Fever Flashcards
What happens if the body temperature is too high?
there may be abnormal neuronal function, or even brain seizures
When is the body temperature the lowest throughout the day
in the morning (highest in afternoon)
Where is the regulatory centre for body temperature
anterior hypothalamus
T/F Oral temperature is more accurate than ear temperature
False
How does fever cause weight loss
Fever takes a lot of energy, so long period of fever will burn fat and muscles, leading to weight loss
How is fever a survival mechanism?
Some enzymes work better at high temperature. We put up temperature to combat infection s
Briefly describe the fever pathogenesis
inflammation => release of TNFa, IL-1, INY => cause local release of PGE2 => reset temperature set-point
What is rigor
feeling of intense cold and uncontrollable shivering
How does rigor occur with fever?
Because the temp set-point is raised. Body achieves it by peripheral vasoconstriction, so the body gets cold
How does meningococcus lead to septacaemia?
they are normal flora of the nose and throat, and can get into the bloodstream through mucosa to cause overwhelming sepsis
Fever at the start, followed by severe hypotension
T/F Falciparum malaria can present days after initial infection
False, it has a short liver phase
How does sphenoectomy sepsis occur?
remove the spleen = unable to deal with encapsulated organisms = sepsis
What’s toxic shock syndrome?
staph and strep release toxin that act as superantigens to over-stimulate T cells. Patients get overwhelming T cell response
Which organism causes necrotising soft tissue infections
Group A strep
how can staph aureus endocarditis be fatal?
the bacteria chew up the valves, leading to embolism and acute heart failure
Is CRP is good marker of fever caused by septacaemia?
No, it rises up slowly, so may not be a good marker for acute diseases
What’s the most common cause of fever due to contact with toddlers?
CMV, as it replicates in urine
How can FBE indicate whether the infection is bacterial or viral
bacterial = neutrophilia viral = lymphocytosis
What is ESR
how fast red cells fall in the blood. It goes up with neurophilia as there are white cells in the blood
When can we characterised someone as having fever (how far above baseline temperature)
38.3
When can we characterise someone as having pyrexia of unknown origin?
prolonged illness over 2-3 weeks
fever of above 38.3 on several occasions
no diagnosis after investigation
What is a common cause of PUO from someone with travel history
TB
What are the differentials of PUO?
infection
autoimmune (connective tissue disorder)
Malignancies
Which malignancy can cause prolonged fever
lymphoma
