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M3 > Fever > Flashcards

Fever Flashcards

1
Q

Normal core body temperature:

A

36.5 C-37.5C

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2
Q

Maximal normal oral temperature at 6AM

A

37.2 C

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3
Q

Maximal normal oral temperature at 4-6PM

A

37.7 C

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4
Q

women who menstruate, the a.m.

temperature is lower when?

A

2 weeks before

ovulation;

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5
Q

women who menstruate, the a.m.
temperature rises by _____ with
ovulation and remains at that level until
menses

A

0.6 C

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6
Q

During postprandial state, body temp is

a. Elevated
b. Depressed

A

A

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7
Q

______ is elevation of normal body temp in
conjunction with an increase in the
hypothalamic set point

A

FEVER

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8
Q

Primary consideration in a patient with fever (most common cause)

A

Infection

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9
Q

________ an unchanged setting in
the hypothalamic set point in conjunction with
an uncontrolled increase in body temp that
exceeds the body’s ability to lose heat

A

Hyperthermia

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10
Q

__________ thermoregulatory failure in association with a warm environment

A

Heat Stroke

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11
Q

___________ hyperthermic and
systemic response to halothane and other
inhalational anesthetics in patients with genetic
abnormality

A

Malingnant Hyperthermia

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12
Q

__________ syndrome of
hyperthermia,autonomic dysregulation and
Extrapyramidal side effects by neuroloeptic agents
( e.g. haloperidol)

A

Neuroleptic Malignant Syndrome

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13
Q

Malignant hyperthermia: hyperthermic and systemic response to ______ and _______ in patients with genetic abnormality

A

halothane; other inhalational anesthetics

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14
Q

Example of neuroleptic agent involved in neuroleptic malignant syndrome

A

Haloperidol

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15
Q

Temperature above 41.5 C is called

A

hyperpyrexia

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16
Q

In the context of fever, Interleukin 1, IL 6, Tumor necrosis factor, interferon alpha are examples of ________

A

pyrogenic cytokines

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17
Q

Cytokines act on the ___________ to elevate the thermoregulatory set point to cause fever

A

Hypothalamic endothelium

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18
Q

T/F hyperthermia involves pyrogenic molecules

A

F

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19
Q

Pathogenesis of hyperthermia

A

Heat production/exogenous heat > heat losing capacity

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20
Q

Patient with high temp due to work and exercise in hot environments temp 38.9C

a. hyperpyrexia
b. fever
c. hyperthermia

A

C

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21
Q

Patient with high temp after taking metamphetamine temp 40 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

C

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22
Q

Patient with high temp after taking anticholinergic temp 38 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

C

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23
Q

Patient with high temp after being given succinylcholine temp 38 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

D

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24
Q

Patient with high temp after halothane temp 38 C

a. hyperpyrexia
b. fever
c. hyperthermia
d. malignant hyperthermia

A

D

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25
Q

Neurotransmitter involved in neuroleptic malignant syndrome

A

Dopamine

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26
Q

______ is seen in patients with inherited abnormality of skeletal muscle sarcoplasmic reticulum that increases intracellular calcium levels as a response to inhalational anesthetics

A

malignant hyperthermia

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27
Q

Mean normal oral temp

A

36.8 +/- 0.4 C

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28
Q

Normal daily temp variati on

29
Q

T/F

Normal temp swings occur in hyperthermia but in higher temp

A

F; this occurs in fever, (e.g. during infection, recovery from infection)

30
Q

Rectal temp are lower than oral temp by how much?

31
Q

T/F

Tympanitic thermometer are more variable compared to oral and rectal values

32
Q

Fever pattern of relpasing fever

A

episodes are separated by intervals of normal temp

33
Q

Fever pattern of malaria by P. vivax

A

Tertian fever: seen on the 1st and 3rd day

34
Q

Fever pattern of malaria by P. malariae

A

Quartan fever: seen on the 1st and 4th day

35
Q

lymphomas and hodgkins disease

A

Pel ebstein fever: lasting 3 to 10 days separated by several day afebrile period of 3 to 10 days

36
Q

What condition will present with 21 days fever with neutropenia

A

Cyclic neutropenia

37
Q

What are the signs of hyperthermia?

A 
HDDPM
Hallucinations
Delirium
Dry Skin
Pupil Dilatation
Muscle Rigidity
38
Q

rapidly fatal and does not respond to antipyretics

a. Hyperthermia
b. Fever

39
Q

High temp, but skin could be cold

a. Hyperthermia
b. Fever

40
Q

What is the cause of exertional hyperthermia?

