Fever (Tyler) Flashcards
What might be on your ddx if a patient presents with a productive cough or SOB in addition to a fever?
Pneumonia, bronchitis, TB
What are chills?
Subjective reports of shivering associated with rapid changes in body temperature. They are the result of involuntary muscle contractions
What might be on your ddx if a patient presents with chest pain in addition to a fever?
PE, pneumonia, pericarditis, bacterial endocarditis
What might be on your ddx if a patient presents with a change in mental status in addition to a fever?
Meningitis, encephalitis, neuroleptic malignant syndrome (NMS), heat stroke, bacterial infection with septic shock
What might be on your ddx if a patient presents with blood in sputum in addition to a fever?
Pneumonia, bronchitis, TB, PE, lung cancer
What two malignancies have the greatest association with fever of unknown origin (FUO)?
Hodgkin’s disease and non-Hodgkin’s lymphoma
What does persistence of fever despite appropriate antibiotic administration suggest?
Superinfection, drug fever, abscess, or a noninfectious mimic of an infectious disease
What does a high-risk/massive PE present with?
Severe dyspnea at rest, hemodynamic instability
Who does microscopic polyangiitis usually present in?
What are the most commonly associated signs and sx?
~57YO, M>F
Palpable purpura, macules, vesicles, bull, urticaria
What might be on your ddx if a patient presents with nausea or vomiting in addition to a fever?
Gastroenteritis, cholecystitis, cholangitis, pyelonephritis, hepatitis, pancreatitis
What might be on your ddx if a patient presents skin redness in addition to a fever?
Cellulitis, phlebitis, fungal infections, drug reaction
What might be on your ddx if a patient presents with hematuria in addition to a fever?
UTI, pyelonephritis, renal cell carcinoma, GPA, SLE, other renal vascular diseases
Who does GPA usually present in?
What are the most commonly associated signs and sx?
~40YO, M=F, W>B
Upper and lower respiratory sx, renal insufficiency, skin lesions, visual disturbance
What might be on your ddx if a patient presents with SOB and chest pain in addition to a fever?
PE, pneumonia, empyema
What is the most common cause of fever in older patients?
Bacterial infections
What might be on your ddx if a patient presents with dry cough, nasal congestion, sinus pain and a sore throat in addition to a fever?
Acute pharyngitis (viral or bacterial), sinusitis, URI
What is a fever of unknown origin (FUO)?
Fever that lasts 3 wks or longer with temperatures exceeding 38.3˚C/100.9˚F with no clear dx despite 1 wk of clinical investigation
What might be on your ddx if a patient presents with a rash in addition to a fever?
Meningitis, bacteremia with septic shock, rickettsial dz, bacterial endocarditis, benign causes (viral exanthema, drug fever)
What are some uncommon causes to consider in a ddx for fever?
CVD (i.e. MI, PE), GI dz (i.e. IBD), other (i.e. drug fever, sarcoidosis)
What are night sweats?
Subjective reports of nocturnal sweating due to an exaggeration of the normal circadian temperature rhythm
What might be on your ddx if a patient presents with dizziness or lightheadedness in addition to a fever?
Bacterial infection with septic shock, adrenal insufficiency, PE, benign causes (viral infection with labyrinthitis)
What is hyperthermia?
An elevation in body temperature due to loss of homeostatic mechanisms and inability to increase heat loss in response to environmental heat, as in heat stroke.
How are fever and hyperthermia different?
Hyperthermia is na elevation of the temperature related to the inability of the body to dissipate heat. Fever is a rise in temperature in response to endogenous cytokines.
What might be on your ddx if a recent chemotherapy patient presents with a fever?
Nosocomial infection with neutropenia
What are the most commonly associated signs and sx seen with pulmonary embolism?
There are no pathognomonic sx or signs. However, there should be a high index of suspicion in patients with risk factors who present with dyspnea, tachypnea, and/or pleuritic chest pain
What are some alarm sx associated with fever?
High fever (>105.8˚F), rash, change in mental status and level of sensorium, dizziness or light-headedness, recent chemotherapy, SOB and chest pain
What might be on your ddx if a patient presents with abdominal pain in addition to a fever?
Gastroenteritis, cholecystitis, cholangitis, pyelonephritis, hepatitis, pancreatic cancer, pancreatitis, liver metastasis, PAN, IBD
What are the two most common infectious causes of fever of unknown origin (FUO)?
TB and intra-abdominal abscesses
What might be on your ddx if a patient presents with a fever >105.8˚F?
CNS infection, neuroleptic malignant syndrome (NMS), heat stroke
What might be on your ddx if a patient presents with diarrhea in addition to a fever?
Gastroenteritis, infectious colitis, parasitic infection, IBD
Is the presence of shaking chills associated with a greater probability of bacteremia or viralemia?
Bacteremia
There is a near-universal agreement that a core body temperature of __ represents fever
38.3˚C / 100.9˚F
What are some common causes to consider in a ddx for fever?
Infection (bacterial, viral, rickettsial, fungal, parasitic, sinus, CNS, dental, endocarditis, pneumonia, liver, biliary system, etc.), autoimmune dz, CNS dz, malignancy
What might be on your ddx if a patient presents with a fever following a recent procedure?
Abscess, wound infection, bacteremia, pneumonia
What is the cornerstone of endocarditis dx?
Blood culture
What is the most common cause of infective endocarditis?
Staph aureus
What might be on your ddx if a patient presents with dysuria in addition to a fever?
UTI, pyelonephritis, renal cell carcinoma, urethritis, prostatitis
What are the two most common signs that a patient with endocarditis might present with?
Fever and heart murmur
What are some inflammatory diseases that are associated with fever?
SLE, GCA, RA, IBD
