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SBL > Clinical Manifestations in Fever > Flashcards

Clinical Manifestations in Fever Flashcards

1
Q

What is bacteremia?

A

abnormal presence of bacteria in blood stream

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2
Q

Most common sources of bacteremia

A

skin and soft tissue infections, catheters, bone and joint infections, endocarditis, pneumonia

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3
Q

Clinical manifestations of bacteremia

A

fever, fatigue, nausea, vomiting, dehydration, leukocytosis and L shift on hemogram

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4
Q

Definition of septicemia

A

derived from bacteremia or inflammatory responses and can progress to early sepsis, sepsis, and/or septic shock; organ dysfunction

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5
Q

Sepsis determination - SOFA

A

lengthy, time consuming organ dysfunction score

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6
Q

Sepsis determination - qSOFA

A

based on resp rate, altered mental status, BP <100 mmHg; predicts chance os sepsis for patients admitted to the medical floor

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7
Q

Sepsis risk factors

A

ICU admission, bacteremia, age>65yo, immunosupression, diabetes and obesity, CA, CA-pneumonia, previous hospitalizations requiring abx therapy

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8
Q

Clinical manifestations of sepsis

A

sxs and signs specific to infectious source, arterial hypotension (SBP < 90 mmHg, MAP < 70), temp >38.3 or <36, HR >90 bpm, tachypnea

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9
Q

End-Organ manifestations of sepis

A

warm, flushed skin, skin may become cool, decreased cap refill, cyanosis, altered mental status, restlessness, oliguria, anuria, ileus or absent bowel sounds

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10
Q

Lab eval in sepsis

A

leukocytosis or leukopenia, hyperglycemia, arterial hypoxemia, acute oliguria, Cr increase, coag abnormalities, thrombocytopenia, hyperlactemia, hyperbilirubinemia

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11
Q

Diagnosis of sepsis

A

H&P, clinical reasoning, evidence based medicine

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12
Q

Staphylococcal bacteremia caused by what organisms

A

Methicillin sensitive S. aureus (MSSA), Methicillin resistant S. aureus (MRSA)

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13
Q

Staph infections are commonly due to…

A

breaks in skin integrity, IV catheters, pacer, ortho hardware

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14
Q

Signs and sxs of systemic staph ifx

A

bone or joint pain, protracted fever and/or sweats, abdominal pain, CVA tenderness, HA

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15
Q

Appearance of MRSA infected wounds

A

erythema with induration and purulent drainage

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16
Q

S. aureus bacteremia can lead to what complications

A

endocarditis, osteomyelitis, deep-seated systemic infections

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17
Q

Erysipelas

A

superficial skin infx with well-defined borders

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18
Q

Cellulitis

A

deeper skin infx involving dermis and subQ fat with indiscrete borders; propensity to lymphangitis, edema, swelling

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19
Q

Risk factors for community-acquired MRSA

A

contact sports, military service, incarceration, injection drug use

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20
Q

S. pyogenes causes what infections

A

tonsillopharyngitis (most common cause in children), impetigo, pharyngitis

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21
Q

S. agalactiae causes what infections in pregnant persons

A

UTI, chorioamnionitis, postpartum endometritis, bacteremia

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22
Q

S. agalactiae causes what infections in nonpregnant adults

A

sepsis, soft tissue infections, endocarditis, other focal infections

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23
Q

Most common cause of bacterial pharyngitis in children

A

S. pyogenes

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24
Q

Scarlatiniform rash

A

“sandpaper” rash appreciated with palpation

25
Q

Tuberculosis

A

occurs with airborne droplets containing viable bacilli and subsequent lymphangitic and hematogenous spread

26
Q

Main sxs of mycobacterium tuberculosis

A

productive cough, hemoptysis, fatigue, weight loss, fever, night sweats

27
Q

Risk factors for mycobacterium TB

A

household exposure, incarceration, rec drug use, travel to endemic area

28
Q

Latent TB infection

A

bacilli contained within granuloma, non-transmissible while latent but may become reactivated

