Term
| What 4 species cause malaria? |
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Definition
| Plasmodium falciparum, P. vivax, P. ovale and P. malariae |
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Term
| What are the symptoms of malaria? |
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Definition
| Fever (up to 41c), general malaise, headache, vomiting/diarrhoea, anaemia and hepatosplenomegaly (vivax or ovale). |
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Term
| How is malaria transmitted? |
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Definition
| Via female anopheline mosquitoes and contaminated blood transfusions. |
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Term
| How do you diagnose malaria? |
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Definition
| At least 3 Giemsa stained films and lumbar puncture may be necessary to rule out bacterial infection. |
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Term
| How can you prevent malaria? |
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Definition
| Anti-malarial prophylaxis, malarone, mefloquine, lariam and doxycycline. |
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Term
| How do you treat malaria? |
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Definition
Most strains susceptible to chloroquine, however falciparum normally most susceptible to quinine.
Vivax and ovale require follow up of primaquine |
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Term
| What is the incubation period for malaria? |
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Definition
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Term
| What are the early warning red flag signs of meningitis? |
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Definition
| Leg pain, cold hands and feet (even with fever), blue-ish or pale appearance around mouth, non-blanching rash. |
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Term
| Name meningitis symptoms in a baby. |
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Definition
| High pitched cry, fast breathing, fever, anorexia, irritable, drowsiness, a bulging fontanel, jerky movements or floppy baby. |
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Term
| Name meningitis symptoms in a child/adult. |
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Definition
| Fever, headache, muscle pains, avoidance of bright light, stiff neck, fast breathing, pale or blotchy skin and vomiting. |
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Term
| What are the bacterial and viral causes of meningitis? |
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Definition
| Neisseria meningitidis (meningococcal), Streptococcus pneumoniae enterovirus and herpes simplex virus. |
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Term
| What is the most common cause of bacterial meningitis in the UK and why? |
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Definition
| Type B meningococcal because of vaccination against Type C and a quadruple vaccine against Type A, W, Y and Z. |
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Term
| How do you diagnose meningitis? |
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Definition
| Treatment normally begins before a confirmed diagnosis is made. Blood test, lumbar puncture, CT scan (assess suspected brain damage), chest X-ray. |
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Term
| When presented in the community, how do you treat meningitis? |
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Definition
| A cephlasporin or a Benzyl penicillin. With suspicion of resistance rifampicin or vancomyocin. |
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Term
| When presented in hospital, how do you treat meningitis? |
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Definition
Antibiotics within 30 mins of arrival, IV fluids in response to shock, Dexomethasone in patients older than neonate to reduce chance of deafness.
NOTE:Patients most poorly 8-12 hours after treatment due to toxins released by killed bacteria. |
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Term
| Which has a better prognosis viral of bacterial meningitis? |
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Definition
| Viral. Bacterial has a 5-10% mortality rate which is doubled in the development of septicaemia. |
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Term
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Definition
| Regulated increase in body temperature as a result of an increased hypothalmic set point. |
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Term
|
Definition
| Pyrogens (pathogens, cytokines) and rarely a hypothalmic lesion (eg. stroke) |
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Term
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Definition
| An unregulated increase in body temperature which is higher than thermoregulatory set point. |
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Term
| What can cause hyperthermia? |
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Definition
| Excessive muscle activity, environment, drugs, anaesthetic agents, endocrine change and skin disorders. |
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Term
| In which four ares can temperature be measured? |
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Definition
| Oral, tympanic, axilla and rectal (most closely associated with core temperature). |
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Term
| What are the four stages of fever? |
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Definition
| Prodromal phase, chill stage, flush stage and Defervescence stage |
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Term
| What symptoms occur in the Prodromal phase of fever? |
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Definition
| Non-specific: headache, fatigue, general malaise, aching. |
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Term
| What symptoms occur in the chill stage of fever? |
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Definition
| Shaking/rigors, vasoconstiction, piloerection, feeling of being cold, urge to put warm clothes on and to curl up. |
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Term
| What symptoms occur in the flush stage of fever? |
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Definition
| body temperature reached new set level - shivering stops, sensation of warmth, skin warm and flushed. |
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Term
| What symptoms occur in the Defervescence stage of fever? |
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Definition
| Sweating to reduce heat as the fever falls. |
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Term
| What are the dangers of treating a fever? |
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Definition
| Impairs the immune response, may miss the development of serious infection, adverse effects of anti-pyretics and mis-conception that antipyretics prevent febrile convulsions. |
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Term
| Which increase in body temperature should you physically cool, hyperthermia, fever or both? |
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Definition
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Term
| What three stages should be used in the initial management of a feverish child <5YO? |
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Definition
1. Identify and manage life threatening features.
2. Assess risk of serious illness using traffic light system.
3. Try to identify a focus of infection or specific condition. |
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Term
| Define intermittent fever |
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Definition
| A fever in which temperature returns to normal at least once every 24 hours. |
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Term
|
Definition
| A temperature which does not return to normal and varies a few degrees in either direction |
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Term
| Define sustained/continuous fever |
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Definition
| Temperature remains above normal with minimal variations |
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Term
| Define recurring/relapsing fever |
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Definition
| One or more episodes of fever lasting as long as several days with one or more days of normal temperature in between episodes |
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Term
| What is the relation of temperature to heart rate? |
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Definition
| Elevation 1 degree C = 15bpm rise in HR |
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Term
| Name 3 pyrogenic cytokines |
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Definition
| IL1, IL6, TNF alpha and INF |
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Term
| Prostaglandin E2 modifies responsiveness of thermosensitive neurones via which enzyme? |
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Definition
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Term
| IL 10 has what effect on the febrile response? |
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Definition
| Limits magnitude and duration by competing with IL 6 |
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Term
| What infection causes present initially with PUO? |
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Definition
| Sepsis (UTI, dental/sinus infections, bone and joint infections, post-op abdominal surgery), infective endocarditis, imported infections, evertic fevers, TB and viral infections. |
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