<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/0c8e9511-17c3-4f49-8bfd-e601ae79fde4/bg1.png"><div class="c x0 y0 w0 h2"><div class="t m0 x1 h3 y1 ff1 fs0 fc0 sc0 lsc ws1c">Brendha F. Pedro<span class="ff2 ls0">!<span class="ff1">i #85 MedPuc-PR</span></span></div></div><div class="t m0 x2 h4 y2 ff3 fs1 fc0 sc0 lsc ws0">26/05/21<span class="blank"> </span><span class="ff4 ws1c v1"><span class="fc2 sc0">S</span><span class="fc2 sc0">i</span><span class="fc2 sc0">nt</span><span class="fc2 sc0">o</span><span class="fc2 sc0">m</span><span class="fc2 sc0">a</span><span class="fc2 sc0">s</span><span class="fc2 sc0"> </span><span class="fc2 sc0">G</span><span class="fc2 sc0">a</span><span class="fc2 sc0">s</span><span class="fc2 sc0">t</span><span class="fc2 sc0">r</span><span class="fc2 sc0">o</span><span class="fc2 sc0">i</span><span class="fc2 sc0">nt</span><span class="fc2 sc0">e</span><span class="fc2 sc0">s</span><span class="fc2 sc0">t</span><span class="fc2 sc0">i</span><span class="fc2 sc0">na</span><span class="fc2 sc0">i</span><span class="fc2 sc0">s</span><span class="fc2 sc0"> </span></span></div><div class="t m0 x3 h5 y3 ff5 fs1 fc0 sc0 lsd ws1">Disfagi<span class="blank"> </span>a</div><div class="t m0 x3 h6 y4 ff3 fs1 fc0 sc0 lsc ws1c">Dificuldade de deglutir</div><div class="t m0 x3 h6 y5 ff3 fs1 fc0 sc0 lsc ws1c">Orofaríngea: problema inicial de mastigar </div><div class="t m0 x4 h6 y6 ff3 fs1 fc0 sc0 lsc ws1c">Esofágica: problema na passagem pelo esôfago </div><div class="t m0 x4 h6 y7 ff3 fs1 fc0 sc0 lsc ws1c">-> Motora: problema de inervação/descoordenação do </div><div class="t m0 x4 h6 y8 ff3 fs1 fc0 sc0 lsc ws1c">esôfago </div><div class="t m0 x4 h6 y9 ff3 fs1 fc0 sc0 lsc ws1c">-> Mecânica: obstrução int<span class="blank _0"></span>erna ou ext<span class="blank _0"></span>erna do esôfago</div><div class="t m0 x5 h6 ya ff3 fs1 fc0 sc0 lsc ws1c">- odinofagia: dor para engolir -> amigdalit<span class="blank _0"></span>e</div><div class="t m0 x6 h6 yb ff3 fs1 fc0 sc0 lsc ws1c">- globo: sensação de \u201cbola\u201d no esôfago</div><div class="t m0 x7 h6 yc ff3 fs1 fc0 sc0 lsc ws1c">O que acont<span class="blank _0"></span>ece ao engolir?</div><div class="t m0 x7 h6 yd ff3 fs1 fc0 sc0 lsc ws1c">Quanto t<span class="blank _0"></span>empo demora para sentir a dificuldade depois de </div><div class="t m0 x7 h6 ye ff3 fs1 fc0 sc0 lsc">ingerir?</div><div class="t m0 x7 h6 yf ff3 fs1 fc0 sc0 lsc ws1c">Cronologia: início, periodicidade</div><div class="t m0 x6 h6 y10 ff3 fs1 fc0 sc0 lsc ws1c">Localização de onde a comida entala</div><div class="t m0 x7 h6 y11 ff3 fs1 fc0 sc0 lsc ws1c">Tipo de comida: sólido, pastoso, líquido => utilizar exemplos </div><div class="t m0 x7 h6 y12 ff3 fs1 fc0 sc0 lsc ws1c">como: carne, purê e água</div><div class="t m0 x7 h6 y13 ff3 fs1 fc0 sc0 lsc ws1c">Fatores de alívio ou piora -> alívio bebendo água ou mas-</div><div class="t m0 x7 h6 y14 ff3 fs1 fc0 sc0 lsc">sageando?</div><div class="t m0 x4 h6 y15 ff3 fs1 fc0 sc0 lsc ws1c">Sintomas associados: dor, regrgitação, tosse, emagre-</div><div class="t m0 x4 h6 y16 ff3 fs1 fc0 sc0 lsc ws1c">cimento, alergia, asma</div><div class="t m0 x5 h5 y17 ff5 fs1 fc0 sc0 lse ws1c">> <span class="fc1 lsc ws2">Or<span class="ff6">\ue009</span>aríngea</span></div><div class="t m0 x3 h6 y18 ff3 fs1 fc0 sc0 lsc">Diferenciais</div><div class="t m0 x8 h6 y19 ff3 fs1 fc0 sc0 lsc ws1c">*sem regurgitação</div><div class="t m0 x9 h6 y1a ff3 fs1 fc0 sc0 lsc ws1c">*anéis esofágicos fazem estreitamento e dão a sen-</div><div class="t m0 x9 h6 y1b ff3 fs1 