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MC > Fever > Flashcards

Fever Flashcards

1
Q

What is the use of body temp elevation?

A

The elevation in body temperature

  1. activates T-cell production,
  2. increases the effectiveness of interferons 3. and limits the replication of some common viruses
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2
Q

Fever can be defined as an early morning oral temperature ____ or a temperature _______at other times of day

A

> 37.2°C

> 37.8°C

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3
Q

Oral temperature is about____ lower than core body temperature

A

0.4°C

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4
Q

Axillary temperature is about____ lower than core body temperature

A

0.5°C

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5
Q

Rectal, vaginal and ear drum temperatures are _____ higher than oral and reflect core body temperature

A

0.5°C

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6
Q

Fevers due to infections have an upper limit of______

A

40.5–41.1°C

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7
Q

T or F

Hyperthermia (temperature above 41.1°C) and
hyperpyrexia appear to have no upper limit

A

t

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8
Q

Drug fever should abate by _____hours after

discontinuation of the drug

A

48

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9
Q

Features of a true chill are _____ and _______ which is quite different from the chilly

A

teeth chattering and bed shaking,

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10
Q

Features of true chills

A

• shaking cannot be stopped voluntarily
• absence of sweating
• cold extremities and pallor (peripheral vascular
shutdown)
• dry mouth and pilo-erection: lasts 10–20
minutes

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11
Q

state when the body’s metabolic heat production or environmental heat load exceeds normal heat loss capacity

A

Hyperthermia or hyperpyrexia

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12
Q

This is the sudden onset of hot, dry, flushed skin with a rapid pulse, temperature above 40 ° C, and confusion or altered conscious state in a person exposed to a very hot environment

A

Heatstroke (sunstroke, thermic fever

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13
Q

In heat stroke:

The BP is usually _______
initially but circulatory collapse may precede

A

not affected

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14
Q

Mx of heat stroke

A

• Immediate effective cooling water applied to skin
• Icepacks at critical points (e.g. axillae, neck, head)
• Ice water bath if possible
• Aim to bring down temperature by 1 ° C every 10
minutes

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15
Q

This is a rare hereditary disorder characterised by rapidly developing hyperpyrexia, muscular rigidity
and acidosis in patients undergoing major surgery

A

Malignant hyperthermia

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16
Q

_______ is usually encountered in hospitalised patients attempting to malinger

A

Factitious fever

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17
Q

Characteristics of factitious fever

A
  • a series of high temperatures is recorded to form an atypical pattern of fluctuation
  • there is excessively high temperature (41.1 ° C) and above
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18
Q

The syndrome includes high temperature, muscle rigidity, autonomic dysfunction
and altered consciousness. It is a rare and potentially lethal reaction in patients taking antipsychotic drugs

A

Neuroleptic malignant syndrome

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19
Q

Drugs asstd with NMS

A

haloperidol alone or with

other drugs especially lithium carbonate

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20
Q

Where to put thermometer if taking oral temp

A

Place under the tongue at the junction of the

base of the tongue and the floor of the mouth to one side of the frenulum—the ‘heat’ pocket. (mouth shut)

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21
Q

How to take oral temp

A

The rule is ‘3 cm in for 3 minutes

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22
Q

How to take vaginal temp (measure ovulation)

A

It should be placed deeply in the vagina for 5 minutes before leaving bed in the morning.

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23
Q

______is now accepted standard practice.

The tympanic membrane (TM) accurately reflects ______temperature, which in turn reflects core body temperature

A

Otic thermography

hypothalamic

24
Q 
According to Yung and Stanley  it is helpful to
consider fever in three categories: 
1
2
3
A

less than 3 days duration;

between 4 and 14 days duration;

protracted fever (more than 14 days).

25
Q

MCC of Fever of less than 3 days duration

A

often due to a self-limiting viral infection

of the respiratory tract

26
Q

MCC of Intermittent fever

A

include various pyogenic

infections, cytomegalovirus and lymphoma.

27
Q

MCC Relapsing fever

A

Malaria (classic)

in quartan fever, caused by Plasmodium malariae

28
Q

This is a fever in which the temperature returns towards normal for a variable period but is always elevated

A

Remittent fever

29
Q

Examples of Remittent fever

A

pelvic abscess, wound infection, empyema and carcinoma). It is a common
feature of empyema.

