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(M\311DICO GASTROENTEROLOGIA - 2013)Tj
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/TT1 10 Tf
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(N\315VEL SUPERIOR - MANH\303)Tj
/CS0 cs 1 scn
/GS1 gs
/T1_0 9.5 Tf
0.1177 Tc 0 Tw -17.28 -38.04 Td
(54.)Tj
/T1_1 9.5 Tf
0.0084 Tc -0.2286 Tw 19.8 0 Td
(Em um paciente com colecistite aguda, ducto biliar)Tj
0.05 Tc 0 -15 TD
(c)Tj
0.2613 Tc 1.3285 Tw (omum medindo 1)Tj
0.2645 Tc 83.88 0 Td
(1 mm e bilirrubina diret)Tj
0.275 Tc 108 0 Td
(a de)Tj
0.0078 Tc 0.5667 Tw -191.88 -15 Td
(4,2 mg/dL deve-se realizar:)Tj
0.0288 Tc 0 -17.88 TD
(\(A\))Tj
0.0483 Tc 17.04 0 Td
(co)Tj
-0.1806 Tc -0.25 Tw 9.96 0 Td
(langiopancreatografia endosc\363pica retr\363grada)Tj
0.0427 Tc 1.325 Tw -9.96 -15 Td
(\(CPER\) terap\352utica e avaliar colecistectomia)Tj
0.0088 Tc 0.6 Tw 0 -15 TD
(24 horas ap\363s a CPER)Tj
0.0288 Tc -17.04 -17.76 Td
(\(B\))Tj
-0.0038 Tc 17.04 0 Td
(ne)Tj
-0.1386 Tc 1.325 Tw (cessariamente colangiorresson\342ncia nuclear)Tj
0.114 Tc 1.3333 Tw T*
(magn\351tica antes da colangiopancreatografia)Tj
0.05 Tc T*
(e)Tj
0.5514 Tc 5.28 0 Td
(ndosc\363pica retr\363grada terap\352utica para)Tj
0.0067 Tc 1.2375 Tw -5.28 -15 Td
(confirmar a exist\352ncia de coledocolit\355ase)Tj
-0.2325 Tc -17.04 -17.88 Td
(\(C\))Tj
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(tratamento cl\355nico e programar cirurgia ap\363s o)Tj
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(quinto dia de antibioticoterapia)Tj
-0.2325 Tc -17.04 -17.88 Td
(\(D\))Tj
0 Tc 17.04 0 Td
(c)Tj
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(olangiopancreatografia endosc\363pica retr\363grada)Tj
0.0147 Tc 1.33 Tw -4.68 -15 Td
(e colecistectomia no mesmo ato cir\372rgico)Tj
/T1_0 9.5 Tf
0.1177 Tc -36.84 -26.28 Td
(55.)Tj
/T1_1 9.5 Tf
0.174 Tc 1.3285 Tw 19.8 0 Td
(Sobre o carcinoma de ves\355cula biliar)Tj
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(, \351 correto)Tj
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(afirmar que:)Tj
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(\(A\))Tj
0 Tc 17.04 0 Td
(a)Tj
-0.087 Tc 0.475 Tw ( dissemina\347\343o do tumor se d\341 principalmente)Tj
0.0088 Tc 0.275 Tw 0 -15 TD
(pela via linf\341tica)Tj
0.0288 Tc -17.04 -17.88 Td
(\(B\))Tj
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(extenso envolvimento do ligamento hepatoduodenal)Tj
0.0064 Tc 0.925 Tw T*
(\351 um crit\351rio de irressecabilidade)Tj
-0.2325 Tc -17.04 -17.88 Td
(\(C\))Tj
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(a alfafetoprote\355na \351 usualmente utilizada para)Tj
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(monitorar recidivas)Tj
-0.5925 Tc -17.04 -17.76 Td
(\(D\))Tj
-0.1594 Tc 1.325 Tw 17.04 0 Td
(no caso do carcinoma )Tj
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-0.1722 Tc 1.3 Tw 97.44 0 Td
(in situ)Tj
/T1_1 9.5 Tf
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( deve-se comple-)Tj
