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Appendicitis Exam Questions and Answers Latest Update
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Appendicitis Exam Questions and Answers Latest Update
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Appendicitis Exam Questions andAnswers Latest Update
*Pathogenesis:* obstruction of lumen, distention, infection
Fecal material (or inflammation of lymphatic tissue in appendix) -> *obstruction* of
lumen -> *distention* of lumen ->ischemia of appendiceal wall -> bacterial invasion
*(infection)* - Answer-*Appendicitis*
History prior to onset of disease -sometimes upper respiratory infection
*Incidence -*
-Most common in 10 - 40 year olds
-But can occur at any age
Cause - obstruction in lumen of appendix causes swelling and eventually decreased
blood supply to the wall of the appendix. - Answer-Appendicitis
*Pathophysiology of appendicitis*
____________ of appendix
-Due to trapped secretions
-Causes peri-umbilical pain (distention of hollow organ)
_______________ -> SUPPURATION
-Due to invasion of bacteria into wall
-Causes RLQ pain (localized peritonitis)
__________________
-Due to increasing distention
-Decreased blood supply to wall of appendix results in gangrenous wall that more easily
breaks - Answer-DISTENTION
INFLAMMATION
PERFORATION (same as "rupture")
-Typical appearance of suppurative appendicitis.
-There is swelling and injection of distal half.
-There is purulent exudate, not only on appendix itself, but on other structures that it
touches.
-This takes HOURS to develop.
-There can *not* be sudden onset of symptoms. - Answer-Yup
, *Pathology:*
-*Obstruction* of lumen
-*Distention* of appendix
-Appendix wall starts to lose blood supply
-Bacteria invade wall -> infection (suppurative appendicitis)
-Appendix wall perforates
-Feces and bacteria spill out (perforated appendicitis) - Answer-Appendicitis
*Symptoms/Signs:*
-Periumbilical pain, nausea, later vomiting, not tender yet
-Pain / tenderness RLQ
-Low grade fever
-Mildly increased WBC
-More pain / tenderness
-More fever, higher WBC - Answer-Appendicitis
*Symptoms and signs of appendicitis*
-PERIUMBILICAL PAIN first (distention), then RLQ pain (inflammation)
-Almost always ANOREXIA, usually VOMITING
-Later develops TENDERNESS
--McBurney's point (if appendix is in iliac fossa)
--Rectal (if appendix is in the pelvis)
--Flank (if appendix is retrocecal)
-These take MANY HOURS to DAYS to develop.
-Appendicitis is generally NOT characterized by *sudden* onset of RLQ pain. - Answer-
Appendicits
Can cause flank pain, CVA tenderness, *positive psoas sign,* few WBCs / RBCs in
urine (near ureter) - Answer-Retrocecal Appendicitis
*What Location of Appendix?*
*Symptoms/Signs:*
-RLQ pain and tenderness
-No psoas sign - Answer-IIiac fossa (anterior) near anterior abdominal wall
*What Location of Appendix?*
*Symptoms/Signs:*
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