fc0 sc0 lsc ws1c">sação </div><div class="t m0 xa h6 y1c ff3 fs1 fc0 sc0 lsc ws1c">*geralment<span class="blank _0"></span>e não acont<span class="blank _0"></span>ecem em momentos de alimen-</div><div class="t m0 xa h6 y1d ff3 fs1 fc0 sc0 lsc">tação</div><div class="t m0 x9 h6 y1e ff3 fs1 fc0 sc0 lsc ws1c">Dificuldade para engolir no começo</div><div class="t m0 x5 h6 y1f ff3 fs1 fc0 sc0 lsc ws1c">\u201cA comida não sai da boca para dentro\u201d -> não consegue </div><div class="t m0 x5 h6 y20 ff3 fs1 fc0 sc0 lsc">engolir</div><div class="t m0 xa h6 y21 ff3 fs1 fc0 sc0 lsc ws1c">Engasgo, tosse ou saída nasal </div><div class="t m0 xa h6 y22 ff3 fs1 fc0 sc0 lsc ws1c">Comida entala no pescoço</div><div class="t m0 xa h6 y23 ff3 fs1 fc0 sc0 lsc ws1c">Pesquisar por problemas neurológicos (tanto próprio do </div><div class="t m0 xa h6 y24 ff3 fs1 fc0 sc0 lsc ws1c">pacient<span class="blank _0"></span>e como familiar)</div><div class="t m0 xb h6 y25 ff3 fs1 fc0 sc0 lsc ws1c">Causas: </div><div class="t m0 xb h6 y26 ff3 fs1 fc0 sc0 lsc ws1c">-> doenças neurológicas: AVC, Parkinson </div><div class="t m0 xb h6 y27 ff3 fs1 fc0 sc0 lsc ws1c">-> dermatopolimiosit<span class="blank _0"></span>e</div><div class="t m0 x5 h6 y28 ff3 fs1 fc0 sc0 lsc ws1c">-> tumores</div><div class="t m0 x5 h6 y29 ff3 fs1 fc0 sc0 lsc ws1c">-> divertículo de Zenker</div><div class="t m0 x5 h6 y2a ff3 fs1 fc0 sc0 lsc ws1c">-> anéis vasculares: má formações art<span class="blank _0"></span>eriais que fazem </div><div class="t m0 x5 h6 y2b ff3 fs1 fc0 sc0 lsc ws1c">a constrição da região</div><div class="t m0 xc h6 y2c ff3 fs1 fc0 sc0 lsc ws1c">-> radiot<span class="blank _0"></span>erapia para tumor de esôfago ou cabeça e </div><div class="t m0 xc h6 y2d ff3 fs1 fc0 sc0 lsc ws1c">pescoço </div><div class="t m0 xc h6 y2e ff3 fs1 fc0 sc0 lsc ws1c">-> ingestão de substâncias corrosivas: soda cáustica, </div><div class="t m0 xc h6 y2f ff3 fs1 fc0 sc0 lsc">pilhas</div><div class="t m0 xd h6 y30 ff3 fs1 fc0 sc0 lsc ws1c">-> medicamentos</div><div class="t m0 xd h5 y31 ff5 fs1 fc0 sc0 lse ws1c">> <span class="fc1 lsc ws3">Es<span class="ff6">\ue009</span><span class="ws2">ágica</span></span></div><div class="t m0 xd h6 y32 ff3 fs1 fc0 sc0 lsc ws1c">Sem problemas para engolir -> \u201ca comida entala mais </div><div class="t m0 xd h6 y33 ff3 fs1 fc0 sc0 lsc ws1c">embaixo\u201d </div><div class="t m0 xe h6 y34 ff3 fs1 fc0 sc0 lsc">Emagrecimento</div><div class="t m0 xe h6 y35 ff3 fs1 fc0 sc0 lsc ws1c">Dor para engolir/descer a comida</div><div class="t m0 xe h6 y36 ff3 fs1 fc0 sc0 lsc">Motilidade:</div><div class="t m0 xf h6 y37 ff3 fs1 fc0 sc0 lsc ws1c">- tanto para alimentos líquidos quanto sólidos</div><div class="t m0 xf h6 y38 ff3 fs1 fc0 sc0 lsc ws1c">- dor retroest<span class="blank _0"></span>ernal</div><div class="t m0 xf h6 y39 ff3 fs1 fc0 sc0 lsc ws1c">- piora com alimentos muito quent<span class="blank _0"></span>es ou muito gelados</div><div class="t m0 xf h6 y3a ff3 fs1 fc0 sc0 lsc ws1c">- movimentos corporais para t<span class="blank _0"></span>entar auxiliar: agachar, </div><div class="t m0 xf h6 y3b ff3 fs1 fc0 sc0 lsc ws1c">levantar os braços</div><div class="t m0 x10 h6 y3c ff3 fs1 fc0 sc0 lsc ws1c">*doença de Chagas, acalásia, espasmo esofágico, es-</div><div class="t m0 x10 h6 y3d ff3 fs1 fc0 sc0 lsc">clerodermia</div><div class="t m0 x11 h6 y3e ff3 fs1 fc0 sc0 lsc">Mecânica:</div><div class="t m0 x12 h6 y3f ff3 fs1 fc0 sc0 lsc ws1c">- no começo a dor para engolir era só para alimen-</div><div class="t m0 x12 h6 y40 ff3 fs1 fc0 sc0 lsc ws1c">tos sólidos, agora acont<span class="blank _0"></span>ece com líquidos também</div><div class="t m0 x12 h6 y41 ff3 fs1 fc0 sc0 lsc ws1c">- regurgitação</div><div class="t m0 x12 h6 y42 ff3 fs1 fc0 sc0 lsc ws1c">- emagrecimento</div><div class="t m0 x13 h6 y43 ff3 fs1 fc0 sc0 lsc ws1c">*neoplasia de esôfago não costuma doer!