fever-发热英语.pptVIP

Non-infective fever Dysfunction of central heat regulation Physical: heat stroke Chemical: barbiturate poisoning Mechanical: cerebral hemorrhage Dysfunction of vegetative nervous system Sympathetic overactivity Clinical manifestation The grade of fever Low grade fever: 37.3~38℃ Middle grade fever: 38~39℃ High grade fever: 39.1~41℃ Hyperthermia fever: 41℃ Clinical manifestation Clinical course of fever Onset Sudden onset Pneumonia Gradual onset Typhoid Persistence Varies pattern Subsidence Crisis Lysis Character of fever Continuous Fever T: kept at 39℃~40℃ constantly Circadian variation: 1℃ Pneumonia Typhoid fever Character of fever Remittent Fever T: 39℃ Circadian variation 2℃ Rheumatic fever Tuberculosis Septicaemia Acute infectious endocarditis Character of fever Intermittent Fever T: sudden rising (few hours) and sudden decreasing Malaria Acute pyelonephritis ? Fever Zhou Yun The Affiliated Hospital of Medical College of Ningbo University Emergency Department Objective Definition Pathophysiology Pathogenesis Etiology and classification Clinical manifestation Definition Definition of fever: A temperature above the normal range Normal body temperature 36-37℃ (set point) Circadian variation： 1℃ ：36.3 - 37.2℃ Rectal T 0.5℃ Oral T 0. 5℃ Axillary T Fever Pyrogens Elevated set-point Maintaining an abnormally elevated Temperature BMR(basal metabolic rate) increases T ? = Elevated set-point BMR ?10% = T ? 0.6oC Hyperthermia Fever due to a disturbance of thermal regulatory control Excessive heat production (e.g. status epilepticus, hyperthyroidism) Decreased dissipation of heat (e.g. extensive skin disease) Loss of regulation (e.g. injury of the hypothalamic regulatory center) Hyperthermia Excessive heat production T ? Decreased dissipation Loss of regulation Pathophysiology Heat production Shivering Basal metabolic rate