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A 25-year-old male presents to the ED with RIF pain. Rank the following findings in terms of their accuracy in predicting appendicitis (1 = most accurate, 5 = least accurate).
Rigidity, tenderness and guarding in the RIF
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Migration of pain
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Raised WCC and CRP
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Anorexia
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Nausea
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This patient shows some signs of sepsis and so should be resuscitated. He should receive oxygen (titrated to maintain saturations >95%), fluids, IV antibiotics, analgesia and be referred to a general surgical team and, if necessary, to critical care.
After fluid resuscitation this patient now has a pulse of 80 beats per minute, blood pressure 110/70 mmHg, respiratory rate 16 per minute, oxygen saturations 98%, temperature 37.5°C.
Which are the next best options?