Medicine
Medicine, 16.04.2021 20:20, fespinoza019

Hombre de 65 años acude a consultar por temblor en reposo. Su esposa refiere que ha notado que se mueve más lento, no ha dormido, y se muestra deprimido y ansioso. Durante el interrogatorio, el paciente habla en tono bajo, sin expresión facial y con temblor en mano izquierda, involucrando muñeca y dedos. Exploración física: signos vitales normales, marcha de base amplia, arrastrando los pies y sin balanceo de extremidades superiores. Resistencia en rueda dentada al movimiento pasivo de extremidades superiores. Define el tipo de patología, etiología y el tratamiento recomendado. 1- Parkinson, 85 – 90% idiopáticos, segunda causa de enfermedad degenerativa de las demencias, enfermedad leve: levo dopa, Inhibidores de MAO B (selegilina), agonistas dopaminérgicos (pramipexol)

2- Alzheimer, más común en el anciano, depósito de proteína T y placas Beta amiloide, antecedentes heredofamiliares, DM, HTA, dislipidemia, EVC, Depresión, obesidad: Efermedad leve: Rivastigmina o donepezilo, o bien memantina; sertralina o citalopram; Haloperidol

3- Crisis de ausencia con alteración breve de la conciencia, causado por la edad, EVC, Alzheimer, traumatismo, infección, metabólica, infección, Etosuximida

4- Esclerosis múltiple, susceptibilidad genética, inflamación, gliosis del SNC y pérdidad neuronal; etapa aguda: metilprednisolona, interferón Beta 1 a y 1 b

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Hombre de 65 años acude a consultar por temblor en reposo. Su esposa refiere que ha notado que se mu...

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