PUO in a rural context

Question 1

Fevers causes more these days?

Answer 1

vasculitis

medication induced

Question 2

PUO categories?

Answer 2

Infection
Inflammatory
Malignancy
Other

Question 3

PUO infective causes, top 3?

Answer 3

TB
infective subacute endocarditis
intra-abdominal abscesses

HIV

Question 4

endocarditis cause usually?

Answer 4

strep viridans

Question 5

PUO classic inflammatory?

Answer 5

Vasculitis:
Autoimmune: Hashimotos
Granulomatis: sarcoid, crohn’s
Still’s Disease

Question 6

PUO top malignancy?

Answer 6

Lymphoma

Question 7

fevers from injury why?

Answer 7

necrotic tissue, releases inflammatory cytokines and cellular contents
crush injury
MIs

Question 8

someone with fever in hospital, likely ddx?

Answer 8

Aspiration pneumonia
UTI-catheter
Line-sepsis
PE
post-surgical
wound infections
drug fever
opportunistic infections: PCP, CMV,

Question 9

neutropenic patients worried about?

Answer 9

pseudomonal

fungal - cavitation

Question 10

if abatoir exposure in rural setting, looks like flu, consider what?

Answer 10

Q-fever
Coxiella Burnetti
Psittacosis

Question 11

leptospirosis from what?

Answer 11

cow urine

Question 12

Gram +ve cocci

Answer 12

Staph Aureus
Strep?
Staph epidermidis

Question 13

how long ABx for septic arthritis? endocarditis?

Answer 13

2 weeks IV, 4weeks oral

endocarditis: 4 weeks IV and no oral

Question 14

why do you get hepatosplenomegaly?

Answer 14

something chronic
too many cells
congestion

Question 15

pancytopaenia in a febrile person, think what?

Answer 15

lymphoma

Question 16

causes of dark urine?

Answer 16

rhabdo
jaundice
haemolysis

Question 17

Haptoglobin low means?

Answer 17

there’s haemolysis

Question 18

PUO old def’n?

Answer 18

PUO, lasting 2-3 weeks
unknown dx despite reasonable
Fever >38.3