Podcast
Questions and Answers
What is the initial characteristic manifestation of acute appendicitis?
What is the initial characteristic manifestation of acute appendicitis?
Rebound tenderness is indicated by pain on the release of pressure at McBurney point.
Rebound tenderness is indicated by pain on the release of pressure at McBurney point.
True
What symptoms are commonly associated with acute appendicitis besides pain?
What symptoms are commonly associated with acute appendicitis besides pain?
Low-grade fever, anorexia, nausea, and vomiting.
In older adults, the diagnosis of appendicitis is sometimes delayed due to less acute pain and __________.
In older adults, the diagnosis of appendicitis is sometimes delayed due to less acute pain and __________.
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Match the following complications of acute appendicitis with their descriptions:
Match the following complications of acute appendicitis with their descriptions:
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Which of the following might lead to complications in acute appendicitis specifically in older adults?
Which of the following might lead to complications in acute appendicitis specifically in older adults?
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In pregnant women, where might pain associated with appendicitis be located due to the displacement of the appendix?
In pregnant women, where might pain associated with appendicitis be located due to the displacement of the appendix?
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Chronic appendicitis is characterized by continuous severe pain in the abdomen.
Chronic appendicitis is characterized by continuous severe pain in the abdomen.
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Study Notes
Acute Appendicitis
- Pain starts generalized and moves to the right lower quadrant of the abdomen within 4 hours
- Pain is worsened by movement, walking, and coughing
- Localized and rebound tenderness at McBurney’s point
- Rebound tenderness is relief of pain with direct palpation, followed by pain on release of pressure
- Extension or internal rotation of the right hip also increases pain
- A low-grade fever, anorexia, nausea, and vomiting are often present
- Older adults have less acute pain and local tenderness, so diagnosis can be delayed
- Appendicitis is more virulent in older adults, leading to complications and increased mortality
- Pregnant women experience pain in the RLQ, periumbilical, or right subcostal due to possible displacement from the distended uterus
- In adolescents and young adult women, symptoms must be differentiated from ovulation (mittelschmerz), ruptured ectopic pregnancy, and pelvic inflammatory disease
- Possible complications include perforation, peritonitis, and abscess
- Perforation is manifested by increased pain and high fever
- Perforation leads to a localized abscess; local peritonitis; or significant generalized peritonitis
- Less common is chronic appendicitis, which includes chronic abdominal pain and recurrent acute attacks.
Chronic Appendicitis
- Chronic recurrent abdominal pain over several months
- Appendectomy is a treatment for chronic appendicitis
Acute Appendicitis Treatments
- Analgesics for pain
- Antibiotics and/or surgery
- Surgical removal of the ruptured appendix
- Pain management
- Antibiotics
- Fluid resuscitation
- Supportive treatment to maintain vital signs
Peritonitis
- High fever, acute severe abdominal pain, abdominal distention
- Resultant death if not treated aggressively and rapidly
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Description
This quiz covers the key characteristics and symptoms of acute appendicitis. Focus on the progression of pain, related symptoms, and how it can present differently in various populations, including older adults and pregnant women. Important diagnostic points and potential complications are also addressed.
