⚕️FREE MSRA PODCAST –Acute Appendicitis Overview
🎧 Everything you need to know about appendicitis for your MSRA exam –simplified, high-yield, and exam-ready.
🧠Key Learning Points
📌Definition
• Appendicitis = inflammation of the vermiform appendix
• Often triggered byobstruction of the lumen (e.g. faecolithsor lymphoid hyperplasia)
• Can lead to infection, perforation,and peritonitis if untreated
📌Causes
• Faecoliths (most common)
• Lymphoid hyperplasia (especially in children)
• Less commonly:foreign bodies, tumours
📌Pathophysiology
📌Risk Factors
👦 Age 10–30 (peak incidence)
👨 Slight male predominance
👪 Family history
🦠 Conditions: Crohn’s disease, cystic fibrosis
📌Symptoms
• Initial peri-umbilical pain, migrating to right iliac fossa (RIF)
• Anorexia, nausea, low-grade fever
• Tenderness at McBurney’s point, guarding,rebound tenderness
• Positive Rovsing’s, psoas, and obturator signs
📌DifferentialDiagnosis
• GI:Diverticulitis, IBD, gastroenteritis
• Urological: UTI,renal colic
• Gynaecological:Ectopic pregnancy, ovarian torsion, PID
• Others: Mesentericadenitis, pneumonia, DKA
📌Investigations
🧪Bloods: ↑ WCC, ↑ neutrophils, ↑ CRP
🚽Urine dip: Rule out UTI, pregnancy test in females
🖼️Imaging:
• Ultrasound – first-line for children andpregnancy
• CT scan – most accurate in adults
• MRI – sometimes used in pregnancy if needed
💡Mnemonic: “US for under 30s &pregnancy, CT for classic adult cases”
📌Management
🔪Laparoscopicappendicectomy = gold standard
💉IV antibiotics pre-operatively (and post-op if perforated)
🧪 Consider conservative antibiotic-only approach inselect uncomplicated cases – but note ~39% recurrence
💧 Supportive care: IV fluids, pain relief
📌Prognosis
• Excellent ifcaught early
• Mortality: <1/1000 for uncomplicated; up to >20% in elderly with perforation
• Worse with delays,comorbidities, or atypical presentations
📌Complications
❗Perforation → peritonitis
❗Appendix mass orabscess
❗Paralytic ileus
❗Adhesionalobstruction, sepsis
📎More AppendicitisMSRA Resources:
📝 Revision Notes: https://www.passthemsra.com/topic/appendicitis-revision-notes-2/
🧠 Flashcards: https://www.passthemsra.com/topic/appendicitis-flashcards-2/
💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/appendicitis-accordion-qa-notes-2/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/appendicitis-rapid-quiz-2/
🎓 Full Course: https://www.passthemsra.com/courses/gastroenterology-for-the-msra/
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