Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SBL Test 2 > Tyler: Fever > Flashcards

Tyler: Fever Flashcards

1
Q
  1. What is bacteremia?
  2. Treatment?
  3. Symptoms?
A
  1. Bacteria in blood stream, MC due to skin and ST infections, central venous catheters, etc
  2. Empiric ABX
  3. Fever, fatigue, N/V, decreased appetite, dehydration and myalgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is septicemia?

A
  • Early sepsis = bacteremia + inflammation
  • Sepsis = organ dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

RF for septicemia?

A
  1. ICU admission
  2. >65 YO
  3. Bacteremia
  4. Immunosuppressed
  5. DB/ obesity
  6. Cancer
  7. Community acquired pneumonia
  8. Previous hospitilizations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs of septicemia

A

Look for signs of infectious source

  1. Hypotension (SBP <90 or MAP <70)
  2. Temp >38.3 or <36C
  3. HR = >90 beats/min
  4. Tachypnea and RR >20 breaths/minute
  5. Organ dysfunction (hypoperfusion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What labs will you see in septicemia?

What sign is assx with poor prognosis?

A
  1. Leukocytosis or bands >10%
  2. Hyperglycemia
  3. ↑ CRP
  4. Arterial hypoxemia
  5. Oliguria
  6. ↑ Cr
  7. INR >1.5; PTT >60 seconds
  8. Thrombocytopenia, hyperbilirubin, hyperlactatemia (manifestation of organ hypoperfusion = poor prognosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Staphylococcus bacterial infection

Progression of symptoms

A
  1. Starts with skin or ST infection (may be due to implanted devices, catheters, orthopedic hardware)
  2. Systemic =>
    1. Bone/joint pain
    2. Protracted fever + sweating;
    3. LUQ abd pain,
    4. CV angle tenderness,
    5. HA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the types of Staphylococcal bacteremia?

A
  1. MSSA (Methicillin sensitive staph aureus)
  2. MRSA (Methicillin resistant staph. aureus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is MRSA (Methicilin Resistant Staph Aureus) infection?

A

MRSA is often d/t hospital acquired infections (long-term, recurrent wounds) in immunocompromised, affecting multiple systems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the wounds seen in MRSA

A
  • Localized erythema + induration + pus (has gram-+ cocci in clusters).
  • Abscesses will often form.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Culture (+) S. aureus bacteremia (MRSA) should focus on what?

A
  • 1. Endocarditis
  • 2. Osteomyelolitis
  • 3. Deep systemic infections (epidural abscess, discitis, abcess formation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

RF for community-acquried MRSA infection

A
    1. Contact sports
    1. Military service
    1. Incarceration
    1. IV drug use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MRSA

  1. Think MRSA in the following situations:
  2. Are joint infections common?
  3. Ostemeomyolitis due to MRSA is associated with what?
A
  1. Think MRSA if..
    1. Infected surgical incisions
    2. Diabatic foot infections
  2. No, they’re unusual. But if they occur, they are associated with [bacteremia or native/prosethic joint].
  3. Fixation device/prosthesis, hematagenous infection in children or nonhealing foot ulcers in DB pts/ peripheral arterial disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What skin lesions occur in MRSA?

A
    1. Erysipelas: superficial, well demarcated, not much puss (minimal lymphagenitis)
    1. Cellulitis: pussy, swollen, violaceous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Group A streptococcal (pyogenes) bacteremia

What symptoms does it cause in children/adolescents and in adults

A

Group A strep => URI and tonsillopharyngitis.

  • Children/adolescents =
    • MCC of tonillopharyngitis
    • Impetigo
    • Skin infection
  • Adult =
    • Pharyngitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Group B streptococcal (aggalactactiae) bacteremia

  • Who does it MC affect and what are the symptoms?
A
  1. Neonates = bacteremia without a focus, sepsis, pneumo or meningitis
  2. PG women = bacteremia, UTI, chorioamnionitis, post-partum endometrisis
  3. Non-PG adults = most common strep pathogens in adults
    1. bacteremia without focus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What rash can you see in Group A strep infection?

