Appendicitis (General Surgery EOR - Smarty PANCE) Exam Questions and Answers 100% Correct

Appendicitis (General Surgery EOR - Smarty PANCE) Exam Questions and Answers 100% Correct What is appendicitis? Inflammation of the appendix caused by obstruction of the appendiceal lumen, producing a closed loop with resultant inflammation that can lead to necrosis and perforation Define Psoas Sign Pain elicited by extending the hip with the knee in full extension, seen with appendicitis and psoas inflammation Define Obturator Sign Pain upon internal rotation of the leg with the hip and knee flexed; seen in patients with appendicitis/pelvic abscess Define Rovsing's Sign Palpation of the left lower quadrant resulting in pain in the right lower quadrant; seen in appendicitis What are the causes of appendicitis? Lymphoid hyperplasia, fecalith (a.k.a. appendicolith) Rare—parasite, foreign body, tumor (e.g., carcinoid) What is the lifetime incidence of acute appendicitis in the United States? 7% What is the most common cause of emergent abdominal surgery in the United States? Acute appendicitis How does appendicitis classically present? Classic chronological order: 1. Periumbilical pain (intermittent and crampy) 2. Nausea/vomiting 3. Anorexia 4. Pain migrates to RLQ (constant and intense pain), usually in 24 hours Why does periumbilical pain occur? Referred pain Why does RLQ pain occur? Peritoneal irritation What are the signs/ symptoms? Signs of peritoneal irritation may be present: guarding, muscle spasm, rebound tenderness, obturator and psoas signs, lo