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SBL Week 4/5 > Clinical Manifestations in Fever > Flashcards

Clinical Manifestations in Fever Flashcards

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1
Q

What is bacteremia?

A

Abnormal presence of bacteria in bloodstream

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2
Q

What notable lab results are found with bacteremia?

A

Leukocytosis and left shift

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3
Q

Early sepsis is derived from?

A

Bacteremia and inflammatory responses

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4
Q

What does SOFA help identify?

A

Patients who potentially have a high risk of dying from infection

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5
Q

What does qSOFA predict?

A

Chance of sepsis for patients admitted

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6
Q

What is qSOFA scored on?

A

1) Respiratory rate ≥ 22/minute
2) Altered mental state
3) Systolic blood pressure ≤100 mmHg

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7
Q

What are the clinical manifestations of sepsis?

A

1) Arterial hypotension
2) High or low temperature
3) Tachycardia
4) Tachypnea

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8
Q

How may the skin present in the early phases of sepsis?

As sepsis progresses to shock, what happens to the skin and why?

A

1) Warm, flushed

2) Becomes cool due to redirection of blood flow to core organs

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9
Q

What physical findings may indicate septic shock?

A

Decreased capillary refill, cyanosis, or mottling

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10
Q

What GI manifestations are often an end-stage sign of hypoperfusion?

A

Ileus or absent bowel sounds

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11
Q

What happens to the serum lactate levels in organ hypoperfusion?

A

Elevated (Hyperlactatemia)

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12
Q

Staphylococcal infections affect what areas?

A

Skin or soft tissue infections

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13
Q

Bone or joint pain due to systemic staphylococcal infections usually suggests?

A

1) Vertebral osteomyelitis

2) Septic arthritis

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14
Q

Protracted fever and/or sweats due to systemic staphylococcal infections usually suggests?

A

Endocarditis

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15
Q

Abdominal pain, particularly the LUQ, due to systemic staphylococcal infections usually suggests?

A

Splenic infarction

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16
Q

Costovertebral angle tenderness due to systemic staphylococcal infections usually suggests?

A

1) Pyelonephritis
2) Renal infarction
3) Psoas abscess

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17
Q

Headaches due to systemic staphylococcal infections usually suggests?

A

1) Meningitis
2) Intracranial infection
3) Septic emboli

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18
Q

Methicillin-Resistant Staphylococcus Aureus (MRSA) gram stain of pus shows?

A

Gram-positive cocci in clusters

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19
Q

A culture positive for s. aureus bacteremia should lead you to what differential?

A

1) Endocarditis
2) Osteomyelitis
3) Deep-seated systemic infections

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20
Q

What category of MRSA skin infections is superficial, usually has well-defined borders, and has minimal lymphangitis?

Which is a deeper skin infection involving dermis and subcutaneous fat and has more propensity to lymphangitis, edema, swelling?

A

1) Erysipelas

2) Cellulitis

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21
Q

What are risk factors for community-acquired MRSA infections?

A

1) Contact sports
2) Military service
3) Incarceration
4) Injection drug use

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22
Q

MRSA is commonly involved in what infections?

A

Diabetic foot infections

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23
Q

What is the most common cause of tonsillopharyngitis in children?

A

Streptococcus pyogenes (Group A)

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24
Q

Pregnant women are highly susceptible to what bacteria as it causes UTIs, chorioamnionitis, and postpartum endometritis?

A

Streptococcus agalactiae (Group B)

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25
Q

What rash is characteristic of Streptococcus pyogenes?

A

Scarlatiniform rash

26
Q

When does latent tuberculosis infection occur?

How does it spread from person to person in this stage?

A

1) When bacilli are contained within granulomas

2) It can’t, its non-transmissible

27
Q

How can TB become reactivated?

A

Patients immune system becomes weakened and can’t contain latent bacteria anymore

28
Q

What are risk factors for reactivation of TB?

A

1) Gastrectomy
2) Silicosis
3) Diabetes mellitus
4) HIV
5) Immunosuppressive drugs

29
Q

What are risk factors for drug resistance to TB?

A

1) Immigration from regions with drug-resistant tuberculosis
2) Close contact with patients infected with drug-resistant tuberculosis
3) Unsuccessful prior anti-tuberculosis therapy
4) Patient noncompliance with treatment

30
Q

What are common symptoms of TB infection?

What is classical heard on auscultation?

A

1) Cough and blood-streaked sputum

2) Posttussive apical rales

31
Q

What type of virus is influenza?

How is it spread?

A

1) Orthomyxovirus

2) Respiratory droplets

32
Q

Which subtypes of influenza produce identical clinical symptoms?

