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Disease processes > Thermoregulation and pyrexia > Flashcards

Thermoregulation and pyrexia Flashcards

1
Q

Conscious intelligence range =

A

35-40 degrees

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2
Q

Usual core temp

A

37 degrees

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3
Q

Diurnal variation

A

Temp reaches lowest point just fore wake and highest 12 hrs after

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4
Q

Ex of intersex variation of temp

A

Females have +0.5 degrees during ovulation

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5
Q

Ways to measure temperature:

A
  • Mecury thermometer
  • Ear
  • Oesophagus
  • Rectal
  • Electrical skin probe
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6
Q

Disadvantages of mecury thermometer

A
  • not quick
  • food and drink can effect
  • difficult for children
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7
Q

Ear thermometers measure the..

A

Typanic membrane

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8
Q

Thermistor and rectal thermometers are used when

A

Patient is asleep (ICU)

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9
Q

Thermoreceptors are mainly found:

A
  • Skin (peripheral)
  • GI tract
  • Great veins
  • Hypothalamus (central)
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10
Q

What kind of fibres are thermoreceptors?

A

Alpha delta

C

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11
Q

Thermoreceptor fibers are:

A
  • Slower

- Smaller diameter

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12
Q

Fibres of thermoreceptors are the same as…

A

pain

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13
Q

Coordinator of thermoregulation

A

Anterior hypothalamus

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14
Q

Hypothalamus coordinates the

A

Set point

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15
Q

Methods of heat production:

A
  • Metabolic
  • Voluntary
  • Shivering
  • Brown fat
  • Vasoconstriction
  • Neuroendocrine
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16
Q

Enzymatic processes in the body are

A

Exothermic

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17
Q

Voluntary actions to reduce heat loss are important in which groups of patients

A

Young people

Dementia etc.

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18
Q

Why is shivering not a good method for certain patients?

A

Metabolically expensive. O2 consumption can increase.

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19
Q

White fat =

A

Metabolically inert

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20
Q

Brown fat has lots of

A

Mitochondria

21
Q

Where is brown fat found

A

Infants: Scapula, clavical, around main organs

22
Q

Paradoxical increased flow with prolonged cold exposure:

A

Cold –> vasoconstriction –> ischemia –> inflammatory products –> vasodilation –> more heat lost

23
Q

Neuroendocrine method of increasing heat:

A
  • Increase catecholamines to increase metabolic activity
24
Q

Catecholamines ex:

A

Dopamine, adrenaline, noradrenaline

25
Q

Hyperthyroidism and temperature =

A

Not much increased temp unless grossly hyper

26
Q

Hypothyrodisim and temperature =

A

Not uncommon for this to make a patient hypothermic

27
Q

Methods of direct heat loss

A
  • Conduction/convection
  • Radiation
  • Evaporation
28
Q

Definition of hypothermia:

A

Core of <35 degrees

29
Q

Severe hypothermia:

A

<28 degrees

30
Q

Causes of hypothermia

A
  • behavioural
  • hypothyroid
  • dermatological
31
Q

Clinical features common to hypothermia and hyperthermia

A

Coma
Confusion
CV collapse

32
Q

Clinical features of hypothermia:

A

Confusion
Coma
CV collapse
Increased change of arrthymias

33
Q

why is the chance of arrthymia increased with hypothermia

A

Catecholamine surge

34
Q

J wave:

A

Junctional wave on QRS complex. Hypothyroidism

35
Q

What causes J wave?

A

Abnormal cardiac replarisation because of low temp

36
Q

Management of hypothermia:

A
  • ABC
  • Silver blanket
  • Controlled warming: hot air blankets, cardiac bypass
37
Q

Definition of hyperthermia:

A

> 38 degrees

38
Q

Life-threatening hyperthermia:

A

40 degrees +

39
Q

Causes of hyperthermia:

A

Extertional
Situational
Drugs
Pyrexia

40
Q

Clinical features of hyperthermia:

A

Confusion
Coma
CV collapse
Seizures

41
Q

Pyrexia is due to =

A

Altered set point

42
Q

What causes ‘chills’

A

Altered set point. Temp is high but body reacts to increase temp (shivering, goosebumps, vasoconstriction)

43
Q

Causes of PUO

A 
Infection
Blood transfusion of pyrogens
Inflammation
Malignancy
Hypothalamic insults = bleed, inflammation
44
Q

PUO =

A

Pyrexia of unknown origin

45
Q

Major pyrogenic cytokines:

A

IL-1,IL-6, TNF, IFN

46
Q

Pyrogenic cytokines act to increase

A

Prostaglandins

47
Q

What acts on the hypothalamus to alter set point?

A

Prostaglandins

48
Q

Treatment of pyrexia:

A 
Paracetamol
NSAIDs
Aspirin
Cooling packs/ice
Exposure
Fan
CPB (cardiopulmonary bypass)

Disease processes (21 decks)

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