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Appendicitis (PG)
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1. What is the most common presenting symptom of acute appendicitis?
*
Left lower quadrant pain
Right upper quadrant pain
Central abdominal pain migrating to the right iliac fossa
Diffuse abdominal pain with vomiting
2. Which age group most commonly presents with appendicitis?
*
Infants under 1 year
Children aged 2–5
Teenagers and young adults
Elderly >70
3. Which of the following is a classical physical sign in appendicitis?
*
Murphy's sign
Rovsing's sign
Cullen’s sign
Grey Turner’s sign
4. Which lab test is often elevated in acute appendicitis?
*
Serum creatinine
CRP and white cell count
HbA1c
Amylase
5. Which imaging modality is most commonly used in suspected appendicitis in adults?
*
MRI
PET
X-ray
CTA
6. Which of these is NOT a typical symptom of appendicitis?
*
Nausea and vomiting
Fever
Pain worsened by movement
Haematemesis
7. Which complication of untreated appendicitis is most serious?
*
Peritonitis
Ileus
Pyrexia
Vomiting
8. What is the usual management of confirmed appendicitis?
*
Oral antibiotics
Laparoscopic appendicectomy
Observation only
Enema
9. You're referring a patient for suspected appendicitis. Which speciality would you discuss with?
*
Medical On-Call
Surgical On-Call
HPB On-Call
GI On-Call
10. Which sign suggests inflammation of the peritoneum overlying the appendix?
*
Rebound tenderness in right iliac fossa
McBurney’s point tenderness
Costovertebral angle tenderness
Psoas sign
11. Which population may present atypically with appendicitis?
*
Men under 30
Fair skinned women aged over 40 with a higher BMI
Pregnant women and elderly patients
Teenagers
12. Where is McBurney’s point located?
*
Right lower quadrant, half way from anterior superior iliac spine to umbilicus
Right lower quadrant, one-third from anterior superior iliac spine to umbilicus
Epigastric region
Directly below xiphisternum
13. Which of these is NOT part of the Alvarado score?
*
Nausea
Leukocytosis
Migration of pain
Bowel sounds
14. In young females, what condition should be considered in the differential diagnosis of appendicitis?
*
Cholecystitis
Ovarian torsion
Renal colic
Diverticulitis
15. Which finding suggests rupture of the appendix has already occurred?
*
Sudden resolution of pain followed by peritonitis
Increased pain on urination with haematuria
Haematuria alone
Flank tenderness
16. How soon after onset of symptoms does appendicitis typically progress to perforation if untreated?
*
<6 hours
12–24 hours
48–72 hours
5 days
17. What is the typical white blood cell count in appendicitis?
*
Low
Normal
Mildly elevated
Elevated with neutrophilia
18. Which lifestyle factor is protective against appendicitis?
*
Low-fibre diet
High-fibre diet
Gluten-free diet
Pescatarian diet
19. What is the risk of appendicitis being a 'negative appendectomy' (normal appendix on histology)?
*
0%
1–2%
10–20%
>50%
20. What is the most common location of the appendix?
*
Retrocecal
Pelvic
Subhepatic
Pre-ileal