</div><div class="t m0 x10 h6 y44 ff3 fs1 fc0 sc0 lsc ws1c">- int<span class="blank _0"></span>ermit<span class="blank _0"></span>ent<span class="blank _0"></span>e + vários copos de água para descer = </div><div class="t m0 x10 h6 y45 ff3 fs1 fc0 sc0 lsc ws1c">má formações em anéis esofágicos</div><div class="t m0 xf h6 y46 ff3 fs1 fc0 sc0 lsc ws1c">*câncer de esôfago, esofagit<span class="blank _0"></span>es, anéis/t<span class="blank _0"></span>eias (má for-</div><div class="t m0 xf h6 y47 ff3 fs1 fc0 sc0 lsc ws1c">mações congênitas), compressão vascular do esôfa-</div><div class="t m0 xf h6 y48 ff3 fs1 fc0 sc0 lsc ws1c">go, infecções (causam esofagit<span class="blank _0"></span>es)</div><div class="t m0 xf h6 y49 ff3 fs1 fc0 sc0 lsc ws1c">*tricobezoar: acúmulo de cabelo deglutido e não</div><div class="t m0 x14 h6 y4a ff3 fs1 fc0 sc0 lsc ws1c"> digerido => \u201cbola de pelo\u201d</div><div class="t m0 x15 h5 y4b ff5 fs1 fc0 sc0 lsd ws1">Dia<span class="blank"> </span>r<span class="blank"> </span>réi<span class="blank"> </span>a</div><div class="t m0 x15 h6 y4c ff3 fs1 fc0 sc0 lsc ws1c">Definição: aumento do número de evacuações, geralmen-</div><div class="t m0 x15 h6 y4d ff3 fs1 fc0 sc0 lsc ws1c">t<span class="blank _0"></span>e com fezes liquefeitas ou mal formadas</div><div class="t m0 x16 h6 y4e ff3 fs1 fc0 sc0 lsc ws1c">Pseudo-diarréia: irritação na região anal ou perianal na </div><div class="t m0 x16 h6 y4f ff3 fs1 fc0 sc0 lsc ws1c">qual, a partir do momento em que o bolo fecal chega na </div><div class="t m0 x16 h6 y50 ff3 fs1 fc0 sc0 lsc ws1c">região, há uma liberação gradual das fezes </div><div class="t m0 x15 h7 y51 ff7 fs2 fc0 sc0 lsc ws1c">*importância clínica: considerada quando há mais de 3 episódios por dia </div><div class="t m1 x17 h8 y52 ff8 fs3 fc2 sc0 lsc">-</div><div class="t m2 x18 h9 y53 ff8 fs4 fc2 sc0 lsf">rs</div><div class="t m3 x19 ha y54 ff8 fs5 fc2 sc0 ls10 ws4">geralmente</div><div class="t m4 x1a hb y55 ff8 fs6 fc2 sc0 ls1 ws5">não</div><div class="t m5 x1b hc y56 ff8 fs7 fc2 sc0 ls2 ws6">tem</div><div class="t m6 x1c hd y57 ff8 fs8 fc2 sc0 ls11">dor</div><div class="t m7 x1d he y58 ff8 fs9 fc2 sc0 ls12">no</div><div class="t m8 x1e hf y59 ff8 fsa fc2 sc0 ls3 ws7">início</div><div class="t m9 x17 h10 y5a ff8 fsb fc2 sc0 lsc">I</div><div class="t ma x1f h11 y5b ff8 fsc fc2 sc0 lsc">I</div><div class="t mb x17 h12 y5c ff8 fsd fc2 sc0 lsc">.</div><div class="t mc x20 h13 y5d ff8 fse fc2 sc0 lsc">"</div><div class="t md x21 h14 y5e ff8 fsf fc2 sc0 lsc">~</div><div class="t me x22 h15 y5f ff8 fs10 fc2 sc0 ls4 ws8">muito</div><div class="t mf x1e h16 y60 ff8 fs11 fc2 sc0 ls5 ws9">comum</div><div class="t m10 x23 h17 y61 ff8 fs12 fc2 sc0 ls13">em</div><div class="t m11 x1c h18 y62 ff8 fs13 fc2 sc0 ls6 wsa">casos</div><div class="t m12 x24 h19 y63 ff8 fs14 fc2 sc0 ls14">de</div><div class="t m13 x25 h1a y64 ff8 fs15 fc2 sc0 ls7 wsb">ansiedade</div><div class="t m14 x20 h1b y65 ff9 fs16 fc2 sc0 lsc">:</div><div class="t m15 x20 h1c y66 ff8 fs17 fc2 sc0 lsc">.