Surgery>>>>>The Appendix
Question 10#

A 29-year-old woman presents with RLQ pain, fever, and leukocytosis. Prior to imaging studies the Alvarado score is used to determine the patient's likelihood of having appendicitis. All of the following variables make up the Alvarado score EXCEPT:

A. Anorexia
B. Left shift of neutrophils
C. Iliopsoas sign
D. RLQ pain
E. Fever

Correct Answer is C

Comment:

The Alvarado score is the most widespread scoring system useful for ruling out appendicitis and selecting patients for further imaging or intervention (Table below). The Alvarado score is calculated using RLQ tenderness, elevated temperature, rebound tenderness, migration of pain, anorexia, nausea/vomiting, leukocytosis, and a left shift on leukocyte differential as predictive factors. Several online calculators are freely available.

Scoring systems:

Score: <3: Low likelihood of appendicitis.	Score: 0-4: Low probability. Outpatient follow-up
4-6: Consider further imaging	5-8: I ndeterm inate group. Active observation or diagnostic laparoscopy.
≥7: High likelihood of appendicitis	9-12: High probability. Surgical exploration