Absceso hepático amebiano (10) Flashcards

1
Q

Agente

A

E histolytica (10% población general)

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2
Q

Forma infecciosa

A

Quiste

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3
Q

Forma que causa la enferemdad invasiva

A

Trofozoito

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4
Q

Clinica

A
  • Fiebre
  • Dolor en hipocondrio derecho
  • Disenteria
  • Astenia y adinamia
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5
Q

Factores de riesgo

A
  • Edad 20 a 40 años
  • Masculino
  • Alcoholismo
  • Homosexual
  • HLA DR3
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6
Q

Estudio dx inicial

A

USG abdominal

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7
Q

Estudio laboratorial para confirmar dx

A

Hemaglutinación indirecta

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8
Q

Gammagarfia por E histolytica

A

Lesion fria con borde brillante en lobulo derecho

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9
Q

Descripción de material

A

Salsa de anchoas o chocolate

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10
Q

Tx

A

Metronidazol 750 mg cada 8 hrs por 10 dias
- Tinidazol ante intolerancia
- Intolerania a imidazoles: nitazoxanida

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11
Q

Tiempo de resolución de absceso

A

30 - 300 días

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12
Q

Indicación para punción percutanea

A
  • Absceso lobulo izquierdo
  • Embarazo
  • Tamaño > 10 cm
  • Ruptura
  • Sin mejoria tras 72 hrs
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13
Q

Caracteristicas de abseceso piogeno en gammagrafia

A

Caliente

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14
Q

Factores de mal pronóstico

A
  • Albumina < 2
  • Multiples
  • Volumen > 500 ml
  • Encefalopatia
  • Bilirrubina > 3.5
  • DM
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15
Q

Agente de absceso piogeno

A

E coli

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16
Q

Fisiopatologia

A

La amebiasis intestinal puede diseminarse a través de las venas mesentéricas por circulación portal para producir amebiasis hepática

17
Q

Incidencia de localizacion abscesos

A
  • Lobulo derecho 74%
  • Unico 77%
18
Q

Tx absceso piogeno

A
  • Cefalosporinas 3G + metronidazol
  • Pipe/Tazo + metronidazol
  • Ampicilina + gentamicina + metronidazol