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Fever Flashcards

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1
Q

What are the normal body temperatures for oral, core, and rectal measurements?

A

Oral: 37°C
Core: 37.8°C
Rectal: 0.5°C higher than oral (37.5°C).

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2
Q

What are the normal variations in body temperature throughout the day and under specific conditions?

A

Daily variation: 1°C (lowest at 6-7 am, highest at 5-7 pm).
Menstrual cycle: >0.5°C variation.
Exercise: Core temperature can reach 40°C.
Elderly: Lower baseline, around 36.4°C.

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3
Q

What are the four mechanisms of heat exchange in the body?

A

Radiation: Emission of heat as electromagnetic waves (loss or gain depends on temperature difference).
Conduction: Heat transfer between objects in direct contact (depends on temperature difference and thermal conductivity).
Convection: Heat transfer via air currents (warm air rises, cool air replaces it).
Evaporation: Heat loss when water transforms from liquid to gas (e.g., skin and respiratory airways).

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4
Q

What is fever, and how does it relate to normal body temperature?

A

Fever is an elevation of body temperature that exceeds normal daily variation, often due to an increased hypothalamic set point.

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5
Q

How does an increase in body temperature affect oxygen consumption?

A

For every 1°C increase over 37°C, oxygen consumption increases by 13%.

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6
Q

What causes headache and joint pain during fever?

A

Headache: Vasodilation increases CO2 levels in the body.
Joint pain: TNF (tumor necrosis factor) is responsible for joint aches.

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7
Q

How does the hypothalamus regulate fever?

A

The hypothalamus acts as the body’s thermostat, maintaining a narrow temperature range (36.5°C–37.5°C).
Pyrogens (exogenous or endogenous) elevate the hypothalamic set point by stimulating prostaglandin E2 (PGE2) production.
Heat-conserving mechanisms (vasoconstriction, shivering) raise body temperature until it matches the new set point.

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8
Q

What is the wide range of ‘normal’ body temperature, and when is fever defined for neonates and others?

A

Normal range: 97°F (36.1°C) to 99°F (37.2°C).
Fever definition:
Neonates (<12 months) and immunocompromised: 38°C.
All others: 38.5°C.

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9
Q

What are the main categories of fever etiologies?

A

Infectious: Systemic (bacteremia, sepsis), respiratory (pneumonia, sinusitis), abdominal (UTI, abscess).
Inflammatory: Lupus, inflammatory bowel disease, Kawasaki.
Oncologic: Cancer.
Others: CNS dysfunction, drug fever, life-threatening conditions.

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10
Q

What steps are involved in assessing a patient with fever?

A

Vital signs: Monitor closely.
Physical exam: Check overall appearance, central/peripheral lines, wounds, and perfusion.
Lab tests: CBC with differential, blood culture, urinalysis, lumbar puncture (for neonates), CRP, PT/PTT, chest X-ray, viral studies.

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11
Q

How is fever treated in non-high-risk patients?

A

Wait before administering empiric antibiotics unless the patient is high-risk.

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12
Q

What do elevated leukocytes, neutrophils, lymphocytes, macrophages, basophils, and eosinophils indicate?

A

Leukocytes: Infection.
Neutrophils: Bacterial infection.
Lymphocytes: Viral infection.
Macrophages: Chronic disease.
Basophils: Allergy.
Eosinophils: Parasites.

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13
Q

What are the most common pathogens isolated in appendicitis cases?

A

Escherichia coli: 57.6%.
Gram-positive cocos (e.g., Enterococcus spp): 19.6%.
Klebsiella pneumoniae: 8.7%.

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14
Q

What is the protective role of fever?

A

Fever enhances immune function and inhibits the growth of certain pathogens.

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15
Q

How does the body return to normal temperature after fever?

A

Antipyretic mechanisms like vasodilation and sweating help lower body temperature once the underlying cause is resolved.

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16
Q

What additional tests are required for neonates with fever?

A

CBC with differential, blood culture, catheterized urinalysis, urine culture, and lumbar puncture.

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17
Q

What lab tests are critical for patients at risk of sepsis?

A

CBC with differential, blood culture, urinalysis, and urine culture.

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18
Q

What are the normal body temperatures for oral, core, and rectal measurements?

A

Oral: 37°C
Core: 37.8°C
Rectal: 0.5°C higher than oral (37.5°C).

