The Alvarado score is used in the clinical assessment of suspected appendicitis. A patient with temperature 37.8°C, WBC 14,000/mm³, rebound tenderness, guarding, migration of pain to RIF, anorexia, and nausea scores how many points?
- A 5
- B 9 ✓
- C 7
- D 10
Correct answer: B. 9
Explanation
The Alvarado (MANTRELS) score: Migration of pain to RIF (1), Anorexia (1), Nausea/vomiting (1), RIF tenderness (2), Rebound tenderness (1), Elevated temperature >37.3°C (1), Leukocytosis WBC >10,000 (2) = total 9. Maximum score is 10 (adding neutrophil shift left = 1). Score ≥7 suggests appendicitis and warrants surgical intervention; 5–6 is equivocal requiring observation or CT. This patient scores 9 (migration 1 + anorexia 1 + nausea 1 + rebound 1 + RIF tenderness 2 + fever 1 + leukocytosis 2).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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