r
! " " " # $"% "" & "% ' () " !$"* + , $"% "% $!" ' $* , "" -"" & "% "- " % $, "* . /0 " ," * "-" % " 1"- 1 2 ," $" 03 " * % $--" "" . 4 54 $ "' 64 7-" 84 $" " 4 r$ . ' $ , # " $"% "" -"" & "% # * + * ," * "-" $, 9 " & # " , # & " "$ (& $$* $" & % " # :" * & $ % $ 9 $ " ; " 2 $" " $ , 9*, $ !" $$* " - # -" $ & " "- " % $ " " $, r 1< $" =" ;( 5>" " $$ ?/0 ?23 / > 1"" / " ! "- $& " * $ . 4 %" " 54 $" 64 $ " 84 6$" # 4 7 r$ . " $, 3 0@ " $ $- $, $ " $ $ * , "+ , & +" " " "" r 1< $" =" ;( 5>" " $$ ?/0 ?23 / > 1"" 2 " - "* % $ $ +. 4 " 54 # " "* 64 $ &!" 84 ," 9 -" 4 r$ . 8 " ," " 9 -" " - % $ $ + $ ) " $ $ " $ &!" $# " "* & " * r1< $" =" ;( 5>" " $$ ?/0 ?23 / > 1""
" " % " $ +. 4 " (!" 54 5" " 64 A $ + 84 " $ + 4 '$ r$ . " " $ - " " 9 " 9 % " $* "* " & # " "" B *C " " % " " " ! " $":D " (!"4 " "" & " -"* " "!- " $ & E # -% , " $-" & & $ " : -9 $" $$" " & " -% " -9 D F+ $ ,"4 $" $' " * r 1< $" =" ;( 5>" " $$ ?// ?/0 / > 1"" r( 8 6" G( ( r( 8 7-& ??? $$ ; H: " "* ?03 " $ ( " * " .
4 8 54 64 6 84 6 4 H r$ . 6 H $ " $ -" ? ?@ & $ 0?@ $ " $ r $ 9 " % " r 1< $" =" ;( 5>" " $$ ?2
?2 / > 1"" A $ 9 " & " 6" " $- $+ " $ " $-" $. 4 - 8 54 - E 64 - 7( 84 - H( 4 - 5 r$ . 8 $- H( * " "9 "" $$" " & , $ " ,"* * 9, r 1< $" =" ;( 5>" " $$ ?3 ?0 / > 1"" 3 /; " :" " - " $"+ (*! ( & $"% - " " $"' ($ $ " + -") ," * "-" ", ,) " * % $--" "" . 4
54 H+ H9I 64 $ "' 84 " -" 4 7* r& $ r$ . 6 $ 9, $$* % & " $ $-" "$ "' r 1< $" =" ;( 5>" " $$ ?// ?/0 / > 1"" 0 " !$"* + " (""' $--" + " $" $ +. 4 ("$ 54 ! "$$" % !$ " " 64 G*" -% 84 J" -"" 4 " % r$ . 5 8 " % % " "$ "' % " " " $ ! "$$" % !$ " " "$ $( ! & :" ") " ("$ $ " " *" -% ,+ " :" -"" + " 6r H ," $" & " " % + $ " " & + " r 1< $" =" ;( 5>" " $$ ?// ?/0 / > 1"" ? " ! "- & " $ . 4 6$" # 54 - * ($% 64 8$* / ( 84 $ " $ " 1 / 4 + 1 8r r$ . 8 $ " " $ " $ " " 9 ! ) " - :" ( DK= / 1 /4 $, " ?;@ " $ "$) " $" + :" " $ , * ," $ $"9 & , $" " $- * ($% + " $ $$* ($% "$ $ " ! $* + $ , $ " * " & " 1 8r $$" ,* $-" r 1< $" =" ;( 5>" " $$ ?// ?/0 / > 1""
" % +. 4 " & " 54 5" " 64 A $ + 84 6" $ + 4 '$ r$ " /;@ " $ "$ ", $ $" " , - 9 ) " " " " " - & " ", 9 =G
r 1< $" = " ;( 5>" " $$ ?// ?/0 / > 1 $ % A; ( - $# $ ' & (- - & % !$ * + (& - * +- & - , * - F( 8 * % $-- * $ $ * + . 4 H 7 r 54 $ * 64 * - 84 6 - 4 5 r . % ! , & ;; - , * - , & * +- + % ' ' : (- & * - r 1< = ; 5 > ?A2 ?A / > 1 3 :- ) A , * 3 + & ,* % - # ) - + % + + & % : ) + + * ) * ,) & , , L6 % + -- M 4 6 * 54 1! 64 84 ! 4 7 % -%
r 6 * - A 0 @ , * & * , * - - , + , - *) + r 1< = ; 5 > ??; ??3
> 1 2 A; + * # 8N - & & H O2 H8 D , %4 6 . 4 + 54 , 64 84 4 r 8 * ; , % -9 - O ;
r 1< = ; 5 >
23
> 1 % * , - L8 % , % * & + - M
4 6 54 * 64 r ! 84 6 4 r . 1 * - 7= & r & 1= , ;@ & 2@ , 2
i ß ß ß
; " ; $ / + ,"* ' $ " " 7 $ ( " ! + " "* % B & "C) -- ,' & - L %" " M " .
