Fatigue + Fever Flashcards

1
Q

Causes of fatigue by system

A

Cardioresp: CHF, COPD, OSA
Endocrine: DM, hypothyroidism, Addisons
GI: celiac, chronic liver dz, biliary cirrhosis, malignancy
Haem: anemia, autoimmune, hemochromatosis, lymphoma, leukamia
Infection: HIV, mono, hepatitis
MSK: RA
Neuro: MS, MG, PD, amyotrophic lateral sclerosis
Other: lupus, malignancy

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2
Q

Chronic fatigue syndrome sx

A

> 6mo
Not alleviated by rest
Impacts lifestyle + 4 of:
Impaired memory or concentration
HA
Sore throat
Tender cervical / axillary lymph nodes
Muscle pain
Multi joint pain with no swelling
Unrefreshing sleep
Post exertional malaise >24hrs

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3
Q

Kawasaki’s criteria

A

Fever >5days
Bilateral Conjunctivitis
Erythema (pharynx, lips, tongue)
Peripheral Extremities Changes (Edema, Desquamation)
Polymorphous Rash
Cervical Adenopathy

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4
Q

Kawasaki management

A

Echo to r/o coronary artery aneurysm
ASA
IVIG

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5
Q

Management principles for febrile sz

A

Check for sources of fever or infection.
Check for signs of trauma or injury.
Check for signs or symptoms that are considered red flags that would warrant further work-up; persistent neurological symptoms, toxic appearance, atypical seizure presentation, prolonged seizure durations requiring anticonvulsants

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6
Q

Febrile sz counselling for parents

A

Febrile seizures are common, do not cause brain damage and there is no impact on intellect and future development.
Febrile seizures are likely to happen again and parents need to be prepared and counselled on how to manage these future episodes (fever control, position the child, do not intervene unless needed, time the seizure, review signs and symptoms to consider calling EMS)
There is a small increase in the risk of developing epilepsy with patients presenting with multiple febrile seizures at younger ages.

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7
Q

Hand foot mouth virus

A

coxsackie (group A)

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8
Q

Management of Infants 0-3 months w/ fever

A

BC, urine, LP, CXR

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9
Q

How to Ix pts w/ fever of unknown origin

A

Blood cultures, echo, bone scans

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10
Q

Life threatening causes of fever

A

Endocarditis
Meningitis
Heat stroke
Malignant neuroleptics syndrome

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11
Q

Sx NMS

A

Delirium
Diaphoresis
Muscle rigidity
Autonomic instability

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12
Q

Ix for fatigue and when to pursue Ix

A

Ix if ongoing >4w
​​
CBC
Electrolytes (glucose, creatinine)
LFT
TSH
Pregnancy test
ESR/CRP
UA

Consider
Celiac screen (Anti-TTG, IgA)
CK if pain or muscle weakness
Tuberculosis, HIV, Hepatitis C (born 1945-1965)

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13
Q

Rx for NMS

A

Rehydration
Cooling
Dantrolene sodium PO
Bromocriptine PO

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14
Q

Myalgic-Encephalitis chronic fatigue syndrome

A

fatigue profound, not improved by rest, post-exertional malaise

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15
Q

Fibromyalgia criteria

A

diffuse body pain x3mo w/ no other explanation, fatigue, sleep, mood, cognitive sx

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16
Q

Environmental sensitivities multiple chemical sensitivities criteria

A

provoked by chemical or biological agents, removal relieves, neurocognitive, resp sx

17
Q

iron supplement with most iron + which one best for kids

A

ferrous fumarate (most iron), ferrous sulfate (best for kids)

18
Q

Criteria for systemic exertional intolerance dz

A

functional impairment >6mo, non-exertional new fatigue, post-exertional malaise, rest not refreshing

19
Q

Non-infectious cause of fever

A

PE, SJS, endocarditis, renal cell carcinoma, GCA, medications, serotonin syndrome, NMS

20
Q

Workup for fever unknown location

A

WBC, midstream urine culture, CXR, blood cultures, lumbar puncture, CT chest abdo pelvis, bone scan, med review, tissue biopsy (lymph, temporal artery, bone marrow, liver), serum protein electrophoresis, echo, viral cultures, ANA, HIV, TB test

21
Q

Ix for sick infants

A

Hb, WBC, CRP, blood cultures, serum glucose, UA, urine culture, CXR, LP, AXR

22
Q

Fever in peritoneal dialysis pts?

A

Spontaneous bacterial peritonitis