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SBL Exam 2 > Clinical Manifestations of Fever > Flashcards

Clinical Manifestations of Fever Flashcards

1
Q

Bacteremia

A

Abnormal presence of bacteria in blood stream

Caused by skin/soft tissue infections, joint inf, pneumonia, endocarditis

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2
Q

3 stages of Septicemia and what criteria we can use to diagnose it

A

3 stages: 1) Early Sepsis from bacteremia 2) Sepsis 3) Septic Shock
qSOFA score based on: RR >22, AMS, Systolic <100 mmHg
Predicts chance of Sepsis

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3
Q

Sepsis Risk Factors

A 
ICU admission
Bacteremia
>65 yrs 
Immunosuppression 
Diabetes
Cancer
Community Acquired Pneumo 
Previous hospitalization
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4
Q

Clinical Manifestations of Sepsis

A

Hypotension (Systolic <90)
T >38.3C (100.94)
P >90
RR >20

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5
Q

What can be a sign of end-organ perfusion abnormalities (septic shock)?

A

Warm, flushed skin early, then pail, cool, cyanotic.

Iléus or absent bowel sounds due to hypo perfusion

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6
Q

Labs of Sepsis

A 
Leukocytosis or Leukopenia 
Normal WBC with >10% immature forms
Hyperglycemia
Coag Abnormalities 
Increased CRP
HYPERLACTATEMIA (most important because associated with poor outcome)
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7
Q

Common Infections that cause Sepsis

A 
Bacterial: Staph/Strep
Viral: Flu, CMV
Fungal: Coccidiomycosis/Histoplasmosis (Bonus: what skin abnormality could be seen???) 
TB
Malaria
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8
Q

What are the 2 common staph infections that cause bacteremia

A

MSSA

MRSA

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9
Q

MRSA skin infections (2)

A
  1. Erysipelas (well defined borders, superficial)

2. Cellulitis (Deeper skin infection, edema, lymphangitis)

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10
Q

Common presentations associated with a MRSA infection

A

Painful, warm, erythematous skin
Lymphangitis (Cellulitis)
Staph may have more purulence

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11
Q

Risk factors for community-acquired MRSA

A

Contact sports
Military (Christian has MRSA)
Incarceration
Injection Drug use (All of us after SBL)

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12
Q

What is the number one cause of bacterial pharyngitis in children?

A 
Strep A (pyogenes) 
Says this like 8 times
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13
Q

What infection do pregnant women mainly deal with and can cause UTI, Chorioamnionitis, PP endometritis

A

Strep B (agalactie)

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14
Q

Symptoms of TB

A 
Cough
Hemoptysis
Fatigue
Weight Loss 
Nigh sweats
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15
Q

Risk factors of TB

A

Household exposure
Incarceration
Drug use
Travel

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16
Q

Explain the stages of TB

A

Latent infection: bacilli contained in granulomata

Reactivation phase: Immunocompromised state causes active infection

17
Q

What are some factors that can cause reactivation of TB

A

Gastrectomy
Silicosis
Diabetes
HIV

18
Q

Influenza

A

orthomyxovirus
Types A, B, C
Fever, myalgia, HA, Rhinorrhea, congestion, non productive cough

19
Q

What is the primary difference between infectious mono caused by CMV compared to EBV

A

Acute acquired CMV Mono infection does no usually present with pharyngeal symptoms

20
Q

Perinatal CMV inclusion disease

A

Can be acquired through breast feeding or blood products.
HEARING LOSS in 50% of infants who are symptomatic at birth
Asymptomatic babies can show neurologic deficits later in life

21
Q

What would be the result of a heterophil Ab test if a mono-like syndrome was caused by CMV?

A

Negative test because it’s trying to detect EBV

22
Q

Primary Coccidoidomycosis symptoms

A

Arthralgias with periarticular swelling of knees and ankles

Erythema Nodosum

23
Q

An HIV-infected patient shows pulmonary miliary infiltrates, lymphadenopathy, and meningitis. What would be a Ddx?

A

Disseminated Coccidoidomycosis

24
Q

Acute Malaria

A 
Begins with headache and fatigue, followed by cyclic fevers (2 days for Vivax and Ovale, 3 days for Malariae) 
Anemia
Jaundice
HSM
Hypotension
25
Q

Multiple Myeloma

A 
CRAB findings: 
HyperCalcemia
Renal Involvement
Anema
Bone lytic lesions
26
Q

How to distinguish Waldenstrom’s Macroglobulinemia from MM?

A

Absence of Lytic bone lesions

27
Q

Kaposi Sarcoma

A

HHV-8
MOST COMMON HIV-related malignancy
Red, purple, dark plagues

28
Q

Auto Immune disorders that can cause fever

A

SLE

Sjogrens

29
Q

SLE

A 
ANA+
Anti-DS DNA + 
Smith + 
Malar rash
pericarditis
Risk of MI
30
Q

Sjogrens

A 
Sicca symptoms: Xerostomia, Xeropthalmia, Vaginal dryness (cough- Allison)
Risk of MALToma
ANA +
RF +
anti-ro +
anti-la +

SBL Exam 2 (7 decks)

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