Fever of Unknown Origin
Fever of Unknown Origin Quiz
Test your knowledge on the diagnosis and management of Fever of Unknown Origin (FUO). This quiz contains carefully crafted questions designed to challenge both your clinical understanding and practical application of FUO concepts.
- 12 questions covering essential aspects of FUO
- Multiple choice and clinical scenario-based questions
- Engaging format for medical professionals and students alike
Name
True about the definition of Fever of Unknown Origin (FUO):
Fever of >38 C
Illness duration of ≥ 2 weeks
No immunocompromised state
No known comorbids
In patients with unexplained symptoms localized to the central nervous system, GI tract, or joints, they should be tested for?
Q fever
Whipple's disease
Coccidiodomycosis
Malaria
You're the intern at the OPD and you have quiet a group this morning. Which of the following patients scheduled warrants the diagnosis of fever of unknown origin (FUO)?
0%
0
29 y/o woman with nearly daily fever of 38.3 C for 3 weeks. You saw her a week prior with facial rash, bilateral athralgias and fatigue. Lab work-up revealed proteinuria, anemia, and positive test for antinuclear antibodies (ANA) at a titer of >1:640
0%
0
0%
0
26 y/o woman on mycophenolate mofetil, tacrolimus, and prednisone after having undergone kidney transplant 1 year ago. She has had fevers >38.3 C for just over 3 weeks. Evaluation 2 weeks ago included unrevealing results of ESR and CRP levels, CBC, electrolytes, LDH, ferritin, ANA, RF, urinalysis and urine culture, CXR, abdominal ultrasound and tuberculin skin test
0%
0
Which of the following statements regarding the epidemiology and prognosis of FUO is true?
For patients with FUO, an etiologic diagnosis is more likely in elderly patients than in young patients
FUO is usually caused by a very rare disease that escaped diagnosis during the initial obligatory workup
In patients with FUO, the ultimate inability to find an etiologic diagnosis portends a very poor prognosis
In both Western countries and countries outside the West, infection accounts for over half of FUO cases
Factitious fever means:
Fever artificially induced by the patient
Elevated body temperature associated with moderate to strenuous exercise lasting for half an hour up to several hours
Patient is normothermic but manipulates the thermometer
None of the above
What is the most important step in the diagnostic workup?
Getting all necessary laboratory tests
Thorough and complete history and physical examination
Biopsy
Imagings (CT scan, ultrasound, x-ray, etc.)
In a patient that you are working up for FUO, you already obtained a complete history and PE, stopped antibiotic treatment and glucocorticoids and have taken all obligatory tests. Still, you have potentially diagnostic clues (PDCs) that are absent or misleading, which is the next best step?
Do a PET CT scan
Do a biopsy
Do cryoglobulin test and funduscopy
Do blood cultures
50 y/o male taxi driver evaluated for fever and weight loss of uncertain etiology. He developed symptoms 3 months ago. He had daily fevers as high as 39.4 C with night sweats and fatigue. He also had loss of appetite and lost 50 lbs when compared to his last annual examination. He has no exposures or ill contacts. Past medical history significant for DM taking high dose insulin, obesity and OSA. He has never received blood transfusion and married with one sexual partner for 25 years. On exam, no focal findings identified. Multiple labs performed that have shown nonspecific findings only with exception of an elevated calcium level. CBC showed WBC of 15.7 with segmenter predominance 80% and lymphocytes of 15%. Peripheral blood smear is normal. ESR elevated. Rheumoatic panel, ferritin, liver and kidney fun
Empiric treatment with corticosteroids
Empiric treatment for Mycobacterium tuberculosis
Needle biopsy of enlarged lymph nodes
Positron emission tomography (PET)-CT imaging
True or False: Empirical therapeutic trials with antibiotics, glucocorticoids, or anti-TB agents should be avoided in FUO except when a patient's condition is rapidly deteriorating after the diagnostic tests failed to provide a definite diagnosis
True
False
True or False: A negative TST or IGRA exclude a diagnosis of tuberculosis
True
False
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