</div><div class="t m16 x26 h1d y67 ff8 fs18 fc2 sc0 lsc">*</div><div class="t m17 x27 h1e y68 ff8 fs19 fc2 sc0 ls15 wsc">problema</div><div class="t m18 x28 h1f y69 ff8 fs1a fc2 sc0 ls16">de</div><div class="t m19 x29 h20 y6a ff8 fs1b fc2 sc0 ls17 wsd">inervação</div><div class="t m1a x2a h21 y6b ff8 fs1c fc2 sc0 lsc">*</div><div class="t m1b x2b h22 y6c ff8 fs1d fc2 sc0 ls18 wse">espasmos</div><div class="t m1c x2c h23 y6d ffa fs1e fc2 sc0 lsc">µ</div><div class="t m1d x2d h24 y6e ff8 fs1f fc2 sc0 ls8 wsf">geram</div><div class="t m1e x2e h25 y6f ff8 fs20 fc2 sc0 ls19 ws10">espasmos</div><div class="t m1f x1f h26 y70 ffb fs21 fc2 sc0 lsc">:</div><div class="t m20 x1f h27 y71 ff8 fs22 fc2 sc0 lsc">/</div><div class="t m21 x1f h28 y72 ff8 fs23 fc2 sc0 lsc">\u2022</div><div class="t m22 xd h29 y73 ff8 fs24 fc2 sc0 lsc">.</div><div class="t m23 x26 h2a y74 ff8 fs25 fc2 sc0 lsc">*</div><div class="t m24 x2f h2b y75 ff8 fs26 fc2 sc0 ls1a ws11">obstrução</div><div class="t m25 x30 h2c y76 ff8 fs27 fc2 sc0 ls9 ws12">intrínseca</div><div class="t m26 x31 h2d y77 ff8 fs28 fc2 sc0 ls1b">ou</div><div class="t m27 x32 h2e y78 ff8 fs29 fc2 sc0 ls1c ws13">ext<span class="blank"> </span>r<span class="blank"> </span>í<span class="blank"> </span>n<span class="blank"> </span>s<span class="blank"> </span>e<span class="blank"> </span>ca</div><div class="t m28 x1f h2f y79 ff8 fs2a fc2 sc0 lsc">\</div><div class="t m29 x2 h30 y7a ff8 fs2b fc2 sc0 lsc">I</div><div class="t m2a x33 h31 y7b ffa fs2c fc2 sc0 lsc">µ</div><div class="t m2b x34 h32 y7c ff8 fs2d fc2 sc0 ls1d ws14">Orofaríngea</div><div class="t m2c x2 h33 y7d ff8 fs2e fc2 sc0 lsc">/</div><div class="t m2d x35 h34 y7e ff8 fs2f fc2 sc0 lsc">></div><div class="t m2e x35 h35 y7f ff8 fs30 fc2 sc0 lsc">></div><div class="t m2f x36 h36 y80 ff8 fs31 fc2 sc0 ls1e ws15">esofagite</div><div class="t m30 x37 h37 y81 ff8 fs32 fc2 sc0 ls1f ws16">eosenofílica</div><div class="t m31 x8 h38 y82 ff8 fs33 fc2 sc0 lsc">></div><div class="t m32 x38 h39 y83 ff8 fs34 fc2 sc0 ls20 ws17">neoplasias</div><div class="t m33 x39 h3a y84 ff8 fs35 fc2 sc0 lsc">e</div><div class="t m34 x5 h3b y85 ff8 fs36 fc2 sc0 lsc">I</div><div class="t m35 x3a h3c y86 ff8 fs37 fc2 sc0 lsc">I</div><div class="t m36 x3a h3d y87 ff8 fs38 fc2 sc0 lsc">I</div><div class="t m37 x3a h3e y88 ff8 fs39 fc2 sc0 lsc">-</div><div class="t m38 x3b h3f y89 ff8 fs3a fc2 sc0 lsc">I</div><div class="t m39 x7 h40 y8a ff8 fs3b fc2 sc0 lsc">I</div><div class="t m3a x34 h41 y8b ffc fs3c fc2 sc0 lsc">\udb8b\udc1b</div><div class="t m3b x3c h42 y8c ffa fs3d fc2 sc0 lsc">\u2463</div><div class="t m3c x3d h43 y8d ff8 fs3e fc2 sc0 lsa ws18">comum</div><div class="t m3d x3b h12 y8e ff8 fsd fc2 sc0 lsc">.</div><div class="t m3e x3e h44 y8f ffd fs3f fc2 sc0 lsc">\u21b3</div><div class="t m3f x3f h45 y90 ff8 fs40 fc2 sc0 lsb ws19">não</div><div class="t m40 x40 h46 y91 ff8 fs41 fc2 sc0 ls21">há</div><div class="t m41 x2b h47 y92 ff8 fs42 fc2 sc0 ls22 ws1a">aumento</div><div class="t m42 x41 h48 y93 ff8 fs43 fc2 sc0 ls23">na</div><div class="t m43 x42 h49 y94 ff8 fs44 fc2 sc0 ls24 ws1b">quantidade</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/0c8e9511-17c3-4f49-8bfd-e601ae79fde4/bg2.png"><div class="c x0 y0 w0 h2"><div class="t m0 x1 h3 y1 ff1 fs0 fc0 sc0 lsc ws1c">Brendha F. Pedro<span class="ff2 ls0">!