Primary Care Exam 1: EENT Questions And
Answers| Already Graded A+| Latest Update
Normal ORAL temperature is - CORRECT ANSWER -98.6°F +/- 1°F
Normal RECTAL temperature - CORRECT ANSWER -is 99.6°F +/- 1°F
Normal AXILLARY temperature is - CORRECT ANSWER -97.6°F +/- 1°F
In healthy individuals, body temperature is - CORRECT ANSWER -lowest upon waking and
highest by late afternoon/evening (but still within normal range)
most common cause of fever is - CORRECT ANSWER -infection and extreme metabolic response:
Upper respiratory infections (URI)
Tonsillitis
Viruses (influenza, gastroenteritis)
Genitourinary infections (UTI)
Drug reaction
Fever: Less Common Causes - CORRECT ANSWER -Meningitis
Intra-abdominal abscess
Sepsis
Diverticulitis
Subacute bacterial endocarditis
Osteomyelitis
Thrombophlebitis
,Crohn's disease
Chronic infection
Hepatitis
Tuberculosis
Infectious mononucleosis
Lymphoma
Occult neoplasms
Sinusitis
Dental abscess
Prostatitis
Recreational drug use (ecstasy, cocaine, amphetamine)
Drug-Induced Hyperthermia (Drug Fever): - CORRECT ANSWER -Penicillins
Cephalosporins
Antituberculous
Sulfonamides
Macrolides
Aminoglycosides
Quinidine
Methyldopa
Procainamide
Phenytoin
Those individuals presenting with fever secondary to some toxic exposure or significant level of
toxicity will exhibit unique signs and symptoms: - CORRECT ANSWER -Altered consciousness
Persistent vomiting
,Diarrhea with tenesmus: urge to pass stool even when colon is empty; may be accompanied by
rectal cramping
Convulsions
Lethargy
Anorexia
Sepsis (respiratory distress, temperature instability, jaundice, apnea: suspension of external
breathing)
following are indications that the fever presentation is emergent and/or requires immediate,
conservative care: - CORRECT ANSWER -Progressive acute fever >102°F
Persistent fever for 3 or more weeks
Significant increase in WBC counts
In infants:
Bulging or tightness of anterior fontanels
Nuchal rigidity; Brudzinski's/Kernig's sign
Indicative of meningitis
Pediatric Fever - CORRECT ANSWER -Children are relatively "warm" and have increased normal
ranges of body temperature. As such, it is not uncommon that children presenting even with
minor infections can reach temperatures up to 104°F
In children less than 3 months of age presenting with fever, meningitis and sepsis MUST be
ruled-out first due to the severity of these conditions
In cases of children less than 3 months of age presenting with fever and symptoms of toxicity: -
CORRECT ANSWER -17% chance of bacterial infection
11% chance of bacteremia
4% chance of meningitis
, In cases of children less than 3 months of age presenting with fever with absent symptoms of
toxicity: - CORRECT ANSWER -8.6% chance of bacterial infection
2% chance of bacteremia
1% chance of meningitis
Children presenting with recurrent fever of irregular intervals, consider: - CORRECT ANSWER -
Repeated viral infections
Inflammatory bowel disease
Repeated bacterial infections
Children presenting with recurrent fever of regular intervals, consider: - CORRECT ANSWER -
PFAPA syndrome (periodic fever, aphthous ulcers, pharyngitis, adenopathy)
When collecting the HPI of a CC of "fever," be sure to ask the following questions as they are
imperative to better understanding the etiology: - CORRECT ANSWER -Any exposure to infected
people?
Any exposure to animals?
Any PMH of sinusitis, UTI, prostatitis, pneumonia?
Any known exposure to chemicals?
Any drug use (medications and illegal), up to 7-10 days prior?
Any recent travel?
Any known immune compromise?
