W29/L6: PUO

Question 1

Define PUO

Answer 1

Prolonged illness (2-3 weeks)
Fever on several occasions above 38.3
No diagnosis after intelligent investigations

Question 2

What time of day is temperature highest & by how much?

Answer 2

Afternoon: .5-1 C higher

Question 3

What’s the normal oral temperature range?

Answer 3

35.8 - 37.8

Question 4

Which neural structure regulates body temperature?

Answer 4

Anterior hypothalamus

Question 5

What are ways we facilitate heat loss?

Answer 5

Peripheral vasodilation
Sweating
Reduced physical activity

Question 6

What are ways we facilitate heat conservation?

Answer 6

Peripheral vasoconstriction
Piloerection
Warmth-seeking behavior

Question 7

What are ways we produce heat?

Answer 7

Shivering

Release of thyroid hormone, GCCs, and catecholamines

Question 8

What early morning oral temperature defines fever?

Answer 8

Above 37.2

Question 9

What oral temperature at any time of day defines fever?

Answer 9

Above 37.8

Question 10

What happens during a rigor?

Answer 10

Feeling of intense cold
Uncontrollable shivering
Pallor of face & limbs
Piloerection
(and during - often a normal temperature; it's afterwards that they have a high temp)

Question 11

Which patients are “at risk” of severe illness?

Answer 11

Recent o/s travel
Asplenic patients
Neutropaenic patients
Elderly, diabetic, IVDU, very young