Acute Appendicitis

Question 1

symptoms

Answer 1

periumbilical pain moves to RIF. anorexia, vomiting, constipation

Question 2

general signs

Answer 2

tachycardia, fever, furred tongue, lying still, coughing hurts, foetor +- flushing, shallow breaths

Question 3

signs in RIF

Answer 3

guarding, rebound and percussion tenderness, PR painful on R side

Question 4

what is Rosvings sign

Answer 4

pain in RIF > LIF when LIF is pressed

Question 5

what is psoas sign

Answer 5

pain on extension of hip due to retrocaecal appendix

Question 6

what is cope sign

Answer 6

pain on flexion and internal rotation R hip if appendix close to obturator internus

Question 7

investigations

Answer 7

incr CRP, neutrophil leucocytosis, USS, CT

Question 8

what would be the presentation if the inflamed appendix was retrocaecal/retroperitoneal

Answer 8

flank or RUQ pain

Question 9

treatment

Answer 9

appendicectomy. antibiotics- metronidazole + cefuroxime

Question 10

DDX

Answer 10

ectopic, UTI, mesenteric adenitis, cystitis, cholecystitis, diverticulitis, salpingitis/PID, dysmenorrhoea, crohns, perforated ulcer, food poisoning

Question 11

complications

Answer 11

perforation, appendix mass, appendix abscess

Question 12

what is McBurneys point

Answer 12

2/3 of the way from umbilicus to right ASIS