General Surgery

20 learning units • 100 chapter sections • 200 explained questions. Assess surgical disease, recognise complications and connect intervention with safe recovery and follow-up.

Original RAHBAR study material for the Year 4 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 08 / 20

Acute Abdomen, Appendicitis & Peritonitis

Interpret evolving pain and peritoneal signs while recognising mimics and the need for timely source control.

Answer all 10 questions, then submit to see your score and explanations. This is a self-study exercise; results are not saved.

Question 01. Central pain migrating to the right lower quadrant supports which diagnosis? A. AppendicitisB. Uncomplicated haemorrhoidsC. Isolated biliary obstructionD. Benign oesophageal reflux alone

Question 02. Does a normal white-cell count exclude appendicitis? A. Yes, alwaysB. NoC. Only if vomiting is presentD. Yes, if symptoms are early

Question 03. Generalised rigidity with hypotension requires what? A. Urgent surgical assessment and resuscitationB. Routine reassessment next weekC. Oral laxatives before examinationD. Discharge after one normal urine test

Question 04. What is the role of an appendicitis score? A. Replace examination in every patientB. Determine the exact operation aloneC. Exclude every gynaecological causeD. Support risk assessment alongside clinical judgement

Question 05. Which diagnosis must be considered in relevant patients with lower abdominal pain and possible pregnancy? A. Ectopic pregnancyB. Haemorrhoids aloneC. Uncomplicated reflux onlyD. A benign scar by default

Question 06. Severe abdominal pain with little early tenderness and vascular risk raises concern for what? A. Mesenteric ischaemiaB. Simple constipation automaticallyC. A healed ulcer scar onlyD. Uncomplicated anal fissure

Question 07. What should determine imaging choice in suspected appendicitis? A. Patient context, probability and available expertiseB. CT for every patient regardless of circumstancesC. No imaging everD. The pain score alone

Question 08. Why can pyuria be misleading in lower abdominal pain? A. Adjacent inflammation can affect the urineB. It proves a urinary cause in every caseC. It excludes appendicitisD. It makes pregnancy testing unnecessary

Question 09. What is appropriate for an uncertain but stable acute abdomen? A. Unmonitored waiting without a review timeB. A definitive benign label after one testC. Immediate discharge regardless of supportD. Planned serial examination with escalation criteria

Question 10. What does source control mean in perforation-related peritonitis? A. Addressing the anatomical source of contaminationB. Treating fever aloneC. Replacing every test with antibioticsD. Waiting for the abdomen to become painless

0 / 10 answered

References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

WSES — Emergency surgery guidelines

Reference review: 27 September 2026. Consult current local protocols for prescribing, procedures and escalation.