30
Q

_______ is characterised by bouts of continuousor remittent fever for several days, followed by afebrile remissions lasting a variable number of days

A

Undulant fever

31
Q

Causes of Undulant fever

A

It is commonly a feature brucellosis infection but is also seen in the lymphomas, especially Hodgkin lymphoma

32
Q

fevers lasting 3 to 10 days followed by afebrile periods of 3 to 10 days.

asstd with Hodgkins Lymphoma

A

Pel–Ebstein fever

33
Q

In this pattern the fever recurs daily

A

Quotidian fever

34
Q

Daily fever spikes in the morning are characteristic of ______

afternoon spikes are indicative of ____________; and

evening spikes suggest localised collection of pus (e.g. empyema of the gall bladder).

A

Pseudomonas infection (e.g. pulmonary superinfection);

cytomegalovirus infection

35
Q 
Double quotidian fever (two fever spikes in a
day) is caused by adult 
1
2
3
A

Still syndrome, gonococcal endocarditis and visceral leishmaniasis

36
Q

This is fever occurring within 24 hours after surgery

A

Postoperative fever

37
Q

MCC of Postoperative fever

A
  • pulmonary atelectasis (common)
  • wound haematoma
  • deep venous thrombosis
  • myocardial infarction
  • allergic drug reaction
38
Q

In children, most authorities would consider a fever of_______ and above to be significant and warrant close scrutiny

A

38.5 ° C

39
Q

T or F

Hyperthermia is common in children

A

F

uncommon

40
Q

MCC of hyperthermia (41C)

A

usually due to CNS

infection or the result of human error

41
Q

febrile convulsions, which occur in _____

of febrile children between 6 months and 5 years

A

5%

42
Q

Febrile convulsions are triggered by a_______rather than its absolute level

A

rapid rise in temperature

43
Q

Tx of high grade fever in children

A

Use 20 mg/kg as a loading

dose and then 15 mg/kg maintenance

44
Q

• Any fever in the elderly is significant.
• ________ is a less common cause of fever in the elderly.
• Fever in the elderly is______ until proven
otherwise (common sites are the lungs and
urinary tract).

A

Viral infection

sepsis

45
Q

The syndrome consists of hyperpyrexia, decreased sweating, delirium
and coma. The core temperature is usually over 41 ° C.

A

Heatstroke

46
Q

Criteria for FUO

A
  • illness for at least 3 weeks
  • fevers >38.3 ° C (100.9 ° F)
  • undiagnosed after 1 week of intensive study
47
Q

Fever in children is usually a transient phenomenon and subsides within ______ days. At least 70% of all infections are ___

A

4–5

viral

48
Q

MCC of FUO in chidlren

A

Infectious causes (40%)
Collagen–vascular disorders (15%)
Neoplastic disorders (7%)
Inflammatory diseases of the bowel (4%)

49
Q

MCC of FUO from neoplasm

A
  • Leukaemia
  • Reticulum cell sarcoma
  • Lymphoma
50
Q

Initial empirical Tx of septicemia

A

Empirical initial
treatment (after blood cultures) is di/flucloxacillin 2 g
IV 1 gentamicin 4–6 mg/kg IV (statim).

51
Q 
The transient presence of bacteria in
the blood (usually asymptomatic) caused by local infection or trauma
A

Bacteraemia

52
Q

The multiplication of bacteria or fungi in the blood, usually causing a systemic infl ammatory response (SIRS).

A

Septicaemia (sepsis

53
Q

SIRS is defined as 2 or more

of (in adults

A

temperature >38°C or <36°C
• respiratory rate >20/min
• heart rate >90/min
• WCC >12 × 109/L or <4 × 109/

54
Q

Sepsis associated with organ dysfunction, hypoperfusion or hypotension with
2 or more of: fever, tachycardia, tachypnoea, and elevated WCC.

A

Severe sepsis

55
Q

Sepsis with critical tissue perfusion causing
acute circulatory failure including hypotension
and peripheral shutdown—cool extremities, mottled skin, cyanosis

A

Septic shock

56
Q

A serious manifestation of septicaemia
whereby organisms and neutrophils undergo embolisation to many sites, causing abscesses, especially in the lungs, liver and brain

A

Pyaemia

57
Q

______ where the focus of

infection is not apparent, while in secondary septicaemia a primary focus can be identifi ed

A

Septicaemia

MC (90 decks)

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