A patient with suspected appendicitis presents with RLQ pain and fever. What is the initial diagnostic test?

• A. Abdominal ultrasound or CT scan to confirm promptly.
• B. CBC and urinalysis are sufficient.
• C. Colonoscopy.
• D. Brain MRI.

Answer: (B)

When evaluating suspected appendicitis, start with basic labs to quickly assess infection and rule out other causes. A CBC often shows leukocytosis with neutrophilia, which supports an inflammatory/infectious process like appendicitis. A urinalysis is important to exclude urinary tract infection or nephrolithiasis, which can mimic appendicitis symptoms. These tests are fast, noninvasive, and help guide urgency and further testing. Imaging with ultrasound or CT is valuable to confirm the diagnosis, especially if the clinical picture is unclear or if there’s a need to avoid missing the diagnosis, but it follows initial labs rather than replacing them. Colonoscopy and brain MRI aren’t appropriate for acute suspected appendicitis.