The Daily PANCE and PANRE Extended Edition: Question 21

Which of the following is LEAST compatible with acute, uncomplicated appendicitis?

  1. periumbilical pain early
  2. localized RLQ pain late
  3. WBC > 22,000
  4. Rebound tenderness
  5. Low-grade fever

Answer: C

WBC > 22,000

A normal WBC does NOT r/o appy. Usually, the pain starts periumbilically or diffusely, then moves to the RLQ later, the fever will be low 99-100, and there is usually rebound tenderness.

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