febrile child

Question 1

what is pyrexia

Answer 1

elevated temp

Question 2

what is hyperthermia

Answer 2

too much heat production or less heat disspation or hypothalamic dysfunction (ie. no effect from antipyretics)

Question 3

what is fever

Answer 3

endogenous pyrogen has reset the thermostat

Question 4

3 examples of endogenous pyrogens

Answer 4

• bacterial & viral products
• antigen-antibody imune complexes
• substances released from tissue injury

Question 5

effect of dehydration on body temp

Answer 5

can exacerbate fevers d/t decreased skin perfusion

Question 6

gold standard for v. accurate temp. reading; estimates the core temp

Answer 6

rectal temp

Question 7

okay as a screening tool; fast but expensive

Answer 7

tympanic/infared thermometer

Question 8

which thermometer is just not recommended in general

Answer 8

LCD forehead/pacifier

Question 9

effect of bundling on temp

Answer 9

in under 3 mo. it can cause a rise in skin temp of 4.8 F but rectal temp would be unaffected

Question 10

dosage of acetaminophen as an antipyretic

Answer 10

10-15 mg/kg Q 4 hrs

Question 11

dosage of ibuprofen as an antipyretic

Answer 11

10 mg/kg Q 6-8 hrs

Question 12

other than antipyretics, what are some ways parents can help cool a kid

Answer 12

• expose then
• sponging w/ water

set point needs to be changed back via antipyretic

Question 13

4 specific body locations to look at in evaluation

Answer 13

fontanelle
nodes
abdomen
rash

Question 14

other than travelling, what are 5 other sources of fevers (five Ws)

Answer 14

Wind
Water
Wound
Walking
Wonder drug

Question 15

6 scenarios that are considered “guilty till proven innocent”

Answer 15

chemo or immune-suppressive therapy
immune syndromes
HIV
sickle cell or splenectomy
invasive lines

Question 16

peak occurence of febrile seizures

Answer 16

18-24 months

Question 17

4 risk factors for febrile seizure recurrence

Answer 17

• under 18 mo
• duration of fever (shorter= higher chance)
• fam h.o epilepsy or febrile seizures
• height of sezures (lower peak= higher rate)

can seize at lower temp

Question 18

4 risk factors for developing afebrile seizures after febrile seizures

Answer 18

• complex febrile seizures
• duration of fever (under 1hr = increased risk)
• fam h.o epilepsy
• neurodevelopmental abnormality (cerebral palsy, hydrocephalus)

Question 19

in respect to febrile seizures, when should you initiate sepsis work-up

Answer 19

if younger than 3 months w/ a fever

Question 20

you could get CT/MR if febrile seizures + what 2 other findings

Answer 20

• evidence of increased ICP
• possible trauma or structural defect (microcephaly, spasticity)

Question 21

how often do yo need to consult w/ neuro or get an EEG?

Answer 21

EEG not helpful except in specific times
consult is rarely needed w/ first time simple febrile seizure