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Infectious Disease > Fever Lecture > Flashcards

Fever Lecture Flashcards

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1
Q

General causes of fever

A

Infection
Inflammation (Rheum, connective tissue disorders)
Vascular (DVT can cause fever)
Endocrine
Malignancy

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2
Q

What is the reference number for a fever

A

38.3C or higher
100.9 F or higher

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3
Q

What is hyperpyrexia and what is the cause typically

A

41.5 or greater
CNS bleed often causes it

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4
Q

What is a pyrogen

A

Any SUBSTANCE that causes a fever
IL-1, IL-6, TNF, IFNa

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5
Q

What part of the brain is responsible for a fever

A

Hypothalamus

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6
Q

Which pyrogen is responsible for body aches, chills, and the other effects of a fever

A

Elevated Prostaglandin E2 (PGE2) in hypothalamus

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7
Q

What is the general pathway of a brain bleed

A

Fever&raquo_space; something raises hypothalamic set point&raquo_space; Triggers vasoconstriction and shunting of blood from periphery decreases heat loss&raquo_space; Shivering my occur (increases heat production)

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8
Q

What is hyperthermia

A

elevated body temperature not caused by a resetting of the temperature set point

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9
Q

What two types of patients should you treat a fever in

A
  1. Pts who have cardiac disease- their O2 demand increases w fever, and this is bad for a pt that is already compromised
  2. Pts who are pulm pts (COPD, asthma, etc)
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10
Q

What is the best antipyretic

A

Acetaminophen (Tylenol)

Asprin, NSAIDS, Steroids

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11
Q

Conditions where a fever is absent

A
  • TNF blockers
  • Cytokine inhibitors
  • Liver Disease patients
    -Newborn and elderly
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12
Q

What other vital signs are fever usually accompanied by

A

-Tachycardia
-Tachypenia
-Sweating, chills

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13
Q

Most acute fevers are likely caused by what

A

viruses/ viral infections

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14
Q

What are the most likely infectious causes of a fever

A
  1. Upper and lower respiratory tract infections
  2. GI infections
  3. UTIs
  4. Skin infections
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15
Q

Digging up in the dirt and working in very dry dirt can predispose you to which illness

A

Coccidioidomycosis (Valley fever)– Fungus/Yeast, Dimorphic

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16
Q

Nicaragua, southern America, Africa, India, and Sri lanka all have which disease in common

A

Maleria

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17
Q

Fever, night sweats, weight loss, and a cough, equals what in ID?

A

TB

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18
Q

What are some exogenous pyrogenes

A

Amphetamines
Cocaine
MDMA, Ecstacy
Antipsychotics
Anesthetics

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19
Q

Which exogenous drugs trigger pyrogeny

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A

Drug pyrogeny fever

Beta lactam antibiotics
Sulfa drugs
Phenytoin- Seizure drugs
Carbamezapine
Quinidine
Interferons

20
Q

Ohio river valley has an endemic organism there that is called what

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A

Histoplasmosis

Transmitted through bat droppings, which are endemic to ohio river valley

21
Q

If your patient owns a turtle/reptile what are they at risk for

22
Q

If your patient owns a cat that SCRATCHES them often, what bacteria is your patient at risk for

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A

Bartonella henselae

23
Q

If your patient owns a cat and it BITES them often, which bacteria are they at risk for

Study These Flashcards
A

Pasteurella multocida- Treat with Ceftriaxone or penacillin, Zosyn

24
Q

How do you treat Pasteurella multocida

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A

Unasyn, Ceftriaxone, Penacillin, Zosyn, Clindamycin

25
Target lesions with a fever suggest which diseases
SJS, TENS, Target lesion
26
Petechial or purpuric rash is concerning for which diseases
Meningococcemia, RMSF
27
Erythema migrans suggests which diseases
Lyme disease (Causes a bulls eye target lesion)
28
Which diseases cause a rash on palms and soles
Rocky mountain spotted fever TSS with strep Scalded skin syndrome Syphilis Neisseria gonorrhoeae
29
Classic sign of psoraisis on nails
pitting
30
Red flags with a fever
- Altered mental status - Headache, stiff neck - Headache, stiff nech, petichial or purpuric rash (Worst red flag- meningitis) - Petechial rash - Hypotension (Low BP- could be SEPSIS, or problem w heart, could be dehydration, could be MI) - Dyspnea - Immunosuppressed patients - Recent travel to areas of illness (Malaria in endemic areas) - Temp >40C
31
How do you make a maleria diagnosis
Blood smear - Look under microscope, see parasites around and in RBCs
32
What 3 labs should you typically always order for patients with a potential ID concern
1. CBC w diff/Chem 14/LFTs 2. Serologies 3. Cultures ("Nobody will ever fault for culture")
33
What is the significance of Glucose in CSF
If glucose is low in CSF, likely dealing with a bacterial, mycobacterial, fungal (cryptococcus, particulary in AIDS patients, or cocci (valley fever)). Could be malignancy. All of those things will cause a very low glucose in CSF. Glucose in CSF needs to stay high.
34
Which medication is perscribed for chlamydia
Doxycycline or azithromycin
35
Diagnosis of Syphilis
RPR VDRL Serology rapid antigen
36
What are the good anti-MRSA drugs
Doxycycline Linezolid (Zyvox) vanco bactrim For MSSA- Diclox
37
Donovan Bodies
Granuloma inguinale
38
What are the pathomnumonic histological findings of granuloma inguinale
Donovan bodies
39
If a patient presents with N/V/D and it is campylobacter positive, what do you treat it with
Treat campylobacter with Azithromycin
40
How do you treat C. Diff
Oral Vancomycin
41
For pelvic salpingitis, what is the gold standard diagnostic?
laparoscopy-- purulent peritineal material is noted as key finding
42
What is the drug of choice for campylobacter
Azithromycin
43
What is the drug of choice for Shigella
Ciprofloxacin or Azithromycin
44
What is the cause of Whipple's disease and how do you treat it
Caused by Tropheryma whipplei. Treated with Ceftriaxone or Penicillin, followed by Bactrim (TMP-SMX) for a year.
45
Arthralgia, fever, diarrhea, abdominal pain, weight loss, anorexia, increased skin pigmentation, lymphadenopathy, chronic cough, and CNS symptoms are indicative of which disease
Whipple's Disease

Infectious Disease (6 decks)

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