Lec 11 Fever of Unknown Origin Flashcards Preview

OS 217 Infectious Diseases > Lec 11 Fever of Unknown Origin > Flashcards

Flashcards in Lec 11 Fever of Unknown Origin Deck (20)
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1

Fever that goes down but not to normal

Remittent

2

Most accurate means of obtaining routine estimates of core temperatures

Rectal thermometry

3

Induce fever, hypoglycemia, shock and death that are seen after administration of LPS (lipopolysaccharides)
a. IFN-gamma
b. TNF-a
c. IL-1
d. AOTA
e. NOTA

d. AOTA

4

Antipyretic medications block conversion of arachidonic acid to prostaglandin by inhibiting:

cyclooxygenase

5

T/F: Fever is harder on adults than children

True

6

Definition of Classic FUO by Durack and Street:

• Temperature of >38.3 (>101 F) on several occasions

• Fever of duration > 3 weeks

• 3 outpatient visits or 3 days in the hospital without elucidation of cause or 1 week of “intelligent and invasive” ambulatory investigation (instead of the outpatient component, the duration for investigation
was lessened because of available technology for diagnosis)

7

Leading cause of FUO

Infections

8

T/F: As the duration of fever increases, the likelihood of an infectious cause of FUO decreases.

True!
Infections predominate early in FUO diagnoses, and the longer FUO remains undiagnosed, the less likely it is caused by an infection. After infections, the etiology of FUO transitions to noninfectious inflammatory diseases and malignancies, which can guide subsequent testing.

9

The emphasis in the approach to FUI is on
a, observation
b. examination
c. empiric therapy
d. AOTA
e. A and B only

e. A and B only

10

Test involving giving of NSAIDs for 3-5 days; if fever disappears, fever is most likely from a noninfectious origin.

Naproxen Test

11

T/F: When no underlying source of FUO is identified after
prolonged observation (6 months), prognosis is generally good.

TRUE

12

Risks of antipyresis

- Vasospasm of diseased coronary arteries due to cold
pressor response (leading to tissue infarction)

- Vasoconstriction in patients with CAD (again leading
to tissue infarction)

- Drug toxicity and adverse events (ex. NSAID allergy, gastric bleeding)

13

T/F: Fevers are always caused by infections

F

14

T/F: Viral infections cause the acute phase response much less than bacterial infections

T

15

Which of the following is NOT an effect of fever on host defense?
Enhanced neutrophil migration

a. Increased production of antibacterial substances by
neutrophils
b. Increased production of interferons
c. Increased antibacterial/antiviral activity of interferons
d. Increased T cell proliferation
e. AOTA
f. NOTA

f. NOTA

Effects of fever on host defense:
• Enhanced neutrophil migration
• Increased production of antibacterial substances by
neutrophils
• Increased production of interferons
• Increased antibacterial/antiviral activity of interferons
• Increased T cell proliferation
• Decreased growth of microorganisms
• IL-1, TNF- α, IFN induce fever, hypoglycemia, shock and death that are seen after administration of LPS
(lipopolysaccharides)
• Potentially deleterious effects of febrile response and
chemical mediators

16

They block transcription of pyrogenic cytokines

Corticosteroids

17

T/F: Bawal maligo pag may sakit

F.

if you take a bath when sick with a fever, it aggravates chills which then leads to a further increase of body temperature. If you’ve already reached the highest temperature then in fact in can cool down your core temp. Hence it is not really harmful because it can stimulate heat loss

18

A test done when in suspicion of malaria in a patient with FUO.

peripheral blood smear

19

The importance of stopping antibiotic treatment and glucocorticoid use in patients with FUO:

They can mask the underlying disease, the one which should be the priority for treatment

20

Site for thermometric measurement that is perfused by a tributary of the artery supplying the body’s thermoregulatory center.

Tympanic membrane