Breaking News
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 Lemierre

Síndrome de Lemierre

PUBLICIDADE

Definição

síndrome de Lemierre refere-se à tromboflebite das veias jugulares com sepse metastática distante no contexto de infecção orofaríngea inicial, como faringite / amigdalite com ou sem abscesso peritonsilar ou retrofaríngeo.

A síndrome foi descrita pela primeira vez por A. Lemierre na revista médica inglesa The Lancet em 1936.

Síndrome de Lemierre – Doença

A síndrome de Lemierre é uma constelação rara, porém importante, de achados clínicos que classicamente inclui quatro manifestações principais: amigdalofaringite aguda, bacteremia, tromboflebite jugular interna e embolização séptica.

Quando foi descrita pela primeira vez no início dos anos 1900, a síndrome de Lemierre era quase universalmente fatal.

No entanto, com o advento dos antibióticos, as taxas de mortalidade diminuíram de aproximadamente 90% para menos de 20%. Uma vez referida como a “doença esquecida”, os clínicos devem ter um elevado senso de consciência para reconhecer com precisão a Síndrome de Lemierre.

Visão global

A síndrome de Lemierre ocorre quando você tem um certo tipo raro de infecção bacteriana na garganta. Quando não é tratada, a infecção pode se espalhar para os vasos que carregam o fluido linfático por todo o corpo. Quando esses vasos são infectados, eles não conseguem devolver corretamente os fluidos que vazaram da corrente sanguínea para o sistema circulatório.

A síndrome de Lemierre também pode fazer com que a veia jugular inche. Quando isso acontece, você pode obter um coágulo de sangue potencialmente fatal na sua veia jugular. Esse inchaço é conhecido como tromboflebite jugular interna. Em alguns casos, você pode precisar de cirurgia para tratar essa condição. Se não for tratada, pode causar complicações graves ou potencialmente fatais.

Síndrome de Lemierre – Resumo

síndrome de Lemierre é uma doença grave causada pela bactéria anaeróbica, Fusobacterium necrophorum, que ocorre tipicamente em adolescentes saudáveis e adultos jovens.

A infecção se origina na garganta e se espalha por meio de uma tromboflebite séptica da veia tonsilar e da veia jugular interna.

A bacteremia subsequente é complicada por êmbolos sépticos em vários locais, como pulmão, articulações e ossos.

Embora raro, há evidências de um ressurgimento da condição nos últimos anos, possivelmente associado à redução do uso de antibioticoterapia para dor de garganta.

O quadro clínico típico é característico, mas muitos clínicos desconhecem a condição e o diagnóstico é frequentemente atrasado com consequências potencialmente fatais.

Os sintomas incluem dor de garganta e febre, seguidos por inchaço da veia jugular interna. Subsequentemente, o tecido que contém pus move-se da localização original para vários órgãos, mais comumente para os pulmões.

Outros locais afetados podem incluir as articulações, músculos, pele e tecido mole, fígado e/ou baço.

O tratamento envolve o uso de antibióticos intravenosos.

O que é a síndrome de Lemierre?

A síndrome de Lemierre é uma possível complicação de uma infecção grave da garganta ou da amígdala, não tratada.

É mais comumente visto em adolescentes e adultos jovens saudáveis.

Os problemas ocorrem quando as bactérias começam a prosperar dentro dos abcessos da garganta, levando a infecções profundas que podem atingir um importante vaso sangüíneo chamado veia jugular. Se a veia estiver comprometida, pode levar a uma perigosa coagulação do sangue e à morte do tecido no trato respiratório. A maioria dos casos da síndrome de Lemierre pode ser curada com antibióticos se a condição for descoberta e tratada imediatamente.

Vários tipos diferentes de bactérias podem levar à síndrome de Lemierre, mas o culpado mais comum é o Fusobacterium necrophorum (F. necrophorum).

As bactérias se ligam às paredes da faringe e acabam criando um abscesso.Fusobacterium necrophorum que atingem a veia jugular desencadeiam uma resposta de coagulação que limita severamente o fluxo sanguíneo da cabeça para o coração. Quando o coágulo começa a se romper, o sangue infectado viaja para os pulmões e por todo o corpo.

