🏥 USMLE Exam Prep

A 25-year-old man presents with a 24-hour history of periumbilical pain that has now migrated to the right lower quadrant. He reports nausea, anorexia, and a low-grade fever (100.4°F). On physical exam, he has tenderness and guarding at McBurney's point. His WBC count is 14,000/µL. What is the most appropriate next step in management?

A Administer intravenous antibiotics and observe.
B Order an abdominal ultrasound.
C Schedule an urgent appendectomy.
D Perform a colonoscopy to rule out inflammatory bowel disease.

✓ Correct Answer: Option C

The patient's history (migratory RLQ pain, anorexia, nausea, fever) and physical exam (McBurney's point tenderness, guarding) are classic for acute appendicitis, warranting urgent surgical intervention.

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