Pyrexia of Unknown Origin

Question 1

define PUO

Answer 1

pyrexia of over 3 weeks with no known cause over 28.3

Question 2

define pyrexia

Answer 2

body temperature above 37, caused by pyrogens

Question 3

list main disease categories of PUO

Answer 3

classic PUO
nosocomial PUO-in hospital
neutropenic PUO- neutrophil <500
HIV associated

Question 4

describe important aspects of history taking

Answer 4

travel, occupation, drug and sexual history
surgical procedures
familial disorders

Question 5

describe imaging of a patient with PUO

Answer 5

to exclude sepsis or malignancy
isotope bone scan-bone infection
ventilation/perfusion scan

Question 6

what are the initial investigations for PUO

Answer 6

chest x ray
urinalysis
FBC and WBC
c reactive protein 
blood cultures

Question 7

indications for further tests

Answer 7

travel to tropical areas
jaw claudication
injection misuse
heart murmur

Question 8

describe management of a PUO patient

Answer 8

usually identified within a week
if unwell, trial of antituberculous therapy
steroids