appendicitis?
IV ceftriaxone + metronidazole
26
What is the most common cause of appendicitis?
Obstruction of the appendix
27
What age group is most commonly affected by appendicitis?
Adolescents and young adults
28
Which gender is more frequently affected by appendicitis?
Male
29
What can untreated appendiceal obstruction ultimately lead to?
Necrosis and rupture
30
What is the incidence of appendicitis per 100,000 people?
100 per 100,000 people
31
Which population has the highest mortality from appendicitis?
Elderly
32
Which of the following is the key pathologic process in appendicitis?
Luminal obstruction and vascular compromise
33
Which of the following is most likely to reduce lymphatic drainage in the appendix?
Luminal distension
34
What is the classic triad of symptoms in appendicitis?
Periumbilical pain, nausea, RLQ pain
35
What is the most feared complication of untreated appendicitis?
Perforation leading to peritonitis
36
Where does pain typically begin in appendicitis?
Periumbilical area
37
What is the classic location for tenderness in appendicitis?
McBurney’s point
38
An elderly patient with appendicitis may most likely present with what?
Sepsis without localized pain
39
Positive psoas sign suggests the appendix is located where?
Retrocecal
40
Positive obturator sign indicates what location of the appendix?
Pelvic
41
Fever >38.3°C in appendicitis suggests what?
Perforation or abscess
42
What is a common GI symptom in pelvic appendicitis?
Tenesmus
43
Urinary frequency and dysuria in appendicitis suggest what?
Inflamed pelvic appendix
44
Anorexia in appendicitis usually occurs when?
Early in disease
45
Emesis in appendicitis typically occurs when?
After the onset of pain
46
First-line lab test for suspected appendicitis?
CBC with differential
47
Left shift in WBC differential suggests what?
Immature neutrophils due to bacterial infection
48
Which imaging has the highest negative predictive value for appendicitis?
CT scan
49
Preferred imaging modality in obese patients for suspected appendicitis?
CT scan
50
Which lab test helps rule out pregnancy in women of childbearing age?
Beta-hCG
51
Finding of appendiceal fecalith on CT confirms what?
Appendicitis
52
Periappendiceal fat stranding on imaging suggests what?
Early appendicitis
53
Which imaging modality is limited by body habitus?
Ultrasound
54
Why might a urinalysis be useful in suspected appendicitis?
To rule out UTI
55
Which lab finding supports severe inflammation?
High band neutrophils
56
What is the first step in managing confirmed appendicitis?
Laparoscopic appendectomy
57
Which patients may undergo initial non-surgical management of appendicitis?
Patients with perforation and abscess
58
Initial non-operative management includes all EXCEPT:
Immediate surgery
59
Which is NOT a typical antibiotic route in initial appendicitis management?
Per rectum
60
Which surgical technique is preferred for uncomplicated appendicitis?
Laparoscopy
61
When is drainage indicated in appendicitis?
In cases of perforation with abscess
62
Why is bowel rest important in appendicitis?
To prevent further distension and vomiting
63
What is the purpose of NG tube decompression in select patients with appendicitis?
Reduce vomiting and abdominal distension
64
What happens if appendicitis is misdiagnosed and left untreated?
Spontaneous rupture
65
In unclear cases, observation is done for how long?
6–8 hours
66
What condition can directly follow appendiceal rupture?
Peritonitis
67
Which finding indicates possible peritonitis?
Rebound tenderness and rigid abdomen
68
What is the feared chain of events post-perforation?
Perforation → Peritonitis → Sepsis → Death
69
Which peritonitis type occurs without GI tract perforation?
Primary peritonitis
70
Which organism is commonly seen in peritonitis?
E. coli
71
A patient post-appendectomy becomes hypotensive, febrile, and confused. What should you suspect?
Septic shock
72
Complication of peritonitis that requires reoperation?
Intra-abdominal abscess
73
Why is early enteral nutrition started post-op?
Promote gut healing and function
74
Which lab test can help assess sepsis severity in peritonitis?
Lactate
75
What is a common late complication after perforated appendicitis?
Fistula formation
76
What finding helps differentiate appendicitis from gastroenteritis?
Pain precedes vomiting
77
What physical exam finding most strongly suggests peritoneal irritation?
Guarding and rebound tenderness
78
Which imaging finding warrants immediate surgery in appendicitis?
CT evidence of free air and perforation
79
What is the most likely complication of delayed appendicitis diagnosis?
Intra-abdominal abscess
80
What is the most appropriate empiric antibiotic therapy for perforated appendicitis?
IV ceftriaxone + metronidazole

exam 4 Acute care (1 decks)

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