Escolar Documentos
Profissional Documentos
Cultura Documentos
QUESTÃO 01- Sobre a Paralisia Facial periférica, assinale a alternativa que não
apresenta sintomas ou sinais que podem ser encontrados nesta patologia:
a) Hiperacusia, paresia de hemiface acometida.
b) Paralisia do músculo masseter, hiperacusia.
c) Alteração da sensibilidade gustativa do 1/3 anterior da língua.
d) Redução do lacrimejamento do olho em hemiface acometida.
e) Hiperacusia, redução do lacrimejamento do olho em hemiface acometida.
QUESTÃO 03-Todos os itens abaixo são fatores de risco para a Síndrome do Túnel
do Carpo, EXCETO:
a) Gestação.
b) Hipotireoidismo
c) Fratura do punho
d) Tabagismo
e) Colagenoses
P ágina |2
The putamen is the site most frequently affected. When the expanding hematoma
involves the adjacent internal capsule, there is a contralateral hemiparesis, usually with
hemianesthesia and hemianopia and in large hematomas, aphasia or impaired awareness
of the disorder. Merritt's Neurology, 11th Edition
d) Como opção para abortar a crise convulsiva no pronto socorro poderia lançar
mão do uso do Diazepam ou Midazolam. Sendo este último, por via intranasal
ou intrarretal.
e) Caso a criança não apresentasse um foco infeccioso definido, a punção lombar
deveria ser realizada.
106. Sirven J, Sperling MR, Wingerchuk DM. Early versus late antiepileptic
drug withdrawal for people with epilepsy in remission. Cochrane Database of
Systematic Reviews 2001, Issue 3. Art. No.: CD001902. DOI:
10.1002/14651858.CD001902.
“Do not reduce blood pressure in acute ischemic stroke, except when levels are
extremely high (SBP>220 mmHg or DBP>120 mmHg). In these cases,
reduction must not exceed 15% of the initial blood pressure values in the first 24
hours. (level of evidence: 5, recommendation grade: D)”
QUESTÕES ABERTAS:
3-Cefaleia súbita
Hematoma intraparenquimatoso
1-Tabagismo
3-Etilismo
e
“Most hemorrhages in the brain parenchyma arise in the region of the small arteries that
serve the basal ganglia, thalamus, and brainstem and are caused by an arteriopathy of
chronic hypertension or microatheroma… Other well established risk factors for
intracerebral hemorrhage include increasing age, cigarette smoking, alcohol
consumption, and low serum cholesterol. Individuals of African, Hispanic, or Asian
heritage show a higher incidence of brain hemorrhage than do whites. A few
hemorrhages arise from congophilic amyloid angiopathy, a degenerative disorder
affecting the media of the smaller arteries, mainly that of the cerebral gray matter, and
seen
in elderly individuals.” Merritt's Neurology, 11th Edition
QUESTÃO 04: Cite 3 manifestações clínicas que você espera encontrar neste
paciente:
1-Dismetria .
3-Cefaleia.
P á g i n a | 11
“Cerebellar hemorrhage warrants separate description because the mode of onset differs
from that of cerebral hemorrhage and because it often necessitates surgical evacuation.
The syndrome usually begins abruptly with vomiting and severe ataxia (which usually
prevents standing and walking); it is occasionally accompanied by dysarthria, adjacent
cranial nerve (mostly sixth and seventh) affection, and paralysis of conjugate lateral
gaze to one side, findings that may mislead clinicians into thinking the disease is
primarily in the brainstem. However, a cerebellar origin is suggested by the lack of
changes in the level of consciousness and lack of focal weakness or sensory loss.
Enlargement of the mass does not change the clinical picture until there is enough
brainstem compression to precipitate coma, at which point it is too late for surgical
evacuation of the hemorrhage to reverse the disorder. This small margin of time
between an alert state and an irreversible coma makes it imperative to consider the
diagnosis in all patients with this clinical syndrome and is a reason to have patients who
present in the emergency room with vomiting of undetermined origin attempt to stand
and walk.” Merritt's Neurology, 11th Edition
QUESTÃO 05: Qual parte do SNC foi afetada por esta patologia:
RX tórax PA
ECG
Ecocardiograma transtorácico
Dupplex scan de Artérias carótidas e vertebrais
Revisão laboratorial incluindo lipidograma
Veja o que a diretriz fala: “Chest x-ray-Performed routinely even without evidence
of cardiac or pulmonary disease, chest x-rays have been subject of various studies,
showing that it may change management in 3.8% of the cases. Although it is a small
percentage, it is not negligible116.Glucose-In relation to glucose levels, importance
resides in defining if the clinical situation is a stroke or hypoglycemia, which can mimic
it. Hyperglycemic values are also important, as they can indicate unfavorable
prognosis.Thus, it is well established the requirement, on admission, of exams, such as
complete blood count, blood glucose and glycozilated hemoglobin (in cases of
hyperglycemia), creatinine, urea, electrolytes, arterial blood gas analysis and coag-
ulation, as well as electrocardiogram and cardiac enzymes, due to the common
comorbidity of acute myocardial infarction. (level of evidence: 5; recommendation
grade: D) Exams to be requested in the sub-acute phase: lipid profile, serology for
Chagas’ disease and syphilis, and, in young patients, in addition to the ones already
mentioned, evaluation of autoimmune diseases, arteritis, homocysteine levels, AVM
research, coagulopathy and genetic profile for thrombophylia. (level of evidence: 5,
recommendation grade: D) EEG is indicated when seizure is the possible cause for the
deficit or when it is a complication of the stroke. It may be a differential diagnosis of
stroke and may change treatment indication118.There is indication of ECG,
transthoracic echocardiography, Holter monitoring and cardiac enzymes for cases of
cardiac arrhythmias with suspected embolic stroke, either by atrial fibrillation, acute
myocardial infarction with ventricular dysfunction, valvular failure or in dilated heart
disease, such as in Chagas’ disease119.In young patients, the execution of
transesophageal echocardiography is preferable due to the incidence of patent foramen
ovale. Other exams will be performed as diagnostic hypotheses are raised and according
to the necessity to evaluate treatment, as toxicologic exams, pregnancy tests and HIV
serology.” Arq Neuropsiquiatr 2012;70(8):621-629