Pedia Patient with Fever

Question 1

most common reason for a sick child visit

Answer 1

fever

Question 2

most common cause of fever in newborn

Answer 2

infection (neonatal sepsis) and overclothing

Question 3

normal body temperature

Answer 3

36.6-37.9

Question 4

t/f body temp is highest in the morning and lowest in evening

Answer 4

false, lowest morning highest evening, variation of 0.5C

Question 5

fever is defined as ___

Answer 5

rectal temp >/=38 C

Question 6

hyperpyrexia is __

Answer 6

> 40 C

Question 7

most accurate method to measure temp

Answer 7

rectal temp

Question 8

___ temp is higher than actual temp, while ___ temp is lower than the actual temp

Answer 8

rectal higher, axillary lower

Question 9

mechanisms that regulate body temp

Answer 9

• hypothalamus responses to changes in blood temp

- skin and muscles have cold and warm receptors

Question 10

endogenous pyrogens

Answer 10

il1b, il6, tnf-a, ifna and gamma

Question 11

exogenous pyrogens

Answer 11

pamp pathogens, damp, toxins

infectious pathogens: microbes, toxins, and other microbial products (most common)
drugs

Question 12

activation of cells leads to secretion of ___

Answer 12

il1 alpha -> pge2 (best mediator of pyrogens)

Question 13

the body increases its core temp by activating ___

Answer 13

sympathetic nervous system -> inhibits sweating and shivering

Question 14

heat production due to volatile inhalational anesthetic agents and muscle relaxants (succinylcholine)

Answer 14

malignant hyperthermia

Question 15

heat production due to aspirin intake leading to development of reye’s syndrome

Answer 15

salicylate toxicity

Question 16

examples of defective heat loss

Answer 16

ectodermal dysplasia

victims of severe heat exposure

Question 17

t/f you give antibiotics if fever has been persistent for 6 days

Answer 17

false

Question 18

most common cause of acute fever

Answer 18

infectious etiology (rarely goes above potentially lethal levels)

Question 19

misc causes for fever

Answer 19

drugs (vancomycin), blood products, self-induced

Question 20

beneficial effects of fever

Answer 20

• impair reproduction and inhibit bacterial and viral replication
• strengthens immune response to pathogens

Question 21

harmful effects of fever

Answer 21

• increased o2 consumption
• co2 production
• increased fluid and caloric reqs
• can precipitate febrile seizures

Question 22

pattern of fever: exaggerated circadian rhythm that includes period of normal temp on most days

Answer 22

intermittent fever (there should be a day/time the pt is fever-free)

Question 23

pattern of fever: extremely wide fluctuations in temp but always with a fever

Answer 23

septic/hectic fever

Question 24

pattern of fever: persistent and does not vary by >0.5C per day

Answer 24

sustained fever

Question 25

pattern of fever: persistent and varies by >0.5C per day

Answer 25

remittent fever

Question 26

pattern of fever: single illness with 2 distinct periods

Answer 26

biphasic fever (poliomyelitis, enterovirus, lepto, dengue, yellow fever)

Question 27

pattern of fever: narrowly describes fever syndromes with a regular periodicity

Answer 27

periodic fever (cyclic neutropenia, pfapa)

Question 28

pattern of fever: characterized by febrile periods that are separated by intervals of normal temp

Answer 28

relapsing fever

Question 29

what is tertian fever

Answer 29

fever on 1st and 3rd days (p vivax malaria)

Question 30

what is quartan fever

Answer 30

fever on 1st and 4th days (p malariae malaria)

Question 31

what is quotidian fever

Answer 31

fever that peaks once in 24 h, non-relapsing (p knowlesi malaria)

Question 32

what is double quotidian fever

Answer 32

fever that peaks twice in 24 h (inflammatory arthritis)

Question 33

pattern of fever: self induced, caused by intentional manipulation of thermometer or pyogenic material

Answer 33

factitious fever

Question 34

hr rises ___ per 1 c rise in temp for children older than 2 months of age

Answer 34

10 bpm per 1 c

Question 35

relative tachycardia vs bradycardia

Answer 35

tachy: non-infectious, toxin responsible brady: typhoid fever, lepto, drug fever

Question 36

if patient presents with fever less/= 7 days duration and no other complication you ___

Answer 36

treat as outpatient, provide patient education, reevaulate to ensure symptoms disappear

Question 37

if patient presents with fever less/= 7 d with special situation (hpi or other family members with illness)

Answer 37

provide patient education, consider hospitalization + diagnostics + culture, iv antibiotics

Question 38

if outpatients with fever >7 days

Answer 38

FUO: >3 w outpatient, >1 w inpatient | hospitalize, diagnostic testing and empirical treatment

Question 39

t/f there is evidence to support that high fever can result in brain damage or other bodily harm

Answer 39

false, except of cases of febrile status epilepticus and heat stroke

Question 40

t/f treating fever in self-limiting diseases to bring body back to regulat remp is not necessary in otherwise healthy child

Answer 40

true, fever is an adaptive response. treatment only for selected cases. especially is no history of febrile seizures

Question 41

t/f fever with temps <39C in healthy children does not require treatment

Answer 41

true

Question 42

t/f antipyretic therapy changes the course of infectious diseases and provides symptomatic relief

Answer 42

false

Question 43

t/f there is likely an association between high fever during pregnancy and teratogenic effects

Answer 43

true, esp in first trimester

Question 44

indications to treat fever in child

Answer 44

- child is uncomfortable - caregiver is concerned - child is in a high risk group

Question 45

children between ____ are more prone to simple febrile seizures and may need treatment

Answer 45

6 mos-5 yo

Question 46

t/f only give one type of medication for fever

Answer 46

true

Question 47

administration of paracetamol

Answer 47

10-15 mg/kg/dose q 4h, effective in 30-60 min rectal: for vomiting or impaired consiousness iv: rapid entry into cns

Question 48

administration for ibuprofen

Answer 48

5-10 mg/kg/dose q 8h, effect in 3-4 h can cause gastritis, gastric ulcer, and nephrotoxicity

Question 49

t/f tepid sponge baths are effective

Answer 49

false