Clinical Fever Flashcards
Bacteremia
Bacteria in blood
Bacteremia source (3)
Anywhere, body infection (skin/lung/heart/bone), internal devices (catheter, IV)
Septicemia progression (3)
Early bacteremia, Sepsis, Septic Shock with Organ Dysfxn (shut down)
SOFA vs qSOFA (3)
SOFA: longer, nonspecific to sepsis, predicts death from infection
qSOFA: faster/bedside, specific to sepsis infection death, scores based on RR, Systolic BP and AMS
Risk Factors for Sepsis (~7)
ICU, Bacteremia, older 65+, immunosuppressed (pneumonia,cancer), DM, Obesity, Hx of recent hospitalization with abx
Main Sepsis Sx (11)
Signs of Infection, Hypotension, Abnormal temperature, High HR & RR, Hyperlactatemia (hypoperfusion/hypoxemia), High Glucose, High CRP, abnormal coagulation, platelet, WBC
Septic Shock Sx Progression (4)
Warm flushed => Cool Skin Cyanosis => Hypoperfusion (AMS, restless, oliguria) => Later (absent bowel sounds)
Staph Causes (2)
- related to
- MRSA less likely sx
Lack of skin integrity/infection, internal device (catheter, IV, cardiac or ortho device)
- Related to diabetic foot infection with MRSA
- MRSA less like to have joint infection
Staph Symptoms (7)
Sensitive & Resistant
Septic Arthritis (joint pain)
Osteomyelitis (bone pain)
Endocarditis (tri)(fever/sweats)
Skin Infection (Abscesses)
-Erysipelas: super, well defined, red, no lymph
-Cellulitis: deep, more lymph, edema, indiscrete borders
Coagulase (+)
-Splenic Infarct (Abd pain, LUQ)
-Pyelonephritis/Renal infarct (Costovertebral tenderness)
MRSA Risk Factors (7)
Long-term recurrent wounds, Immunocompromised, Hospital, Contact sports, Military, Prison, IV drug use
Strep Pyrogenes (A)(4) Sx
Kids: Tonsillopharyngitis, Impetigo, scarlatiniform rash (sand paper), palatal petechiae/red tongue
Strep Agalactiae (B) Sx (3/1)
Tx mom with penicillin
Kid: from mom (vagina), meningitis, sepsis, pneumonia
Pregnant: Infection (UTI, Bacteremia, Endometritis, Chorioamnionitis)
Mycobacterium TB Sx (7)
Progression
Productive cough, blood streaked sputum, fever, fatigue, night sweats, apical rales (ghon complex on lung)
Latent in granuloma non transmissible => Reactive active bacteria due to low immune system
TB Risk Factors
Dx (4)
Reactivation (2)
Resistance (4)
Dx: Close contact, Prison, Drug Use, Endemic Travel
Active: Immunosuppression or variation in endocrine/metabolic system
Resist: Endemic immigration, close contact, poor tx, noncompliance
Influenza Sx
Systemic (6)
Resp (4)
Fever, Chills, malaise, HA, myalgia, GI in kids
Runny nose, congestion, pharyngitis, nonproductive cough
Cytomegalovirus Sx
Infection (6)
Disease
Mimic mononucleosis (no pharyngeal, (-) heterophil abx)
Infection: rash, fever, malaise, abnormal WBC, abnormal liver fxn test, Compromised AIDS: inflammation of eye, GI, lung and brain (nerve)
Disease: Immunocompromised
same as above plus perinatal hearing loss and neuro defects (retardation, CNS calcifications motor disability, microcephaly), hepatosplenomegaly (jaundice), thrombocytopenia (purpura)
Histoplasmosis
Risk (3)
Sx (10)
Risk: Bird/bat dropping, AIDS/compromised, Older with COPD
Sx: mimic influenza, or atypical pneumonia with fever, cough, chest pain (mimic TB)
-Disseminated: sudden, fever and multi organ involvement, mimic septic shock
Coccidioidomycosis
Primary
Disseminated
Primary: arthralgia, erythema nodosum, mimic pneumo
Disseminated: meningitis, lung infiltrates, skin lesion and bone infection, lymphadenopathy
Malaria (Plasmodium) Sx
Irregular/Regular Fever, HA, fatigue, malaise, splenomegaly (jaundice, anemia, hypotension)
Multiple Myeloma Sx (5)
Lytic bone lesions, anemia, kidney failure, hypercalcemia, clonal plasma cells with monoclonal ig
Kaposi Sarcoma
Related
Sx (3)
Herpes 8 and HIV related
Sx Purple nodules on skin/mucous membranes, Pulm sx (SOB, cough, hemoptysis), mimic melanoma
Systemic Lupus Erythematosus Sx
Malar rash, Joint sx, Alopecia, Mucous lesions ,Raynaud, genreal fever, anorexia, cotton-wool spots, pericarditis/myocarditis, pleurisy
Sjogren Syndrome Sx
Dry eye & dry mouth, enlarged parathryosi, pancrititis, pelurtitis, obstructino, vasculitis
Sjogren associated Diseases
RA, SLE, Scleroderma, Polymyositis, biliary cirrhosis, Hashimoto, Polyarteritis, interstitial pulmonary fibrosis
