Systemic paediatrics: acute appendicitis imaging: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Systemic paediatrics: acute appendicitis imaging

Sample item

A 9-year-old has 24 hours of periumbilical pain that has shifted to the right iliac fossa, with anorexia, vomiting, fever of 38 degrees C and rebound tenderness. Which imaging is preferred first?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Graded-compression ultrasound of the abdomen

In children with suspected appendicitis, ultrasound is the preferred first imaging because it avoids radiation and is reasonably accurate. CT is reserved for equivocal cases. The diagnosis is mainly clinical, and plain films add little.

Option by option

  • A. Contrast-enhanced CT of the abdomen

    CT has higher accuracy but carries radiation, so it is reserved for equivocal ultrasound.

  • B. Plain radiograph of the abdomen

    A plain radiograph rarely shows an appendicolith and has low diagnostic yield.

  • C. Barium enema

    A barium enema is not used for suspected appendicitis and risks perforation.

  • D. Graded-compression ultrasound of the abdomen (correct)

    Correct. Graded-compression ultrasound is radiation-free and is the first-line imaging in children.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Graded-compression ultrasound of the abdomen. In children with suspected appendicitis, ultrasound is the preferred first imaging because it avoids radiation and is reasonably accurate.

Why is "Contrast-enhanced CT of the abdomen" not the answer?

CT has higher accuracy but carries radiation, so it is reserved for equivocal ultrasound.

Why is "Plain radiograph of the abdomen" not the answer?

A plain radiograph rarely shows an appendicolith and has low diagnostic yield.

Why is "Barium enema" not the answer?

A barium enema is not used for suspected appendicitis and risks perforation.

What concept does this question test?

It tests Systemic paediatrics: acute appendicitis imaging in Pediatrics. CT is reserved for equivocal cases. The diagnosis is mainly clinical, and plain films add little.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic paediatrics: acute appendicitis imaging?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.