1. fever and hyperthermia
DIFFERENTIAL DIAGNOSIS AND TACTICS GENERAL PRACTITIONERS

2. FEVER:
This increase in body temperature relative to normal daily values ​​due to changes in the thermoregulatory center.

3. hyperthermia
This increase in body temperature without the participation of the hypothalamus , usually due to lack of heat ( such as during exercise , taking medicines that reduce sweating, and high ambient temperature )

4. frequency of occurrence

5. pyrogens
Pyrogenic nazyvayutendogennye or exogenous substances that cause fever .
Endogenous pyrogens are produced in the body otet to different stimuli ; most often it is an infection or inflammation.
Exogenous pyrogens consist principally microorganisms and their toxins and waste products.

6. Prevalence

7. Statistics

8. Pathogenesis of fever Fever Fever heat production heat irradiation
Жаропонижающи
препараты
organisms
Toxins Mediators of
inflammation
Monocytes and macrophages endothelial cells other cells
Fever
pyrogenic cytokines (IL -1 , TNF α, IL -6 , interferons)
heat production
heat irradiation
Anterior hypothalamic area
Temperature setpoint
Prostaglandin E2

9. Manifestations of febrile reactions
Backache
generalized myalgia
Arthralgia
Decreased appetite
Drowsiness
Chills
Disorders of consciousness
Febrile seizures

10. Diagnostics
Diagnosis of diseases accompanied by fever requires general practitioner all his knowledge and skills , particularly in the collection of medical history .
It is very important chronology of symptoms , their association with medication , surgery , and dentistry

11. Daily fluctuations to within 1 ° C
Constant
daily fluctuations in body within t C
remitting
daily fluctuations of more than 1 t C Morning - the norm or below
intermittent.
hectic
Daily fluctuations C .
Incorrect
fever
without a certain regularity

12. Contact with animals poisonous fumes
When collecting medical history is necessary to pay attention to the following points
Contact with animals poisonous fumes
The sources of infection and allergens
Contact with patients with fever or infectious diseases
Culinary preferences
Sexuality - Precautionary measures
Bad habits Injuries
Animal and insect bites
Blood transfusion
Vaccinations
Allergic reactions

13. Diagnostics
Physical examination : It is necessary to examine carefully and regularly
Register all the physiological indicators The temperature measured is always in the same place
Particular attention is paid to the skin .
The lymph nodes , eyes, nail bed , ENT organs , the organs of the chest cavity and abdomen , musculoskeletal system , genitourinary system .

14. medical examination Stiff neck - meningitis
Painful joints - septic arthritis or rheumatism
Rapid breathing or chest indrawing - pneumonia
Petechial rash - meningococcal disease or dengue fever
Makulopapululeznaya rash - a viral infection or a reaction to drugs
Полностью разденьте ребенка и тщательно осмотрите с целью возможного выявления следующих локальных признаков инфекции

15. medical examination
Changes in the mucous membrane of the throat - an infection
Soreness in the ear - otitis media
Jaundice or external signs of anemia or sepsis - malyariya
Changes in the spine and hip - septic arthritis
Palpation of the abdomen - pain in the suprapubic region with urinary tract infections

16. medical examination Prolonged fever without local symptoms :
Septicemia
salmonellosis
miliary tuberculosis
HIV infection
Urinary tract infection

17. laboratory and instrumental
Clinical signs
FEVER
laboratory and instrumental
Anamnesis external evidence
fever type
Specific indicators

18. Laboratory research Microscopic research methods Blood chemistry
Bacteriological studies
X-ray examination

19. Causes of hyperthermia
Heatstroke
Drug hyperthermia
Neuroleptic malignant syndrome Malignant hyperthermia
Diseases of the endocrine system

20. Diseases of the central nervous system
Infection
Autoimmune diseases
Drugs
tumors
FEVER
unknown origin
Diseases of the central nervous system
Simulation
Internal illnesses
acute viral infection
vermin

21. Categories Infectious fever without local symptoms
Infectious fever with local symptoms , but without rash
Fever with a rash
Случаи лихорадки у детей можно разделить на три основных категории
Спросите курсантов какие заболевание входят в 1,2,3 категорию. Ответ в следующих слайдах.

22. The differential diagnosis of fever without local symptoms
Malaria ( only if there is a risk of malaria transmission )
Septicemia
Typhoid fever
Urinary tract infection
Fever associated with HIV infection

23. Skin and soft tissue infections Pneumonia Viral infection of the upper
The differential diagnosis of fever with the presence of local symptoms
Meningitis
Otitis media
Mastoiditis
Osteomyelitis
Septic arthritis
Skin and soft tissue infections
Pneumonia
Viral infection of the upper
respiratory tract
throat abscess
Sinusitis
genyantritis

24. The differential diagnosis of fever with rash
Measles
Viral infections
Meningococcal disease
Hemorrhagic fever

25. Tactics OF GP In some cases, you have to rush to the hospital ?
In some cases, you need to send to the expert?
In some cases, you have to treat a patient on an outpatient basis ?
Спросите курсантов задавая следующие вопросы. Ответы в следующем слайде

26. Referral to hospital It is a serious disease Acute laryngitis
Acute epiglottitis
Acute obstructive bronchitis
Acute pneumonia ( severe)
Acute mastoiditis
And etc.