ENARE Practice Questions - ENARE - Exame Nacional De Residências (Brazil) Exam

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A 22-year-old previously healthy man presents with a 24-hour history of periumbilical abdominal pain that has migrated to the right lower quadrant. He reports anorexia, nausea, and low-grade fever (37.9°C). On examination, he has localized tenderness and rebound tenderness at McBurney's point, with a positive Rovsing sign. Laboratory tests reveal leukocytosis (14,200/mm³) with 82% neutrophils. His Alvarado score is calculated as 8 points. What is the most appropriate management plan?

Observation in the ward without antibiotics or surgery until repeat blood counts in 48 hours. Discharge home on oral ciprofloxacin and metronidazole with follow-up in one week. Upper gastrointestinal endoscopy to exclude peptic ulcer perforation. Surgical consultation and prompt appendectomy (laparoscopic or open).

Correct Answer:

Surgical consultation and prompt appendectomy (laparoscopic or open).

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