Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult/Ped Medicine 5 > Fever - Hoffman > Flashcards

Fever - Hoffman Flashcards

1
Q

Fever Criteria
Rectal:
Oral:
Axillary:

A

Rectal: 100.4 F or 38 C
Oral: add 1/2 degree, starts at 99.9 F
Axillary: add 1 degree, starts at 99.4 F
Aural - accurate if perfect seal achieved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fever Without a Source

A

children with a fever lasting for one week or less without adequate explanation after a careful history and thorough physical examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fever of Unknown Origin

A

fever > 101 F of at least 8 days duration

no diagnosis apparent after initial outpatient or hospital evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

All babies 3 months or younger with a fever of 100.4 or higher MUST

A

BE SEEN THAT SAME DAY!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fever in Infants < 3 months: Bacterial S&S

A

bacterial infections

s&s: low grade fever, poor feeding, irritability, sleepiness/sleeplessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fever in Infants < 3 months: History

A

Associated Symptoms: respiratory, GI, ENT

Behavioral Symptoms: poor feeding, irritability, poor sleeping, abnormal cry

Exposure to Sick Contacts: siblings, babysitter, day care

Previous Illness

Birth History

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fever in Infants < 3 months: Physical Exam

A

Gestalt
Abnormal Vital Signs
Toxic Appearance
Signs of Localized Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Toxic Appearance

A 
irritability
inconsolability
poor perfusion
poor tone
decreased activity
lethargy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common Pathogens < 3 months - Bacteremia

A 
S. pneumoniae
Hib
group B strep
N. meningitis
salmonella
Listeria monocytogenes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common Pathogens < 3 months - UTI

A

E. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common Pathogens < 3 months - Pneumonia

A

S. aureus
S. pneumoniae
group B strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Common Pathogens < 3 months - Meningitis

A 
S. pneumoniae
Hib
group B strep
meningococcus
herpes simplex
enterovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sepsis Evaluation

A 
CBC w/ differential
Serum Glucose
Lumbar Puncture
Blood Culture
Urine Culture
Inflammation Indicators: ESR, CRP, Procalcitionin
Consider: stool culture, CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When to admit fever in infant < 3 months for empiric antibiotics? (3)

A

Toxic Looking
< 1 month of age
Poor social situation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Outpatient Observation Fever < 3 months

A

Option 1: blood culture, urine culture, lumbar puncture - Ceftriaxone - re-evaluate in 24 hours

Option 2: urine culture, careful observation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fever in Children < 3 years

A

most illness in this age group are self-limited viral infections

increased risk of occult bacteremia

17
Q

Common Pathogens for Fever in Children < 3 years

A

S. pneumoniae
Hib
N. meningitis
non-typhoidal Salmonella

UTI and pneumonia are possible causes of occult infection

18
Q

Fever in Children < 3 years - History

A

Functional Status: oral intake, activity level, irritability

Cough, Vomiting, Dysuria, Frequency, Potty Accidents

Immunization Status!!!!

19
Q

Physical Exam Children 3-36 Months - Findings warranting extra attention

A 
Toxic Appearing
Cyanosis
Hypo/Hypervenilation
Abnormal Vital Signs - SpO2 < 95%
Tachycardia
Tachypnea
Lesions in Oropharynx
Abdominal Tenderness
Pain with bone palpation or passive ROM
Petechiae, cellulitis, viral exanthem
20
Q

Gestalts in feverish children < 3 years

A

Alertness
Playfulness
Irritability
Consolability

21
Q

Risk Factors for Occult Bacteremia

A

Temp > 102.2 F
WBC > 15,000/mm3
Elevated neutrophils or bands
Elevated ESR, CRP or PCT

22
Q

What type of fever has:

high spike and rapid resolution

A

Intermittent Fever

TB, lymphoma, JIA/JRA

23
Q

What type of fever has:

fluctuant peaks, but doesn’t return to normal

A

Remittent Fever

viral, endocarditis, sarcoid, lymphoma, atrial myxoma

24
Q

What type of fever has:

fever persists with little fluctuation (unless meds given)

A

Sustained Fever

typhoid fever, typhus, brucellosis

25
Q

What type of fever has:

fevers that relapse after 1 or more days with no fever

A

Relapsing Fever

Malaria, rat-bite fever, Borrelia infection, lymphoma

26
Q

What type of fever has:

episodes of fever more than 6 months duration

A

Recurrent Fever

other causes: metabolic defects, CNS abnormalities, immunodeficiency

27
Q

Fever of Unknown Origin

A 
weight loss
drug/medications
immunizations
immunosuppressive therapy
Pica
exposure to soil borne or water borne organisms
history of blood transfusions
travel
exposure to animals
ticks of mosquitos
recent surgery or dental work
tattoos, body piercing
sexual activity
28
Q

Fever of Unknown Origin - Skin Examination

A

presence of sweating
petechiae
rash
sparse hair

29
Q

Fever of Unknown Origin - Eye Examination

A 
Conjunctivitis
Retinopathy
Absence of pupillary response
Absent tears or corneal reflexes
Abnormal fundoscopic exam
30
Q

Fever of Unknown Origin - Oropharynx Examination

A 
Hyperemia of posterior pharynx
Dental abscess
Abnormal Dentition
Smooth tongue
Ginigival Hypertrophy
31
Q

Fever of Unknown Origin - Lymph Node Examination

A

Enlarged and/ore multiple lymph nodes

32
Q

Fever of Unknown Origin - Chest Examination

A

Crackles

New onset murmur

33
Q

Fever of Unknown Origin - Abdomen Examination

A

Organomegaly

Tenderness with liver palpation

34
Q

Fever of Unknown Origin - Musculoskeletal

A

Tenderness to bones or muscles

Hyperactive DTRs

35
Q

Fever of Unknown Origin - GU

A

STD testing
Careful exam for any masses or abscesses
Stool should be examined for occult blood

Adult/Ped Medicine 5 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions