APPENDICITIS – PEDS EXAM
QUESTIONS WITH COMPLETE
ANSWERS
Which typical sign of appendicitis is not reliable in children? - Answer-rebound
tenderness
What is the cardinal feature of appendicitis? - Answer-Pain - initially localized
periumbilically; however, may descend to the RLQ (McBurney's point); referred pain
elicited by light percussion around the abdomen may indicate peritoneal irritation;
movement may worsen pain (riding in car, being rocked)
What are clinical manifestations of appendicitis? - Answer--RLQ pain (McBurney's point)
-Fever
-Rigid Abdomen
-Decreased or absent bowel sounds
-Vomiting (typically follows the onset of pain)
-Constipation or diarrhea
-Anorexia
-Tachycardia
-Rapid, shallow breathing
-Pallor
-Lethargy
-Irritability
-Stooped posture
What are signs that the appendix has ruptured and peritonitis has occurred? - Answer-
sudden relief from pain after rupture; subsequent increase in pain and rigid guarding of
abdomen; progressive abdominal distention; tachycardia; rapid, shallow breaths as child
refrains from using abdominal muscles; pallor; chills; irritability; and restlessness.
How is appendicitis best treated if the appendix is not ruptured? - Answer--
appendectomy (open performed through RLQ incision; laparoscopic performed in non-
perforated acute appendicitis)
-antibiotics given pre-op w/ fluids and electrolyte rebalancing
Why should you advocate for a laparoscopic surgery? - Answer-it has a reduced time of
surgery and anesthesia w/ a reduced risk of post-op infections
Explain the therapeutic management of a patient with a ruptured appendix? - Answer--
pre-op IV of fluids and electrolytes, antibiotics, and NG suction
-post-op Iv fluids, antibiotics, and NG suction until intestinal activity returns
QUESTIONS WITH COMPLETE
ANSWERS
Which typical sign of appendicitis is not reliable in children? - Answer-rebound
tenderness
What is the cardinal feature of appendicitis? - Answer-Pain - initially localized
periumbilically; however, may descend to the RLQ (McBurney's point); referred pain
elicited by light percussion around the abdomen may indicate peritoneal irritation;
movement may worsen pain (riding in car, being rocked)
What are clinical manifestations of appendicitis? - Answer--RLQ pain (McBurney's point)
-Fever
-Rigid Abdomen
-Decreased or absent bowel sounds
-Vomiting (typically follows the onset of pain)
-Constipation or diarrhea
-Anorexia
-Tachycardia
-Rapid, shallow breathing
-Pallor
-Lethargy
-Irritability
-Stooped posture
What are signs that the appendix has ruptured and peritonitis has occurred? - Answer-
sudden relief from pain after rupture; subsequent increase in pain and rigid guarding of
abdomen; progressive abdominal distention; tachycardia; rapid, shallow breaths as child
refrains from using abdominal muscles; pallor; chills; irritability; and restlessness.
How is appendicitis best treated if the appendix is not ruptured? - Answer--
appendectomy (open performed through RLQ incision; laparoscopic performed in non-
perforated acute appendicitis)
-antibiotics given pre-op w/ fluids and electrolyte rebalancing
Why should you advocate for a laparoscopic surgery? - Answer-it has a reduced time of
surgery and anesthesia w/ a reduced risk of post-op infections
Explain the therapeutic management of a patient with a ruptured appendix? - Answer--
pre-op IV of fluids and electrolytes, antibiotics, and NG suction
-post-op Iv fluids, antibiotics, and NG suction until intestinal activity returns
