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  #1  
Old 06-24-2012
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Surgery Appendicitis Management


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Old 06-24-2012
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emergent appendectomy.......???
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  #3  
Old 06-25-2012
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D but I am more concerned about the car
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Old 06-25-2012
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Why not antibiotics if its asking for best next step?

MTB3 2nd edition p294:




FA-CK:
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Old 06-25-2012
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Quote:
Originally Posted by neoeinstein View Post
Why not antibiotics if its asking for best next step?
You are right. The answer is indeed A.
I wasn't paying attention.:sorry:
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Old 06-25-2012
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u world and kaplan surgery too says that if acute appendicitis is confirmed on Clinical features for sure.. then the next step is to 1st start an iv line and then 2nd to go straight to the OR and operate.
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Old 06-25-2012
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ans should be appendectomy .

there is some mantrel score .

migration,anorexia,nausea,tenderness,rebound pain,elevated temp and leukocytosis. this guy has all.

since clinical suspicion is high, next is surgery.

whats ans btw ?
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Old 06-25-2012
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This is Kaplan's answer and I believe this is wrong. No wonder less than 20% got it right.
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Old 06-25-2012
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I think when ever there are signs of peritoneal inflammation , we should go for emergency operative procedure, so the next best step is er appendicectomy


QUOTE=neoeinstein;128698]
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Old 06-25-2012
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Quote:
Originally Posted by cytokine View Post
I think when ever there are signs of peritoneal inflammation , we should go for emergency operative procedure, so the next best step is er appendicectomy
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Originally Posted by tyagee View Post
ans should be appendectomy .
But the question was asking for the most appropriate next step?

If the question was definitive treatment or most appropriate treatment, the answer will be definitely appendectomy.

Im confused, its either kaplan qbank is wrong or both mtb3&FACK are wrong.
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Old 06-25-2012
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Next step in management>>>Hydration and Abs since this patient is clearly dehydrated as suggested by his high Hematocrit and dry oral mucosa.

Best step in management>>>Appendectomy

The Kaplan explanation is stupid. The anesthetist will refuse to induce this patient unless you have hydrated him.
Moreover, now a days there is a trend toward not doing the Appendectomy in the middle of the night but defer it for the morning and various studies have shown no untoward outcome. In fact they have shown it to have a better outcome.
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Old 06-25-2012
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Weird,when iwas in my surgery rotation wefirst hydrated the patient and gave antibiotics while rushing to the OR, kaplan answer is pathetic
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  #13  
Old 06-26-2012
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i dont know if i am wrong but i can remember from kaplan surgery videos that when suspicion for appendicits is high, next step is appendectomy especially stating that CT and USG or any other investigation is not required. maybe i am low in surgery clinicals experience...

novo comments perfect. i guess this q is not standard of real exam so why bother much
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