Scenario 1

Clarifying unfamiliar term

• Fever

• nauseas
Fever
Increasing of temperature in our body (our set
point in hipotalamus)
Cause by microorganism.
Nauseas:
a sympthom in our digestis system
A feeling if you want to vomit
 Problem Definition
• How is the mechanism of Fever
• The connection between nauseas and fever
• Why the after 3 days treatment, the patient
hasn’t healed yet?
• Why the patient feel painful?
• Is there any relation between nose bleeding
and fever?
• The type of fever and what is the type of her?
What is the treatment?
Is fever disturbing our other system?
How the mother knows that is a fever?
 Brainstroming
1. How is the mechanism of Fever
Microorganism  stimulate leukocyte  excrete
phyrogen  increase set point in hypothalamus.

inflammatory agent  entering organ  PGE-2

 caused increasing set point.
 Analyzing The Problem
Pirogen (exogen (microorganisme toxic and classic) and
endogen (IL-1, IL-6, TNF, HFNS))

Pyrogen exogen stimulate lecocytes  leucocytes release a

phyrogenic cytocinesis (IL-1, IL-6, TNF, HFNS)  enetering the
circulation system  stimulate hypothalamus cell  releasing
arakhidonat acid (help by enzyme fosfolipase)  stimulate
synthesis of prostaglandin(PGE-2) in peripheral and brain 
connect the EP-3 in a cell glia  stimulate the releasing of
CAMP  CAMP activate the neuron from hypothalamus to
increase the set point  heat production temperature  fever.
 Physiologic Fever

LO
- High environment temperature?
• Is fever always include the increasing set
point?
• Fever  to kill the bacteria
• Increasing our body temperature.
• A circle system
• A signal that there is a disturbance in our body
• Also an alarm that our body need an energy.
2. The connection between nauseas and fever
Microorganism attack our organs, it cause a nauseas
and fever

• Microorganism attack GI track (intestines or other) –

>> nauseas and fever
ex: Thypoid Fever
• Eat something that there is microorganism In that
food (because the HCL can’t kill it)  disturb the GI
track  give a signal, set point in hypothalamus 
vomit and fever.
(Not all time HCL can kill the bacteria.)
(our immune system isn’t in a good condition)
3. Why the after 3 days treatment, the patient
hasn’t healed yet?
- the work of medicine
- the microorganism system is still alive
(antigen structure)
- ineffective drugs (not a proper medicine, the
function of medicine is different.)
- The Doctor need to know deeper about the
real problem.
• The microorganism can change the structure
 it will cause the fever naik turun.
• Need a time to break the material.
• One of the kind of fever.
4. Why the patient feel painful?
- Our hypothalamus increase set point  feel
cold  stiff  pain

Our body need support/energy  our body feel

cold ask a help to get more heat  do
activities that can get more heat  when our
body is cold, the joint is stiff  blood
circulation.
Microorganism stimulate hypothalamus
(prostaglandin)  inflammation.
 5. Is there any relation between nose bleeding
and fever?
- YES

• Nose bleeding: a symptom of fever

• Our blood  vasodilatation  our nose is dry
 bleeding.
• Vasodilatation  increasing body temperature
 fever.
 6. The type of fever and what is the type of fever that suffer her?

• Remiten Fever
• Continue Fever
• Intermitten Fever
• Quartana
• Malignant Tertiana
• Relapsing Fever (Ratbite Fever)
• Dengue Fever ( kind of bivasic fever)
• Malaria
• Ratbite Fever
• Thypoid and Parathypoid Fever
• Septic Fever and Hectic fever (kind of intermittent fever)
• undulant fever
begin with increasing bt slowly, and come back
to normal slowly.
• Prolonged fever
- in 10 days
-
• The type of her fever?
- Intermitten Fever (hectic and septic fever)
Septic fever  disertai menggigil and sweating
(increasing a temperature in night day, and
drecreasing in the morning to the normal
temperature)
 7. What is the treatment?

• A medicine
• Take a rest
• Drink a lot of warm water
• Compress the patient by warm water
• Traditional medicine (jamu)

Should all fever medicate by medicine?

Can fever just treated by take a rest? (No)
 8. Is fever disturbing our other system?

• YES
 9. How the mother knows that is a fever?

• There is an increasing body temperature

• The mother using thermometer
• They know because she bring her children to a
doctor
 LO
1. What is the disease? And the type
2. Physiologic fever
3. What is the treatment?
4. Is fever disturbing our other system?