Os primeiros sintomas da síndrome de Lemierre incluem tipicamente um agravamento da dor de garganta, febre moderada e sensibilidade na parte frontal e lateral do pescoço. Sintomas semelhantes aos da gripe, como dor e fadiga nas articulações, podem surgir quando uma infecção começa a se espalhar.

A coagulação pode levar a extrema fraqueza, tonturas e desmaios. Respiração superficial e frequência cardíaca lenta são sinais de que a infecção atingiu os pulmões.

Síndrome de Lemierre
A dor de garganta é frequentemente um dos primeiros sintomas da síndrome de Lemierre

Síndrome de Lemierre
Síndrome de Lemierre

Um médico pode diagnosticar a síndrome de Lemierre revisando os sintomas, fazendo exames de diagnóstico por imagem do pescoço e analisando os resultados laboratoriais dos exames de sangue.

A tomografia computadorizada e ultrassonografias do pescoço revelam extensa inflamação da faringe e coagulação sangüínea na veia jugular.

Se a infecção se espalhou para os pulmões ou gânglios linfáticos, testes de imagem podem ser usados para avaliar a extensão dos danos.

As hemoculturas positivas para Fusobacterium necrophorum ajudam a confirmar o diagnóstico. Os pacientes geralmente são hospitalizados para que os médicos possam monitorar as alterações nos sintomas e determinar o melhor curso do tratamento.

tratamento da síndrome de Lemierre depende da gravidade da infecção. Muitos casos podem ser tratados com um longo período de antibióticos intravenosos. Diluentes de sangue também podem ser administrados para quebrar coágulos existentes e reduzir o risco de futuras obstruções. Se a veia jugular está gravemente danificada, pode ser necessário removê-la ou contorná-la usando um grande vaso sanguíneo transplantado. Outras cirurgias ou procedimentos clínicos podem ser considerados no caso de uma infecção disseminada.

A maioria dos pacientes que recebem tratamento nos estágios iniciais da síndrome de Lemierre é capaz de recuperar completamente em cerca de dois meses.

Fonte: www.antimicrobe.org/www.ncbi.nlm.nih.gov/www.wisegeek.org/www.malacards.org/radiopaedia.org/www.omicsonline.org/ajcc.aacnjournals.org

 

 

 

Conteúdo Relacionado

Veja também

Displasia Tanatofórica

PUBLICIDADE A displasia tanatofórica é uma displasia esquelética letal. É a displasia esquelética letal mais …

Síndrome de Ramsay Hunt

PUBLICIDADE Definição A síndrome de Ramsay Hunt é uma erupção cutânea dolorosa ao redor da …

Colesteatoma

PUBLICIDADE O colesteatoma é uma doença do ouvido também conhecida como tumor epidermóide, cisto epitelial, …

Deixe uma resposta

O seu endereço de e-mail não será publicado. Campos obrigatórios são marcados com *

Time limit is exhausted. Please reload the CAPTCHA.

QUESTION 1 You are managing a SharePoint farm in an Active Directory Domain Services (AD DS) domain. You need to configure a service account to use domain credentials. What should you do first? A. Configure the service account to use a domain user account. B. Register the domain credentials in the Farm Administrators group. C. Configure the service account to use a local user account. D. Register the domain credentials as a SharePoint managed account. Correct Answer: D Explanation QUESTION 2 A company named Contoso, Ltd. has a SharePoint farm. The farm has one Search service application configured. The Search service application contains five crawl databases, all of which contain content. Contoso plans to crawl knowledge base content from its partner company Litware, Inc. The knowledge base content must be stored in a dedicated crawl database.https://www.pass4itsure.com/az-103.html You need to configure crawling. What should you do? A. Add a crawl database that contains the Litware knowledge base to the existing Search service application. B. Provision a new Search service application. Configure the service application to crawl the Litware knowledge base content. C. Set the MaxCrawlDatabase parameter to 6. D. Create a dedicated Microsoft SQL Server instance for the Litware crawl database. Correct Answer: B Explanation Explanation/Reference: https://www.pass4itsure.com/az-9002.html The maximum number of crawl databases is 5 per Search service application so we need another Search service application. This maximum limit is increased to 15 with an Office 2013 update but the question doesn't mention that this update is installed so we have to assume the question was written before the update was released. https://www.pass4itsure.com/az-300.html QUESTION 3 A company uses SharePoint 2013 Server as its intranet portal. The Marketing department publishes many news articles, press releases, and corporate communications to the intranet home page. You need to ensure that the Marketing department pages do not impact intranet performance. Which two actions should you perform? (Each correct answer presents part of the solution. Choose two.) A. In Central Administration, set up a User Policy for the Super User and Super Reader accounts. B. Configure IIS to use the Super User and Super Reader accounts for caching. C. Use the Farm Configuration Wizard to configure the Super User and Super Reader accounts. D. Use Windows PowerShell to add the Super User and Super Reader accounts. Correct Answer: AD Explanation Explanation/Reference: A: The way to correct this problem is to first create two normal user accounts in AD. These are not service accounts. You could call them domain\superuser and domain\superreader, but of course that's up to you. The domain\superuser account needs to have a User Policy set for that gives it Full Control to the entire web application. D: If you are using any type of claims based authentication you will need to use Windows PowerShell. And Windows PowerShell is the hipper more modern and sustainable option anyway. If you are using classic mode authentication run the following cmdlets on one of your SharePoint servers: $w = Get-SPWebApplication "http:///" $w.Properties["portalsuperuseraccount"] = "domain\superuser" $w.Properties["portalsuperreaderaccount"] = "domain\superreader" $w.Update() If you are using claims based authentication run these cmdlets on one of your SharePoint https://www.pass4itsure.com/n10-007.html servers: $w = Get-SPWebApplication "http:///" $w.Properties["portalsuperuseraccount"] = "i:0#.w|domain\superuser" $w.Properties["portalsuperreaderaccount"] = "i:0#.w|domain\superreader" $w.Update() Note: * If you have a SharePoint Publishing site and you check the event viewer every once in a while you might see the https://www.pass4itsure.com/70-331.html following warning in there: Object Cache: The super user account utilized by the cache is not configured. This can increase the number of cache misses, which causes the page requests to consume unneccesary system resources. To configure the account use the following command 'stsadm -o setproperty -propertynameportalsuperuseraccount -propertyvalue account -urlwebappurl'. The account should be any account that has Full Control access to the SharePoint databases but is not an application pool account. Additional Data: Current default super user account: SHAREPOINT\system This means that the cache accounts for your web application aren't properly set and that there will be a lot of cache misses. If a cache miss occurs the page the user requested will have to be build up from scratch again. Files and information will be retrieved from the database and the file system and the page will be rendered. This means an extra hit on your SharePoint and database servers and a slower page load for your end user. Reference: Resolving "The super user account utilized by the cache is not configured." QUESTION 4 You are managing a SharePoint farm. Diagnostic logs are rapidly consuming disk space. You need to minimize the amount of log data written to the disk. Which two actions should you perform? (Each correct answer presents part of the solution. Choose two.) A. Set the log event level to Information. B. Set the log event level to Verbose. C. Set the log trace level to Medium. D. Set the log trace level to Verbose. E. Set the log event level to Warning. F. Set the log trace level to Monitorable. Correct Answer: EF Explanation Explanation/Reference: E: Event Levels Warning, Level ID 50 Information, Level ID: 80 Verbose, Level ID: 100 F: Trace levels: Monitorable: 15 Medium: 50 Verbose: 100 Note: When using the Unified Logging System (ULS) APIs to define events or trace logs, one of the values you must supply is the ULS level. Levels are settings that indicate the severity of an event or trace and are also used for throttling, to prevent repetitive information from flooding the log files. Reference: Trace and Event Log Severity Levels QUESTION 5 A company's SharePoint environment contains three web applications. The root site collections of the web applications host the company intranet site, My Sites, and a Document Center. SharePoint is configured to restrict the default file types, which prevents users from uploading Microsoft Outlook Personal Folder (.pst) files. The company plans to require employees to maintain copies of their .pst files in their My Site libraries. You need to ensure that employees can upload .pst files to My Site libraries. In which location should you remove .pst files https://www.pass4itsure.com/70-342.html from the blocked file types? A. The File Types area of the Search service application section of Central Administration B. The General Security page in the site settings for the site collection C. The Blocked File Types page in the site settings for the site collection D. The General Security section of the Security page of Central Administration Correct Answer: D Explanation