Welcome to the procedure part of the appendicitis module. Here the learner will go through a pre-test and interactive case scenario to learn about laparoscopic management of appendicitis.

Pre-test

Learners will first take a pre-test to assess their baseline knowledge of the topic. This test is available on our interactive platform and gives real-time grading for learners to immediately assess their knowledge coming into the module. It is also copied in appropedia format below. On our platform, answer explanations are not displayed for the pre-test (but are displayed in the post-test).

1 Which of the following is the most common cause of appendicitis?

Abdominal adhesions
Colitis
Obstruction (fecalith)
Traumatic injury

2 Which of the following patient criteria would most strongly cause you to choose open surgical management over laparoscopic management of acute appendicitis?

Patient has a leukocyte count greater than 20,000
Patient has a morbid obesity with BMI>40
Patient presents with a fever >40 C
Patient has multiple adhesions from prior lower abdominal surgeries

3 How urgently must laparoscopic appendectomy be performed following diagnosis of acute appendicitis?

Within 1 hour
Within 12 hours
Within 24 hours
Within 1 week

4 Which of the following is an advantage of laparoscopic over open management of acute appendicitis?

No requirement for perioperative antibiotics
Use of spinal anesthesia
Lower equipment cost
Decreased risk of wound infection

5 Which of the following is true regarding the use of antibiotic treatment versus surgical management of appendicitis?

Overall complication rates are significantly lower in patients treated with antibiotics
Antibiotic therapy for appendicitis decreases length of hospital stay
Among patients who receive antibiotics for appendicitis, 100% will eventually undergo appendectomy
Antibiotics are a reasonable management option for both complicated and uncomplicated appendicitis

6 What is the standard pressure of pneumoperitoneum for a standard transabdominal laparoscopic procedure in adults?

5 mmHg
10 mmHg
15 mmHg
20 mmHg

7 What is the proper positioning of a patient undergoing laparoscopic appendectomy?

Supine position, Trendelenberg, left arm tucked with surgeon and camera on right side
Supine position, Trendelenberg, left arm tucked with surgeon and camera on left side
Prone position, reverse Trendelenberg, both arms tucked with surgeon and camera on right side
Supine position, reverse Trendelenberg, right arm tucked with surgeon and camera on right side

8 Which of the following trocars should be placed first during a laparoscopic appendectomy?

Camera port at RUQ
Camera port at umbilicus
Instrument port at LLQ
Instrument port at suprapubic region

9 Which of the following demonstrates the basic steps of a laparoscopic appendectomy?

Trocar placement, locate appendix, bluntly dissect cecum base, divide the mesoappendix, divide appendix base, remove appendix
Locate appendix, trocar placement, bluntly dissect cecum base, divide appendix base, remove appendix
Trocar placement, locate appendix, divide the mesoappendix, divide appendix base, bluntly dissect cecum base, remove appendix
Trocar placement, locate appendix, divide appendix base, divide the mesoappendix, bluntly dissect cecum base, remove appendix

10 While performing a laparoscopic appendectomy, you quickly dissect the mesoappendix and notice mild bleeding. Which of the following is the next best step?

Convert to open appendectomy
Apply direct pressure with the instrument to control the bleeding
Control the bleeding by ligating the ileocolic artery
Turn down pneumoperitoneum and observe


Case scenario

The psychomotor learning is embedded in the sequence of a full clinical case, allowing the learner to digest pre-, intra-, and operative concepts of ectopic pregnancy.

Learners will go through an interactive case scenario with embedded course material. The case scenario is presented in a question / answer format. As learners progress through the case, they will digest information that is presented to them as they answer case questions. It is highly recommended that the learner be familiar with this content before proceeding to the skill pages.

PDF of Acute Appendicitis Case Scenario

How the Appendicitis case scenario looks on our site


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