PAEA Surgery End Of Rotation (EOR) Practice Exam

What are common initial symptoms of appendicitis?

1. High fever and headache

2. Poorly localized periumbilical pain

3. Cough and sore throat

4. Chest pain and dysphagia

The correct answer is: Poorly localized periumbilical pain

The initial symptoms of appendicitis commonly include poorly localized periumbilical pain. This symptom typically manifests as a dull, cramp-like sensation near the belly button and is often one of the first indications of the condition. As the inflammation progresses, the pain usually becomes more localized to the right lower quadrant of the abdomen (McBurney's point), but the initial discomfort can be vague and difficult to pinpoint. This characteristic of appendicitis stems from the embryological development of the appendix and the innervation of the visceral nerves, leading to referred pain in the periumbilical area. Therefore, the presence of poorly localized periumbilical pain is a hallmark feature that aids in the differential diagnosis of acute abdominal conditions and is critical for early identification of appendicitis. In contrast, other options present symptoms that are not typically associated with appendicitis; high fever and headache can occur in various infections but are not specific to appendicitis, while cough and sore throat as well as chest pain and dysphagia indicate other potential health issues unrelated to appendicitis.