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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
Q

Fever

A

Abnormal elevation of core body temp.

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26
Q

Body temp is normally ____

A

37 degrees C (98.6 degrees F)

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27
Q

Prexia is a temp of ___

A

38 C or higher (100.4 F)

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28
Q

Hyperprexia is is a temp of ____

A

41.6 C or higher (106 F)

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29
Q

Hypothermia is a temp of ____

A

35 C or lower (95 F)

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30
Q

Physiology of a fever

A

. 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

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31
Q

Fever’s role in disease

A

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

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32
Q

Oral temp compared with core body temp

A

. 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

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33
Q

Etiology of fever

A

Infection, cancer, withdrawal, rheumatologic disease, endocrine, allergy, fever of unknown origin (FUO), drug reaction, trauma

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34
Q

Complications of fever

A

. Dehydration/electrolyte and glucose abnormality
. Mental status change/delirium
. Neurotoxic effect/seizure

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35
Q

Low grade fever temp.

A

. 100.5-102.1 F

. 38.1-39 C

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36
Q

Moderate fever temp

A

. 102.2-104.0 F

. 39.1-40 C

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37
Q

High fever temp

A

. 104.1-106.0 F

. 40.1-41.1 C

38
Q

How long is an acute fever?

A

Less than 7 days

39
Q

How long is sub-acute fever

A

Up t o 14 days

40
Q

How long is chronic/persistent fever?

A

14+ days

41
Q

Continuous fevers

A

. No fluctuations or fever breaks throughout length of time

. Lack true chills/rigor

42
Q

Infectious etiologies of continuous fever

A

Typhoid, TB, bacterial endocarditis, fungal disease and bacterial pneumonia

43
Q

Non-infectious etiologies in continuous fever

A

Neoplasms, CT, drugs

44
Q

Intermittent fevers

A

. Interval when temp is elevated for several ours followed by an interval when temp drops back to normal

45
Q

Etiologies of intermittent fevers

A

. Rat bite fever, malaria, cholangitis, infections w/ Borrelia recurrent is, Hodgkin’s and other neoplasms

46
Q

What is double quotidian fever and what is it indicative of?

A

. 2 spikes of fever throughout day

. Indicative of gonococcal endocarditis

47
Q

What is 48 hour interval fever symptom of?

A

Plasmodia Vivax, P. Ovale

48
Q

What disease has symptom of 72 hour interval fever?

A

P. Malariae

49
Q

Drug fever

A

. 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
Q

What are administration related mechanisms for drug fever?

A

. Fluid contamination

. Phlebitis (irritation of vessel from fluid)

51
Q

What are some pharmacological action of drugs that cause drug fever?

A

Jarisch-Herxheimer rxn, tumor cell necrosis w/ chemotherapy

52
Q

What causes alteration of thermoregulation leading to drug fever?

A

Hyperthermia

53
Q

Cytokines-induced fever seldom exceeds ____

A

41.1 C

54
Q

Chills

A

. 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
Q

Night sweats

A

Subjective reports of nocturnal sweating that results from exaggeration of normal circadian temp. Rhythm

56
Q

What accompanies rise in temp?

A

Feeling cold, goosebumps, and shivering

57
Q

What accompanies fall in temp?

A

Hot and sweating

58
Q

Babies have ____ temp than adults

A

Warmer

59
Q

Why do babies have higher temp than adults?

A

. Larger body surface area compared to weight
. More metabolically active generating more heat
. Don’t regulate temp well (sweat less)

60
Q

With increasing age, body temp ____

A

Decreases

61
Q

Are fever responses greater in kids or adults?

A

Kids

62
Q

What populations are more likely to be sick but have normal temps or hypothermia?

A

. Older patients, neonates, certain medications, immunocompromised

63
Q

What can occur w/ high temps in first trimester of pregnancy?

A

Birth defects (anacephaly)

64
Q

Fever effect on insulin and metabolism

A

. Increases insulin requirements, alters metabolism and disposition of drugs

65
Q

What is a fever lasting longer than 3 weeks indicative of?

A

FUO, bacterial infection

66
Q

What is fever plus shortness of breath indicative of?

A

Pneumonia, esp if patient is less than 2 or older than 65

67
Q

What is fever plus swollen neck/fatigue indicative of?

A

EBV

68
Q

What is fever plus excessive fatigue indicative of?

A

. Usually low grade fever

. Lymphoma, leukemia, renal or liver

69
Q

What is fever plus right lower abdomen pain indicative of?

A

Appendicitis

70
Q

What is fever plus low back pain/hematuria indicative of?

A

UTI
Pyelonephritis
. Nephrolithiasis

71
Q

What is fever plus sore throat indicative of?

A

. Strep, pericarditis/endocarditis

72
Q

What is fever plus leg pain/swelling indicative of?

A

Blood clot (DVT)

73
Q

What is fever plus GI symptoms indicative of?

A

IBS, crohns, UC, celiac, gastroenteritis

74
Q

What is fever plus joint pain indicative of?

A

RA

75
Q

What are red flags with fever that prompt hospitalization

A 
. 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
Q

Pleural effusion

A

Fluid in lining

77
Q

CHF

A

Congestive heart failure

78
Q

Hypothermia causes

A 
. Cold exposure
. Paralysis/reduced movement
. Vasoconstriction issue from sepsis/excess alcohol
. Starvation
. hypothyroidism
. Hypoglycemia
. Older adults
79
Q

What causes central fever?

A 
. Directly from brain injury
. Subarachnoid or intraventricular hemorrhage 
. Brain tumor
. Absence of infiltrate in chest 
. Neg. cultures
80
Q

Hyperthermia causes

A

. NOT cytokines

. Body metabolic heat production/environmental heat load exceeds heat loss capacity or impaired heat loss

81
Q

hyperthermia example diseases

A

Heat stroke, thyroid storm (hyperthermia)))

82
Q

Result of high levels of hyperthermia?

A

Produces irreversible protein denaturation and resultant brain damage, death

83
Q

Neuroleptic malignant syndrome

A

. Rare, potentially lethal idiosyncratic rxn to neuroleptic meds
. Lead pipe riding its in reflexes

84
Q

Serotonin syndrome

A

. Occurs w/in hours of ingesting agents that inc. serotonin in CNS
. Clonus and hyperflexia in reflexes

85
Q

Neuroleptic malignant syndrome is similar to what disease?

A

Serotonin syndrome

86
Q

Clonus

A

Bringing tendon back quickly and it shakes

87
Q

FUO must last over ____

A

. 3 weeks

88
Q

Fever of unknown origin (FUO)

A

. Fever over 38.3 C on several occasions

. Diagnosis has not been made after 3 outpatient visits or 3 days of hospitalization

89
Q

Hospital associated FUO

A

. Hospitalized pt w/ fever greater than 38.3 C on several occasions due to process not present or incubating at time of admission

90
Q

Neutropenic FUO

A

Less than 500 neutrophils/microliter

91
Q

Language Barrier Aspects in USA

A

. 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
Q

INTERPRET

A 
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

PSP (35 decks)

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