<span class="ff1">i #85 MedPuc-PR</span></span></div></div><div class="t m0 x4 h6 y95 ff3 fs1 fc0 sc0 lsc ws1c">Incontinência fecal: não há capacidade esfinct<span class="blank _0"></span>eriana para </div><div class="t m0 x4 h6 y96 ff3 fs1 fc0 sc0 lsc ws1c">\u201csegurar\u201d as fezes</div><div class="t m0 x7 h6 y97 ff3 fs1 fc0 sc0 lsc ws1c">- aguda: até 2 semanas</div><div class="t m0 x7 h6 y98 ff3 fs1 fc0 sc0 lsc ws1c">- persist<span class="blank _0"></span>ent<span class="blank _0"></span>e: entre 2 e 4 semanas</div><div class="t m0 x7 h6 y99 ff3 fs1 fc0 sc0 lsc ws1c">- crônica: mais de 4 semanas</div><div class="t m0 x4 h6 y9a ff3 fs1 fc0 sc0 lsc ws1c">Disent<span class="blank _0"></span>eria: diarréia com sangue</div><div class="t m0 x7 h6 y9b ff3 fs1 fc0 sc0 lsc">Causas:</div><div class="t m0 x4 h6 y9c ff3 fs1 fc0 sc0 lsc ws1c">Classificação cronológica:</div><div class="t m0 x6 h6 y9d ff3 fs1 fc0 sc0 lsc ws1c">-> Orgânica</div><div class="t m0 x6 h6 y9e ff3 fs1 fc0 sc0 lsc ws1c">-> Funcional</div><div class="t m0 xb h6 y9f ff3 fs1 fc0 sc0 lsc ws1c">- doenças infecciosas</div><div class="t m0 xb h6 ya0 ff3 fs1 fc0 sc0 lsc ws1c">- verminoses</div><div class="t m0 xb h6 ya1 ff3 fs1 fc0 sc0 lsc ws1c">- tumores</div><div class="t m0 xb h6 ya2 ff3 fs1 fc0 sc0 lsc ws1c">- hipertireoidismo</div><div class="t m0 xb h6 ya3 ff3 fs1 fc0 sc0 lsc ws1c">- diabet<span class="blank _0"></span>es</div><div class="t m0 xb h6 ya4 ff3 fs1 fc0 sc0 lsc ws1c">- não está associada à uma causa orgnânica</div><div class="t m0 x5 h6 ya5 ff3 fs1 fc0 sc0 lsc ws1c">- geralment<span class="blank _0"></span>e associadas a problemas emocionais</div><div class="t m0 x43 h6 ya6 ff3 fs1 fc0 sc0 lsc">Perguntar:</div><div class="t m0 x6 h6 ya7 ff3 fs1 fc0 sc0 lsc ws1c">- cronologia</div><div class="t m0 x6 h6 ya8 ff3 fs1 fc0 sc0 lsc ws1c">- número de vezes que vai ao banheiro</div><div class="t m0 x7 h6 ya9 ff3 fs1 fc0 sc0 lsc ws1c">- contínua ou em episódios (paroxística)</div><div class="t m0 x7 h6 yaa ff3 fs1 fc0 sc0 lsc ws1c">- início súbito (t<span class="blank _0"></span>eve que parar tudo para ir ao banheiro) </div><div class="t m0 x7 h6 yab ff3 fs1 fc0 sc0 lsc ws1c">ou gradual (começou com alguns episódios)</div><div class="t m0 x6 h6 yac ff3 fs1 fc0 sc0 lsc ws1c">- presença de muco, pus ou sangue <span class="ff7 fc3">=> sinal de alerta </span></div><div class="t m0 x6 h4a yad ff7 fs1 fc3 sc0 lsc ws1c">para problemas invasivos!</div><div class="t m0 x7 h6 yae ff3 fs1 fc0 sc0 lsc ws1c">- sintomas de depleção do espaço extracelular (DEEC) ou </div><div class="t m0 x7 h6 yaf ff3 fs1 fc0 sc0 lsc ws1c">desnutrição: tontura, muita sede, etc</div><div class="t m0 x6 h6 yb0 ff3 fs1 fc0 sc0 lsc ws1c">- fatores de melhora ou piora</div><div class="t m0 x7 h6 yb1 ff3 fs1 fc0 sc0 lsc ws1c">- o que acont<span class="blank _0"></span>ece no jejum</div><div class="t m0 x7 h6 yb2 ff3 fs1 fc0 sc0 lsc ws1c">- alimentos específicos</div><div class="t m0 x7 h6 yb3 ff3 fs1 fc0 sc0 lsc ws1c">- medicamentos </div><div class="t m0 x7 h6 yb4 ff3 fs1 fc0 sc0 lsc ws1c">- viagens para áreas endêmicas</div><div class="t m0 x7 h6 yb5 ff3 fs1 fc0 sc0 lsc ws1c">- sintomas associados: náusea, vômito, dor</div><div class="t m0 x7 h6 yb6 ff3 fs1 fc0 sc0 lsc ws1c">- aspectos das fezes</div><div class="t m0 x7 h6 yb7 ff3 fs1 fc0 sc0 lsc ws1c">Sinais de alerta: neoplasia, infecções graves e doença </div><div class="t m0 x7 h6 yb8 ff3 fs1 fc0 sc0 lsc ws1c">inflamatória int<span class="blank _0"></span>estinal (DII)</div><div class="t m0 x7 h6 yb9 ff3 fs1 fc0 sc0 lsc ws1c">- perda de peso</div><div class="t m0 x7 h6 yba ff3 fs1 fc0 sc0 lsc ws1c">- febre</div><div class="t m0 x7 h6 ybb ff3 fs1 fc0 sc0 lsc ws1c">- disent<span class="blank _0"></span>eria </div><div class="t m0 x7 h6 ybc ff3 fs1 fc0 sc0 lsc ws1c">- histórico familiar</div><div class="t m0 x7 h6 ybd ff3 fs1 fc0 sc0 lsc ws1c">- HIV</div><div class="t m0 x7 h6 ybe ff3 fs1 fc0 sc0 lsc ws1c">- diarreia persist<span class="blank _0"></span>ent<span class="blank _0"></span>e/crônica com mais de 50 anos</div><div class="t m0 x43 h6 ybf ff3 fs1 fc0 sc0 lsc ws1c">- acordar por causa da diarréia (afasta causa funcional)</div><div class="t m0 x44 h6 yc0 ff3 fs1 fc0 sc0 lsc ws1c">Relacionadas a int<span class="blank _0"></span>estino delgado: aquosa, vários episódios, </div><div class="t m0 x44 h6 yc1 ff3 fs1 fc0 sc0 lsc ws1c">restos alimentares, dor periumbilical</div><div class="t m0 x45 h6 yc2 ff3 fs1 fc0 sc0 lsc ws1c">Relacionadas a int<span class="blank _0"></span>estino grosso: pastosa, poucos episódios, </div><div class="t m0 x45 h6 yc3 ff3 fs1 fc0 sc0 lsc ws1c">dor em baixo ventre, t<span class="blank _0"></span>enesmo retal/puxo (espasmo do </div><div class="t m0 x45 h6 yc4 ff3 fs1 fc0 sc0 lsc ws1c">esfínct<span class="blank _0"></span>er, sensação de evacuação incompleta, dor em re-</div><div class="t m0 x16 h6 yc5 ff3 fs1 fc0 sc0 lsc ws1c">gião anal -> DII)</div><div class="t m0 x45 h6 yc6 ff3 fs1 fc0 sc0 lsc ws1c">Disent<span class="blank _0"></span>eria: </div><div class="t m0 x44 h6 yc7 ff3 fs1 fc0 sc0 lsc ws1c">- doença inflamatória</div><div class="t m0 x46 h6 yc8 ff3 fs1 fc0 sc0 lsc ws1c">- neoplasia</div><div class="t m0 x46 h6 yc9 ff3 fs1 fc0 sc0 lsc ws1c">- colit<span class="blank _0"></span>e isquêmica: necrose dos vasos que irrigam o int<span class="blank _0"></span>es-</div><div class="t m0 x46 h6 yca ff3 fs1 fc0 sc0 lsc ws1c">tino </div><div class="t m0 x46 h4a ycb ffe fs1 fc0 sc0 lsc ws1c">- bactérias graves:<span class="blank _1"> </span><span class="fff fs45 v2">Salmonella, Shigella, Entamoeba, E. Coli</span></div><div class="t m0 x44 h4b ycc fff fs45 fc0 sc0 lsc ws1c">(O157:H7), Campylobacter</div><div class="t m0 x44 h6 ycd ff3 fs1 fc0 sc0 lsc ws1c">Colit<span class="blank _0"></span>e pseudomembranosa </div><div class="t m0 x30 h4c yce fff fs46 fc4 sc0 lsc ws1c">(Clostridium dif\ufb01cile)</div><div class="t m0 x47 h6 ycf ff3 fs1 fc0 sc0 lsc ws1c">- pacient<span class="blank _0"></span>e que est<span class="blank _0"></span>eve recent<span class="blank _0"></span>ement<span class="blank _0"></span>e hospitalizado</div><div class="t m0 x47 h6 yd0 ff3 fs1 fc0 sc0 lsc ws1c">- uso de antibítico</div><div class="t m0 x46 h6 yd1 ff3 fs1 fc0 sc0 lsc ws1c">- pacient<span class="blank _0"></span>es institucionalizados: idosos que moram em asilo</div><div class="t m0 x47 h5 yd2 ff5 fs1 fc0 sc0 lse ws1c">> <span class="fc1 lsd">Dia<span class="blank _2"> </span>rréi<span class="blank _2"> </span>a <span class="blank _2"> </span>Se<span class="blank _2"> </span>cre<span class="blank _2"> </span>tó<span class="blank _2"> </span>ri<span class="blank _2"> </span>a</span></div><div class="t m0 x20 h6 yd3 ff3 fs1 fc0 sc0 lsc ws1c">Geralment<span class="blank _0"></span>e pacient<span class="blank _0"></span>es com abuso de laxant<span class="blank _0"></span>es</div><div class="t m0 x20 h6 yd4 ff3 fs1 fc0 sc0 lsc ws1c">Caract<span class="blank _0"></span>erísticas: aquosa, volumosa, indolor, acont<span class="blank _0"></span>ecem </div><div class="t m0 x20 h6 yd5 ff3 fs1 fc0 sc0 lsc ws1c">mesmo no jejum</div><div class="t m0 x48 h6 yd6 ff3 fs1 fc0 sc0 lsc ws1c">Causas: laxant<span class="blank _0"></span>es, álcool, bactérias, colorréica (sais bilia-</div><div class="t m0 x48 h6 yd7 ff3 fs1 fc0 sc0 lsc ws1c">res causam a diarréria), cirurgia int<span class="blank _0"></span>estinal, doença de </div><div class="t m0 x48 h6 yd8 ff3 fs1 fc0 sc0 lsc ws1c">Addison, tumores que aumentam a secreção do VIP </div><div class="t m0 x48 h6 yd9 ff3 fs1 fc0 sc0 lsc ws1c">(peptídeo vasoativo int<span