1. At what temperature does a child have fever?

a. for a child <3 months old and >2 years old, a rectal temperature of >38°C (100.4°F)
constitutes fever.
b. In infants between the ages of 3 and 24 months , a rectal temperature of ≥38°C (101°F) likely
constitutes fever.
c. In those >2 years old, fever more commonly is defined as a rectal temperature of >38,5°C
(100.4°F).
d. for a child <3 months old, a rectal temperature of >38,3°C (100.4°F) constitutes fever.

2. How does temperature vary among different body sites?

a. Rectal Standard
Oral 0.5-0.6°C (1°F) higher
Axillary 0.8-1.0°C (1.5-2.0°F) lower
Tympanic 0.5-0.6°C (1°F) lower

b. Rectal 0.8-1.0°C (1.5-2.0°F) lower

Oral 0.5-0.6°C (1°F) lower
Axillary Standard
Tympanic 0.5-0.6°C (1°F) lower

c. Rectal Standard
Oral 0.5-0.6°C (1°F) lower
Axillary 0.8-1.0°C (1.5-2.0°F) lower
Tympanic 0.5-0.6°C (1°F) lower

3. Endogenous pyrogens are produced by:

a. macrophages
b. microbes
c. microbial toxins
d. hypothalamus

4. What is truth?
a. Various infectious toxins directly stimulate the hypothalamus.
b. Endogenous pyrogens include the cytokines interleukin 1 (IL-1) and IL-6, tumor necrosis
factor-α (TNF-α), and interferon-β (IFN-β) and IFN-γ.
c. Circadian temperature rhythm results in lower body temperatures in the early morning and
temperatures approximately 2°C higher in the late afternoon or early evening.
d. Antigen-antibody complexes in the presence of complement, complement components,
lymphocyte products, bile acids, and androgenic steroid metabolite the are pyrogens

5. When is a chest radiograph indicated for a febrile young infant?

a. chest x-rays should be performed for all febrile infants who are <2-3 months old
b. for infants who have respiratory symptoms or signs, including cough, tachypnea, irregular
breathing, retractions, rales, wheezing, or decreased breath only
c. for infants who have rectal temperature of >38°C

6. A single isolated fever spike is associated with:

a. an infectious disease
b. the infusion of blood products
c. tissue injury
d. malignancy
7. A single isolated fever spike is associated with:
a. some drugs
b tissue injury
c. malignancy
d. endocrine disorders

8. Cause of very high temperatures (>41°C) is:

a. malignant neuroleptic syndrome
b. infectious disease
c. immunologic-rheumatologic disorders
d. granulomatous diseases

9.Cause of very high temperatures (>41°C) is:

a. endocrine disorders
b. infectious disease
c. heatstroke
d. tissue injury

10. Temperatures that are lower than normal (<36°C) can be associated with:
a. immunologic-rheumatologic disorders
b. overwhelming sepsis
c. hyperthyroidism.
d. tissue injury

11. Temperatures that are lower than normal (<36°C) can be associated with:
a. overuse of antipyretics
b. . vaccines,
c. metabolic disorders
d. heatstroke

12. Intermittent fever is :

a. persistent and does not vary by more than 0.5°C/day
b. persistent and varies by more than 0.5°C/day
c. characterized by febrile periods that are separated by intervals of normal temperature
d. an exaggerated circadian rhythm that includes a period of normal temperatures on most days

13. Remittent fever is:

a. characterized by febrile periods that are separated by intervals of normal temperature
b. persistent and varies by more than 0.5°C/day
c. extremely wide fluctuations
d. persistent and does not vary by more than 0.5°C/day

14. Sustained fever is:

a. persistent and does not vary by more than 0.5°C/day
b. persistent and varies by more than 0.5°C/day
c. characterized by febrile periods that are separated by intervals of normal temperature
d. an exaggerated circadian rhythm that includes a period of normal temperatures on most days

15. Relapsing fever is :

a. persistent and does not vary by more than 0.5°C/day
b. persistent and varies by more than 0.5°C/day
c. characterized by febrile periods that are separated by intervals of normal temperature;
 d. occurs on the 1st and 3rd days

16. Biphasic fever is not characteristic of:

a. poliomyelitis
b. leptospirosis,
c. dengue fever
d. familial Mediterranean fever

17. Periodic fever is characteristic of:

a. yellow fever
b. African hemorrhagic fevers
c. cyclic neutropenia
d. chronic lung disease

18. What is truth?

a. Relative bradycardia (temperature-pulse dissociation), when the pulse rate remains low in the
presence of fever, suggests noninfectious diseases
b. Relative tachycardia, when the pulse rate is elevated out of proportion to the temperature, is
usually due to brucellosis, leptospirosis,
c. Bradycardia in the presence of fever also may be a result of a conduction defect resulting from
cardiac involvement with acute rheumatic fever, Lyme disease, viral myocarditis, or infective
endocarditis.

