APPENDICITIS EXAM GUIDE
QUESTIONS WITH CORRECT ANSWERS
The psoas sign can be best described as abdominal pain
elicited by:
A. passive extension of the hip.
B. passive flexion and internal rotation of the hip.
C. deep palpation.
D. asking the patient to cough. - Answer-A. passive extension of the hip.
The obturator sign can be best described as abdominal
pain elicited by:
A. passive extension of the hip.
B. passive flexion and internal rotation of the hip.
C. deep palpation.
D. asking the patient to cough. - Answer-B. passive flexion and internal rotation of the
hip.
An 18-year-old man presents with periumbilical pain,
vomiting, and abdominal cramping over the past
48 hours. Physical examination reveals rebound tenderness,
and laboratory analysis shows the presence of
bandemia and a total WBC of 28,000 mm3. To support
the diagnosis of acute appendicitis with suspected
appendiceal rupture, you consider obtaining the
following abdominal imaging study:
A. magnetic resonance image (MRI).
B. computed tomography (CT) scan.
C. ultrasound.
D. flat plate. - Answer-B. computed tomography (CT) scan.
Abdominal computerized tomography (CT) of the abdomen is generally considered the
imaging of choice in suspected appendicitis; its ability to define better the anatomical
abnormality associated with appendicitis is superior to other
imaging options.
Which of the following WBC forms is an ominous finding
in the presence of severe bacterial infection?
A. neutrophil
B. lymphocyte
C. basophil
D. metamyelocyte - Answer-D. metamyelocyte
, Although additional neutrophil forms exist, these do not belong in circulation even with
severe infection. Myelocytes and metamyelocytes are immature neutrophil forms that
are typically found in only the granulopoiesis pool. The presence
of these cells is an ominous marker of life-threatening infection, and these are
occasionally found in the presence of appendiceal rupture.
Which of the following best represents the peak ages for
occurrence of acute appendicitis?
A. 1 to 20 years
B. 20 to 40 years
C. 10 to 30 years
D. 30 to 50 years - Answer-C. 10 to 30 years
Clinical findings most consistent with appendiceal
rupture include all of the following except:
A. abdominal discomfort less than 48 hours in duration.
B. fever greater than 102°F (>38°C).
C. palpable abdominal mass.
D. marked leukocytosis with total WBC greater than
20,000/mm3. - Answer-A. abdominal discomfort less than 48 hours in duration.
Which of the following imaging studies potentially
exposes the patient being evaluated for abdominal
pain to the lowest ionizing radiation burden?
A. ultrasound
B. barium enema
C. CT scan
D. abdominal flat plate - Answer-A. ultrasound
Commonly encountered diagnoses other than acute
appendicitis can include which of the following in a
28-year-old with a 2-day history of lower abdominal
pain and with right-sided pain slightly worse than left?
(More than one can apply.)
A. constipation
B. pelvic inflammatory disease
C. ectopic pregnancy
D. splenetic infarct - Answer-A. constipation
B. pelvic inflammatory disease
C. ectopic pregnancy
Rebound tenderness is best described as abdominal
pain that worsens with:
A. light palpation at the site of the discomfort.
B. release of deep palpation at the site of the discomfort.
C. palpation on the contralateral side of the abdomen.
QUESTIONS WITH CORRECT ANSWERS
The psoas sign can be best described as abdominal pain
elicited by:
A. passive extension of the hip.
B. passive flexion and internal rotation of the hip.
C. deep palpation.
D. asking the patient to cough. - Answer-A. passive extension of the hip.
The obturator sign can be best described as abdominal
pain elicited by:
A. passive extension of the hip.
B. passive flexion and internal rotation of the hip.
C. deep palpation.
D. asking the patient to cough. - Answer-B. passive flexion and internal rotation of the
hip.
An 18-year-old man presents with periumbilical pain,
vomiting, and abdominal cramping over the past
48 hours. Physical examination reveals rebound tenderness,
and laboratory analysis shows the presence of
bandemia and a total WBC of 28,000 mm3. To support
the diagnosis of acute appendicitis with suspected
appendiceal rupture, you consider obtaining the
following abdominal imaging study:
A. magnetic resonance image (MRI).
B. computed tomography (CT) scan.
C. ultrasound.
D. flat plate. - Answer-B. computed tomography (CT) scan.
Abdominal computerized tomography (CT) of the abdomen is generally considered the
imaging of choice in suspected appendicitis; its ability to define better the anatomical
abnormality associated with appendicitis is superior to other
imaging options.
Which of the following WBC forms is an ominous finding
in the presence of severe bacterial infection?
A. neutrophil
B. lymphocyte
C. basophil
D. metamyelocyte - Answer-D. metamyelocyte
, Although additional neutrophil forms exist, these do not belong in circulation even with
severe infection. Myelocytes and metamyelocytes are immature neutrophil forms that
are typically found in only the granulopoiesis pool. The presence
of these cells is an ominous marker of life-threatening infection, and these are
occasionally found in the presence of appendiceal rupture.
Which of the following best represents the peak ages for
occurrence of acute appendicitis?
A. 1 to 20 years
B. 20 to 40 years
C. 10 to 30 years
D. 30 to 50 years - Answer-C. 10 to 30 years
Clinical findings most consistent with appendiceal
rupture include all of the following except:
A. abdominal discomfort less than 48 hours in duration.
B. fever greater than 102°F (>38°C).
C. palpable abdominal mass.
D. marked leukocytosis with total WBC greater than
20,000/mm3. - Answer-A. abdominal discomfort less than 48 hours in duration.
Which of the following imaging studies potentially
exposes the patient being evaluated for abdominal
pain to the lowest ionizing radiation burden?
A. ultrasound
B. barium enema
C. CT scan
D. abdominal flat plate - Answer-A. ultrasound
Commonly encountered diagnoses other than acute
appendicitis can include which of the following in a
28-year-old with a 2-day history of lower abdominal
pain and with right-sided pain slightly worse than left?
(More than one can apply.)
A. constipation
B. pelvic inflammatory disease
C. ectopic pregnancy
D. splenetic infarct - Answer-A. constipation
B. pelvic inflammatory disease
C. ectopic pregnancy
Rebound tenderness is best described as abdominal
pain that worsens with:
A. light palpation at the site of the discomfort.
B. release of deep palpation at the site of the discomfort.
C. palpation on the contralateral side of the abdomen.
