NEUROAIDS / HIV Flashcards

1
Q

NEUROTOXOPLASMOSE (NTX)

A

NEUROINFECC + FREQ
PVHIV CD4 < 100
TOXOPLAS GONDI (PROTOZ)

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2
Q

CLINICA NEUROTOXOPLASMOSE (NTX)

A

HIV + , CONFUSÃO CEFALEIA, CONVULSÃO TONICA OU CLONICAS, HEMIPARESIA
TOMO LESÕES NODUL

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3
Q

TC DE CRANIO NEUROTOXOPLASMOSE (NTX)

A

1 OU + LESÃO NODUL HIPODENSA COM REFORÇO/SINAL ANELAR CONTRASTE + EDEMA PERILESÃO
(DIFER MENING POR CRITOCO > TC É NORMAL)

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4
Q

DX NEUROTOXOPLASMOSE (NTX)
CD4 < 100

A

*CONFIRM > BIOPS + ANATOPAL
*PRATICA > CLIN + IMAGEM

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5
Q

TX NEUROTOXOPLASMOSE (NTX)
(TX SU/PI) SULFA DIA ZINA

A

1LINHA MINS SAUDE > SULFADIAZINA + PIRIMETAMINA + AC FOLINICO X 6 SEM

*ALT VENDO A OPÇÃO NA PERGUNTA > BACTRIM + AC FOLINICO X 6 SEM

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6
Q

ALERGIA SULFAS TX NEUROTOXOPLASMOSE (NTX)
DICA INTERNAÇÃO PRÉVIA ASSOCIA SULFAS
(SD STEVENS JHONSON)

A

CLINDA + PRIMAQUINA + AC FOLINICO X 6 SEM

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7
Q

QUANDO USAR CORTICOIDE NTX

A

-EM EDEMA CEREBRAL + EFEITO DE MASSA
-CUIDADO > PODE MASCARAR DX DIFERENCIAL LINFOMA PRIMARIO SNC , CASO NÃO MELHORA COM TX 15D NTX > PENSAR EM LINFOMA IND BIOPSIA.

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8
Q

MENINGITE CRIPTOCÓCICA

A

ABANDONO TX TARV
CEFALEIA FORTE INTEN, F + IRRITAÇÃO MENINGEA, TC CRANIO NORMAL C/C

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9
Q

MENINGITE CRIPTOCÓCICA
DX

A

-LCR > PLEOCIT / LINFOC
-TINTA CHINA/NANQUIM > ,FORMAS GEMULANTES , DX CRIPTOCOCO 70-90%
-CULTURA (PADRÃO OUR) DX 95-100%
-FLUXO LAT/CRIPTOLATEX (FL-CRAg) > ATG CRIPTO DX EM 10 MIN

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10
Q

TX MENINGITE CRIPTOCÓCICA

A

ANFO B LIPO/COMPLE LIPO EV + FLUTICASONA POR 14 DIAS > POSTER LCR > TRANS FLUCONAZOL 400 MG X DIA 8 SEMANAS > MANUTENÇÃO FLUCO 6M-12M

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11
Q

TX MENINGITE CRIPTOCÓCICA QUANDO INICIAR TARV

A

APÓS 4-6 SEM PÓS TX

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12
Q

JÁ DX COM NEUROCRIPTO INICIANDO TX COM ANFOB + FLUTI EVOLUI COM HIC

A

-TRAIDE DE CUSHING > BRADICAR + HIPERTENS ART + ALT RESP
-TX PUNÇÃO LIQURICA DE ALIVIO (REPETIR SOB DEMANDA) DIM HIC
-AQUI MANITOL NÃO TEM PAPEL NO TX HIC

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13
Q

LEUCOENCEFALOPATIA MULTIFOCAL PROGRESSIVA (LEMP)
-PX COM GRAVE IMUNODEP CD4 < 50

A

-HEMIPARESIA (MOTOR) QUADRANTOPSIA (VISUAL) ATAXIA (COORDENAC)
-INFEC OPORT VIRUS JC (JOHN CONNINGTON) EM LCR
-TX NÃO ESPECIF > TX TARV “IMUNORECONSTRUIÇÕA”

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14
Q

LEMP > RN ENCEFALO

A

LESÃO MULTIFOCAL HIPOSINAL T1 HIPERSINAL T2, COROA RADIADA.

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