Fever (Mackin)

Fever
-also known as what?
-has a body temperature greater than?
a hot animal that wants to be warmer

1. Pyrexia
2. 103

What controls the thermoregulatory set point?
Hyperthermia-hot animal that wants to be cooler

1. Hypothalamus

What happens to thermoregulatory set point when you have a true fever
Thermoregulatory set point tells diff btw fever (108) and hyperthermia (99)

1. It "resets" to a higher level

Pyrogens (reset set point)
-What are the 4 exogenous causes
-What are the endogenous causes (1 but really 3)

1. Organisms
2. Antigens
3. Foreign substances
4. Drugs
1. Cytokines (IL-1,6) TNF

Reset thermoregulatory set point via local ________

1. prostaglandins

1. IL-1 secreted by phagocytes travels in blood to hypothalamus
2. Hypothalamus secretes prostaglandin, which resets hypothalamic thermostat
3. Nerve impulses cause shivering, higher metabolic rate, inhibition of sweating, and vasocontriction
4. These inc

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Pyrogens
Endogenous Pyrogens
-_______ ______ response to many infectious inflammatory and neoplastic diseases
-______ of systemic inflammatory response

1. non-specific
2. mediators

Hyperthermia
1. Demeanor (Excited, Agitated)
2. Behavior (Panting, Vasodilation, Sweating)
3. Body Temp (up to 110 or greater)

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Fever
1. Demeanor (Lethargic, Depressed)]
2. Behavior (Shivering, Vasoconstriction, piloerection)
3. Body Temp (rarely >106-107)

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Causes of fever (5)

1. infectious
2. Inflammatory
3. Immunologic
4. Neoplastic
5. Drug associated

Fever
infection is not the only cause of fever
______ infection is, however, probably the most common cause of fever

1. bacterial

Fever
-may be a _____ mechanism

1. protective

What are 4 ways it can be a protective mechanism?
Does make patient feel miserable

1. Enhances host immunity
2. Inhibits bacterial growth by reducing serum iron conc
3. Contributes to neoplastic cell death
4. Encourages rest in affected animal

Inflammation
local inflammation
-complex reaction in vascularized ____ _____
-leads to accumulation of _____ and _____ in extravascular tissue
-protective mechanism, because removes what two things
-potentially harmful consequences cause (5)

1. connective tissue
2. fluid and WBC
1. Cause of cell injury
2. Consequences of cell injury
1. Hypersensitivity
2. Chronic inflammatory disease
3. Immune mediated disease
4. Scar tissue
5. Systemic inflammatory response

Inflammation
-entire inflammatory process is mediated by chemicals derived from _____ and _____
numerous mediators are recognized

1. plasma and cells

5 Cardinal signs of Inflammation

1. Heat
2. Redness
3. Swelling
4. Pain
5. Loss of function

Inflammatory Mediators (7)
last one most important

1. Vasoactive amines
2. Plasma Proteases
3. Arachidonic Acid Metabolites
4. Platelet Activating Factor
5. Nitric Oxide
6. Oxygen derived free radicals
7. Cytokines

Cytokines come from what 2 main things
IL-1,6 and TNF have local and systemic effects

1. Lymphocytes and macrophages

Systemic Inflammatory Respeonse
Cytokine mediated (IL-1,6 TNFalpha)
What are 7 signs/results of this

1. Fever
2. Anorexia/cachexia
3. Lethargy/malaise
4. Acute phase proteins
5. Neutrophilia
6. Anemia of chronic disease
7. Glucocorticoid release

Laboratory Results in Patient with Fever
-4 Predictable Results

1. Inflammatory or stress leukogram
2. Anemia of chronic disease
3. Mild hypoalbuminemia
4. Mild to marked hyperglobulinemia

Patient Cooling
-Physical Cooling
You want to cool with fans, water, ice packs but its contraindicated. It also will stress and distress th patient. If need to use ______

NSAIDS

NSAID reset thermoregulatory set point

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