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Acute appendicitis — MCCQE Part 1 MCQ

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EasyAbdominal PainAcute appendicitisMCCQE Part 1

A 19-year-old man has periumbilical pain migrating to the right lower quadrant, anorexia, low-grade fever and rebound tenderness at McBurney point. Which of the following is the most appropriate next step?

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Correct answer: DArrange surgical assessment and imaging according to local pathway

Arrange surgical assessment and imaging according to local pathway is the single best answer because the age, timing, examination findings and investigations in the vignette fit Acute appendicitis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Association of General Surgeons guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Association of General Surgeons guidance