Appendicitis
Pain that starts around the umbilicus and migrates to the right iliac fossa with anorexia and low-grade fever is classic for acute appendicitis.
What our notes say
- Pain that starts around the umbilicus and migrates to the right iliac fossa with anorexia and low-grade fever is classic for acute appendicitis. (Surgery Question Bank: 12 Clinical MCQs)
- Five diagnostic scoring systems for acute appendicitis (5 marks) (General Surgery CAT 2 (MBSG 4600): 4 October 2021)
- Adult Appendicitis Score (AAS), and the Paediatric Appendicitis Score (PAS) (General Surgery CAT 2 (MBSG 4600): 4 October 2021)
- Differential diagnosis: acute alcoholic hepatitis, alcoholic gastritis, perforated or bleeding peptic ulcer, acute cholecystitis, acute appendicitis, mesenteric ischaemia, bowel obstruction, and inferior myocardial infarction. (Internal Medicine (MBIM 4100) main exam, Paper One: 3 July 2019)
- Spread from nearby sites (for example appendicitis), and *Mycobacterium tuberculosis*. (Gynaecology Year 4 CAT (MBOG 4212): 30 November 2018, ovarian cysts, abnormal me)
- Rovsing's sign: LLQ palpation → RLQ pain — appendicitis (*2). (Cranial Nerves, Eye Exam & Vital Signs: MBChB Clinical Revision)
Study material on Appendicitis
- Pathology Spot Exam Revision: Lymphoma, Adenoma, Appendicitis, FISH
- GASTROINTESTINAL PATHOLOGY (Part 2)
- General Surgery CAT 2 (MBSG 4600): 4 October 2021
- Pinworm (Enterobius vermicularis)
- Surgery Question Bank: 12 Clinical MCQs
- Gastrointestinal and liver
Practice questions on Appendicitis
A 23-year-old man presents with acute appendicitis that ruptures shortly after admission. He is taken to the operating room for surgery, and postsurgical cultures reveal Escherichia coli and Bacteroides fragilis, susceptibilities pending. Which of the following provides adequate empiric coverage of these two pathogens?
- Cefepime
- Aztreonam
- Piperacillin/tazobactam
- Ceftaroline
- Reduced by routine feedback control
Answer: C. Piperacillin/tazobactam is a β-lactam/β-lactamase inhibitor combination that provides excellent coverage against both gram-negative aerobes (E. coli) and anaerobes (Bacteroides fragilis). While the other agents cover E. coli, only piperacillin/tazobactam provides adequate coverage against Bacteroides species, which are common in intra-abdominal infections. ---