A

Scarlatiniform rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mycobacterium TB

Symptoms

A
  1. Cough = MC symptom
  2. Blood-streaked sputum
  3. Constituonal sx: Fatigue, WL, Night sweats, Fever
  4. Pt is chronically ill.
  5. Atypical sx more common in elderly and HIV pts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

RF for M. TB infection

A
  • 1. Household exposure
  • 2. Incarceration
  • 3. Recreational/illicit drug use
  • 4. Travel to endemic area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does primary and latent M.TB infection occur?

A

Primary: person to person (airborne)

Latent: bacilli are in granulomata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are RF for reactivation of a latent M.TB infection?

A
  1. Gastrectomy
  2. Silicosis
  3. DM
  4. HIV
  5. Immunosuppresion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Influenza

  1. Symptoms
    1. How do they occur
A
  1. Fever (3-5 days), chills, malaise, cough, arthralgias, myalgias + respiratory sx
    1. ​If Influenza B = GI sx
  2. Most often occur as epidemics/pandemics in the fall/winter.
    1. Influenza A MC occurs as a part of pademic with antigenic shift
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

HIV

Symptoms

What complications can occur?

A
  • Sweats, diarrhea, WL and wasting
  • Complications
    1. Opportunistic infections due to decreased cellularity
    2. Aggressive cancers (NHL)
    3. Neuro sx (dementia, asepetic meningitis, neuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What conditions are highly suggestive of HIV infection?

A
    1. Hairy leukopenias of tongue
    1. Disseminated Kaposi sarcoma
    1. Cutaneous bacillary angiomatosis
    1. Generalized LAD early in infection
24
Q

What are AIDs definiing illness?

