Nonspecific Patient Presentations

Question 1

Identify when providers tend to become concerned with fatigue and weight loss

Answer 1

Fatigue is normal unless persistent
Unintentional weight loss

Unintentional weight loss can suggest serious physical/psychological

Fatigue can be affected by many psychological and physical causes

Question 2

Threshold for a high fever

Answer 2

Temp about 99 (morning) and 100 at night

Question 3

What are the two proinflammatory cytokines

Answer 3

IL-1 is the big player in fever

TNF

Question 4

Chronic fatigue

Answer 4

Epstein bar infection, generalizes pain

Question 5

Alarm flag for weight loss

Answer 5

Losing a lot of weight unintentionally

Depression, anorexia nervous, bulimia, disease of any organ system

Question 6

If someone is peeing a lot and they are losing weight unintentionally

Answer 6

Diabetes

Question 7

What arachidonic acid prostaglandin is related to fever

Answer 7

PGE2

Question 8

The three criteria used to define fever of unknown origin (FUO)

Answer 8

• illness for at least 3 weeks
• Temp above 101
• failure to diagnosis after three outpatient visit is or three days of hospitalization

Question 9

Fever less than 102

Answer 9

Low grade fever

Question 10

Fever above 102

Answer 10

High grade fever

Question 11

High fever for newborn

Answer 11

99

Question 12

Top three causes of FUO

Answer 12

Infection
Neoplasm
Autoimmune disorders

Question 13

Headache warning signs that always point to a serious underlying condition

Answer 13

Visual loss
Disequilibrium
Confusion or lethargy
New onset seizure

Question 14

Cancer that causes FUO

Answer 14

Lymphoma

Question 15

Giant cell arteritis

Answer 15

Nodular and can impede blood flow, can impact the eyes and cause loss of vision. Can cause claudication, which is pain produced by lack of blood flow.

Question 16

Who is most likely to get migraines

Answer 16

Young women

Question 17

Pain of migraine

Answer 17

Throbbing or pulsation, evolves

Question 18

Laterality of migraine

Answer 18

Typically unilateral, but can alternate sides

Question 19

How long do migraines last

Answer 19

Typically 4-72 hours and aggravated by physical activity

Question 20

Who is affected by tension headaches

Answer 20

All ages and genders

Question 21

When do tension headaches occur

Answer 21

Generally occur late in day on weekdays

Question 22

How long to tension headaches last

Answer 22

30min to 1 week

May be worse with stress and precede a migraine

Question 23

Distribution of tension headaches

Answer 23

Present with band-like distribution with varying intensities

Question 24

What is really aggravating to migraines

Answer 24

Light

Question 25

Who is affected by cluster HA

Answer 25

Middle aged men | Smokers and drinkers

Question 26

Laterality of cluster HA

Answer 26

Unilateral usually- orbital or temporal

Question 27

What is unique about cluster HA

Answer 27

Wakes people up

Question 28

Duration of cluster HA

Answer 28

Generally 1-2 attacks per day, lasting less than an hour

Question 29

Suicide headache

Answer 29

Cluster HA

Question 30

These HA often present with red eyes and/or nasal stuffiness

Answer 30

Cluster HA

Question 31

This type of HA may cause transient or permanent ipsilateral Hornets syndrome

Answer 31

Cluster HA

Question 32

Pre=ganglionic or pst-ganglionic lesion in sympathetic nervous system pathway from hypothalamic to eye-abnormal pupil is miotic (larger in pupil size between eyes in dark)

Answer 32

Hornets Syndrome

Question 33

Why should giant cell arteritis be treated with steroids immediately? (Prednisone)

Answer 33

Can go blind

Question 34

Who gets temporal arteritis

Answer 34

Occurs in pts over 60

Question 35

Pain in temporal arteritis

Answer 35

Present with pain in temporal scalp area, jabbing neck pain, jaw claudication, and fever

Question 36

This HA is a medical emergency

Answer 36

Temporal arteritis

Question 37

Medium large arteries are inflamed, many present blindness

Answer 37

Temporal arteritis

Question 38

Cause HA in all ages, interrupt sleep, cause nausea, vomiting, and visual changes, steadily become more severe, tend to be worse in morning

Answer 38

Brain tumors

Question 39

Stroke FAST

Answer 39

FACE: paralyzed? ARMS: can they hold them both out and parallel to the ground SPEECH: is their speech slurred TIME: is critical, get them to a hospital immediately