A

caused by exercise in high heat/humidity

41
Q

What is the cause of non-exertional hyperthermia?

A

exposure to high heat and humidity

42
Q

Hyperthermia in patients taking anticholinergic medications, antiparkinsonian drugs, diuretics

a. Exertional
b. Non-exertional

43
Q

Drugs that can cause non-exertional hyperthermia

A

LET CAM SLAP
Lysergic acid
Ecstasy
TCA

Cocaine
Amphetamines
Monoamine oxidase inhibitors

Salicylates
Lithium
Anticholinergic
Phenciclidine

44
Q

Characterized as a lead pipe muscle rigidity, EP s/e, autonomic dysfunction and hyperthermia.

A

Neuroleptic Malignant Syndrome

45
Q

Presents with high temperature, increased mucle metabolism, muscle rigidity, rhabdomyolysis, acidosis, CV instability develops
A

A

Malignant hyperthermia

46
Q

T/F Malignant Hyperthermia is always fatal

47
Q

Drugs that can cause Neuroleptic Malignant Syndrome

A 
How Much ang PF sa DTtB?
Haloperidol
Metoclopramide
Phenothiazines
Fluoexetine
Domperidone
Thioxetine
Baclofen withdrawal
48
Q

overlapping features, including hyperthermia (agitation, increased reflexes, tremor, sweating, dilated pupils)but is distinguished by diarrhoea, tremor and myoclonu

A

Serotonin Syndrome

49
Q

Drugs that cause Serotonin Syndrome

A 
selective serotonin uptake inhibitors(Fluoxetine, Citalopram)
MAOIs
TCA
tramadol
dextrometorphan
50
Q

What distinguishes Serotonin Syndrome from other types of hyperthermia?

A

diarrhea, tremor, myoclonus

51
Q

Give 2 complications of Serotonin Syndrome

A

Seizure/muscle breakdown

52
Q

2 Endocrinopathies causing high temp

A

Thyrotoxicosis

Pheochromocytoma

53
Q

CNS Damage causing high temp

A

Cerebral hemorrhage
Status epilepticus
hypothalamic injury

54
Q

Tempo and complexity of work up depends on (3)

A

Pace of illness
Diagnostic considerations
Immune status

55
Q

Light blue-gray, oval, basophilic, leukocyte inclusions located in the peripheral cytoplasm of neutrophils. They measure 1-3 µm in diameter thought to be remnants of the rough endoplasmic reticulum. Present in conjunction with toxic granulation

A

Dohle Bodies

56
Q

Approximate value of ESR and CRP in Rheumatolgic disease: greater than ______

57
Q

Lab test for: malaria parasites, babesia, ehrlichia, Borrelia, trypanosomes

A

Blood smear

58
Q

Liver function is ____ in hyperthermia

a. low
b. high

59
Q

Treatment to reduce fever is recommended in

A
  1. Patients with cardiac, cerebrovascular and pulmonary insufficiency
  2. Organic brain disease
  3. Children with history of febrile or non febrile seizures
60
Q

It is better to give antipyretics as needed than in regular schedule T/F

61
Q

T/F Chronic high dose therapy with antipyretics ( aspirin or NSAIDS used in arthritis) does not reduce normal core body temperature

62
Q

Acetaminophen is preferred over Aspirin for treatment of fever because

A 
Acetaminophen 
Does not mask signs of inflammation
Does not impair platelet function
Does not adversely affect the GI tract
Not associated with Reyes syndrome
63
Q

True about hyperpyrexia

a. temp > 40 C
b. use of cooling blankets even without anipyretic
c. antipyertics are of no use
d. NOTA

64
Q

True about hyperthermia

a. Antipyretic is effective
b. physical cooling can be given with antipyretic treatment
c. hemodialysis and cardiopulmonary bypass can be done in extreme cases
d. NOTA

65
Q

Treatment of malignant hyperthermia

A

Dantrolene, antiarrhythmic

66
Q

When fever contines for 2-3 weeks and repeat exams and lab tests are unrevealing , patient is diagnosed as having _______

67
Q

Prognosis of hyperthermia depends on

A

rapidity of cooling

68
Q

There is no common preventive measure for fever

T/F

69
Q

False of Hyperthermia

a. Avoid excessive activity in hot or humid environment
b. Adequate fluid intake before, during, after strenous activity
c. maintain proper ventilation to promote cooling from sweat evaporation
d. NOTA
e. AOTA

M3 (66 decks)

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