Pyrexia of Unknown Origin Flashcards
1
Q
Classic definition of PUO
A
- Temperature more than 38 degress on multiple occasions
- Illness more than 3 weeks duration
- No diagnosis despite 1 weeks inpatient
2
Q
Common causes of PUO
A
- Infection - TB, abscess, IE, brucelosis
- Autoimmune/CT disease - temporal arteritis, vasculitis
- Neoplastic - leukaemia, lymphoma, renal cell carcinoma
- Other - drugs, thromboembolism, hyperthyroidism, adrenal insifficiency
3
Q
History for PUO
A
- Chronological order of symptoms
- Pets/animals
- Exposure
- Travel history
- Occupation
- Drugs
- FH
- Vaccination
- Sexual contacts
4
Q
Examination for PUO
A
- Lymph node palpation
- Stigmata of endocarditis?
- Evidence of weight loss
- Joint abnormalities?
5
Q
Investigations for PUO
A
- FBC, LFTs, U&Es, CRP, Clotting
- TFTs
- Multiple blood cultures
- Autoimmune screen? IG’s?
- HIV, Hep B&C, sputum cultures
- There are lots ella :)
6
Q
Management of PUO
A
- Establish diagnosis rather than treat blindly
- Do not start emperical abx without speaking to reg/consultant
- Ask Rheum and Haematology to see patients if presentation could suggest the need
- Front sheet in notes of what tests have been done?
- Stable can be outpatient
7
Q
Prognosis for PUO
A
If no diagnosis despite prolonged investigation - prognosis is good
8
Q
A
