Pharma Quiz 206: Appendicitis Quiz | Appendicitis MCQs for Exam Prep | Pharma Knowledge Online скачать в хорошем качестве

Pharma Quiz 206: Appendicitis Quiz | Appendicitis MCQs for Exam Prep | Pharma Knowledge Online

Get Exam-Ready with Our Appendicitis Pharma Quiz! ✅ LIKE this video if it boosts your study game! 📤 SHARE it with your fellow learners! 🔔 SUBSCRIBE to Pharma Knowledge Online and hit the bell for instant updates on pharma content! 📚💡 Stay informed and learn something new every day with Pharma Knowledge Online! 👉 Subscribe NOW: 🌐    / pharmaknowledgeonline   #PharmaKnowledgeOnline #Appendicitis What is Appendicitis? 1. Definition Appendicitis is the acute inflammation of the appendix, a small, finger-like pouch attached to the cecum (the first part of the large intestine). If untreated, it can progress to rupture, leading to life-threatening complications like peritonitis (infection of the abdominal cavity). 2. Anatomy of the Appendix Location: The appendix arises from the posteromedial wall of the cecum, typically in the right lower quadrant (RLQ) of the abdomen. Position Variations: It may lie retrocecal (behind the cecum), pelvic (near the bladder/rectum), or subhepatic (under the liver), causing atypical symptoms. Function: The appendix has lymphoid tissue and may play a role in immune function, but it is not essential for survival. 3. Causes Luminal Obstruction: Fecaliths (hardened stool) – Most common cause. Lymphoid Hyperplasia: Swelling due to infections (e.g., viral or bacterial). Parasites (e.g., Enterobius vermicularis), tumors, or foreign bodies. Infection: Bacterial overgrowth (e.g., E. coli, Bacteroides) following obstruction. Ischemia: Reduced blood flow due to swelling and inflammation. 4. Pathophysiology Obstruction: Blocks mucus drainage from the appendix. Increased Pressure: Mucus buildup stretches the appendix, impairing blood flow. Bacterial Proliferation: Leads to inflammation and infection. Ischemia and Necrosis: Tissue death due to lack of blood supply. Perforation: Rupture of the appendix within 48–72 hours if untreated. 5. Epidemiology Age: Most common in adolescents and young adults (10–30 years). Incidence: Lifetime risk is 7–8%, with a slight male predominance. 6. Clinical Presentation Classic Symptoms: Migratory Pain: Starts as vague periumbilical pain (visceral inflammation) and later localizes to the RLQ (somatic peritoneal irritation). Nausea/Vomiting: Follows pain onset (unlike gastroenteritis, where vomiting precedes pain). Fever: Low-grade (37.5–38.5°C) initially; high fever suggests perforation. Physical Exam Signs: McBurney’s Tenderness: Maximal pain at McBurney’s point (one-third from the right ASIS to the umbilicus). Rovsing’s Sign: RLQ pain when pressing the left lower quadrant. Rebound Tenderness: Pain upon sudden release of pressure (peritoneal irritation). Psoas Sign: Pain on right hip extension (retrocecal appendix). Obturator Sign: Pain on internal rotation of the flexed right hip (pelvic appendix). 7. Diagnosis Clinical Evaluation: Alvarado Score: A 10-point scoring system combining symptoms (migration of pain, anorexia, nausea/vomiting) and signs (RLQ tenderness, rebound pain, fever, leukocytosis). Laboratory Tests: C-reactive Protein (CRP): Elevated in inflammation. Imaging: Ultrasound: Preferred for children and pregnant women. MRI: Used in pregnancy to avoid radiation. 8. Differential Diagnosis Gastrointestinal: Gastroenteritis, mesenteric adenitis, Crohn’s disease, diverticulitis. Gynecologic: Ectopic pregnancy, ovarian torsion, pelvic inflammatory disease. Urologic: Kidney stones, urinary tract infection. Other: Testicular torsion, cholecystitis, pancreatitis. 9. Treatment Surgery (Appendectomy): Laparoscopic: Minimally invasive, shorter recovery (standard approach). Open Surgery: Used in complicated cases (e.g., perforation, abscess). Antibiotics: Pre-op: Broad-spectrum antibiotics (e.g., ceftriaxone + metronidazole). Non-operative Management: For uncomplicated cases (controversial, but increasingly used). Abscess Drainage: Percutaneous drainage if perforation with abscess occurs. 10. Complications Perforation: Leads to peritonitis, sepsis, or abscess. Post-operative: Wound infection, ileus, intra-abdominal abscess. Chronic Appendicitis: Rare, with recurrent RLQ pain. 11. Special Populations Pregnant Women: Pain may localize to the right upper quadrant due to uterine displacement. Ultrasound/MRI preferred for diagnosis. Elderly: Atypical symptoms (e.g., mild pain, delayed presentation) increase perforation risk. Children: Often misdiagnosed as gastroenteritis; vomiting is more prominent. 12. Prognosis Uncomplicated: Excellent with timely surgery (recovery in 2–3 weeks). Perforated: Higher risk of complications but manageable with antibiotics and drainage. 13. Prevention No proven prevention, but high-fiber diets may reduce fecalith formation. Early Recognition: Key to avoiding complications.