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Acute appendicitis — MCCQE Part 1 MCQ

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ModerateAbdominal PainAcute appendicitisMCCQE Part 1

A 21-year-old man has periumbilical pain migrating to the right lower quadrant with anorexia and low-grade fever. He has localized rebound tenderness at McBurney point. Which of the following is the most appropriate next step?

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Correct answer: C — Surgical assessment with imaging as needed and appendectomy or selected antibiotic pathway

Migratory pain to the right lower quadrant with peritoneal tenderness is classic appendicitis and requires urgent surgical assessment. A normal white count does not exclude appendicitis, and laxatives may worsen a surgical abdomen. Colonoscopy and acid suppression are not appropriate acute steps.

Reference: Canadian Association of General Surgeons practice; provincial emergency surgery pathways