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Acute Appendicitis Study
Appendicitis
21
Medical
Professional
09/01/2012

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Cards

Term
Number of cases of appendicitis/yr in US.
Definition
70,000
Term
Lifetime risk for boys and girls.
Definition
8.7% for boys
6.7% for girls
Term
Peak incidence age of acute appendicitis.
Definition
Between 12 and 18 years
Term
Name some infectious agents that may be implicated in appendicitis.
Definition
Yersinia
Salmonella
Shigella
Mumps virus
Coxsackie B
Adenovirus
Term
Appendicitis in neonates should raise suspicion of these 2 conditions.
Definition
Cystic fibrosis
Hirschprung's disease
Term
Variable strongly associated with greater rates of perforation.
Definition
Younger age. Cannot communicate symptoms.
82% perf rate <5 yo
100% perf rate in 1yo
Term
2 most classic first symptoms of appendicitis.
Definition
Anorexia
Vague periumbilical pain
Term
Dermatome of the referred pain of appendicitis.
Definition
8th to 10th thoracic dorsal ganglia for periumbilical pain.
Term
T/F. Diarrea does not occur in appendicitis.
Definition
False. It occurs in perforated appendicitis or in toddlers or infants.
Term
Most common laboratory finding in acute appendicitis.
Definition
Mild leukocytosis (11,000 to 15,000/uL)
Term
If a WBC is 40,000/uL, what may that indicate in a patient who had recent RLQ pain?
Definition
Perforated appendicitis
Term
T/F. Plain films are helpful in evaluating appendicitis.
Definition
F. They may show fecaliths, but are nonspecific and not helpful. They may help, however, if bowel obstruction or free peritoneal air is being considered.
Term
Appropriate pressure during an ultrasound evaluation of potential acute appendicitis.
Definition
Visualization of psoas muscle and iliac vessels.
Term
Antibiotic to be used for appendicitis. Spectrum.
Definition
Cefoxatin. Broad range gram negative, gram positive and anaerobes. Does not cover pseudomonas, enterococci, enterobacter cloacae, or MRSA.

wiki
Term
How long should antibiotics be given after resection of appendix after uncomplicated acute appendicitis?
Definition
They should not. Only before operation. Cefoxitin.
Term
Name possible antibiotic regimens for perforated appendicitis. Which is most cost effective?
Definition
Ampicillin, gentamicin, and clindamycin Piperacillin/tazobactam (Zosyn) Cefoxatime, and metronidazole (cost effective)
Term
Why is uncomplicated acute appendicitis no longer an indication for emergent surgery?
Definition
Because antibiotics are just as good at treating it, so the surgery can wait until the morning.
Term
Most clinically relevant definition of a perforation.
Definition
Identifiable hold in appendix, or a fecalith in the abdomen.
Term
Injection of ____ into an appendiceal abscess wound has been shown to decrease postoperative pain.
Definition
bupivicaine
Term
3 options for treating perforated appendix.
Definition
Antibiotics only
Antibiotics followed by interval appendectomy
Appendectomy on presentation
Term
2 options of treating appendiceal abscess on presentation.
Definition
Percutaneous drainage with interval appendectomy
Immediate laparoscopic appendectomy
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