Family Nurse Practitioner Exam

A positive psoas sign is suggestive of which condition?

1. Ectopic pregnancy

2. Acute appendicitis

3. Peritonitis

4. Abdominal aortic aneurysm

The correct answer is: Acute appendicitis

A positive psoas sign indicates irritation of the iliopsoas muscle, which can occur in cases of acute appendicitis. When the appendix becomes inflamed, it may come into contact with the psoas muscle, leading to pain during movements such as hip extension. This reflexive pain elicited by flexing the hip against resistance is what constitutes a positive psoas sign. In the context of acute appendicitis, the classic presentation may include right lower quadrant abdominal pain, fever, and nausea, but the physical examination revealing a positive psoas sign is a specific indicator that supports the diagnosis. The other conditions listed might have overlapping symptoms but do not elicit a psoas sign in the same way as acute appendicitis does. For instance, while ectopic pregnancy may cause abdominal pain, it typically would not present with a psoas sign. Similarly, peritonitis mainly indicates generalized abdominal pain and tenderness rather than localized psoas involvement, and while an abdominal aortic aneurysm can cause significant pain, it does not specifically trigger a psoas sign response. Thus, a positive psoas sign is particularly suggestive of acute appendicitis due to the anatomical relationship between the appendix and the ili