Here is the paraphrased version of question 112 with five options, correct answer, explanation, and the related specialty:
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### **Specialty: General Surgery**
**Question:**
A 27-year-old obese woman presents with right iliac fossa pain accompanied by anorexia, nausea, and vomiting. On examination, she has moderate tenderness in the right iliac fossa. Laboratory tests show leukocytosis. What is the most appropriate next step in management?
**Options:**
A) Immediate open surgery
B) Computed tomography (CT) scan
C) Abdominal ultrasound
D) Diagnostic laparoscopy
E) Observation and repeat labs
**Correct Answer:** B) Computed tomography (CT) scan
**Explanation:** In an obese patient with symptoms suggestive of acute appendicitis, **CT scan** is the most appropriate diagnostic tool. It is more accurate than ultrasound in visualizing the appendix in obese individuals and can help confirm the diagnosis and assess for complications such as perforation or abscess formation. While surgery may ultimately be required, imaging is the best next step to confirm the diagnosis before proceeding.
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This question falls under the **General Surgery** specialty. Let me know if you need further assistance