19. What is truth?

a. Administration of antimicrobial agents can result in a very rapid elimination of bacteria, but fever
can continue for days after all microbes have been eradicated.
b. Fever is a common manifestation of infectious diseases and it is predictive of severity.
c. All infections respond well to appropriate antimicrobial or supportive therapy

20. Febrile Patients at Decreased Risk for Serious Bacterial Infections

a. Neonates (<28 days)
b. IMMUNOCOMPETENT children >36 mo
c. PATIENTS with hyperpyrexia (>40°C)
d. PATIENTS with petechiae

21. Febrile Patients at Increased Risk for Serious Bacterial Infections

a. PATIENTS with hypopyrexia

b. children >36 mo
c. PATIENTS with petechiae
d. . IMMUNOCOMPETENT PATIENTS

22. What is falsehood?

a. An infectious agent, usually viral, is identified in 70% of infants <3 mo of age with fever.
b. Bacteremia is present in 50% of febrile infants <3 mo of age.
c. Febrile infants <3 mo of age require the use of research: cultures of blood, urine, and
cerebrospinal fluid (CSF).
d. Potential bacterial diseases in this age group include otitis media, pneumonia, omphalitis,
mastitis, and other skin and soft tissue infections, sepsis, meningitis, urinary tract infections,
enteritis, osteomyelitis, and suppurative arthritis

23. What is falsehood?

a. Serious bacterial infections are present in 10–15% of previously healthy full-term infants
presenting with rectal temperatures of ≥38°C.
b. Organisms responsible for bacteremia of febrile infants <3 mo of age include group B
streptococcus and Listeria monocytogenes, Salmonella, Escherichia coli, Neisseria meningitidis,
Streptococcus pneumoniae, and Haemophilus influenzae type b, and Staphylococcus aureus ,
c. Ill-appearing (toxic) febrile infants <3 mo of age require prompt hospitalization and immediate
parenteral antimicrobial therapy
d. Infants <3 mo of age with fever who have a total white blood cell (WBC) count of 5,000–15,000
cells/μL, an absolute band count of <1,500 cells/μL are likely to have a serious bacterial infection.

24. Risk factors indicating increased probability of occult bacteremia include:

a. temperature ≥38°C,
b.WBC count ≥10,000/μL,
c. an elevated absolute neutrophil count, band count, erythrocyte sedimentation rate, or C-reactive
protein,
d. Without treatment of acute respiratory infection

25. What is falsehood?

a. Independent of age, fever with petechiae in an ill-appearing patient with or without localizing
signs indicates high risk for life-threatening bacterial infections such as bacteremia, sepsis, and
meningitis.
b. H. influenzae type b disease and Rocky Mountain spotted fever can also present with fever
and petechiae.
c. Management includes prompt hospitalization, culture of blood and CSF, and administration
of appropriate parenteral antimicrobial agents.
d. If no further petechiae develop or if they are secondary to emesis or coughing and the patient
remains well, the patient should be hospitalized anyway.

26. Truth ore false?

FUO (FEVER OF UNKNOWN ORIGIN) is best reserved for children with a fever documented
by a health care provider and for which the cause could not be identified after 2 wk of
evaluation as an outpatient or after 1 wk of evaluation in hospital

27. Truth ore false?

The principal causes of FUO in children are infections and rheumatologic (connective tissue or
autoimmune) diseases, neoplastic disorders, drug fever.

28. Truth ore false?

The systemic infectious diseases most commonly implicated in children with FUO are
salmonellosis, tuberculosis, rickettsial diseases, syphilis, Lyme disease, cat-scratch disease,
atypical prolonged presentations of common viral diseases, infectious mononucleosis,
cytomegalovirus (CMV) infection, viral hepatitis, coccidioidomycosis, histoplasmosis, malaria,
and toxoplasmosis.

29. Truth ore false?

Screening laboratory tests (labs) for children with FUO include a complete blood cell count,
measurement of erythrocyte sedimentation rate, urinalysis, blood and urine cultures, and a chest
radiograph. PCR, polymerase chain reaction.

30. Antipyretic therapy is beneficial in :

a. high-risk patients who have chronic cardiopulmonary diseases, metabolic disorders, or
neurologic diseases and in those who are at risk for febrile seizures;
 b. all children with a temperature greater than 38 degrees
c. children with symptoms of acute viral infection

31. What is falsehood?

a. antipyretic therapy does not change the course of infectious diseases.
b. aspirin is recommended for the treatment of fever in children with of ≥40°C
c. Acetaminophen, 10–15 mg/kg orally every 4 hr, is not associated with significant adverse
effects; however, prolonged use may produce renal injury, and massive overdose may produce
hepatic failure.
.
32. What is falsehood?
a. Fever with temperatures less than 38,5-39°C in healthy children generally does not require
treatment (if patients does not feel uncomfortable).
b. Ibuprofen, 5–10 mg/kg orally every 6–8 hr, is also effective and may cause dyspepsia,
gastrointestinal bleeding, reduced renal blood flow, and rarely, aseptic meningitis, hepatic
toxicity, or aplastic anemia.
c. The decline of body temperature after antipyretic therapy distinguish serious bacterial from
less serious viral diseases.