class="blank _0"></span>estinal)</div><div class="t m0 x47 h5 yda ff5 fs1 fc0 sc0 lse ws1c">> <span class="fc1 lsd">Dia<span class="blank _2"> </span>rréi<span class="blank _2"> </span>a <span class="blank _2"> </span>Osm<span class="blank _2"> </span>óti<span class="blank _2"> </span>ca</span></div><div class="t m0 xc h6 ydb ff3 fs1 fc0 sc0 lsc ws1c">Presença de uma substância osmótica que \u201cpuxa\u201d o lí-</div><div class="t m0 xc h6 ydc ff3 fs1 fc0 sc0 lsc ws1c">quido para dentro da luz int<span class="blank _0"></span>estinal</div><div class="t m0 xd h6 ydd ff3 fs1 fc0 sc0 lsc ws1c">Caract<span class="blank _0"></span>erísticas: pastosa, cessam com o jejum, alimen-</div><div class="t m0 xd h6 yde ff3 fs1 fc0 sc0 lsc ws1c">tos específicos, acompanhada de flatulências</div><div class="t m0 xd h6 ydf ff3 fs1 fc0 sc0 lsc ws1c">Causas: laxant<span class="blank _0"></span>es, dissacaridases (intolerância a lacto-</div><div class="t m0 xd h6 ye0 ff3 fs1 fc0 sc0 lsc">se)</div><div class="t m0 x48 h5 ye1 ff5 fs1 fc0 sc0 lse ws1c">> <span class="fc1 lsd">Dia<span class="blank _2"> </span>rréi<span class="blank _2"> </span>a <span class="blank _2"> </span>Inf<span class="blank _3"> </span>lamató<span class="blank _2"> </span>ri<span class="blank _2"> </span>a</span></div><div class="t m0 xd h6 ye2 ff3 fs1 fc0 sc0 lsc ws1c">Causas: doença de Crohn, retocolit<span class="blank _0"></span>e ulcerativa (RCU), </div><div class="t m0 xd h6 ye3 ff3 fs1 fc0 sc0 lsc">eosinofílica</div><div class="t m0 xd h6 ye4 ff3 fs1 fc0 sc0 lsc ws1c">Caract<span class="blank _0"></span>erísticas:pastosas, pode t<span class="blank _0"></span>er febre associada, </div><div class="t m0 xd h6 ye5 ff3 fs1 fc0 sc0 lsc ws1c">dor em baixo ventre, muco/pus e sangue nas fezes</div><div class="t m44 x17 h4d ye6 ff8 fs47 fc2 sc0 lsc">\</div><div class="t m45 x15 h4e ye7 ff8 fs48 fc2 sc0 lsc">.</div><div class="t m46 x2 h4f ye8 ff8 fs49 fc2 sc0 lsc">'</div><div class="t m47 x49 h50 ye9 ff8 fs4a fc2 sc0 lsc">,</div><div class="t m48 x1f h51 yea ff8 fs4b fc2 sc0 lsc">°</div><div class="t m49 x49 h52 yeb ff8 fs4c fc2 sc0 lsc">,</div><div class="t m4a x1f h53 yec ff8 fs4d fc2 sc0 lsc">\</div><div class="t m4b x49 h54 yed ff8 fs4e fc2 sc0 lsc">/</div><div class="t m4c x1f h55 yee ff8 fs4f fc2 sc0 lsc">/</div><div class="t m4d x47 h12 yef ff8 fsd fc2 sc0 lsc">s</div><div class="t m4e x47 h12 yf0 ff8 fsd fc2 sc0 lsc">-</div><div class="t m4f x46 h56 yf1 ff8 fs50 fc2 sc0 lsc">-</div><div class="t m50 x4a h57 yf2 ff10 fs51 fc2 sc0 lsc">\u2192</div><div class="t m51 x4b h58 yf3 ff8 fs52 fc2 sc0 lsc">></div><div class="t m52 x4c h59 yf4 ff8 fs53 fc2 sc0 ls25 ws1d">amarelado</div><div class="t m53 x4d h5a yf5 ff8 fs54 fc2 sc0 ls26 ws1e">catarro</div><div class="t m54 x4e h5b yf6 ff8 fs55 fc2 sc0 lsc">(</div><div class="t m55 x4f h5c yf7 ff8 fs56 fc2 sc0 lsc">"</div><div class="t m56 x1a h5d yf8 ff8 fs57 fc2 sc0 ls29">espuminha</div><div class="t m57 x50 h5e yf9 ff8 fs58 fc2 sc0 lsc">"</div><div class="t m58 x1c h5f yfa ff8 fs59 fc2 sc0 lsc">)</div><div class="t m59 x48 h60 yfb ff8 fs5a fc2 sc0 lsc">></div><div class="t m5a x51 h61 yfc ff8 fs5b fc2 sc0 ls2a">rs</div><div class="t m5b x52 h62 yfd ff8 fs5c fc2 sc0 ls27 ws1f">muito</div><div class="t m5c x53 h63 yfe ff8 fs5d fc2 sc0 ls28 ws20">comum</div><div class="t m5d x54 h64 yff ff8 fs5e fc2 sc0 ls2b ws21">diarreia</div><div class="t m5e x55 h65 y100 ff8 fs5f fc2 sc0 ls2c ws22">medicamentosa</div><div class="t m5f x48 h66 y101 ff8 fs60 fc2 sc0 lsc">.