fever of unknown origin

Question 1

3 criteria that define Fever of Unknown Origin (FUO)

Answer 1

• Fever of 101F (38.3C) on several occasions
• 3 week duration of fever (at least)
• uncertain diagnosis after 1 week of study in the hospital.

Question 2

3 major categories of disease that cause Fever of Unknown Origin (FUO)

Answer 2

• infection (most common)
• malignancy
• immune-mediated (rheumatologic diseases)

Question 3

What is the main step to identify potential diagnostic clues and refine the DDx for pt’s with Fever of Unknown Origin (FUO)?

Answer 3

good history and THOROUGH physical exam, REPEAT both of them often (hear story different ways, find new info)
-lab studies, imaging studies, and procedures also useful for diagnostic clues.

Question 4

name 5 laboratory features of systemic inflammation

Answer 4

• leukocytosis with neutrophilia (high WBCs )
• thrombocytosis (high platelets)
• anemia of inflammation
• high ESR/CRP
• evidence of liver dysfunction

Question 5

laboratory features of anemia of inflammation

Answer 5

• normochromic
• normocytic
• serum Fe low
• TIBC low
• % saturation of ferritin- normal or low normal
• serum ferritin should be normal to increased.

Question 6

5 criteria to diagnose giant cell arteritis (Need 3 of the 5 to diagnose)

Answer 6

• age at onset** >50 yo**
• new headache
• temporal artery abnormality (tender, decreased pulsation)
• ESR>50
• abnormal artery biopsy

memory age cutoff and ESR cutof both 50.

Question 7

what are 4 labs which show liver dysfunction?

Answer 7

AST, ALT, PT/PTT(increased), and albumin (decreased in liver damage)