29
Q

Risk factors for TB reactivation

A

gastrectomy, silicosis, DM, HIV, immunosuppressive drugs

30
Q

Risk factors for drug resistance

A

immigration from regions with drug-resistant TB, close pt contact, unsuccessful therapy, pt noncompliance

31
Q

Clinical manifestations of TB

A

cough, blood-streaked sputum, pt appears chronically ill, post-tussive apical rales, malaise, anorexia, wt loss, fever, night sweats

32
Q

Influenza virus category

A

orthomyxovirus transmitted by respiratory droplets

33
Q

Systemic symptoms of influenza

A

fever, chils, HA, malaise, myalgias

34
Q

Resp symptoms of influenza

A

rhinorrhea, congestion, pharyngitis, hoarseness, nonproductive cough, substernal soreness

35
Q

Cytomegalovirus infection

A

virus isolation or detection in body fluid regardless of symptoms

36
Q

Cytomegalovirus disease

A

evidence of CMV infection with attributal symptoms or signs, may manifest as viral or tissue-invasive disease

37
Q

Perinatal CMV prevents as…

A

jaudice, hepatosplenomegaly, thrombocytopenia, purpura, microcephaly, periventricular CNS calcifications, mental retardation

38
Q

Complications of perinatal CMV

A

hearing loss, neuro deficits

39
Q

How is perinatal CMV acquired?

A

breast feeding, blood products

40
Q

CMV presents similarly to what other infection in immunocompetent persons?

A

mononucleosis - fever, malaise, myalgias, arthalgias, splenomegaly, lymphocytes, abn LFT

41
Q

CMV presentation in immunocompromised persons

A

retinitis, esophagitis, colitis, pneumonitis, neuro manifestations

42
Q

Complications of CMV

A

mucosal GI damage, encephalitis, severe hepatitis, thrombocytopenia, Guillain-Barré, pericarditis, myocarditis

43
Q

Histoplasmosis is common in what areas of the US

A

Ohio river and Mississippi River valleys

44
Q

Clinical manifestations of Histo

A

influenza-like illness, atypical pneumonia with fever and cough, typically normal, PE usually normal

45
Q

Coccidioidomycosis primary infection

A

influenza-like illness with malaise, fever, backache, HA, and cough

46
Q

Coccidioidomycosis dissemination

A

results in meningitis, arthralgias, bone lesions, skin and soft tissue abscesses

47
Q

Coccidioidomycosis infections result from what organisms?

A

Coccidioides immitis, Coccidioides posadasii

48
Q

Where areas of the world are Coccidioides species common in?

A

SW US, Mexico, Central and South America

49
Q

Primary coccidioidomycosis incubation period

A

10-30 days

50
Q

Coccidioidomycosis sxs

A

nasopharyngitis with fever and chills, arthalgias with periarticular swelling of knees and ankles, erythema nodosum

51
Q

Disseminated coccidioidomycosis sxs

A

productive cough, enlarged mediastinal lymph nodes, lung abscesses, skin and bone infections, chronic basilar meningitis, subQ abscesses

52
Q

Disseminated coccidiodomycosis in HIV pts

A

pulmonary miliary infiltrates, LAD, meningitis

53
Q

Species of Plasmodium responsible for malaria

A

P vivax, malariae, ovale, falciparum

54
Q

Plasmodium responsible for severe disease

A

P. falciparum

55
Q

Acute malaria sxs

A

prodrome followed by fever, HA, malaise, myalgias, cough, anorexia, N/V/D

56
Q

Plasmodium that causes 48 hour fever cycles

A

P vivax and ovale

57
Q

Plasmodium that causes 72 hour fever cycles

A

P malariae

58
Q

Malaria signs and sxs

A

anemia, jaundice, splenomegaly, mild hepatomegaly, hypotension, seizure

59
Q

Most common HIV related malignancy

A

Kaposi sarcoma

SBL (21 decks)

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