Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals: Surgery > Appendicitis > Flashcards

Appendicitis Flashcards

1
Q

Define Appendicitis

A

Appendicitis refers to inflammation of the appendix

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

What is the key symptom patients present with?

A

Acute Abdominal pain

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

At what age is there peak incidence of appendicitis

A

20-40 year olds

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

Why is appendicitis uncommon in the extremes of age?

A

The young have a relatively wide appendiceal lumen

Whilst in the elderly the appendix is almost entirely obliterated

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

Is there higher prevalence of appendicitis in:

a) Males
b) Females

A

a) Males

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

Where in the bowel does the appendix open

A

Opens onto the caecum of the large bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The majority of appendix are in which position

A

Retrocaecal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What supplies the appendix

A

Appendix is supplied by the appendiceal mesentery, which hangs from the terminal ileum and contains the appendiceal branch of the ileocolic artery (from the superior mesenteric artery)

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

What are the taeniae coli

A

Three longitudinal muscles that run the length of the large intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name some of the causes of luminal obstruction of the appendix

A
  • Faecolith [most common cause] i.e. hard collections of stool that form and block the lumen
  • Lymphoid hyperplasia
  • Caecal tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the pathophysiology of appendicitis

A
  • Typically caused by an obstruction of the lumen of the appendix i.e., the point where the appendix meets the caecum
  • Obstruction can result in the trapping of pathogens within the appendix. The stasis can result in bacteria overgrowth leading to infection and inflammation
  • Reduced venous drainage and inflammation can result in increased pressure within the appendix.
  • As the pressure rises further, the arterial supply to the appendix becomes compromised leading to ischaemia, which in turn can cause perforation of the appendix
  • When the appendix ruptures, faecal contents and infective material are released into the peritoneal cavity causing peritonitis i.e. inflammation of the peritoneal lining
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name some of the risk factors for appendicitis

A
  • Age
    • Peak incidence in 20-40 year olds
      • Uncommon in the extremes of age i.e. young children and >50 because the young have a relatively wide appendiceal lumen, whilst in the elderly, it is almost entirely obliterated
  • Sex – Higher male prevalence
  • Family history
  • Ethnicity – more common in Caucasians
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the abdominal pain associated with appendicitis

A

Dull central pain that progresses and becomes a sharp pain that moves and becomes localised to the right iliac fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name some of the symptoms of appendicitis

A
  • Abdominal pain – key symptom
  • Nausea and vomiting
  • Loss of appetite
  • Low grade fever
  • Weight loss
  • Constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define the term “rebound tenderness”

A

Pain upon removal of pressure of the palpitation rather than application of pressure to the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rebound tenderness is a sign of appendicitis over what location of the abdomen?

A

McBurney’s point - a specific area two thirds of the way between the umbilicus (2) and the anterior superior iliac spine (3)

17
Q

Name some of the signs associated with appendicitis

A
  • Rebound tenderness over McBurney’s point
  • Percussion tenderness over McBurney’s point i.e. pain and tenderness when percussing the abdomen
  • Rovsing sign: pain in the RIF on palpation of the LIF
  • Psoas sign: RIF pain on passive extension of the right hip
    • This is suggestive of an inflamed appendix near the psoas major muscle in a retrocaecal position
  • Guarding
  • Signs of sepsis e.g. tachycardic, hypotensive, pyrexia
  • RIF mass – suggestive of an appendiceal abscess
18
Q

Rovsing sign is a sign suggestive of what condition

A

Appendictis

  • Rovsing sign: pain in the RIF on palpation of the LIF
19
Q

Define Rovsing sign

A

Pain in the RIF on palpation of the LIF

20
Q

Psoas sign is a sign suggestive of which condition

A

Appendicitis

21
Q

Define Psoas sign

A

RIF pain on passive extension of the right hip

22
Q

How is appendicitis diagnosed

A

It is a clinical diangosis i.e. the diagnosis is based on signs and symptoms rather than diagnostic tests.

Can be confirmed with a CT scan

Raised inflammatory markers are suggestive of appendictiis however these may not be elevated early in the disease process

23
Q

What is the first line imaging modality for confirming appendicitis diagnosis

A

CT scan

24
Q

Why is ultrasound scan the 1st line imaging modality to confirm appendicitis diagnosis in children

A

To minimise radiation exposure

25
Q

In which patient group is ultrasound scan the 1st line imaging modality in confirming a diagnosis of appendicitis

A

In women in child bearing age where gynaecological pathology is still a potential

In children

26
Q

Serum beta hCG is testing for?

A

Pregnancy

27
Q

Which blood test is used for pregnancy

A

Serum beta HCG

28
Q

What is the gold standard treatment for appendicitis

A

Laparoscopic appendicectomy i.e. appendix removal

29
Q

Why is laparoscopic preferred over open surgery?

A

Fewer complications and faster recovery time however conversion to open surgery occurs when necessary

30
Q

Antibiotic therapy should be commenced prior to appendicectomy for appendicitis. Which antibiotic is the typical choice?

A

Co-amoxiclav

31
Q

Describe the time duration of antibiotic therapy in relation to appendicitis

A

Antibiotic therapy should be commenced prior to surgery and should be continued for 7 days after surgery if pus or perofartion is noted intra-operatively

32
Q

When should antibiotic therapy be continuted for a week after laparoscopic appendicectomy?

A

If pus or perforation is noted intra-operatively

33
Q

Name the 3 complications of acute appendicitis

A
  • Perforation – causing peritoneal contamination
  • Appendix mass
  • Pelvic abscess
34
Q

When would an appendiceal mass occur in the case of an acute appendicitis

A

Occurs when the omentum and small bowel adhere to inflamed appendix forming a mass in the RIF

35
Q

What is the management of an appendiceal mass secondary to acute appendicitis

A

Antibiotic therapy and supportive treatment followed by appendicectomy once the acute condition has resolved

36
Q

How would an appendix mass secondary to acute appendicitis present

A

Fever with a palpable RIF mass

37
Q

How would an appendix mass secondary to acute appendicitis diagnosis be confirmed?

A

With a CT scan

38
Q

Name some of the complications of appendicectomy

A
  • Bleeding, infection, pain and scars
  • Damage to bowel, bladder or other organs
  • Removal of a normal appendix
  • Anaesthetic risks
  • Venous thromboembolism (deep vein thrombosis or pulmonary embolism)
  • Failure

Finals: Surgery (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions