Gastrointestinal surgery: appendicitis in pregnancy: practice question

A General Surgery 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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General Surgery · Gastrointestinal surgery: appendicitis in pregnancy

Sample item

A woman at 30 weeks of pregnancy has fever and right abdominal pain with maximal tenderness in the right flank above the iliac crest. What best explains the site of pain?

ARound ligament stretchingBReferred pain from the gallbladderCUpward displacement of the caecum and appendix by the gravid uterusDHormonal relaxation of the abdominal wall

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

The answer and the reasoning

C. Upward displacement of the caecum and appendix by the gravid uterus

As the uterus enlarges the caecum and appendix are pushed upward and laterally, so pain in late pregnancy may be felt in the right flank or upper quadrant. Appendicectomy is not delayed because perforation endangers mother and fetus.

Option by option

A. Round ligament stretching
Round ligament pain is a benign, intermittent groin ache.
B. Referred pain from the gallbladder
No gallbladder disease is described.
C. Upward displacement of the caecum and appendix by the gravid uterus (correct)
Correct. The uterus displaces the appendix upward.
D. Hormonal relaxation of the abdominal wall
Hormones do not move the pain site.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Upward displacement of the caecum and appendix by the gravid uterus. As the uterus enlarges the caecum and appendix are pushed upward and laterally, so pain in late pregnancy may be felt in the right flank or upper quadrant.

Why is "Round ligament stretching" not the answer?

Round ligament pain is a benign, intermittent groin ache.

Why is "Referred pain from the gallbladder" not the answer?

No gallbladder disease is described.

Why is "Hormonal relaxation of the abdominal wall" not the answer?

Hormones do not move the pain site.

What concept does this question test?

It tests Gastrointestinal surgery: appendicitis in pregnancy in General Surgery. Appendicectomy is not delayed because perforation endangers mother and fetus.

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 Gastrointestinal surgery: appendicitis in pregnancy?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.