Exam 1 - Fever of unknown origin (FUO) Flashcards

1
Q

What are the two definitions of FUO?

A
  • Core body temp >/= 38.1 C (100.5 F) measured at least once daily for 14+ consecutive days and diagnosis not apparent after careful history, physical exam, and relatively simple, noninvasive tests
  • Temp >38 C (101 F) or greater on several occasions of more than 3 weeks duration, and with failure to reach a diagnosis, despite one week of intense investigation
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2
Q

__% of FUO self resolve and thought to be due to ___ processes

A

25% of FUO self resolve and thought to be due to viral processes

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3
Q

When evaluating a patient with fever of unknown origin, what specialist should the FNP work closely with?

A

Infectious disease specialist

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4
Q

Components of HPI that should be collected during interview

A

Same as fever without source in addition to the following:

  • History of fever pattern
  • Family history of autoimmune disease or hereditary fever syndromes
  • Family pets or exposure to animals
  • Eating habits
  • History of pica and travel
  • Insects
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5
Q

Lab tests and diagnostics that should be ordered when evaluating FUO

A
  • CBC w/ diff
  • Blood culture
  • BMP
  • LIFT
  • ESR
  • CRP
  • UA and urine culture
  • Chest x-ray (if indicated)
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6
Q

When evaluating for FUO and labs return as normal, what are the FNPs next steps?

A
  • Further workup required with infectious disease specialist
  • Specific lab testing and imaging
    • Ultrasound
    • CT scant
    • MRI
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7
Q

Is empiric treatment with antibiotics recommended in managing fever of unknown origin?

A

No - will delay diagnosis and mask symptoms

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8
Q

What is the drug of choice in managing fever in pediatrics - acetaminophen or ibuprofen?

A

Acetaminophen

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9
Q

What is the usual dosage of acetaminophen that can be given to children for fever management?

A

10-15 mg/kg q4-6h

  • Should not exceed five doses in 24 hours
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10
Q

Does acetaminophen or ibuprofen have a longer duration of action?

A

Ibuprofen

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11
Q

Ibuprofen should be used for infants and children of what ages?

A

6 months to 12 years old

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12
Q

What is the usual dose of ibuprofen given to children with a temp <102.5 F?

A

5 mg/kg q6-8h

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13
Q

What is the usual dose of ibuprofen given to children with a temp >102.5 F?

A

10 mg/kg q6-8h

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14
Q

What is the maximum daily dose of ibuprofen?

A

40 mg/kg

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15
Q

Antipyretic education

A
  • Adequate hydration
  • Do not bundle (will raise temp)
  • Tepid bath water only is temp >104 F
  • No ASA d/t Reyes syndrome
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