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Clinica Médica > Sd Demencial E Parkinson > Flashcards

Sd Demencial E Parkinson Flashcards

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1
Q

Epidemio e fisiopato alzheimer

A

Causa mais comum de demencia

Atrofia de hipocampo
Baixa acetilcolina
Deposiçao de amiloide
Fosforilaçao proteina tau

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2
Q

Fatores de risco alzheimer

A 
Idade >60 anos
Historia familiar
Gene apoeE4
Vida sedentaria
Atividade intelectual baixa
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3
Q

Clinica alzheimer

A

Amnesia anterograda:
Afasia
Apraxia (perda destreza)
Agnosia ( reconheximento)

Em 10a evolui: imobilidade/ incontinencia

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4
Q

Diagnostico alzheimer

A 
Por exclusao
Descartar
Metabolicas: funçao renal, hepatica, TSH, B12 e calcio
Infecciosas: VDRL e HIV
Estruturais: TC e RNM
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5
Q

Exames de imagem e caracteristicas do alzheimer

A

Tc: atrofia cortical cm hidrocefalia compensatoria

PET: baixa perfusao/ metabolismo prietal e temporal

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6
Q

Tto alzheimer

A

Anticolinesterasicos de açao central

Antagonistas do receptor NMDA do glutamato

Vitamina E

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7
Q

Anticolinesterasicos de açao central

A

Donezepil
Rivastigmina
Galantamina

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8
Q

Antagonistas do receptor NMDA do glitamato e indicaçao

A

Memantina

Fase avançada alzheimer

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9
Q

Caracteristicas da demencia vascular

A

Progressao em degraus

Associaçao com aterosclerose

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10
Q

Tto demencia vascular

A

Tratar fatores de risco

Anticolinesterasicos (?)

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11
Q

Demencia corpusculos de lewy

A

Demencia
Alucinaçoes visuais
Flutuaçao nivel de consciencia

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12
Q

Dç de Pick

A

Alteraçao comportamento

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13
Q

Sinonimo e clinica hidrocefalia normobarica

A

Hakim-Adams

Ataxia+ incontinencia

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14
Q

Paralisia supranuclear

A

Desvio do olhar conjugado vertical

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15
Q

Dç de creutzfeldt jakob

A

Mioclinia e demencia rapidamente progressiva

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16
Q

Funcionamento do sistema extra piramidal

A 
Substancia negra (dopamina)
Inibe
Corpo estriado (acetilcolina)
Que inibe
Córtex pré motor
17
Q

Fisiopato parkinson

A

Diminuiçao da dopamina na via nigroestriatal

18
Q

Clinica do parkinson

A 
Sinais cardinais
Tremor (+ comum)
Bradcinesia
Rigidez plástica
Instabilidade postural

Nao motores
Hiposmia, apneia sono, demencia e depressao, disautonomia, seborreia

19
Q

Tremor essencial x parkinson

A

Essencial: tremor bilateral, rapido e piora contra a gravidade (lembrar da descarga adrenergica)

Parkinson: repouco (contar moedas)
Assimetrico e unilateral
Frequencia lenta

20
Q

Diagnostico parkison

A

Excluir causas secundarias

Drogas: metoclopramida, flunarizina, haloperidol
Dano: trauma, vascular
Demencias: a maioria faz

21
Q

Tto parkinson

A

Padrao
Levodopa + carbidopa (inibe degradaçao da Dopa)

Opçao: pramipexol (agonista dopaminergico)
Seleginina (inibidor MAO-B)
Amantadina

22
Q

Ef adverso drogas do parkinson

A

Discinesias

On-off

23
Q

Tto parkinson refratario

A

Estimulaçao cerebral profunda

Clinica Médica (61 decks)

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