18 Hours Of Worsening in Surgery — 19yo Man | General Surgery | SMLE Q#20276

SMLE Question #20276

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: July 2026
A 19-year-old man presents to the emergency department with 18 hours of worsening periumbilical pain migrating to the right lower quadrant, associated with nausea and anorexia. Examination shows localized right lower quadrant tenderness with guarding. CT abdomen shows a dilated, thick-walled appendix with periappendiceal fat stranding. In uncomplicated acute appendicitis, which organisms are most commonly involved?

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