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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 Pickwick

Síndrome de Pickwick

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Definição

A síndrome de Pickwick é a combinação de obesidade, sonolência (sonolência), hipoventilação e face pletórica (vermelha).

Síndrome de Hipoventilação da Obesidade

Também conhecida como síndrome de Pickwick.

A síndrome da hipoventilação da obesidade é um distúrbio respiratório que afeta algumas pessoas que foram diagnosticadas com obesidade.

A síndrome faz com que você tenha muito dióxido de carbono e muito pouco oxigênio no sangue.

Sem tratamento, pode levar a problemas de saúde graves e até fatais.

Distúrbios

A síndrome de Pickwick, ou síndrome de hipoventilação da obesidade, compreende a tríade de obesidade (IMC =30 kg / m2), hipoventilação durante o dia (hipercapnia e hipoxemia acordada) e distúrbios respiratórios do sono na ausência de explicações alternativas (por exemplo, doença pulmonar parenquimatosa grave, ou anormalidades metabólicas).

O que é

A síndrome de Pickwick, também conhecida como síndrome da hipoventilação da obesidade, é uma condição médica grave caracterizada por respiração prejudicada que afeta indivíduos obesos mórbidos.

Nomeada por um personagem de Charles Dickens, a síndrome de Pickwick afeta principalmente a respiração de um indivíduo enquanto ele ou ela dorme.

O tratamento para essa condição geralmente envolve o uso de ventilação mecânica e mudanças no estilo de vida para promover a perda de peso.

Não há causa definida e conhecida para o desenvolvimento da síndrome de Pickwick.

Tem sido afirmado que um defeito dentro da parte do cérebro que controla a respiração combinada com o peso desnecessário que repousa sobre a parede torácica pode prejudicar a capacidade do indivíduo de respirar adequadamente.

O comprometimento da respiração do indivíduo leva a um desequilíbrio de oxigênio e dióxido de carbono no sangue, causando a manifestação de sintomas indicativos de privação de oxigênio.

Indivíduos obesos com a síndrome de Pickwick podem apresentar e experimentar vários sinais e sintomas.

O sintoma mais predominante é o desenvolvimento da apneia do sono ou a interrupção da respiração durante o sono, que pode ocorrer quando o indivíduo está deitado de costas.

Alguns indivíduos cuja respiração é limitada podem apresentar cianose ou um tom azulado na pele causado por falta de oxigênio.

Os indivíduos sintomáticos também podem apresentar fadiga pronunciada com pouco ou nenhum esforço físico, falta de ar e inchaço das pernas e pés.

Indivíduos com a síndrome de Pickwick também podem apresentar uma tez avermelhada e sonolência, também conhecida como sonolência.

Os testes de diagnóstico utilizados para determinar se um indivíduo tem a síndrome de Pickwick podem incluir um teste de função pulmonar e um teste de gasometria arterial.

Um teste de função pulmonar pode ser utilizado para avaliar a eficiência da funcionalidade pulmonar de um indivíduo, incluindo capacidade de volume e difusão.

Um teste de gasometria arterial pode ser realizado para medir os níveis de dióxido de carbono e oxigênio no sangue e avaliar qualquer grau de desequilíbrio.

Além disso, o indivíduo pode ser encaminhado para participar de um estudo do sono para avaliar a gravidade de sua apneia do sono.

O tratamento da síndrome de Pickwick, muitas vezes inclui a utilização de ventilação mecânica. Indivíduos com obesidade mórbida podem necessitar de assistência respiratória para garantir a oxigenação adequada do sangue.

Um indivíduo pode ser equipado com uma máscara de ventilação que se encaixa confortavelmente no nariz ou na boca enquanto ele ou ela dorme.

Aqueles que necessitam de assistência ventilatória constante devido a uma passagem estreita da via aérea podem ser submetidos a uma traqueostomia, que envolve a colocação de um tubo respiratório diretamente na traqueia através de uma incisão cirúrgica no pescoço.

Aspectos adicionais do tratamento podem incluir a implementação de mudanças na dieta e no estilo de vida para promover a perda de peso e o exercício.

A síndrome de Pickwick é um distúrbio que pode ser revertido se medidas proativas forem tomadas.

Os indivíduos são frequentemente encorajados a procurar grupos de apoio que facilitem a implementação de mudanças no estilo de vida com materiais educacionais, grupos de discussão e amizade.

Se a síndrome de Pickwick não for tratada, pode levar ao desenvolvimento de sérios problemas cardiovasculares e circulatórios.

Outras complicações associadas à síndrome de Pickwick incluem hipertensão, disfunção sexual e alterações do humor, como irritabilidade e depressão.

A síndrome de hipoventilação da obesidade pode ser evitada com medidas conscientes que incluem a manutenção de um estilo de vida saudável e peso corporal.

Resumo

A síndrome de Pickwick, também chamada de síndrome de hipoventilação da obesidade, um complexo de sintomas respiratórios e circulatórios associados à obesidade extrema.

O nome se origina do garoto gordo descrito em The Pickwick Papers, de Charles Dickens, que mostrou alguns dos mesmos traços. (Por algumas definições, ser obeso é exceder o peso ideal de alguém em 20% ou mais; uma pessoa extremamente obesa excederia o peso ideal em uma porcentagem muito maior.) Essa condição geralmente ocorre em associação com a apnéia do sono, que é outra complicação da obesidade.

Na síndrome de Pickwick, a taxa de respiração é cronicamente diminuída abaixo do nível normal.

Por causa da remoção inadequada de dióxido de carbono pelos pulmões, os níveis de dióxido de carbono no sangue aumentam, levando à acidose respiratória.

Em casos mais graves, o oxigênio no sangue também é significativamente reduzido.

Indivíduos com a síndrome de Pickwick muitas vezes se queixam de pensamento lento, sonolência e fadiga.

O baixo nível de oxigênio no sangue faz com que os pequenos vasos sanguíneos que entram nos pulmões se contraiam, aumentando assim a pressão nos vasos que suprem os pulmões.

A pressão elevada estressa o ventrículo direito do coração, causando finalmente insuficiência cardíaca direita.

Finalmente, o excesso de líquido se acumula por todo o corpo (edema periférico), especialmente sob a pele da parte inferior das pernas.

Fonte: Equipe Portal São Francisco

 

 

 

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