4 "$" 2 F+ 54 "$" P ; F+ 64 8" 3; / ( 84 "$" P 8" 4 "$" P 6"( r$ . 6 $ " " " " " " " ?@ " $ & " "* " + ; 3 + " " $ "' $ " $ & $ " "( " " "" " & " "$" - " r 1< $" =" ;( 5>" " $$ ?? ??; / > 1""
A / $ " & " * B(('* C ' / 2 $# ( " + $ " - ") $! A ,"* & ( , " "" $! " & % $# + G $ !$* ( " !$"* ", !$ " " $"$* $ " B $C + & " "- " "& " ," * "-" DQH4 # F( $ " # K H1 # " 6 R " L6%" " *M 4 7- % $ * $ $ " $" 54 r " $" -'+ 64 84 7-" 4 r$ . 8 7- % " $ " - (& $$" H+ -" $ rr==H " & 0@ " , $ 6r8==H $) $
9 ,% G G - QH r r # ) @ r & % ) & & QH r 1< = ; 5 > > 1
2; ' # ! ) ! 9 G ! & ! ! 8 ! . 3 ' ! ! : . 4 H 54 = 64 H 84 5 4 H r . 8 8 5 & : ! ' : r 1< = ; 5 > 0
> 1 0 ' ! . 4 H 8> 54 H S 64 H 84 4 r . 5 S ' ! ?T r 1< = ; 5 > 0
> 1 ? H ! ! . 4 7 ! 54 ! 64 84 H 4 5 r . 5 ! : !
r 1< = ; 5 > 0
> 1
H * + . 4 B6 C 54 B6 C 64 5 84 4 - r . 5 B6 - * N B * * * r 1< = ; 5 > 0
> 1
H % - H + . 4 7 54 1 64 + 6 84 + * 4 Q * - r . - - * % - r 1< = ; 5 > 0
> 1 6H 6=G=6
* + * + - * G - : * +
L6 % + +M 4 7 54 S 64 H I- 84 4 U r . 8 * * + r 1< = ; 5 > ?0?0;
> 1 2 * % -- . 4 8 U 54 - 64 H+ - 84 8 % 4 H+
r$ . : $ $ $ r 1< $ = ; 5> $$ ?0?0;
> 1
* . 4 - $ 54 6$* 64 6$* - 84 * ! 4 1 r$ . 5 $* $ - - -' $ r 1< $ = ; 5> $$ ?0?0;
> 1
;A $ - -' - ! - $ -' $ - $ $ !$ * * -* - - $ G $ ! * - S $ D$* -' 4 $ -. 5 % $ - * -
; LU# * $ $M 4 BH 1- 6 54 64 r $ 6; 84 4 5$ r$ . $* * -$ - !- -* * ! - $* -' - $ $ - $ 6; $ - - - $ $* !$ r 1< $ = ; 5> $$ A 0
> 1
A 2 - $! ! % $%$ $ 2 * - 6 R F QH ;F ' $- $ $- . 4 # $ 54 8$ 64 % 84 4 !
Respuesta correcta: B
Ref. Harrison¶s, Principles of Internal Medicine15th Ed, editors Braunwald, E. et al, pp. 2524-2529, 2001, McGraw Hill.
