A 30-year-old male patient came to an emergency room with complaints of general lower abdominal pain. Later on the pain was more localized to right lower quadrant with nausea and vomiting. Then, the surgeon made diagnosis of appendicitis and scheduled for surgery.What is the most likely surgical complication that may happen in this patient? a. Abdominal abscess b. Septicemia c. Dehydration d. Severe bleeding A new born baby was admitted to a hospital due to severe respiratory distress and jaundice. Physical examination shows that the baby has pallor,hepatosplenomegaly, edema,petechiae and ascites. The child is positive for coombs test and his hemoglobin value is 9g/dL . What is the most appropriate initial step in the care of this baby? a. Initiate phototherapy b. Full exchange transfusion c. Determine bilirubin level every 4-8 hours d. Immediate resuscitation and supportive therapy

1. The most likely surgical complication that may happen in this patient with appendicitis is:<br /><br />a. Abdominal abscess<br /><br />Abdominal abscesses are a common complication of appendicitis, especially if the infection spreads beyond the appendix. The patient's symptoms of localized pain in the right lower quadrant, nausea, and vomiting are consistent with appendicitis, and the surgeon's diagnosis further supports this. If the appendix ruptures or if there is a delay in treatment, an abscess can form, which may require drainage and further treatment.<br /><br />2. The most appropriate initial step in the care of this baby with severe respiratory distress, jaundice, pallor, hepatosplenomegaly, edema, petechiae, and ascites, and a positive Coombs test is:<br /><br />b. Full exchange transfusion<br /><br />The baby's symptoms and positive Coombs test indicate hemolytic anemia, which is a condition where red blood cells are destroyed faster than they can be made. This can lead to severe anemia, jaundice, and organ damage. A full exchange transfusion is a procedure where the baby's blood is replaced with donor blood to remove the damaged red blood cells and improve oxygen-carrying capacity. This is a critical intervention to address the baby's severe respiratory distress and other symptoms. Phototherapy is a treatment for mild to moderate jaundice and would not be sufficient in this case. Determining bilirubin levels every 4-8 hours is important but not the most immediate step. Immediate resuscitation and supportive therapy may be necessary, but the full exchange transfusion is the most appropriate initial step to address the underlying cause of the symptoms.