Multiple Choice Questions (MCQ)

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Category: Surgery--->The Appendix
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Question 1# Print Question

The incidence of appendectomy for acute appendicitis was decreasing in the United Status until the 1990s, at which point the frequency of appendectomy for nonperforated appendicitis began to rise. What is one potential explanation for this observation?

A. Increased use of diagnostic imaging and detection of appendicitis that otherwise would have resolved
B. Increased incidence of obesity and the impact of periappendicular fat on luminal obstruction
C. Increasing incidence of inflammatory bowel disease and the potential mitigation of ulcerative colitis symptoms seen with appendectomy
D. Reimbursement patterns have changed in the United States, favoring aggressive surgical decision making

Question 2# Print Question

What imaging finding would exclude appendicitis?

A. A computed tomographic (CT) scan with a nonvisualized appendix
B. A barium enema where a short (2 cm) appendix was clearly identified
C. An ultrasound study with a compressible appendix that is <5 mm in diameter
D. A CT scan showing an edematous but retrocecal appendix

Question 3# Print Question

 A 25-year-old man presents with migratory right lower quadrant (RLQ) pain, leukocytosis, and a CT scan consistent with acute, uncomplicated appendicitis. He is physiologically normal and it is 2 AM. You are planning an appendectomy, what difference might be expected in his outcome if his operation is delayed until the next morning?

A. Increased risk of an intra -abdominal abscess
B. Increased risk of surgical-site infection
C. Decreased operative time
D. Increased risk of perforation
E. No difference in perforation rates, surgical-site infection, abscess, conversion rate or operative time

Question 4# Print Question

A 55-year-old man has CT evidence of complicated appendicitis with a contained abscess in the RLQ. He is mildly tachycardic, afebrile, and normotensive with focal RLQ tenderness but no peritonitis. What is the optimal approach to this patient? 

A. Immediate laparotomy
B. Laparoscopic exploration and abscess drainage
C. Percutaneous drainage, intravenous (IV) fluids, bowel rest, and broad spectrum antibiotics
D. IV fluids, bowel rest, and broad spectrum antibiotics

Question 5# Print Question

A 23-year-old woman who is 28 weeks pregnant presents with right -sided abdominal pain, leukocytosis, and an abdominal ultrasound that does not visualize the appendix. What intervention would you recommend?

A. Exploratory laparoscopy
B. Abdominal CT scan
C. Abdominal magnetic resonance imaging (MRI) scan
D. Serial clinical observations

Category: Surgery--->The Appendix
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