A
  1. Pneumocystitis jivrocvi
  2. Mult. recurrent bacterial infections
  3. Lymphoma
  4. Kaposi
  5. CMV
  6. Coccidiomyocosis
  7. M. TB at any site
25
**_CMV_** 1. Symptoms 2. Increases with what factors?
1. **Most asymptomatic,** but acute acquired is similar to infectious mono without pharyngeal symptoms 2. Age, lower SES, number of sexual partners, hx of STI, employment in child day cares.
26
What is the difference between CMV infection and disease?
**CMV infection** = virus in tissue/serum; not always sx **CMV disease** = show symptoms
27
How does **CMV** present in perinatal?
Get via breastfeeding. Most infected neonates are asx. Other 1. Jaundice 2. Hepatosplenomegaly 3. Thrombocytopenia 4. Purpura 5. Microcephaly 6. Periventricular CNS calcifications 7. Mentral retardation 8. **Hearing loss \>50%**
28
How does CMV present in **immunocompetant**?
1. **EBV like, but heterophile (-)** 2. Often occurs **post-splenectomy** 3. **Cutaneous rash** = common. 4. Leukopenia =\> leukocytosis
29
How does **CMV** present in immunocompromnised?
Often focus on **GI/hepatobilliary** * **Retinitis \*** * **Small bowl inflammation\*/** * **Pneumonitis** * **Neuro sx** (encephalitis and transverse myelitis)
30
Complications of **CMV**
* 1. Mucosal GI damage * 2. Encephalitis * 3. Severe hepatitis * 4. GB-syndrome * 5. Pericarditis/myocaridits
31
What to remember about **Histoplasmosis**, according to Dr. Tyler (4)?
1. **Most** patients are **asymptomatic** 2. Most common clinical problem = **respiratory illness** 3. Most likely to cause **disseminated disease i**n HIV pts with CD4+ \< 100 (immunocompromised patient) 4. **Chronic progressive pulmonary histoplasmosis** can occur in older patients with COPD.
32
**Disseminated coccidioidomycosis o**ccurs in who and what sx do you see?
1. **HIV patients** 2. **Miliary infiltrates + LAD + meningitis (**skin lesions are uncommon)
33
Common symptoms in **Primary Coccidioidomycosis**
1. Incubation period = 10-30 days 2. Sx = **usually respiratory (40%)** 1. NAsopharyngitis + fever + chills 2. Common cause of CAP 3. Erythema nodosum
34
What type of malaria is MC for all severe disaeses? Symptoms?
1. P. falciparum via mosquitos 2. Attacks of chills, fever and sweating 1. without therapy, fever becomes regular
35
What malignancies are most often assx with fever?
**1. Multiple myeloma** **2. Kaposi sarcoma**
36
What is Multiple Myeloma? Common symptoms/signs in Multiple Myeloma
* Malignancy of HSC terminally differenaited as plasma cells, MC in pts \>65YO. * Sx= CRABS * Bone pain (spin, ribs, proximal long bones) * Ig in serum/urine * Anemia
37
**Kaposi sarcoma** is due to ____ and MC occurs in \_\_\_\_\_ How do lesions present?
* HHV-8 * HIV patients * Red, purple, dark plaques or nodules on skin/mucosa
38
What immunological causes cause fever?
**1. SLE** **2. Sjrogens**
39
Who does SLE MC occur in?
**young women**
40
What can cause intermittant fevers + pharyngitis + myalgias + stomach pain + LAD?
Infection * 1. Infectious mono * 2. CMV * 3. Streptococcal pharyngitis * 4. Acute HIV
41
What is **ESSENTIAL** to ask about in a person with fever?
* 1. Age * 2. Localizing sx * 3. WL * 4. Joint pain * 5. IV drug use * 6. Immunsuppresion, hx of cancer, meds, travel.
42
1. What is considered a fever? 2. Physiologically, how does a fever occur?
1. Elevated body temp **\>38.3** 2. **Pyogenic cytokines** act on the **hypothalamus** and create an new elevated "set point" of body temperature
43
In what conditions is the **fever pattern** important to consider?
* 1. Relapsing fever in **malaria** * 2. **Borreliosis** * 3. **Lymphoma** (esp Hodgkins)
44
What is a FUO (fever of undetermined origin)?
Unexplained fever \>38.3 on several occasions for at least 3 weeks in a patient WITHOUT neutropenia or immunosuppresion.
45
In HIV+ ppl, fever can be due to...
* 1. Lymphoma * 2. Disseminated Mycobacterium acium * 3. Pneucystis jirovecii * 4. CMV * 5. Disseminated histoplasmosis
46
What mode of checking temp is most accurate?
Rectal
47
Increase in temperature (fever) is common in what conditions in a female?
**1. Ovulation** **2. Menstrual cycle** **3. 1st trimester of PG**
48
What are important complications of sepsis?
1. DIC 2. Kidney/liver hypoperfusion 3. ARDS
49
How to manage septic shock?
* 1. Restore perfusion * 2. Adequate O2 * 3. Come up with goal-directed therapy protocol early * 4. ID and tx infection: use broad-band ABX initially =\> narrow ABX based on cultures. * 5. Replete fluids
50
Central venous catheter infection can be d/t ________ and has a higher risk of infection if is placed \_\_\_\_\_\_\_\_, compared to \_\_\_\_\_\_
1. MRSA 2. Femoral site 3. Subclavian/internal jugular
51
When should a central line be removed?
1. Purulence at exit site 2. If staph aureus, gram (-) rod, candida is ID'd. 3. Persistent bacteremia; septic thromboplebitis, endocarditis, metastatic abcesses
52
What is essential to diagnose healthcare assx infections?
1. Acquired during course of treatment for other condtions **more than 48 hours after admission** 2. Most are preventable; **hand washing** is most effective!
53
1. **Healthcare-assx infections** are usually d/t \_\_\_\_\_\_. 2. What is key to prevent? 3. Often occur in what type of patients?
1. Devices for diagnosing, monitoring or therapy such as IV catheters 2. Proper sterilization of equipment 3. Critically ill patients in hospital for long time and on broad-spectrum ABX.
54
What finding is key to dx pneumocystitis, a opportunistic AIDS infection?
**Diffuse interstitial infiltrate** shaped lk **bat/butterfly wing**s on CXR
55
Which test is used to dx and confirm HIV?
* Dx = HIV Ab via ELISA * Confirm dx = Western blot
56
What T-cell count can AIDS be made?
\< 200/uL
57
Long duration of fever + WL + fatigue + cough with hemoptysis after incarceration Dx?
**TB**

SBL Test 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions