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QUESTION 1 You have a hybrid Exchange Server 2016 organization. Some of the mailboxes in the research department are hosted on-premises. Other mailboxes in the research department are stored in Microsoft Office 365. You need to search the mailboxes in the research department for email messages that contain a specific keyword in the message body. What should you do? A. From the Exchange Online Exchange admin center, search the delivery reports. B. Form the on-premises Exchange center, search the delivery reports. C. From the Exchange Online Exchange admin SY0-401 exam center, create a new In-Place eDiscovery & Hold. D. From the Office 365 Compliance Center, create a new Compliance Search. E. From the on-premises Exchange admin center, create a new In-Place eDiscovery & Hold. Correct Answer: E QUESTION 2 You have an Exchange Server 2016 organization. You plan to enable Federated Sharing. You need to create a DNS record to store the Application Identifier (AppID) of the domain for the federated trust. Which type of record should you create? A. A B. CNAME C. SRV D. TXT Correct Answer: D QUESTION 3 Your company has an Exchange Server 2016 200-310 exam Organization. The organization has a four- node database availability group (DAG) that spans two data centers. Each data center is configured as a separate Active Directory site. The data centers connect to each other by using a high-speed WAN link. Each data center connects directly to the Internet and has a scoped Send connector configured. The company's public DNS zone contains one MX record. You need to ensure that if an Internet link becomes unavailable in one data center, email messages destined to external recipients can 400-101 exam be routed through the other data center. What should you do? A. Create an MX record in the internal DNS zone B. B. Clear the Scoped Send Connector check box C. Create a Receive connector in each data center. D. Clear the Proxy through Client Access server check box Correct Answer: AQUESTION 4 Your network contains a single Active Directory forest. The forest contains two sites named Site1 and Site2. You have an Exchange Server 2016 organization. The organization contains two servers in each site. You have a database availability group (DAG) that spans both sites. The file share witness is in Site1. If a power failure occurs at Site1, you plan to mount the databases in Site2. When the power is restored in Site1, you Cisco CCNP Security 300-207 exam SITCS need to prevent the databases from mounting in Site1. What should you do? A. Disable AutoReseed for the DAG. B. Implement an alternate file share witness. C. Configure Datacenter Activation Coordination (DAC) mode. D. Force a rediscovery of the EX200 exam network when the power is restored. Correct Answer: C QUESTION 5 A new company has the following: Two offices that connect to each other by using a low-latency WAN link In each office, a data center that is configured as a separate subnet Five hundred users in each office You plan to deploy Exchange Server 2016 to the network. You need to recommend which Active Directory deployment to use to support the Exchange Server 2016 deployment What is the best recommendation to achieve the goal? A. Deploy two forests that each contains one site and one site link. Deploy two domain controllers to each forest. In each forest configure one domain controller as a global catalog server B. Deploy one forest that contains one site and one site link. Deploy four domain controllers. Configure all of the domain controllers as global catalog servers. C. Deploy one forest that contains two sites and two site links. Deploy two domain controllers to each site in each site, configure one domain controller as a global catalog server D. Deploy one forest that contains two sites and one site link. Deploy two domain controllers to each site. Configure both domain controllers as global catalog servers Correct Answer: C QUESTION 6 How is the IBM Content Template Catalog delivered for installation? A. as an EXE file B. as a ZIP file of XML files C. as a Web Appli cati on Archive file D. as a Portal Application Archive file Correct Answer: D QUESTION 7 Your company has a data center. The data center contains a server that has Exchange Server 2016 and the Mailbox server role installed. Outlook 300-101 exam anywhere clients connect to the Mailbox server by using thename outlook.contoso.com. The company plans to open a second data center and to provision a database availability group (DAG) that spans both data centers. You need to ensure that Outlook Anywhere clients can connect if one of the data centers becomes unavailable. What should you add to DNS? A. one A record B. two TXT records C. two SRV records D. one MX record Correct Answer: A QUESTION 8 You have an Exchange Server 2016 EX300 exam organization. The organization contains a database availability group (DAG). You need to identify the number of transaction logs that are in replay queue. Which cmdlet should you use? A. Test-ServiceHealth B. Test-ReplicationHealth C. Get-DatabaseAvailabilityGroup D. Get-MailboxDatabaseCopyStatus Correct Answer: D QUESTION 9 All users access their email by using Microsoft Outlook 2013 From Performance Monitor, you discover that the MSExchange Database\I/O Database Reads Average Latency counter displays values that are higher than normal You need to identify the impact of the high counter values on user connections in the Exchange Server organization. What are two client connections 400-051 exam that will meet performance? A. Outlook on the web B. IMAP4 clients C. mobile devices using Exchange ActiveSync D. Outlook in Cached Exchange ModeE. Outlook in Online Mode Correct Answer: CE QUESTION 10 You work for a company named Litware, Inc. that hosts all email in Exchange Online. A user named User1 sends an email message to an Pass CISCO 300-115 exam - test questions external user User 1 discovers that the email message is delayed for two hours before being delivered. The external user sends you the message header of the delayed message You need to identify which host in the message path is responsible for the delivery delay. What should you do? A. Review the contents of the protocol logs. B. Search the message tracking logs. C. Search the delivery reports 200-355 exam for the message D. Review the contents of the application log E. Input the message header to the Exchange Remote Connectivity Analyzer Correct Answer: E QUESTION 11 You have an Exchange Server 2016 organization. The organization contains three Mailbox servers. The servers are configured as shown in the following table You have distribution group named Group1. Group1 contains three members. The members are configured as shown in the following table. You discover that when User1 sends email messages to Group1, all of the messages are delivered to EX02 first. You need to identify why the email messages sent to Group1 are sent to EX02 instead. What should you identify? A. EX02 is configured as an expansion server. B. The arbitration mailbox is hosted 300-320 exam on EX02.C. Site2 has universal group membership caching enabled. D. Site2 is configured as a hub site. Correct Answer: A
Home / Saúde / Síndrome de Churg-Strauss

Síndrome de Churg-Strauss

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Definição de doença

A síndrome de Churg-Strauss é uma das muitas formas de vasculite. As doenças da vasculite são caracterizadas pela inflamação dos vasos sanguíneos.

A síndrome de Churg-Strauss, em particular, ocorre em pacientes com história de asma ou alergia e apresenta inflamação dos vasos sanguíneos (também referida como angiite) nos pulmões, pele, nervos e abdome.

Os vasos sanguíneos envolvidos na síndrome de Churg-Strauss são pequenas artérias e veias.

O que é

A síndrome de Churg-Strauss é uma desordem auto-imune rara descrita pela primeira vez em 1951.

É uma forma de vasculite, na qual os vasos sangüíneos ficam inflamados, com a inflamação se espalhando para sistemas orgânicos, como os pulmões e a pele.

Historicamente, essa condição era fatal, porque o corpo não era capaz de lidar com a inflamação.

Tratamentos modernos tornaram a síndrome de Churg-Strauss gerenciável, especialmente se for diagnosticada precocemente, antes que o paciente tenha sofrido danos nos órgãos.

Esta condição geralmente começa com o início de rinite alérgica, pólipos nasais e irritação sinusal.

Eventualmente, o paciente desenvolve asma, que se torna mais grave com o tempo, à medida que a síndrome de Churg-Strauss se move gradualmente para a terceira fase, o que envolve danos aos sistemas orgânicos do corpo.

Se amostras de sangue são retiradas do paciente, elas revelam uma alta concentração de um tipo de glóbulo branco chamado eosinófilo. Normalmente, essas células fazem parte do sistema imunológico, mas quando estão presentes em grande número, causam inflamação.

Os sintomas da síndrome de Churg-Strauss podem incluir falta de ar, náusea, vômito, diarréia, perda de peso, problemas de pele e dor abdominal. Churg-Strauss também pode envolver os nervos, causando formigamento, dormência e dor. Um médico pode usar uma combinação de exames de sangue, histórico do paciente e exames de imagens médicas para diagnosticar um paciente com a doença e determinar a extensão do dano.

Os pacientes podem ouvir que síndrome de Churg-Strauss é referida como angiite alérgica ou granulomatose alérgica.

O tratamento para essa condição envolve altas doses de prednisona para tratar da inflamação, com a dosagem gradualmente reduzida ao longo do tempo.

Drogas imunossupressoras também podem ser usadas para atenuar a resposta do sistema imunológico.

O tratamento pode levar de um a dois anos, com o paciente sendo cuidadosamente monitorado durante o tratamento para confirmar se as dosagens dos medicamentos são apropriadas e procurar sinais de danos.

Os pacientes geralmente consultam um reumatologista para o tratamento da síndrome de Churg-Strauss.

Tal como acontece com muitas condições auto-imunes, a causa da síndrome de Churg-Strauss não é conhecida.

Não parece haver um componente genético, e a condição não é comunicável, pois envolve um problema fundamental com o sistema imunológico do paciente, em vez de um agente causador de doenças que poderia ser transmitido.

Homens e mulheres parecem estar em risco igual de desenvolver essa condição, e a idade média de início é em torno da meia-idade. Os pacientes às vezes podem viver por anos nos estágios iniciais da síndrome, e pode ser complicado diagnosticar porque os sintomas são muitas vezes vagos e muito amplos nos estágios iniciais.

A raridade da condição também significa que um médico terá menos probabilidade de suspeitar de Churg-Strauss até que a síndrome tenha progredido bastante.

Doença

A síndrome de Churg-Strauss é uma doença rara que pode afetar múltiplos sistemas orgânicos, especialmente os pulmões.

O distúrbio é caracterizado pelo agrupamento anormal de certos glóbulos brancos (hipereosinofilia) no sangue e tecidos, inflamação dos vasos sanguíneos (vasculite) e o desenvolvimento de lesões nodulares inflamatórias chamadas granulomas (granulomatose).

Os indivíduos mais afetados têm histórico de alergia.

Além disso, a asma e outras anormalidades pulmonares (pulmonares) associadas (isto é, infiltrados pulmonares) frequentemente precedem o desenvolvimento dos sintomas generalizados (sistémicos) e os resultados observados na síndrome de Churg-Strauss em menos de seis meses ou até duas décadas. A asma, um distúrbio respiratório crônico, é caracterizada por inflamação e estreitamento das vias aéreas dos pulmões, causando dificuldades respiratórias (dispnéia), tosse, produção de um som agudo assobiando durante a respiração (chiado) e / ou outros sintomas e achados.

Achados inespecíficos associados à síndrome de Churg-Strauss tipicamente incluem sintomas semelhantes aos da gripe, como febre, sensação geral de fraqueza e fadiga (mal-estar), perda de apetite (anorexia), perda de peso e dores musculares (mialgia). Sintomas e descobertas adicionais podem variar dependendo dos sistemas orgânicos específicos afetados.

Os nervos fora do sistema nervoso central (nervos periféricos), rins ou trato gastrointestinal estão frequentemente envolvidos. Sem tratamento adequado, podem resultar sérios danos aos órgãos e complicações potencialmente fatais.

Embora a causa exata da síndrome de Churg-Strauss seja desconhecida, muitos pesquisadores indicam que o funcionamento anormal do sistema imunológico desempenha um papel importante.

Sintomas

A síndrome de Churg-Strauss é uma doença altamente variável. Algumas pessoas têm apenas sintomas leves. Outros experimentam complicações graves ou potencialmente fatais.

A síndrome de Churg-Strauss tem três estágios, ou fases, cada um com seus próprios sinais e sintomas. Nem todo mundo desenvolve todas as três fases. Nem as fases surgem sempre na mesma ordem. Isso é especialmente verdadeiro quando a doença é capturada e tratada antes que ocorram os danos mais sérios.

Causas

A síndrome de Churg-Strauss é rara. A causa da síndrome não é conhecida, mas envolve uma ativação excessiva anormal do sistema imunológico em uma pessoa com doença pulmonar broncoprosica subjacente (asma).

Embora se tenha relatado que a síndrome de Churg-Strauss está associada a certos medicamentos para a asma, chamados modificadores dos leucotrienos, se eles realmente causam a doença ou se os pacientes que os tomam têm asma mais grave que empresta uma tendência ao desenvolvimento de Churg-Strauss não é ainda claro.

Resumo

A síndrome de Churg-Strauss é um distúrbio marcado pela inflamação dos vasos sanguíneos. Essa inflamação pode restringir o fluxo sanguíneo para órgãos e tecidos vitais, às vezes danificando-os permanentemente.

Esta condição também é conhecida como granulomatose eosinofílica com poliangiite.

A asma é o sinal mais comum da síndrome de Churg-Strauss.

O distúrbio também pode causar uma variedade de outros problemas, como febre do feno, erupção cutânea, sangramento gastrointestinal e dor e dormência nas mãos e nos pés.

A síndrome de Churg-Strauss é rara e não tem cura. Mas seu médico geralmente pode ajudá-lo a controlar os sintomas com esteróides e outros medicamentos imunossupressores poderosos.

Fonte: rarediseases.org/www.vasculitis.org.uk/www.wisegeek.org/www.ncbi.nlm.nih.gov/my.clevelandclinic.org/www.gpnotebook.co.uk/www.kidney-international.org

 

 

 

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