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Microbiology
June 25, 2013
Chapter 23 – Microbial Diseases of the Digestive System
Chapter 24 – Microbial Diseases of the Urinary and Reproductive Systems
Acute Appendicitis
* Located in the right lower quadrant of the abdomen
* Not vestigial, as once thought
* Lymphoid organ, similar to tonsils
* Protects the large intestine from developing infection by producing T lymphocytes
* Generally does not present in any textbook manner
* Any woman between the age of 13 and 52 who comes with any type of abdominal pain, regardless of where it is, the first thing you need to rule out is ectopic pregnancy; second thing to rule out for woman and first for men is acute appendicitis
* Divided into four stages
* Stage One
* Appendix gets obstructed by undigested food or fecal material, causing the appendix to dilate
* When the appendix dilates, it causes crampy, diffused abdominal pain
* Patients may also complain of nausea, vomiting, diarrhea, and anorexia
* Stage Two
* Dilated appendix gets invaded by the intestinal bacteria
* Causes fever, anorexia, nausea, vomiting, and periumbilical pain
* Puss starts to be produced
* Stage Three
* Infection becomes larger and infects the peritoneal wall
* Pain shifts from periumbilical region to right lower quadrant region, along with McBurney’s Point tenderness
* Two thirds between umbilicus and ileus
* Stage Four
* Appendix ruptures, bursts open, and the puss goes all over the abdominal cavity, causing acute peritonitis
Signs and Symptoms
* Abdominal pain
* Abdominal guarding
* When walking, they do it very carefully
* Abdominal rigidity
* Diffused abdominal tenderness
* Rebound tenderness
* Pushing patient on one side of the abdomen and having it hurt on the other
Diagnosis
* CBC with Diff
* Blood cultures
* Abdominal...