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19
Q

What are the normal variations in body temperature throughout the day and under specific conditions?

A

Daily variation: 1°C (lowest at 6-7 am, highest at 5-7 pm).
Menstrual cycle: >0.5°C variation.
Exercise: Core temperature can reach 40°C.
Elderly: Lower baseline, around 36.4°C.

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20
Q

What is radiation, and how does it contribute to heat exchange in the body?

A

Radiation: Emission of heat energy from the body’s surface in the form of electromagnetic waves.

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21
Q

What is conduction, and how does it transfer heat in the body?

A

Conduction: Transfer of heat between objects of differing temperatures that are in direct contact.

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22
Q

What is convection, and how does it work in the body?

A

Convection: Transfer of heat energy by air currents.

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23
Q

What is evaporation, and how does it cool the body?

A

Evaporation: The process where heat is absorbed from the skin to transform water from a liquid to a gaseous state, cooling the body.

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24
Q

What is fever, and how does it relate to normal body temperature?

A

Fever is an elevation of body temperature that exceeds normal daily variation, often due to an increased hypothalamic set point.

How well did you know this?
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25
How does an increase in body temperature affect oxygen consumption?
For every 1°C increase over 37°C, oxygen consumption increases by 13%.
26
What causes headache and joint pain during fever?
Headache: Vasodilation increases CO2 levels in the body. Joint pain: TNF (tumor necrosis factor) is responsible for joint aches.
27
How does the hypothalamus regulate fever?
The hypothalamus acts as the body’s thermostat, maintaining a narrow temperature range (36.5°C–37.5°C).
28
What is the wide range of 'normal' body temperature, and when is fever defined for neonates and others?
Normal range: 97°F (36.1°C) to 99°F (37.2°C). Fever definition: Neonates (<12 months) and immunocompromised: 38°C. All others: 38.5°C.
29
What are the main categories of fever etiologies?
Infectious: Systemic (bacteremia, sepsis), respiratory (pneumonia, sinusitis), abdominal (UTI, abscess). Inflammatory: Lupus, inflammatory bowel disease, Kawasaki. Oncologic: Cancer. Others: CNS dysfunction, drug fever, life-threatening conditions.
30
What steps are involved in assessing a patient with fever?
Vital signs: Monitor closely. Physical exam: Check overall appearance, central/peripheral lines, wounds, and perfusion. Lab tests: CBC with differential, blood culture, urinalysis, lumbar puncture (for neonates), CRP, PT/PTT, chest X-ray, viral studies.
31
How is fever treated in non-high-risk patients?
Wait before administering empiric antibiotics unless the patient is high-risk.
32
What do elevated leukocytes, neutrophils, lymphocytes, macrophages, basophils, and eosinophils indicate?
Leukocytes: Infection. Neutrophils: Bacterial infection. Lymphocytes: Viral infection. Macrophages: Chronic disease. Basophils: Allergy. Eosinophils: Parasites.
33
What are the most common pathogens isolated in appendicitis cases?
Escherichia coli: 57.6%. Gram-positive cocci (e.g., Enterococcus spp): 19.6%. Klebsiella pneumoniae: 8.7%.
34
What is the protective role of fever?
Fever enhances immune function and inhibits the growth of certain pathogens.
35
How does the body return to normal temperature after fever?
Antipyretic mechanisms like vasodilation and sweating help lower body temperature once the underlying cause is resolved.
36
What additional tests are required for neonates with fever?
CBC with differential, blood culture, catheterized urinalysis, urine culture, and lumbar puncture.
37
What lab tests are critical for patients at risk of sepsis?
CBC with differential, blood culture, urinalysis, and urine culture.
38
How do blood pressure and heart rate change during fever?
Blood pressure: Decreases. Heart rate: Increases.
39
What role do cytokines play in fever?
Cytokines (e.g., interleukin-1, interleukin-6, TNF-alpha) stimulate prostaglandin E2 (PGE2) production in the hypothalamus, raising the body’s temperature set point.
40
What mechanisms does the body use to conserve heat during fever?
Vasoconstriction, shivering, and increased metabolic activity.
41
How does the body lower temperature after fever?
Through vasodilation and sweating.
42
What are pyrogens, and how do they induce fever?
