Causes of Fever of Unknown Source Interactive Game! Family Medicine Specialist CME October 15-17, 2012 Pakse
Dec 14, 2015
Causes of Fever of Unknown Source
Interactive Game!
Family Medicine Specialist CMEOctober 15-17, 2012Pakse
Fever of unknown source
Infections
Infections
Infections
Infections + Other
Other
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Topic 1: 200
•Question:•What disease, transmitted by day biting
mosquitos, presents with fever, headache, and diffuse whole body bone and muscle pain?
•Answer•Dengue Fever
Back
Topic 1: 400
•Question:•What disease, transmitted by a dawn and
dusk biting mosquito, classically presents with cyclic symptoms every 48 hours, of fevers, chills, sweats, headache, and muscle pain?
•Answer•MalariaBa
ck
Topic 1: 600
•Question:•Typical physical exam findings of a non-
itchy macular rash on the trunk, enlarged lymph nodes, enlargement of liver or spleen, and relative bradycardia suggest which infection?
•Answer•Scrub typhusBa
ck
Topic 1: 800
•Question:•A farmer presents with fever, vomiting,
bloody diarrhea and shortness of breath. On exam, he has redness and inflammation of the eyes, and petechiae and purpura over his body. Labs show renal and liver failure. Chest x-ray shows alveolar infiltrates. What does he likely have?
•Answer▫Leptospirosis
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Topic 1: 1000
•Question:•What are 5 risk factors for acquiring and
dying from melioidosis?
•Answer▫Diabetes▫Alcoholism▫Immunosuppression▫Renal failure▫Thalassemia
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Topic 2: 200
• Question:• This test is done by inflating a blood pressure cuff
between the patient’s systolic and diastolic pressure for 5 minutes. If the skin under the cuff has >20 petechiae in an area measuring 2.5cm x 2.5cm then the test is positive. What is the (a) name of this test and (b) if it is positive, what disease do you suspect?
• Answer▫ (a) Tourniquet test (b) Dengue hemorrhagic feverBa
ck
Topic 2: 400
•Question:•A patient presents with 6 weeks of fever,
night sweats, weight loss, and cough. What infection is most likely given the subacute presentation?
•Answer•Tuberculosis
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Topic 2: 600
•Question:•What are the 3 most common bacteria
that cause bacterial endocarditis?
•Answer▫a) Staphylococcus aureus▫b) Viridans group streptococci▫c) Enterococci
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Topic 2: 800
•Question:•Liver and spleen abscesses are common
complications of this disease, occurring in 25% of infected patients. It is therefore important to look for these abscesses with ultrasound, if available, even if patients are asymptomatic. What is this disease?
•Answer▫Melioidosis
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Topic 2: 1000•Question:• You see these findings when examining a febrile
patient: a) Non painful pink lesions to palms b) petechiae c) painful purple nodules on fingers d) splinter hemorrhages under nailbed. What disease does he have?
Answer Infective endocarditis
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Topic 3: 200
•Question:•A patient presents with an ulcer at the
site of a mite larvae bite, which has then become necrotic and formed an eschar. What disease does he have?
•Answer▫Scrub typhusBa
ck
Topic 3: 400
•Question:•What are the 2 most common species of
Plasmodium that cause malaria in Lao PDR. Which of the two causes much more severe disease?
•Answer•Plasmodium falciparum >> Plasmodium
vivax▫P. falciparum causes much more severe
disease
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Topic 3: 600
•Question:•How is leptospirosis transmitted?
•Answer•Through contact with soil or freshwater
that is contaminated by the urine of infected animal carriers (rats, cows, pigs, dogs, goats)
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Topic 3: 800
• Question:• What are 4 risk factors that increases the risk for
infective endocarditis?
• Answer▫1. Injection recreational drug use▫2. Structural heart disease (such as rheumatic
heart disease)▫3. Previous history of having infective endocarditis▫4. Invasive intravascular procedures or lines (such
as hemodialysis lines)Back
Topic 3: 1000
• Question:• These chest X-ray findings are all consistent with
which disease?
▫Answer▫Pulmonary tuberculosis(A. Upper lobe cavity B. Lymphadenopathy C. Infiltrates)
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Topic 4: 200
•Question:•What are the 2 most common types of
cancers that cause fever and often present with enlarged lymph nodes, night sweats, weight loss, and abnormal blood counts?
•Answer:•Leukemia and LymphomaBa
ck
Topic 4: 400
•Question:•What type of cancer presents not only
with fever, but also with hematuria and a flank mass?
•Answer•Renal Cell Carcinoma
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Topic 4: 600
•Question:•A farmer has been working in his field all
day. That night, he presents to the hospital with fever, flushing, lethargy, tachypnea, and tachycardia. What is the cause of his fever?
•Answer▫Heat strokeBa
ck
Topic 4: 800
•Question:• A 30 year old man has had 3 months of fever and
diffuse lymphadenopathy. His WBC is low. He has pain when swallowing, and his tongue has a white coating on it. 1) What underlying infection is causing the fever? 2) What is the white coating on his tongue?
•Answer• 1) HIV 2) Candidiasis (yeast)Ba
ck
Topic 4: 1000
•Question:•What laboratory abnormalities can you
see in someone with renal cell carcinoma?
•Answer• Polycythemia (high hematocrit and hemoglobin)• Hypercalcemia• High liver enzymes (even without liver
metastases)Back
Topic 5: 200
•Question:•What 2 autoimmune diseases are these
findings classic for (both of which can cause fever)?
a. b.
▫Answer a. Lupus b. Rheumatoid arthritis
Back
Topic 5: 400
•Question:•What is the most common autoimmune
disease to present with fever in older adults and also presents with jaw claudication, loss of vision, and often pain in the shoulders and hips?
•Answer•Giant cell (temporal) arteritisBa
ck
Topic 5: 600
•Question:•What disease occurs 2-4 weeks after
pharyngitis, and can present with arthritis, rash, subcutaneous nodules, carditis, chorea, and fever?
•Answer•Rheumatic fever
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Topic 5: 800
•Question:•A patient presents with fever, tachycardia,
tremor, anxiety, sweating. On exam, you see they have a stare and lid lag. What disease does this patient have?
•Answer•Hyperthyroidism
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