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32 Cards in this Set
- Front
- Back
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Are standard antipyretics effective against hyperthermia?
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No (hyperthermia is not caused by pyrogenic cytokines)
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Temperatures over 41.5 C or 106.7 F are called what?
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Hyperpyrexia
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What lab findings will be elevated due to the effeets of inflammatory cytokines?
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CRP, ESR, haptoglobin, ferritin, fibrinogen
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What is fever of uknown origin?
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T > 38.3 on several occasions, with duration of fever for 3 weeks or more, and no certain diagnosis after one week of investigation
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What area of the hypothalamus controls body temperature?
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Preoptic area
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What are the pyrogenic cytokines?
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IL-1, TNF-a, IL-6, CNF, IFN-g
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What happens in the preoptic area of the hypothalamus when pyrogenic cytokines are carried there?
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activation of PLA2 > release of AA > synthesis of PGE2 > PGE2 is a fever mediator
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Above what temperature is generally considered fever?
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38-38.2 (100.4 - 100.8)
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What are the limitations of rectal temperatures?
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stool in the rectum may delay or decrease temp reading; during shock poor rectal perfusion = low reading
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Where in the mouth is the correct position of the thermometer?
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sublingual pocket
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How can oral temperature measurements be altered by activity of the patient?
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Chewing and smoking increases by 20 min; mouthbreathing in cold weather, cold drinks decreases by 10 mins
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What can alter TM temperature readings?
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Discharge, chewing, ear wax (decrease)
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Are axillary temperatures accurate in the adult or older children?
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NO (fairly accurate in the neonate)
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Who is very sensitive to a childs forehead for temperature changes above 38?
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mothers
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What happens to female temperatures at the time of ovulation?
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increases 0.5C or 0.9F
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What is the average lethal limit of temperature in humans?
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109F
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Is fever > 105 in patients with infections?
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Rarely
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How much does the heart rate increase for every 1F increase in fever?
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2.4 bpm (metabolic demand increases)
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For every 1 C degree above 37C, what is the increase in oxygen consumption?
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13% increase
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In what diseases/disorders is reducing fever beneficial?
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Those in which an increased metabolic demand is poorly tolerated (cardiovascular and pulmonary disease); Organic brain disorder; prevention of febrile seizures in children
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What drugs are associated with poor outcomes in CAD (coronary artery disease)?
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indomethacin and COX-2 NSAIDS
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IS reducing fever in ALL patients required?
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NO; fever is useful in battling infections
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What is "relative bradycardia"?
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A fever in which the heart rate does not appropriatly increase with fever
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Which conditions show an attenuated febrile response?
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newborn status; uremia; cirrhosis; antiyretics; corticosteroids; large burns; extracorporeal membrane oxygenation
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What conditions cause a "relative bradycardia" - osis?
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Typhoid fever; Brucellosis; Dengue; Q fever; Leptospirosis; Legionellosis; Psittacosis; Typhus; Sand Fly Fever; Rocky Mountain Spotted Fever; Malaria; Yellow Fever; Bebebiosis; Drug Fevers; Factitious Fever; Lymphoma; CNS lesions; (use of beta blockers)
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What are the characteristics of SIRS (systemic inflammatory response syndrome), an indicator of a higher level of severity for the patient's conditions?
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T > 38 or < 36; HR > 90; WBC > 12000 or < 4000 or > 10% band; RR > 20; PaCO2 < 32 (40 norm)
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What do viral infections show on CBC with differential?
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atypical lymphocytes
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What lab studies need to be run in patients with fever?
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CBC with diff; Babesia/malaria blood smear (if + travel and recent blood trans); fluid collection; Blood chem; CXR; lumbar puncture (if CNS signs)
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What is the most important thing in diagnosing fever?
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History
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What therapeutic strategies exist in critically ill febril patients?
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Rapid assesment (collect diagnostic samples) + Empiric antibiotics and resuscitation
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What has the potential to induce reyes syndrome in young children and should not be used as an anti-pyretic?
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Aspirin
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What is the mean normal temperature?
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98.2
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