Pyrogens: Substances that induce fever. Types: Exogenous: Bacterial endotoxins. Endogenous: Cytokines (e.g., interleukin-1, interleukin-6, TNF-alpha) produced by immune cells. They stimulate prostaglandin E2 (PGE2) production in the hypothalamus, raising the body’s temperature set point.
43
What is the role of prostaglandin E2 (PGE2) in fever?
PGE2 acts directly on the hypothalamus to elevate the body’s temperature set point, triggering heat-conserving and heat-producing mechanisms.
44
What are the body’s heat-producing mechanisms during fever?
Shivering: Generates heat through muscle activity. Increased metabolic activity: Raises heat production.
45
What are the body’s heat-conserving mechanisms during fever?
Vasoconstriction: Reduces blood flow to the skin, minimizing heat loss. Behavioral changes: Feeling cold and seeking warmth.
46
Why do chills occur during fever?
Chills occur because the body is trying to generate heat to match the new, higher hypothalamic set point.
47
How does fever enhance immune function?
Fever increases the activity of immune cells and inhibits the growth of certain pathogens, providing a protective role.
48
When can fever become harmful?
Excessively high fevers can damage tissues and organs, requiring medical intervention.
49
How does the respiratory system contribute to heat loss?
Evaporative heat loss occurs continuously from the linings of the respiratory airways, cooling the body.
50
Is evaporative heat loss related to sweat glands?
No, evaporative heat loss from the skin and respiratory airways is unrelated to sweat glands and not under physiological control.
51
How does the body respond to extreme temperatures?
The body uses heat exchange mechanisms (radiation, conduction, convection, evaporation) to maintain core temperature.
52
What lab tests are critical for patients at risk of sepsis?
CBC with differential: To check for infection. Blood culture: To identify pathogens. Urinalysis and urine culture: To check for urinary tract infections.
53
What additional tests are required for neonates with fever?
CBC with differential: To assess infection. Blood culture: To identify pathogens. Catheterized urinalysis and urine culture: To check for UTIs. Lumbar puncture: To rule out meningitis.
54
What inflammatory markers are used in fever assessment?
CRP (C-reactive protein): Indicates inflammation. PT/PTT and fibrinogen: Assess coagulation status.
55
What imaging studies might be used in fever assessment?
Chest X-ray: To check for respiratory infections. Additional imaging: Based on suspected infection site (e.g., abdominal ultrasound for abscesses).
56
When are viral studies particularly important in fever assessment?
Viral studies are crucial in immunosuppressed patients to identify viral infections.
57
What life-threatening conditions can cause fever?
Sepsis: Systemic infection. Meningitis: Infection of the brain and spinal cord membranes. Endocarditis: Infection of the heart valves.
58
How can CNS dysfunction cause fever?
Damage to the hypothalamus (e.g., trauma, stroke) can impair temperature regulation, leading to fever.
59
What is drug fever, and how does it occur?
Drug fever: A fever caused by an adverse reaction to medication. It occurs due to hypersensitivity reactions or drug-induced inflammation.
60
What chronic diseases can cause fever?
Lupus: Autoimmune disease. Inflammatory bowel disease: Chronic inflammation of the digestive tract. Juvenile inflammatory arthritis: Chronic joint inflammation in children.
61
What is Kawasaki disease, and how is it related to fever?
Kawasaki disease: A condition causing inflammation in blood vessels, often presenting with prolonged fever in children.
62
What is purpura, and how is it related to fever?
Purpura: A condition involving purple spots on the skin due to bleeding underneath, often associated with fever in inflammatory or infectious diseases.
63
What is bacteremia, and how does it cause fever?
Bacteremia: The presence of bacteria in the bloodstream, often leading to systemic infection and fever.
64
What is endocarditis, and how does it cause fever?
Endocarditis: Infection of the heart valves, often causing persistent fever and systemic symptoms.
65
What is meningitis, and how does it cause fever?
Meningitis: Infection of the membranes surrounding the brain and spinal cord, often presenting with fever, headache, and neck stiffness.
66
How do abscesses cause fever?
Abscesses are localized collections of pus caused by infection, which can trigger a systemic inflammatory response and fever.
67
How do bone infections cause fever?
Bone infections (osteomyelitis) cause inflammation and systemic symptoms, including fever.

Oolong (13 decks)

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