Fever

Question 1

Avg normal body temp ‘C and ‘F

Answer 1

37’C, 98.6’F

Question 2

Clinical importance of body temperature:

Answer 2

Simple
Objective
Accurate indicator of physiologic state that is less subject to external and psychogenic stimuli than other vital signs

Question 3

What does body temp assist in estimatin?

Answer 3

Severity of febrile illness (esp. in adults) - 2 exceptions.
Course and duration of febrile illness
Effect of therapy on febrile illness

Question 4

2 exceptions to severeity of a febrile illness

Answer 4

Febrile response of children to illness is greater than that of adults. Exception 2: geriatric and neonatal responses are less marked or even absent.

Question 5

T/F oral temperature is a better estimate of core body temperature

Answer 5

F: rectal temperature is better estimate of core body temperature. Temperature is 1.0F (0.5C) higher than oral

Question 6

Normal diurnal variation

Answer 6

Range form 96.5F in morning to 99.3F in late afternoon.

Usually 1F higher in afternoon as compared to morning

Question 7

In general, fever is your __

Answer 7

Friend.

Don’t be afraid of fever. It’s to help you fight off infection. Giving antipyretics = shown to prolong the fever.

Question 8

When is emergency care required ?

Answer 8

<2 month old with temp >100.9F (PNA/meningitis)
OR
>2 months with temp >106F emergency CARE MAY be required.

Question 9

What’s the important feature to watch for in children with fever ?

Answer 9

Significant change in their demeanor!

If they won’t drink water, eat food, can’t interest them in anything they usually enjoy = serious maybe.

Question 10

Benefits of fever

Answer 10

Draws attention to underlying condition.
Activation of IL-1 mediated immune response
Increases chemotactic, phagocytic and bacterial activities of neutrophils

Question 11

Detrimental aspects of fever (7)

Answer 11

Muscle wasting/loss of adipose tissue
Myalgias/arthralgias
Metabolic changes (increase in insulin demand)
CNS alterations (irreversible brain damage >106F in adults)
Loss of electrolytes d/t sweating
Trigger epileptic seizures
Possible birth defects with high maternal fever during first trimester

Question 12

Accompaniments of fever (6)

Answer 12

Systemic (HA, arthraliga, myalgia, tachycardia, tachypnea)
Chills/rigors
Sweating
Changes in mental status
Convulsions
Herpes labialis

Question 13

What are chills/rigors?

Answer 13

Shaking that occurs with high fever. This occurs d/t cytokines and prostaglandin release d/t immune response and increase set point for body temp in hypothalamus.
ASSOCIATED WITH PYOGENIC INFECTIONS WITH BACTEREMIA OR VIREMIA.

Question 14

Febrile convulsions most frequently occur in what population?

Answer 14

MC seen in children <5 years old. Not necessarily a signal of serious cerebral disease.
If a kid starts to convulse, put them in a cold bath and give acetametaphine.

Question 15

Important causes of fever (9)

Answer 15

*hoyer says not to know whole list, just know there's a latte)
Infections
rheumatologic
CNS
Malignant
Hematologic
Cardiopulmonary
GI diseases
Endocrine disease
Disorders d/t chemical agents

Question 16

FUO. What is it and what are the essentials of diagnosis?

Answer 16

Fever of unknown origin
Illness of at least 3 weeks.
Temp of 101F on several occasions during those 3 weeks.
No other dx after 3 outpatient visits or 3 days of hospitalization.
CANNOT HAVE NEUTROPENIA OR IMMUNOSUPPRESSION

Question 17

Common causes of FUO in adults and children

Answer 17

Both: infections, cancer, autoimmune.

~40% remain undiagnosed and resolve during the course of further investigation.