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MD1 Locomotor > Fever and PUO > Flashcards

Fever and PUO Flashcards

1
Q

What are the criteria for pyrexia of unknown origin?

A

2-3 weeks of illness
Fever above 38.3 degrees on several occasions
No diagnosis after intelligent investigations

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2
Q

What is the oral temperature range?

A

35.8-37.8 degrees

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3
Q

What is the variation in body temperature diurnally?

A

Lowest in morning

Highest in afternoon

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4
Q

Which part of the brain regulates temperature?

A

Anterior hypothalamus by temperature sensitive neurons

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5
Q

How is heat lost from the body?

A

Peripheral vasodilation
Sweating
Reduced physical activity

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6
Q

How is heat conserved by the body?

A

Peripheral vasoconstriction
Piloerection
Warmth seeking behaviour

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7
Q

How is heat produced by the body?

A 
Shivering
Release of
- Thyroid hormone
- Glucocorticoids
- Catecholamines
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8
Q

How is fever defined?

A

Early morning oral temperature >37.2 degrees

Oral temperature >37.8 any time of day

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9
Q

How much lower is oral temperature than core body temperature?

A

0.5 degrees

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10
Q

How much lower is axillary temperature than core body temperature?

A

1 degree

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11
Q

What is the febrile response?

A

One mechanism by which body regulates immune response to infection
Rise in core temperature switches on range of immune, endocrine, and physiological mechanisms
Optimum temperature for their activity = 39.5

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12
Q

Why don’t fevers have to be brought down?

A

Good for you if fighting infection

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13
Q

When are fevers dangerous?

A

Malignant pyrexia - causes brain damage

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14
Q

Why do prolonged fevers present with weight loss?

A

Expensive to maintain level of metabolic activity to keep temperature at this level

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15
Q

What is rigor?

A 
Feeling of intense cold
Uncontrolled shivering
Striking pallor of face and limbs
Pilo-erection
Person exhausted after with high fever
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16
Q

What is a good marker of high fever?

A

Rigor

17
Q

What is the most common cause of a fever of short duration?

A

Infection

18
Q

What are the signs of serious illness?

A

Shock
Impaired conscious state
Cyanosis
Tachypnoea

19
Q

How do you identify at risk patients for severe illness?

A 
Recent overseas travel
Asplenic
Neutropaenic
Elderly
Diabetic
Intravenous drug use
20
Q

What are the warning signs of an acute fever?

A 
Rapid onset
Rigors
Severe muscle pains
Impaired conscious state
Vomiting
Severe headache
Rash
Jaundice
21
Q

What is the management for severe fevers?

A

Investigate
Empirical intravenous antibiotics if bacterial infection likely
Admit/prolonged stay in ED for observation
Instructions and early review next day

22
Q

What are the differential diagnoses for pyrexia of unknown origin?

A 
Infections
Connective tissue disorders
Malignancies
Other
- Drugs
- Factitious

MD1 Locomotor (17 decks)

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