Consider age
Decreased immune response in geriatric populations
Consider postoperative effects
Infection, atelectasis ("collapsed lung"), reaction to anesthesia or other medications
Answers| Already Graded A+| Latest Update
Normal ORAL temperature is - CORRECT ANSWER -98.6°F +/- 1°F
Normal RECTAL temperature - CORRECT ANSWER -is 99.6°F +/- 1°F
Normal AXILLARY temperature is - CORRECT ANSWER -97.6°F +/- 1°F
In healthy individuals, body temperature is - CORRECT ANSWER -lowest upon waking and
highest by late afternoon/evening (but still within normal range)
most common cause of fever is - CORRECT ANSWER -infection and extreme metabolic response:
Upper respiratory infections (URI)
Tonsillitis
Viruses (influenza, gastroenteritis)
Genitourinary infections (UTI)
Drug reaction
Fever: Less Common Causes - CORRECT ANSWER -Meningitis
Intra-abdominal abscess
Sepsis
Diverticulitis
Subacute bacterial endocarditis
Osteomyelitis
Thrombophlebitis
,Crohn's disease
Chronic infection
Hepatitis
Tuberculosis
Infectious mononucleosis
Lymphoma
Occult neoplasms
Sinusitis
Dental abscess
Prostatitis
Recreational drug use (ecstasy, cocaine, amphetamine)
Drug-Induced Hyperthermia (Drug Fever): - CORRECT ANSWER -Penicillins
Cephalosporins
Antituberculous
Sulfonamides
Macrolides
Aminoglycosides
Quinidine
Methyldopa
Procainamide
Phenytoin
Those individuals presenting with fever secondary to some toxic exposure or significant level of
toxicity will exhibit unique signs and symptoms: - CORRECT ANSWER -Altered consciousness
Persistent vomiting
,Diarrhea with tenesmus: urge to pass stool even when colon is empty; may be accompanied by
rectal cramping
Convulsions
Lethargy
Anorexia
Sepsis (respiratory distress, temperature instability, jaundice, apnea: suspension of external
breathing)
following are indications that the fever presentation is emergent and/or requires immediate,
conservative care: - CORRECT ANSWER -Progressive acute fever >102°F
Persistent fever for 3 or more weeks
Significant increase in WBC counts
In infants:
Bulging or tightness of anterior fontanels
Nuchal rigidity; Brudzinski's/Kernig's sign
Indicative of meningitis
Pediatric Fever - CORRECT ANSWER -Children are relatively "warm" and have increased normal
ranges of body temperature. As such, it is not uncommon that children presenting even with
minor infections can reach temperatures up to 104°F
In children less than 3 months of age presenting with fever, meningitis and sepsis MUST be
ruled-out first due to the severity of these conditions
In cases of children less than 3 months of age presenting with fever and symptoms of toxicity: -
CORRECT ANSWER -17% chance of bacterial infection
11% chance of bacteremia
4% chance of meningitis
, In cases of children less than 3 months of age presenting with fever with absent symptoms of
toxicity: - CORRECT ANSWER -8.6% chance of bacterial infection
2% chance of bacteremia
1% chance of meningitis
Children presenting with recurrent fever of irregular intervals, consider: - CORRECT ANSWER -
Repeated viral infections
Inflammatory bowel disease
Repeated bacterial infections
Children presenting with recurrent fever of regular intervals, consider: - CORRECT ANSWER -
PFAPA syndrome (periodic fever, aphthous ulcers, pharyngitis, adenopathy)
When collecting the HPI of a CC of "fever," be sure to ask the following questions as they are
imperative to better understanding the etiology: - CORRECT ANSWER -Any exposure to infected
people?
Any exposure to animals?
Any PMH of sinusitis, UTI, prostatitis, pneumonia?
Any known exposure to chemicals?
Any drug use (medications and illegal), up to 7-10 days prior?
Any recent travel?
Any known immune compromise?
Consider age
Decreased immune response in geriatric populations
Consider postoperative effects
Infection, atelectasis ("collapsed lung"), reaction to anesthesia or other medications