</div><div class="t m60 x48 h67 y102 ff8 fs61 fc2 sc0 lsc">I</div><div class="t m61 x2 h68 y103 ff8 fs62 fc2 sc0 lsc">I</div><div class="t m62 x56 h12 y104 ff8 fsd fc2 sc0 lsc">-</div><div class="t m63 x56 h69 y105 ff8 fs63 fc2 sc0 lsc">I</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/0c8e9511-17c3-4f49-8bfd-e601ae79fde4/bg3.png"><div class="c x0 y0 w0 h2"><div class="t m0 x1 h3 y1 ff1 fs0 fc0 sc0 lsc ws1c">Brendha F. Pedro<span class="ff2 ls0">!<span class="ff1">i #85 MedPuc-PR</span></span></div></div><div class="t m0 x8 h5 y106 ff5 fs1 fc0 sc0 lse ws1c">> <span class="fc1 ls2e ws23">Est<span class="blank _0"></span>e<span class="blank _0"></span>a<span class="blank _0"></span>t<span class="blank _0"></span><span class="ff6 ws24">\ue00d<span class="ff5 ws23">r<span class="blank _4"></span>éi<span class="blank _4"></span>a</span></span></span></div><div class="t m0 x57 h6 y107 ff3 fs1 fc0 sc0 lsc ws1c">Presença de gordura nas fezes</div><div class="t m0 x57 h6 y108 ff3 fs1 fc0 sc0 lsc ws1c">Caract<span class="blank _0"></span>erísticas: gordurosas, mal-cheirosas, fezes </div><div class="t m0 x57 h6 y109 ff3 fs1 fc0 sc0 lsc ws1c">\u201cboiando\u201d, difícil de dar descarga, má-absorção int<span class="blank _0"></span>es-</div><div class="t m0 x57 h6 y10a ff3 fs1 fc0 sc0 lsc ws1c">tinal (não absorve substâncias important<span class="blank _0"></span>es - pode </div><div class="t m0 x57 h6 y10b ff3 fs1 fc0 sc0 lsc ws1c">levar à desnutrição)</div><div class="t m0 x57 h6 y10c ff3 fs1 fc0 sc0 lsc ws1c">Causas: doença celíaca, insuficiência pancreática, doen-</div><div class="t m0 x57 h6 y10d ff3 fs1 fc0 sc0 lsc ws1c">ça de Whipple (doença infecciosa rara), giardíase, es-</div><div class="t m0 x57 h6 y10e ff3 fs1 fc0 sc0 lsc ws1c">trongiloidíase, colit<span class="blank _0"></span>e isquêmica</div><div class="t m0 x57 h5 y10f ff5 fs1 fc0 sc0 lse ws1c">> <span class="fc1 lsc ws2">S<span class="blank _0"></span>índr<span class="ff6">\ue00b</span><span class="ws1c">e do Intestino I<span class="blank _4"></span>rritável </span></span></div><div class="t m0 x58 h6 y110 ff3 fs1 fc0 sc0 lsc ws1c">Dor abdominal difusa</div><div class="t m0 x58 h6 y111 ff3 fs1 fc0 sc0 lsc ws1c">Alívio com defecção \u2018urgent<span class="blank _0"></span>e\u2019</div><div class="t m0 x58 h6 y112 ff3 fs1 fc0 sc0 lsc ws1c">Fezes com muco</div><div class="t m0 x58 h6 y113 ff3 fs1 fc0 sc0 lsc ws1c">Costuma a ser matinal</div><div class="t m0 x58 h6 y114 ff3 fs1 fc0 sc0 lsc ws1c">Relacionada ao estresse</div><div class="t m0 x3 h5 y115 ff5 fs1 fc0 sc0 ls2d ws1c">Caus<span class="blank _0"></span>as de Diarr<span class="blank _0"></span>éia f<span class="ff6">\ue00d</span>a do Apar<span class="blank _0"></span>elho Gastroin<span class="blank _0"></span>testinal </div><div class="t m0 x7 h6 y116 ff3 fs1 fc0 sc0 lsc ws25">Diabet<span class="blank _0"></span>es</div><div class="t m0 x7 h6 y117 ff3 fs1 fc0 sc0 lsc ws1c">Hipertireoidismo </div><div class="t m0 x7 h6 y118 ff3 fs1 fc0 sc0 lsc ws1c">Factícia: ingestão de alguma substância que faz diarréia</div><div class="t m64 x8 h6a y119 ff8 fs64 fc2 sc0 lsc">-</div><div class="t m65 x9 h6b y11a ff11 fs65 fc2 sc0 lsc">i</div><div class="t m66 x38 h6c y11b ff12 fs66 fc2 sc0 lsc">:</div><div class="t m67 x57 h6d y11c ff13 fs67 fc2 sc0 lsc">i</div><div class="t m68 x38 h6e y11d ff8 fs68 fc2 sc0 lsc">-</div><div class="t m69 x3 h6f y11e ff8 fs69 fc2 sc0 lsc">I</div><div class="t m6a x3 h70 y11f ff8 fs6a fc2 sc0 lsc">/</div><div class="t m6b x2 h71 y120 ff8 fs6b fc2 sc0 lsc">/</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
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