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Fever Flashcards

1
Q

Pneumonia

A

. Infection that inflames the air sacs in one or both lungs

. Air sacs may fill with fluid or pus causing cough with phlegm or pus

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2
Q

Pneumonia signs and symptoms

A

Fever or hypothermia, tachypnea, cough, dyspnea, bronchial sounds or crackles on auscultation

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3
Q

Tachypnea

A

Rapid breathing

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4
Q

Dyspnea

A

Difficult or labored breathing

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5
Q

Pneumonia etiology

A

Viral, bacterial, fungal

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6
Q

Acute lymphocytic leukemia (ALL)

A

Cancer of the blood and bone marrow, common in kids

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7
Q

Signs and symptoms of ALL

A

Fever, bleeding from gums, easy bruising, loss of appetite, night sweats, weight loss

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8
Q

Pyelonephritis

A

. Infection of renal pelvis and kidney

. Results from ascent of bacterial pathogen up ureters from bladder to kidneys

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9
Q

Signs and symptoms of pyelonephritis

A

Fever, flank pain, painful urination (dysuria), urinary frequency

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10
Q

Pyelonephritis nephrology

A

Escherichia Coli, Proteus, Klebsiella, Enterobacter

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11
Q

Bacteremia

A

Presence of bacteria in blood

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12
Q

Signs and symptoms of bacteremia

A

Fever and chills, nausea, vomiting, loss of appetite, skin rash

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13
Q

Bacteremia etiology

A

Gram-negative and gram-positive organisms both aerobic and anaerobic

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14
Q

Influenza

A

Viral infection that attacks resp. System

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15
Q

Influenza signs and symptoms

A

. Fever, chills, malaise, cough, Coryza, and myalgias

. Elderly present with confusion w/o fever

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16
Q

Influenza etiology

A

influenza A, B, or C

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17
Q

Coryza

A

Upper respiratory tract inflammation

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18
Q

Myalgias

A

General discomfort

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19
Q

Influenza route of transmission

A

Respiratory droplet nuclei

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20
Q

ROS list

A 
. General
. Skin
. HEET
. Neck
. Breasts
. Resp. 
. Cardio
. GI
. Peripheral vascular
. Urinary
. Genital 
. Musculoskeletal
. Psychiatric
. Neurological
. Hematologists
. Endocrine
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21
Q

What does SOS stand for?

A

Structure (anatomy), Organs (systems), and Science (pathophysiology)

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22
Q

Structure relating to illness discovery

A

Think about anatomy superficial to deep and what potential issues could arise

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23
Q

Organs (systems) in relation to illness discovery

A

Think about how the different body systems work together and what would happen if a particular body system malfunctioned

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24
Q

Science (pathophysiology) in regards to illness discovery

A

Think about how things normally function and what a possible disease could be based on previous scientific knowledge

