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Acute appendicitis — MCCQE Part 1 MCQ

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ModerateAbdominal PainAcute appendicitisMCCQE Part 1

A 22-year-old man presents with 18 hours of abdominal pain that began peri-umbilically and migrated to the right lower quadrant. He is anorexic, temperature is 38.1°C, and there is focal tenderness with guarding at McBurney point. Urinalysis is normal. What is the most likely diagnosis?

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Correct answer: C — Acute appendicitis

Migratory pain, anorexia, fever and focal right lower-quadrant peritonism are classic for acute appendicitis. Ureteric colic usually produces flank-to-groin pain and haematuria. Testicular torsion can present with abdominal pain, so testicular examination is important, but the abdominal findings here strongly support appendicitis.

Reference: Canadian Association of General Surgeons resources; MCC Objectives—Abdominal Pain