-0.1824 Tc 0.6375 Tw -122.4 -15 Td
(mentar a cirurgia com braquiterapia)Tj
/T1_0 9.5 Tf
0.1177 Tc -36.84 -26.4 Td
(56.)Tj
/T1_1 9.5 Tf
0.3618 Tc 1.33 Tw 19.8 0 Td
(A respeito da colangite esclerosante prim\341ria)Tj
0.0053 Tc 0.6 Tw T*
(\(CEP\), pode-se afirmar que:)Tj
0.0288 Tc 0 -17.88 TD
(\(A\))Tj
0.2883 Tc 1.325 Tw 17.04 0 Td
(o transplante hep\341tico est\341 contraindicado)Tj
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(pelo risco de recorr\352ncia)Tj
0.0288 Tc -17.04 -17.76 Td
(\(B\))Tj
0.0088 Tc 1.1928 Tw 17.04 0 Td
(cerca de 10% dos pacientes com CEP apre-)Tj
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(sentam tamb\351m retocolite ulcerativa)Tj
-0.2325 Tc -17.04 -17.88 Td
(\(C\))Tj
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(o)Tj
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( uso de \341cido ursodeoxic\363lico leva \340)Tj
0 Tc -5.28 -15 Td
(r)Tj
-0.0842 Tc 0.2833 Tw 3.12 0 Td
(egress\343o da doen\347a na maioria dos pacientes)Tj
-0.2325 Tc -20.16 -17.88 Td
(\(D\))Tj
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(\351 um importante fator de risco para)Tj
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(colangiocarcinoma)Tj
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(57.)Tj
/T1_1 9.5 Tf
0 Tc 19.8 0 Td
(O)Tj
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( achado histol\363gico caracter\355stico nos pacientes)Tj
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(com defici\352ncia de alfa-1-antitripsina e fen\363tipo PiZZ)Tj
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(\351 a presen\347a de:)Tj
0.0288 Tc 0 -17.76 TD
(\(A\))Tj
0.0681 Tc 1.325 Tw 17.04 0 Td
(corp\372sculos P)Tj
0.0698 Tc 61.08 0 Td
(AS positivos)Tj
0.0288 Tc -78.12 -17.88 Td
(\(B\))Tj
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(necrose em saca bocado)Tj
-0.2325 Tc -17.04 -17.88 Td
(\(C\))Tj
0.0398 Tc 1.325 Tw 17.04 0 Td
(esteatose hep\341tica microvesicular)Tj
-0.2325 Tc -17.04 -17.88 Td
(\(D\))Tj
0.0312 Tc 17.04 0 Td
(corp\372sculos de Mallory)Tj
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(58.)Tj
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0.0078 Tc 0.6071 Tw 19.92 0 Td
(Para um paciente com queixa de pirose refrat\341ria)Tj
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(ao uso de omeprazol 20 mg por dia, endoscopia)Tj
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(erosiva leve e bi\363psias de es\364fago com 25)Tj
0.1 Tc T*
(e)Tj
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(osin\363filos por campo de grande aumento, a)Tj
0.0115 Tc 0.8333 Tw -5.4 -17.4 Td
(conduta mais adequada \351:)Tj
0.0288 Tc 0 -20.16 TD
(\(A\))Tj
0.0316 Tc 1.325 Tw 16.92 0 Td
(iniciar fluticasona t\363pica)Tj
0.0288 Tc -16.92 -20.04 Td
(\(B\))Tj
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(iniciar diet)Tj
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(a isent)Tj
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(a de leite, ovos, frutos do mar)Tj