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25
Fever
Abnormal elevation of core body temp.
26
Body temp is normally ____
37 degrees C (98.6 degrees F)
27
Prexia is a temp of ___
38 C or higher (100.4 F)
28
Hyperprexia is is a temp of ____
41.6 C or higher (106 F)
29
Hypothermia is a temp of ____
35 C or lower (95 F)
30
Physiology of a fever
. Fever reflects change in hypothalamic setpoint . Bacterial infection signals immune rxn and necrosis . TNF and IL-1 are released causing NE and arachidonic acid to be released from hypothalamus signal . PGE2 is released increases temp causing fever, vasoconstriction, and muscle shivering
31
Fever’s role in disease
Inc. blood vessel size -inc. blood vol. - inc. metabolism - inc. immune rxns, chemotactic, phagocytic, and bactericidal activity of polymorphonuclear leukocytes - slows down proliferation of microorganisms
32
Oral temp compared with core body temp
. Usually lower than core body and rectal by 0.5-0.7 C (0.7-0.9 F) . higher than auxiliary temp by 1 degree
33
Etiology of fever
Infection, cancer, withdrawal, rheumatologic disease, endocrine, allergy, fever of unknown origin (FUO), drug reaction, trauma
34
Complications of fever
. Dehydration/electrolyte and glucose abnormality . Mental status change/delirium . Neurotoxic effect/seizure
35
Low grade fever temp.
. 100.5-102.1 F | . 38.1-39 C
36
Moderate fever temp
. 102.2-104.0 F | . 39.1-40 C
37
High fever temp
. 104.1-106.0 F | . 40.1-41.1 C
38
How long is an acute fever?
Less than 7 days
39
How long is sub-acute fever
Up t o 14 days
40
How long is chronic/persistent fever?
14+ days
41
Continuous fevers
. No fluctuations or fever breaks throughout length of time | . Lack true chills/rigor
42
Infectious etiologies of continuous fever
Typhoid, TB, bacterial endocarditis, fungal disease and bacterial pneumonia
43
Non-infectious etiologies in continuous fever
Neoplasms, CT, drugs
44
Intermittent fevers
. Interval when temp is elevated for several ours followed by an interval when temp drops back to normal
45
Etiologies of intermittent fevers
. Rat bite fever, malaria, cholangitis, infections w/ Borrelia recurrent is, Hodgkin’s and other neoplasms
46
What is double quotidian fever and what is it indicative of?
. 2 spikes of fever throughout day | . Indicative of gonococcal endocarditis
47
What is 48 hour interval fever symptom of?
Plasmodia Vivax, P. Ovale
48
What disease has symptom of 72 hour interval fever?
P. Malariae
49
Drug fever
. Exceeds 40.5 C . From administration related mechanisms, pharmacological action of drug, alteration of thermoregulation, or specific drug sensitivity . Rapid resolution upon discontinuation of meds
50
What are administration related mechanisms for drug fever?
. Fluid contamination | . Phlebitis (irritation of vessel from fluid)
51
What are some pharmacological action of drugs that cause drug fever?
Jarisch-Herxheimer rxn, tumor cell necrosis w/ chemotherapy
52
What causes alteration of thermoregulation leading to drug fever?
Hyperthermia
53
Cytokines-induced fever seldom exceeds ____
41.1 C
54
Chills
. Subjective shivering/shaking assoc. w/ rapid body changes in body temp. . Causes involuntary muscle contractions that occur in response to sudden lowering of body temp. Below altered setpoint from fever
55
Night sweats
Subjective reports of nocturnal sweating that results from exaggeration of normal circadian temp. Rhythm
56
What accompanies rise in temp?
Feeling cold, goosebumps, and shivering
57
What accompanies fall in temp?
Hot and sweating
58
Babies have ____ temp than adults
Warmer
59
Why do babies have higher temp than adults?
. Larger body surface area compared to weight . More metabolically active generating more heat . Don’t regulate temp well (sweat less)
60
With increasing age, body temp ____
Decreases
61
Are fever responses greater in kids or adults?
Kids
62
What populations are more likely to be sick but have normal temps or hypothermia?
. Older patients, neonates, certain medications, immunocompromised
63
What can occur w/ high temps in first trimester of pregnancy?
Birth defects (anacephaly)
64
Fever effect on insulin and metabolism
. Increases insulin requirements, alters metabolism and disposition of drugs
65
What is a fever lasting longer than 3 weeks indicative of?
FUO, bacterial infection
66
What is fever plus shortness of breath indicative of?
Pneumonia, esp if patient is less than 2 or older than 65
67
What is fever plus swollen neck/fatigue indicative of?
EBV
68
What is fever plus excessive fatigue indicative of?
. Usually low grade fever | . Lymphoma, leukemia, renal or liver
69
What is fever plus right lower abdomen pain indicative of?
Appendicitis
70
What is fever plus low back pain/hematuria indicative of?
UTI Pyelonephritis . Nephrolithiasis
71
What is fever plus sore throat indicative of?
. Strep, pericarditis/endocarditis
72
What is fever plus leg pain/swelling indicative of?
Blood clot (DVT)
73
What is fever plus GI symptoms indicative of?
IBS, crohns, UC, celiac, gastroenteritis
74
What is fever plus joint pain indicative of?
RA
75
What are red flags with fever that prompt hospitalization
``` . Hypoxia . Shock . Pleural effusion . Multilobar infiltrates in chest (sever pneumonia) . Failure of prior outpatient therapy . Confusion . Unable to tolerate oral intake . Unreliable social situation . Sickle cell, immunocompromised, COPD or CHF ```
76
Pleural effusion
Fluid in lining
77
CHF
Congestive heart failure
78
Hypothermia causes
``` . Cold exposure . Paralysis/reduced movement . Vasoconstriction issue from sepsis/excess alcohol . Starvation . hypothyroidism . Hypoglycemia . Older adults ```
79
What causes central fever?
``` . Directly from brain injury . Subarachnoid or intraventricular hemorrhage . Brain tumor . Absence of infiltrate in chest . Neg. cultures ```
80
Hyperthermia causes
. NOT cytokines | . Body metabolic heat production/environmental heat load exceeds heat loss capacity or impaired heat loss
81
hyperthermia example diseases
Heat stroke, thyroid storm (hyperthermia)))
82
Result of high levels of hyperthermia?
Produces irreversible protein denaturation and resultant brain damage, death
83
Neuroleptic malignant syndrome
. Rare, potentially lethal idiosyncratic rxn to neuroleptic meds . Lead pipe riding its in reflexes
84
Serotonin syndrome
. Occurs w/in hours of ingesting agents that inc. serotonin in CNS . Clonus and hyperflexia in reflexes
85
Neuroleptic malignant syndrome is similar to what disease?
Serotonin syndrome
86
Clonus
Bringing tendon back quickly and it shakes
87
FUO must last over ____
. 3 weeks
88
Fever of unknown origin (FUO)
. Fever over 38.3 C on several occasions | . Diagnosis has not been made after 3 outpatient visits or 3 days of hospitalization
89
Hospital associated FUO
. Hospitalized pt w/ fever greater than 38.3 C on several occasions due to process not present or incubating at time of admission
90
Neutropenic FUO
Less than 500 neutrophils/microliter
91
Language Barrier Aspects in USA
. 60 million Americans speak a language other than English at home . Over 2% have limited English proficiency . Spanish is primary non-English language . Less likely to have regular primary/preventative care and more likely to experience dissatisfaction and adverse outcomes from clinical errors
92
INTERPRET
``` Guidelines for using interpreter I: introductions N: note goals T: transparency E: ethics R: respect beliefs P: patient focus R: retain control E: explain T: thanks ```

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