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Fever Flashcards

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1
Q

Normal core body temperature:

A

36.5 C-37.5C

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2
Q

Maximal normal oral temperature at 6AM

A

37.2 C

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3
Q

Maximal normal oral temperature at 4-6PM

A

37.7 C

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4
Q

women who menstruate, the a.m.

temperature is lower when?

A

2 weeks before

ovulation;

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5
Q

women who menstruate, the a.m.
temperature rises by _____ with
ovulation and remains at that level until
menses

A

0.6 C

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6
Q

During postprandial state, body temp is

a. Elevated
b. Depressed

A

A

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7
Q

______ is elevation of normal body temp in
conjunction with an increase in the
hypothalamic set point

A

FEVER

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8
Q

Primary consideration in a patient with fever (most common cause)

A

Infection

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9
Q

________ an unchanged setting in
the hypothalamic set point in conjunction with
an uncontrolled increase in body temp that
exceeds the body’s ability to lose heat

A

Hyperthermia

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10
Q

__________ thermoregulatory failure in association with a warm environment

A

Heat Stroke

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11
Q

___________ hyperthermic and
systemic response to halothane and other
inhalational anesthetics in patients with genetic
abnormality

A

Malingnant Hyperthermia

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12
Q

__________ syndrome of
hyperthermia,autonomic dysregulation and
Extrapyramidal side effects by neuroloeptic agents
( e.g. haloperidol)

A

Neuroleptic Malignant Syndrome

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13
Q

Malignant hyperthermia: hyperthermic and systemic response to ______ and _______ in patients with genetic abnormality

A

halothane; other inhalational anesthetics

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14
Q

Example of neuroleptic agent involved in neuroleptic malignant syndrome

A

Haloperidol

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15
Q

Temperature above 41.5 C is called

A

hyperpyrexia

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16
Q

In the context of fever, Interleukin 1, IL 6, Tumor necrosis factor, interferon alpha are examples of ________

A

pyrogenic cytokines

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17
Q

Cytokines act on the ___________ to elevate the thermoregulatory set point to cause fever

A

Hypothalamic endothelium

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18
Q

T/F hyperthermia involves pyrogenic molecules

A

F

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19
Q

Pathogenesis of hyperthermia

A

Heat production/exogenous heat > heat losing capacity

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20
Q

Patient with high temp due to work and exercise in hot environments temp 38.9C

a. hyperpyrexia
b. fever
c. hyperthermia

A

C

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21
Q

Patient with high temp after taking metamphetamine temp 40 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

C

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22
Q

Patient with high temp after taking anticholinergic temp 38 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

C

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23
Q

Patient with high temp after being given succinylcholine temp 38 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

D

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24
Q

Patient with high temp after halothane temp 38 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

