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Flashcards in GI -appendix Deck (15)
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1
Q

what kind of inflammation is involved in appendicitis

A

acute neutrophilic inflammation involving the muscle coat

2
Q

what 3 features are seen in histology of appendicitis in addition to neutrophilic inflammation involving muscle coat

A

thickened wall
mucosal ulceration
pus in lumen

3
Q

Appendicitis is caused by gut organisms invading through appendix wall after lumen obstruction by what

A

lymphoid hyperplasia
faecolith - perforation cause
filarial worms (nematodes residing in lymphatic tissue)
tumour (rare)

4
Q

s/s appendicitis

A
periumbilical pain that moves to RIF
nausea/vomiting
tachycardia
fever
coughing hurts
constipation/maybe diarrhoea
increased WCC
anorexia
5
Q

what is the point at which appendicitis pain is felt in the RIF and where is this

A

McBurney’s point

1/3 between ASIS and umbilicus

6
Q

why does the pain move from umbilicus to RIF

A

irritates parietal peritoneum - visceral –> parietal

7
Q

what nerves are involved in peritonitis

A

somatic afferents

8
Q

what is the first line investigation for appendicitis

what is the best investigation is unclear

A

U/S

CT

9
Q

what are some other tests for appendicitis

A
PR exam
Special tests 
- iliopsoas test
- Rovings sign
-Bloods
10
Q

what is the iliopsoas test (posts/cope sign)

A

lying on side facing left with legs bent up

examiner extends the patients right leg at hip

11
Q

what is Rosvings sign

A

pressing LIF - pain in RIF

12
Q

what would bloods of appendicitis show

A

neutrophil leukocytosis

CRP elevation

13
Q

what is the treatment of appendicitis

A

Laprascopic appendicectomy

metronidazole + cefuroxime

14
Q

what MANTREL score indicates appendicitis is likely

A

7-10

15
Q

what are some complications of appendicitis

A
mortality (pregnancy)
rupture/perforation --> guarding and rebound tenderness
Abscess
Fistula
Sepsis
Liver Abscess