| Fever in the Returning Traveler | Non infectious fever | Critical Care | Non Critical | Hodgepodge |
|---|---|---|---|---|
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Name 3 essential categories of questions to ask on history
o Travel prep/immunizations
o Exposure o PMHx (DM, immunosupressed, pregnant) o Travel history (duration, destination, purpose, budget) o Adverse incidents (bites, assault, trauma) o High risk behaviours (sex, drugs) o Sick contacts/health of other travelers |
Name 5 causes of non-infectious fever
MI, PE, Pulm infarct, ICH, Stroke, NMS, Thyroid storm, Adrenal insufficiency, Transfusion Reaction, CHF, Dehydration, Seizure, Sickle cell, Transplant Rejection, DVT Pancreatitis, Malignancy, Sarcoid, Crohns
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What is the most frequent lung condition leading to ARDS?
Pneumonia
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Can antibiotics replace surgery in uncomplicated appendicitis?
No
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What is the difference between fever and hyperthermia?
In fever it is the body’s homeostatic response whereas primary hyperthermia is the body’s inability to get rid of heat
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What are the top 6 most common causes of fever after travel to tropical regions?
1) Malaria
2) Resp tract infections 3) Diarrheal disease 4) UTI 5) Dengue fever 6) Typhoid fever |
What are the risk factors for an acute transfusion reaction?
1) Prior pregnancy
2) Previous transfusion 3) Transplant 4) IgA Deficiency (protects mucous membranes, found in Lupus, RA) |
A patient presents with sudden, severe upper abdominal pain, vomiting, fever and hypotension. What is the most likely diagnosis?
Perforated viscous
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What is the treatment for PID?
Azithromycin 2g x 1 and Ceftriaxone 250mg IM x 1
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Name the 3 general categories of illness that account for FUO
1) Infections
2) Connective tissue diseases 3) Malignancies |
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Which species causes the majority of malaria cases and what is the classic triad of malaria symptoms?
Falciparum
1) Fever 2) Splenomegaly 3) Thrombocytopenia |
What are the diagnostic criteria for NMS?
Treatment w antipsychotic w/in 7 days of Sx onset + 2 Major criteria: fever and muscle rigidity and 5 Minor criteria: AMS, IncHR, Inc/DecBP, Inc/DecRR, IncCK, DecpH, IncWBC, diaphoresis, tremor, incontinence
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Which diagnosis can you not miss when you have the following sx: fever, unilateral periorbital edema, headache, photophobia, proptosis, chemosis and 6th CN palsy?
Cavernous sinus thrombosis
Cavernous sinus thrombosis
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Which are the 1st and 2nd is the most common infections in FUO?
1) TB 2) Abscess
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What percent of elderly presenting with infections don’t mount a fever?
30%
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4. How is typhoid fever spread AND name 3 classic symptoms
Contaminated food/water – fecal/oral
1) Rose spots 2) Fever 3) Diarrhea/Constipation 4) Bradycardia |
What is the most common cause of thyroid storm and what are the steps to treating it?
Graves disease
1) Supportive care
2) Inhibition of thyroid hormone release w thionamides (methimazole, PTU) 3) Inhibition of thyroid hormone production (iodine) 4) B-blocker 5) Prevent peripheral conversion of T4 to T3 6) Treat precipitating event |
What can be done to address cytokine storm seen in COVID-19 patients in the ICU?
Supportive care, steroids, possibly convalescent plasma
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34F presents with right ear pain, headache and fever. On exam her external ear and the area around it is very tender to palpate. Her TM is difficult to visualize. What Dx must you consider and which test(s) will help you make the Dx?
Otomastoiditis, CT
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What is the increase in HR and RR per degree core body temperature increase?
HR = 10-20 BPM, RR = 2-4
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To make the clinical Dx of dengue fever you need fever plus 2 or more of?
1) Leukopenia
2) Nausea/Vomiting 3) Arthralgias 4) Petechial rash 5) Positive tourniquet test |
List the 4 most common malignancies that present with fever
1) Lymphoma (especially NHL)
2) Leukemia 3) Renal cell carcinoma 4) Hepatocellular carcinoma (or other tumors with mets to liver) |
In cerebral malaria, what do you find in the CSF?
CSF is usually normal except for a slightly elevated opening pressure and protein concentration or possibly mild pleocytosis (inc # lymphocytes)
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Which Dx do you need to think of with the following: fever, arthralgias, night sweats, SOB, petechiae and a new heart murmur?
Endocarditis
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What percent of children with fever have seizures?
4%
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