Test 3. Dunphy. Primary care IIB Questions
and Answers Graded A+
How many appendectomies are done annually? 200,000
Appendicitis occurs at any age but is most common between ages ____ and _____ 10 and
30
Men are ______ as likely to be diagnosed with appendicitis between 10 and 30 years than
women, but this equalizes over the life span. twice
_________ will affect 10 in 100,000 people in the United States, with a lifetime risk for
individuals projected at 7%-10%. Appendicitis
Appendicitis is more common in ________countries. Western
Appendicitis is more common in diets that are_____ ? low in fiber, high in fat, and high
in refined sugars and other carbohydrates
,__________ of the appendix by a variety of pathological processes is the cause of the majority of
appendicitis Obstruction
Appendicitis is ______ of the appendix, followed by obstruction and subsequent bacterial
infection Dilation
In appendicitis ______, is obstructed by hardened feces (fecalith), inflammatory processes
(including parasites, viruses, or bacteria), strictures, neoplasms, or foreign bodies (including
vegetable or fruit seeds or barium) lumen
In appendicitisn ______ continues to secrete fluid, which further distends the lumen, impairing
the venous blood flow and leading to tissue necrosis Mucosa
Left untreated, in appendicitis _____ ______is impeded
Bacteria continue to proliferate and, in the absence of treatment, perforation of the appendix
occurs arterial inflow
Subjective complaints of appendicitis Acute onset of mild to severe colicky, epigastric, or
periumbilical pain
,Vague at first, but within 24 hours it localizes over the right lower quadrant
Exacerbated by walking or coughing
In male patients the pain may radiate into the testicles
May be associated with abdominal muscle spasm in male or female patients
What starts after the onset of pain in appendcitis? nausea and anorexia, then vomiting
after abdominal pain. Sensation of constipation is typical
Objective findings in appendicitis? Mildly elevated temperature of 99-100°F
Physical examination-
Distress - Hypertension and tachycardia proportionate to the degree of fever and pain
Abdomen:
Psoas sign
Obturator sign
McBurney's sign (rebound tenderness)
Rovsing's sign
, What is the psoas sign? Pain on passive extension of the right thigh. Patient lies on left
side. Examiner extends patient's right thigh while applying counter resistance to the right hip
What is the obturator sign? Pain on passive internal rotation of the flexed thigh. Examiner
moves lower leg laterally while applying resistance to the lateral side of the knee resulting in
internal rotation of the femur.
What is McBurney's point? + rebound pain peritoneal inflammation, RLQ
If palpation of the left lower quadrant of a patient's abdomen increases the pain felt in the right
lower quadrant, the patient is said to have a positive ______ _____and may have an acute
appendicitis. Rosving's sign
Diagnostics for Appendicitis? Laboratory findings are not diagnostic
Diagnosis is made from the history and physical exam (clinical diagnosis)
CBC usually reveals a mild to moderate leukocytosis (WBC 10 to 20,000 mcg/L) with a left shift
Urinalysis show microscopic hematuria or pyuria in 25% of patients
Urine human chorionic gonadotropin (hCG) test completed to rule out (ectopic) pregnancy
and Answers Graded A+
How many appendectomies are done annually? 200,000
Appendicitis occurs at any age but is most common between ages ____ and _____ 10 and
30
Men are ______ as likely to be diagnosed with appendicitis between 10 and 30 years than
women, but this equalizes over the life span. twice
_________ will affect 10 in 100,000 people in the United States, with a lifetime risk for
individuals projected at 7%-10%. Appendicitis
Appendicitis is more common in ________countries. Western
Appendicitis is more common in diets that are_____ ? low in fiber, high in fat, and high
in refined sugars and other carbohydrates
,__________ of the appendix by a variety of pathological processes is the cause of the majority of
appendicitis Obstruction
Appendicitis is ______ of the appendix, followed by obstruction and subsequent bacterial
infection Dilation
In appendicitis ______, is obstructed by hardened feces (fecalith), inflammatory processes
(including parasites, viruses, or bacteria), strictures, neoplasms, or foreign bodies (including
vegetable or fruit seeds or barium) lumen
In appendicitisn ______ continues to secrete fluid, which further distends the lumen, impairing
the venous blood flow and leading to tissue necrosis Mucosa
Left untreated, in appendicitis _____ ______is impeded
Bacteria continue to proliferate and, in the absence of treatment, perforation of the appendix
occurs arterial inflow
Subjective complaints of appendicitis Acute onset of mild to severe colicky, epigastric, or
periumbilical pain
,Vague at first, but within 24 hours it localizes over the right lower quadrant
Exacerbated by walking or coughing
In male patients the pain may radiate into the testicles
May be associated with abdominal muscle spasm in male or female patients
What starts after the onset of pain in appendcitis? nausea and anorexia, then vomiting
after abdominal pain. Sensation of constipation is typical
Objective findings in appendicitis? Mildly elevated temperature of 99-100°F
Physical examination-
Distress - Hypertension and tachycardia proportionate to the degree of fever and pain
Abdomen:
Psoas sign
Obturator sign
McBurney's sign (rebound tenderness)
Rovsing's sign
, What is the psoas sign? Pain on passive extension of the right thigh. Patient lies on left
side. Examiner extends patient's right thigh while applying counter resistance to the right hip
What is the obturator sign? Pain on passive internal rotation of the flexed thigh. Examiner
moves lower leg laterally while applying resistance to the lateral side of the knee resulting in
internal rotation of the femur.
What is McBurney's point? + rebound pain peritoneal inflammation, RLQ
If palpation of the left lower quadrant of a patient's abdomen increases the pain felt in the right
lower quadrant, the patient is said to have a positive ______ _____and may have an acute
appendicitis. Rosving's sign
Diagnostics for Appendicitis? Laboratory findings are not diagnostic
Diagnosis is made from the history and physical exam (clinical diagnosis)
CBC usually reveals a mild to moderate leukocytosis (WBC 10 to 20,000 mcg/L) with a left shift
Urinalysis show microscopic hematuria or pyuria in 25% of patients
Urine human chorionic gonadotropin (hCG) test completed to rule out (ectopic) pregnancy
