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C
Regarding the diagnosis
of acute appendicitis, all
the following are true
EXCEPT:
A. Vital signs are usually
abnormal, even early
in the course of acute
appendicitis.
B.Rebound is usually
elicited only after the
appendix has ruptured
or infarcted.
C. Rovsing's sign is pain
in the right lower
quadrant upon
palpation of the left
lower quadrant.
D.The obturator sign is
pain upon flexion and
internal rotation of the
hip.
E.The psoas sign is pain
upon extension of the
hip.
A. Vital signs are usually abnormal, even early in the
course of acute appendicitis.
The answer is A. The presentation of acute
appendicitis varies tremendously. Early in its
course, vital signs including temperature may be
normal. Once perforation has occurred, the rate
of low-grade fever (<38 C) increases to about
40%. Other variations in presentation include
pain in the right upper quadrant, typically from
a retrocecal or retroiliac appendix.