0 Tc 123 0 Td
(,)Tj
0.0041 Tc 0.6875 Tw -192.96 -17.4 Td
(amendoim, ervilha, milho e soja)Tj
-0.2325 Tc -16.92 -20.16 Td
(\(C\))Tj
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(dobrar a dose de omeprazol e repetir a EDA)Tj
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(com bi\363psias)Tj
-0.2325 Tc -16.92 -20.16 Td
(\(D\))Tj
0.0055 Tc 1.0666 Tw 16.92 0 Td
(realizar teste radio-alergo-absorvente \(RAST\))Tj
0.0557 Tc 1.325 Tw T*
(e testes cut\342neos)Tj
/T1_0 9.5 Tf
0.1177 Tc -36.84 -28.68 Td
(59.)Tj
/T1_1 9.5 Tf
0.1397 Tc 1.3285 Tw 19.92 0 Td
(Em rela\347\343o ao tratamento de um paciente com)Tj
0.008 Tc 0.85 Tw T*
(ascite por cirrose hep\341tica, pode-se afirmar que:)Tj
0.0288 Tc 0 -20.16 TD
(\(A\))Tj
0.6663 Tc 1.325 Tw 16.92 0 Td
(a principal complica\347\343o da anastomose)Tj
0.0078 Tc 0.475 Tw 0 -17.28 TD
(portocava transjugular \351 a peritonite)Tj
0.0288 Tc -16.92 -20.16 Td
(\(B\))Tj
0.7825 Tc 1.33 Tw 16.92 0 Td
(todos pacientes com ascite devem ser)Tj
0.0524 Tc 1.325 Tw T*
(tratados com diur\351ticos)Tj
-0.2325 Tc -16.92 -20.16 Td
(\(C\))Tj
0.2 Tc 16.92 0 Td
(e)Tj
0.3188 Tc 5.52 0 Td
(m casos de s\355ndrome hepatorrenal tipo I)Tj
0.1112 Tc -5.52 -17.28 Td
(deve-se, precocemente, usar furosemida na)Tj
0.0087 Tc 0.2071 Tw T*
(dose de 160mg por dia para estimular diurese)Tj
-0.2325 Tc -16.92 -20.16 Td
(\(D\))Tj
0.672 Tc 5.5099 Tw 16.92 0 Td
(o uso de diur\351ticos pode precipitar)Tj
0.015 Tc 1.35 Tw T*
(encefalopatia hep\341tica)Tj
/T1_0 9.5 Tf
0.1177 Tc -36.84 -28.68 Td
(60.)Tj
/T1_1 9.5 Tf
0.0099 Tc 0.2857 Tw 19.92 0 Td
(No que diz respeito \340 peritonite bacteriana espon-)Tj
0.0078 Tc 0.7 Tw T*
(t\342nea \(PBE\), pode-se afirmar que:)Tj
0.0288 Tc 0 -20.16 TD
(\(A\))Tj
0.0093 Tc 1.3 Tw 16.92 0 Td
(nos casos de PBE complicada em pacientes)Tj
0.1163 Tc 0 -17.28 TD
(qu)Tj
0.3497 Tc 1.325 Tw (e faziam uso regular de norfloxacino, a)Tj
0.5535 Tc 1.33 Tw T*
(primeira escolha de antibi\363tico deve ser)Tj
0.039 Tc 1.325 Tw T*
(sulfametoxazol e trimetoprima)Tj
0.0288 Tc -16.92 -20.16 Td
(\(B\))Tj
0 Tc 16.92 0 Td
(e)Tj
-0.0846 Tc 0.5286 Tw 5.4 0 Td
(m rela\347\343o \340 preven\347\343o de PBE, os pacientes)Tj
0.0071 Tc 0.52 Tw -5.4 -17.4 Td
(com hemorragia digestiva alta devem receber)Tj
0.0086 Tc 0.95 Tw T*
(antibi\363ticos por apenas 7 dias)Tj
-0.2325 Tc -16.92 -20.16 Td
(\(C\))Tj
0.05 Tc 16.92 0 Td
(n)Tj
0.1796 Tc 1.3285 Tw 5.4 0 Td
(os casos em que h\341 resolu\347\343o do quadro)Tj
0.0087 Tc 1.3 Tw -5.4 -17.28 Td
(infeccioso, o progn\363stico \351 excelente)Tj
-0.2325 Tc -16.92 -20.16 Td
(\(D\))Tj
0.671 Tc 4.5332 Tw 16.92 0 Td
(na maioria dos casos, a infec\347\343o \351)Tj
0.0804 Tc T*
(polimicrobiana)Tj
1 0 0 rg
/GS2 gs
/TT2 12 Tf
-32768 Tc 0 Tw 1 0 0 1 220.625 12 Tm
(www.pciconcursos.com.br\r\n)Tj
/TT3 12 Tf
-2060.3249 Tc 0 0 TD
(www.pciconcursos.com.br\r\n)Tj
/TT4 12 Tf
-15457.1038 Tc T*
(www.pciconcursos.com.br\r\n)Tj
/TT5 12 Tf
0.5537 Tc 152.079 0 Td
(\r\n)Tj
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