Fever of Unknown Origin History Flashcards
Most common cause of PUO
Bacterial infection
-abscess
-endocarditis
-TB
-osteomyelitis
Viral
-CMV
-EBV
-HIV
AI
-RA
-PMR
Malignancy
-Hogdkin, Non-hodgkin
Fever
-approach
-associated features
SOCRATES
Have they taken a temperature
Associated features
-fatigue
-N/V
-night sweats
-rigors
-weight loss
-pain
-swelling
-itching, rash
Questions around underlying infection
-screening questions
Resp - cough, SOB, hemoptysis
CV - chest pain
GI - abdo pain, diarrhoea
Hepatic - jaundice, N/V, RUQ pain
GU - dysuria, freqeuncy, hematuria, urethral discharge
CNS - headache, photophobia, seizures, confusion
MSK - joint pain, swelling
Derm - rash, erythema
Recent infections, symptoms and treatment
Local exposure to sources of infection
Close contact with unwell people
Contaminated food, water
Recent injuries
Contact with animals
Sexual activities without protection
Rec drug use
Travel history key areas
Location - urban or rural
Departure and return dates
Chemoprophylaxis and compliance - travel vaccines
Activities
-water based activities
-animal contact
Accommodation - malaria bed nets
Insect bites
Breaks in skin
Food and water consumption
-ice
-fresh veg
Sick contacts
Sexual activity
Tattoos and piercings
Autoimmune screen
Morning joint stiffness and swelling - RA, PsA
Rashes
-butterfly => lupus
-erythema nodosum => sarcoid
-salmon patch => Stills
Discoloured fingers, toes from Raynaud’s - RA, SLE, sclerosis
Headache, jaw claudication, scalp tenderness, visual loss => GCA, PMR
Dry eyes, mouth => Sjogrens
Red, painful eyes
Dry cough
Malignancy screen
Weight loss
Fatigue
Change in bowel habit, blood
Hemoptysis, hematuria
SOB
Masses
Bone pain
Night sweats
LN
Systemic enquiry screening questions
Systemic - weight loss
CV - palpitations
Resp - SOB, cough
GI - abdo pain, diarrhoea
Neuro - confusion
MSK - back pain
Derm - rash, erythema, skin breaks
PMHx
DMedical conditions
Surgical Hx
Immunisation Hx
Allergy and reaction
DHx
-meds to pay attention for
ABx
Immunosuppresants
Chemo
FHx
SHx
Contacts with infectious people
ETOH, smoking, rec drugs
Occupation and hobbies - potential exposures