Which produces milder disease?

A

1) Types A and B

2) Types C

33
Q

What are influenza pandemics usually due to?

A

Type A infections with major antigenic shift

34
Q

What are some respiratory symptoms seen in influenza?

A

1) Rhinorrhea
2) Congestion
3) Pharyngitis
4) Hoarseness
5) Nonproductive cough
6) Substernal soreness

35
Q

When are gastrointestinal symptoms and signs due to influenza most common?

A

Young children with influenza B virus infections

36
Q

How long does fever typically last with influenza?

What may be a marker of secondary complications?

A

1) 3-5 days

2) Leukocytosis

37
Q

Acute acquired Cytomegalovirus infection presents similar to what other infection?

However, it differs in what ways?

A

1) Infectious mononucleosis

2) Pharyngeal symptoms is unusual in Acute CMV

38
Q

How can CMV infection and disease be used synonymously?

A

They can’t, not all patients with infection develop disease

39
Q

Perinatal CMV inclusion disease can cause what at birth?

What may ensue later in life?

A

1) Hearing loss

2) Neurologic deficits

40
Q

How does CMV infection in immunocompetent persons present?

A

Mononucleosis-like syndrome with negative heterophile antibodies

41
Q

What neuro complications can arise from CMV?

What cardio problems?

Hematological problems?

Liver problems?

A

1) Encephalitis and Guillain-Barre
2) Pericarditis and myocarditis
3) Thrombocytopenia
4) Hepatitis

42
Q

What is the most common clinical problem of histoplasmosis?

Disseminated disease is common in?

Chronic progressive pulmonary histoplasmosis occurs in older patients with?

A

1) Respiratory illness
2) Immunosuppressed states such as HIV/AIDS
3) COPD

43
Q

Mild symptomatic illness from histoplasmosis presents as?

More severe illness from histoplasmosis presents as?

A

1) Influenza-like illness, often lasting 1–4 days

2) Atypical pneumonia, with fever, cough, and mild central chest pain for 5–15 days

44
Q

What type of coccidioidomycosis infection results in influenza- like illness with malaise, fever, backache, headache, and cough?

Which results in meningitis, arthralgias, bone lesions, or skin and soft tissue abscesses?

A

1) Primary acute infection

2) Dissemination

45
Q

Coccidioidomycosis infection results from inhalation of?

A

Coccidioides immitis or Coccidioides posadasii

46
Q

What are hallmarks of primary coccidioidomycosis infection?

A

1) Arthralgias with periarticular swelling of knees and ankles
2) Erythema nodosum

47
Q

Disseminated coccidioidomycosis in HIV-infected patients more often shows?

A

1) Pulmonary miliary infiltrates
2) LAD
3) Meningitis

48
Q

What is the mode of transmission for malaria?

A

Bite of infected female anopheline mosquitoes

49
Q

Which plasmodium species is responsible for nearly all severe malaria?

A

P falciparum

50
Q

What does acute malaria typically begin with?

A

Headache and fatigue followed by fever

51
Q

P vivax and P ovale have a fever cycle of?

P malariae has a fever cycle of?

A

1) 48 hours

2) 72 hours

52
Q

Bone pain, often in the spine, ribs, or proximal long bones is characteristic of what malignacy?

A

Multiple myeloma

53
Q

Myeloma is a malignancy of?

A

Hematopoietic stem cells terminally differentiated as plasma cells

54
Q

Waldenström’s macroglobulinemia is similar to multiple myeloma but will have absence of?

A

Lytic bone lesions

55
Q

What leads to kidney failure in multiple myeloma?

A

Light chain components of Igs

56
Q

Why are Myeloma patients especially prone to infections from Streptococcus pneumoniae and Haemophilus influenzae?

A

They are encapsulated organisms

57
Q

What are the clinical manifestations of multiple myeloma?

A

1) Symptoms of anemia
2) Lytic bone lesions
3) Symptoms of kidney failure
4) Soft tissue masses

58
Q

What is the most common HIV-related malignancy?

A

Kaposi Sarcoma

59
Q

What cutaneous or mucosal symptoms are present with Kaposi Sarcoma?

A

Red/purple plaques or nodules

60
Q

What are common symptoms of Sjögren’s Syndrome?

What other condition can it occur with?

A

1) Dryness of eyes and dry mouth (sicca component)

2) Rheumatoid arthritis

61
Q

What causes the dryness of the eyes and mouth in Sjögren’s Syndrome?

A

Immune-mediated dysfunction of the lacrimal and salivary glands

SBL Week 4/5 (7 decks)

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