/3 " 2; $%" (" & "" ( & ' ; + ,"* (-+ $ B$" $+ ",* $-" -, $# - & !$"* + L6%" " % $M
4 H" $" % 54 & ", (" 64 1 6r $ 8G 5" "+ ," 84 8 " & , *" 4 = ! & =G
r$ . 6 & 3@ # " ;@ " $* " ," "" & " $- "* $ 5" - $, V ?@ $ & & " * " $" D 6r4 8G 5" 0;@ r 1< $" =" ;( 5>" " $$ / / / > 1""
" /2 2 ,"* " "- - ' / ( " , % $ "" ( & -"" ') ( * " "*" $ $* - " " & ,* - " ' * *$ $# " !$"* " $" & "
/0 " * % $--" . 4 5( 54 , 64 =* * 84 $" " 4 H=8 r$ . 8 + " $" " (-" $ /2 " "-" " " # " $ - $ ,+ 5( "& :" " & " ,+ $ -"" " " -# " - (-" !" " , (& $$* :" " , & * ,# , & " $$* " $$" $# - * "- -" * * $ " " "- $ , ! - $ & ,+ H=8 + $ $"$+ $ (-" $ $ -"% ! " "+ r 1< $" =" ;( 5>" " $$ ?? ?; / > 1"" /? - !$"* "+ " $ +. 4 - H$" 54 - H(I- 64 - "- 84 - 4 - ""
r$ . 5 $ H : ' $ $$ D B QC4 $ $ $ $ $ $ $ ; $$ $ r 1< $ = ; 5> $$ ???;
> 1 2 ' $ $ . 4 H 54 64 ' 84 $ 4 r$ . $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ r 1< $ = ; 5> $$ ???;
> 1
; $ ' ) $ 1 5 $ $ ) F
2 L6 $ M 4 54 64 5 84 $ $ 4 $ r$ . $ $ $ $ $ $ $) $ $ $ $ $ $$ $ $ r 1< $ = ; 5> $$ ?03??
> 1
2 ) $ $ r 2 $ $ $ $ $ $ $
$ " !$"* -" " $!" & " $" " "- $ " $, .A $* 8G , rG $,
2/ L6%" " * % $--"M 4 $ "' 54 " 64 H+ HI $ 84 ! " , 4 8 r$ . 8 ! " , * r& & $ "" " $ $ rG $ r 1< $" =" ; 5>" " $$ ?; ?A / > 1"" 22 $," " $!. 4 @ " $-"* 54 /@ " $-"* 64 @ " $-"* 84 $ " - 4 $ ""* - r$ . 6 " "* % & ,+ 2 / @ $ @ r 1< $" =" ; 5>" " $$ ?/0 ?23 / > 1"" 2 "' %! " . 4 / & " A 54 A & " /; 64 2; & " ; 84 ; & " A; 4 A; & " 0 r$ . 6 $* " % " & " " , " 0@ " $ ""%" " 2; & " ; r 1< $" =" ; 5>" " $$ ?/0 ?23 / > 1"" 2; " $ $ $ "$ "' . 4 @ 54 2;@ 64 ;@ 84 3;@ 4 ?@ r$ . G 9 ! r 1< = ; 5 >
> 1
2A 6%" " " " % " (. 4 54 $ "' 64 84 $" " 4 r$ . " " % " ( " ' " "" " $ $ "" r 1< $" =" ;( 5>" " $$ ?03 ??
> 1"" 23 L6%" " % $ $ " "" M 4 ' 54 H! " 64 6 " 84 $ 4 $ # r$ . " % $ $ " H" "
@ 9 ; ! " " ; A ! " $" 2@ A; ! A0@ r 1< $" =" ;( 5>" " $$ ?03 ??
> 1"" 20 " 9 9 $" . 4 $ "' 54 H H9I 64 8 84 " 4 ! " 9 9 r$ . 5 " H9I $ $" ; @ % 2@ " $ % " " " "$ "' $" ; ; $ ( " " " $ ( $ " $ ! " 9 9 " $ % " "$ r 1< $" =" ;( 5>" " $$ ?
? 2 ?23 ?20 ?; ?A ; ; ; > 1"" 20 L6%" " % " 9 " $ $M 4 8 " 54 $" 9 64 84 " " " DB"4 4 $ r$ . " 9 " $# " % " $ $$ $# %$ " " 9 $" $ $ " 3 ! r 1< $" =" ;( 5>" " $$
A
"
> 1""
2? 6 "* " $"+ $ $ L6%" " & $" ; $# " 3 M 4 r 54 6 64 Q#- 84 6"" 4 1 r$ . 5 $"+ " " " " $# " " * " " ; & -" " " - " " " -" ; $# " 3 r 1< $" =" # 5>" " $$
3
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