D

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25
Neurotransmitter involved in neuroleptic malignant syndrome
Dopamine
26
______ is seen in patients with inherited abnormality of skeletal muscle sarcoplasmic reticulum that increases intracellular calcium levels as a response to inhalational anesthetics
malignant hyperthermia
27
Mean normal oral temp
36.8 +/- 0.4 C
28
Normal daily temp variati on
0.5 C
29
T/F Normal temp swings occur in hyperthermia but in higher temp
F; this occurs in fever, (e.g. during infection, recovery from infection)
30
Rectal temp are lower than oral temp by how much?
0.4C
31
T/F Tympanitic thermometer are more variable compared to oral and rectal values
T
32
Fever pattern of relpasing fever
episodes are separated by intervals of normal temp
33
Fever pattern of malaria by P. vivax
Tertian fever: seen on the 1st and 3rd day
34
Fever pattern of malaria by P. malariae
Quartan fever: seen on the 1st and 4th day
35
lymphomas and hodgkins disease
Pel ebstein fever: lasting 3 to 10 days separated by several day afebrile period of 3 to 10 days
36
What condition will present with 21 days fever with neutropenia
Cyclic neutropenia
37
What are the signs of hyperthermia?
``` HDDPM Hallucinations Delirium Dry Skin Pupil Dilatation Muscle Rigidity ```
38
rapidly fatal and does not respond to antipyretics a. Hyperthermia b. Fever
A
39
High temp, but skin could be cold a. Hyperthermia b. Fever
B
40
What is the cause of exertional hyperthermia?
caused by exercise in high heat/humidity
41
What is the cause of non-exertional hyperthermia?
exposure to high heat and humidity
42
Hyperthermia in patients taking anticholinergic medications, antiparkinsonian drugs, diuretics a. Exertional b. Non-exertional
B
43
Drugs that can cause non-exertional hyperthermia
LET CAM SLAP Lysergic acid Ecstasy TCA Cocaine Amphetamines Monoamine oxidase inhibitors Salicylates Lithium Anticholinergic Phenciclidine
44
Characterized as a lead pipe muscle rigidity, EP s/e, autonomic dysfunction and hyperthermia.
Neuroleptic Malignant Syndrome
45
Presents with high temperature, increased mucle metabolism, muscle rigidity, rhabdomyolysis, acidosis, CV instability develops A
Malignant hyperthermia
46
T/F Malignant Hyperthermia is always fatal
T
47
Drugs that can cause Neuroleptic Malignant Syndrome
``` How Much ang PF sa DTtB? Haloperidol Metoclopramide Phenothiazines Fluoexetine Domperidone Thioxetine Baclofen withdrawal ```
48
overlapping features, including hyperthermia (agitation, increased reflexes, tremor, sweating, dilated pupils)but is distinguished by diarrhoea, tremor and myoclonu
Serotonin Syndrome
49
Drugs that cause Serotonin Syndrome
``` selective serotonin uptake inhibitors(Fluoxetine, Citalopram) MAOIs TCA tramadol dextrometorphan ```
50
What distinguishes Serotonin Syndrome from other types of hyperthermia?
diarrhea, tremor, myoclonus
51
Give 2 complications of Serotonin Syndrome
Seizure/muscle breakdown
52
2 Endocrinopathies causing high temp
Thyrotoxicosis | Pheochromocytoma
53
CNS Damage causing high temp
Cerebral hemorrhage Status epilepticus hypothalamic injury
54
Tempo and complexity of work up depends on (3)
Pace of illness Diagnostic considerations Immune status
55
Light blue-gray, oval, basophilic, leukocyte inclusions located in the peripheral cytoplasm of neutrophils. They measure 1-3 µm in diameter thought to be remnants of the rough endoplasmic reticulum. Present in conjunction with toxic granulation
Dohle Bodies
56
Approximate value of ESR and CRP in Rheumatolgic disease: greater than ______
100
57
Lab test for: malaria parasites, babesia, ehrlichia, Borrelia, trypanosomes
Blood smear
58
Liver function is ____ in hyperthermia a. low b. high
B
59
Treatment to reduce fever is recommended in
1. Patients with cardiac, cerebrovascular and pulmonary insufficiency 2. Organic brain disease 3. Children with history of febrile or non febrile seizures
60
It is better to give antipyretics as needed than in regular schedule T/F
F
61
T/F Chronic high dose therapy with antipyretics ( aspirin or NSAIDS used in arthritis) does not reduce normal core body temperature
T
62
Acetaminophen is preferred over Aspirin for treatment of fever because
``` Acetaminophen Does not mask signs of inflammation Does not impair platelet function Does not adversely affect the GI tract Not associated with Reyes syndrome ```
63
True about hyperpyrexia a. temp > 40 C b. use of cooling blankets even without anipyretic c. antipyertics are of no use d. NOTA
B
64
True about hyperthermia a. Antipyretic is effective b. physical cooling can be given with antipyretic treatment c. hemodialysis and cardiopulmonary bypass can be done in extreme cases d. NOTA
C
65
Treatment of malignant hyperthermia
Dantrolene, antiarrhythmic
66
When fever contines for 2-3 weeks and repeat exams and lab tests are unrevealing , patient is diagnosed as having _______
FUO
67
Prognosis of hyperthermia depends on
rapidity of cooling
68
There is no common preventive measure for fever | T/F
T
69
False of Hyperthermia a. Avoid excessive activity in hot or humid environment b. Adequate fluid intake before, during, after strenous activity c. maintain proper ventilation to promote cooling from sweat evaporation d. NOTA e. AOTA
D

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