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Flashcards in fever Deck (26)
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1

Define fever:

systematic, nonspecific defense response to infection or tissue damage.
>38.3

2

5 categories of fever:

1) Infection
2) collagen vascular
3) neoplasms
4) misc
5) FUO

3

What fever mechanism is triggered by IL-1 and TNF?

endogenous

4

What triggers the exogenous fever mechanism?

destruction (via phagocytosis) of the lipopolysaccharide structure of bacteria which releases endotoxins

5

You are sweating and lethargic. Your basal metabolic rate is dropping and you're experiencing vasodilation. Is your body trying to increase or decrease your temperature?

decrease, you're too hot!

6

You're too cold, what can your body do to elevate your temperature?

shiver, increase thyroid activity-->which increases BMR, vasoconstriction

7

What benefit does an increase in metabolism have during fever?

increases tissue repair

8

Healthy individuals can tolerate a fever up to _________ degrees prior to seeing any ill effects

105

9

Extreme hyperthermia begins at _____ degrees and can cause what effects?

108.
1) DIC
2) metabolic derangement
3) hypoxia
4) sz/coma

10

When should you treat a fever aggressively?

Patients with severe primary disease (heart/lungs/kidneys)

11

What is you goal when recommending an antipyretic?

Reduce fever just enough to relieve symptoms, but not all the way to normal, so it maintains beneficial effects

12

Any child with a fever under the age of ________ is at serious risk for what?

3 months, meningitis or other serious infection

13

What is the most frequent cause of fever?

virus

14

fever and RASH

r/o meningococcal septicemia

15

fever and belly pain, n/v

r/o appendix and UTI

16

fever and neck pain

r/o CNS infection

17

fever and joint pain

r/o septic joint or rheumatic fever

18

What is the criteria to make a dx of FUO?

1) illness x 3 wks
2) fever > 38.3 several times over that 3 wks
3) No dx after 1 week of study

19

Big 3 of FUO:

1) infection
2) collagen vascular
3) neoplasm

20

New murmur, elevated WBC....what are you thinking?

bacterial endocarditis

21

Your patient c/o muscle/bone pain and has a fever. What CAN'T you miss? What is your screening tool?

osteomyelitis, xrays are first line

22

If you see a fever and an elevated ESR, what should you start to investigate?

collagen vascular/autoimmune disease

23

What is the one genetic disease we discussed as being causative for FUO?

Mediterranean fever...dx by genetic testing and FHx

24

What is the most common solid tumor cancer a/w FUO?

renal cell carcinoma
(non solid = lymphoma and leukemia)

25

Some drugs can cause fever. Obviously you'll d/c those drugs. What are they?

beta lactams, procainamide, isoniazid, alpha-methyldopa, quinidine, and phenytoin

26

What endocrine disorders might cause fever?

hyperthyroid, thyroiditis, adrenal insufficiency