Rule Out / Past cases / Acute appendicitis
Rule Out case #1 · GentleAcute appendicitis: a six-clue practice case
Read the clues in order and name the diagnosis as early as you can. Clues move from the patient’s story to the classic findings.
Play it as a game firstGuess before each clue unlocks, then share your score.The clues
Clue 1: A 19-year-old college student has had belly pain since last night.
Clue 2: The pain started around the belly button and has moved to the lower right side.
Clue 3: They have no appetite and threw up once after the pain began.
Clue 4: Temperature is 38.1 °C. Pressing on the lower right belly hurts, and letting go hurts even more.
Clue 5: White blood cell count is 14,000/µL.
Clue 6: Pressing on the lower LEFT belly causes pain on the right (Rovsing sign).
Show the diagnosis and takeaways
What gives it away
- The classic story is pain that starts near the belly button, then moves to the right lower quadrant.
- Loss of appetite, nausea, low-grade fever and a high white count support it; ultrasound or CT confirms.
- Treatment is usually surgery; the risk of rupture rises the longer it waits.
Ran as Rule Out #1 (Sunday, October 18, 2026).
Rule Out is free and the same for everyone. Start a league with your club or study group and compare scores each week.
Play today’s caseFree question banks