E1 Algemene klachten,
infectieziekten en
endocriene ziekten
SAMENVATTING
Lieke Schönberger
,Inhoud
Ziekten van de hypofyse .....................................................................................................................6
Centrale ligging en functie van de hypofyse ....................................................................................6
Bilaterale hemianopsie ................................................................................................................6
Dubbelzien ..................................................................................................................................7
Diabetes insipidus en SIADH ............................................................................................................7
Diabetes insipidus .......................................................................................................................7
SIADH .............................................................................................................................................8
Hypopituïtarisme ............................................................................................................................9
Hypofysetumoren ......................................................................................................................... 10
Prolactinoom ................................................................................................................................ 10
Acromegalie .................................................................................................................................. 10
Syndroom van Sheehan................................................................................................................. 12
Bijnierziekten .................................................................................................................................... 13
Syndroom van Cushing .................................................................................................................. 13
Screening naar Cushing ............................................................................................................. 14
Syndroom van Cushing en ziekte van Cushing............................................................................ 15
beeldvorming ............................................................................................................................ 15
Behandeling .............................................................................................................................. 15
Primair hyperaldosteronisme (syndroom van Conn) ..................................................................... 16
Primair en secundair hyperaldosteronemie ............................................................................... 16
Hypertensie door drop .............................................................................................................. 17
Bijnierschorsinsufficiëntie (ziekte van Addison) ............................................................................. 17
Bijniercrisis (Addison crisis) ........................................................................................................... 20
Bijniercrisis................................................................................................................................ 20
Iatrogene Cushing en iatrogene bijnierschorsinsufficiëntie ............................................................ 20
Feochromocytoom ........................................................................................................................ 21
Schildklierziekten en hypogonadisme................................................................................................ 22
Interpretatie van schildklieruitslagen ............................................................................................ 22
Hyperthyreoïdie ............................................................................................................................ 22
Graves’ hyperthyreoïdie ............................................................................................................ 23
Subacute granulomateuze thyreoïditis (thyreoïditis van de Quervain ........................................ 24
Toxisch adenoom ...................................................................................................................... 24
, Hypothyreoïdie ............................................................................................................................. 24
Primaire hypothyreoïdie............................................................................................................ 24
Struma .......................................................................................................................................... 26
Schildkliernodus en schildkliercarcinoom ...................................................................................... 26
Hypogonadisme bij de man ........................................................................................................... 27
Polyglandulaire endocriene syndromen ........................................................................................ 29
PAIS1 en PAIS2 .......................................................................................................................... 30
Multiple endocriene neoplasie (MEN)-syndromen..................................................................... 30
Moeheid ........................................................................................................................................... 31
Algemene aspecten van voeding ....................................................................................................... 33
Overgewicht en obesitas ............................................................................................................... 35
Voedingsbehoefte bij specifieke ziekte en ouderen ....................................................................... 37
Gewichtsverlies en eetlust bij ouderen ...................................................................................... 38
Anemie ............................................................................................................................................. 39
Hemoglobine, hematocriet en erythrocyten .................................................................................. 39
MCV en reticulocyten ................................................................................................................ 39
Aanmaak erytrocyten.................................................................................................................... 39
Hemoglobine (Hb) ..................................................................................................................... 40
2,3-disfosfoglycinezuur............................................................................................................. 41
Afbraak erythrocyten .................................................................................................................... 42
Anemie ......................................................................................................................................... 43
Klachten en symptomen............................................................................................................ 43
Diagnostiek ............................................................................................................................... 43
Verlies van erytrocyten ............................................................................................................. 43
Gestoorde aanmaak van erytrocyten......................................................................................... 44
Verhoogde afbraak/hemolyse ................................................................................................... 48
Kind met gewichtsverlies .................................................................................................................. 53
Oorzaken matige gewichtstoename bij een zuigeling ................................................................ 53
Normaal voedingspatroon zuigeling .......................................................................................... 53
Digestie en opname van voedingsstoffen .................................................................................. 54
Coeliakie ................................................................................................................................... 54
Koorts bij een kind ............................................................................................................................ 55
Bovenste luchtweginfecties (neus, mond, keel, middenoren, trachea) ...................................... 57
Otitis media acuta ..................................................................................................................... 57
, Gastro-enteritis ......................................................................................................................... 57
Urineweginfecties ..................................................................................................................... 58
Kinderziekten.................................................................................................................................... 59
Difterie ......................................................................................................................................... 63
Kinkhoest ...................................................................................................................................... 63
Tetanus ......................................................................................................................................... 64
Polio ............................................................................................................................................. 64
Bof (parotitis infectiosum)............................................................................................................. 65
Mazelen ........................................................................................................................................ 65
Rode hond (rubella) ...................................................................................................................... 66
Haemophilus influenzae type B ..................................................................................................... 67
Pneumokokken ............................................................................................................................. 67
Meningokokken C ......................................................................................................................... 67
Humaan popillomavirus ................................................................................................................ 68
Kinderziekten buiten het RVP............................................................................................................ 69
Vijfde ziekte (Erythema infectiosum) ............................................................................................. 69
Zesde ziekte (Exanthema subitum) ................................................................................................ 71
Roodvonk (scarlatina) ................................................................................................................... 71
Waterpokken (Varicella zoster) ..................................................................................................... 72
Infectieziekten .................................................................................................................................. 73
Ziekenhuisinfectie ......................................................................................................................... 74
Wondinfectie ............................................................................................................................ 76
Schimmels, opportunistische infectie ............................................................................................ 79
Cryotockokkose......................................................................................................................... 79
Invasieve aspergillose................................................................................................................ 79
Candida..................................................................................................................................... 80
Lymeziekte.................................................................................................................................... 81
Erythema Migrans ..................................................................................................................... 82
Acrodermatitis chronica atrophicans (ACA) ............................................................................... 82
Neuroborelliose ........................................................................................................................ 82
Importziekten ............................................................................................................................... 83
Entamoeba histolytica ............................................................................................................... 85
Malaria ......................................................................................................................................... 86
Niet-infectieuze koorts...................................................................................................................... 88
infectieziekten en
endocriene ziekten
SAMENVATTING
Lieke Schönberger
,Inhoud
Ziekten van de hypofyse .....................................................................................................................6
Centrale ligging en functie van de hypofyse ....................................................................................6
Bilaterale hemianopsie ................................................................................................................6
Dubbelzien ..................................................................................................................................7
Diabetes insipidus en SIADH ............................................................................................................7
Diabetes insipidus .......................................................................................................................7
SIADH .............................................................................................................................................8
Hypopituïtarisme ............................................................................................................................9
Hypofysetumoren ......................................................................................................................... 10
Prolactinoom ................................................................................................................................ 10
Acromegalie .................................................................................................................................. 10
Syndroom van Sheehan................................................................................................................. 12
Bijnierziekten .................................................................................................................................... 13
Syndroom van Cushing .................................................................................................................. 13
Screening naar Cushing ............................................................................................................. 14
Syndroom van Cushing en ziekte van Cushing............................................................................ 15
beeldvorming ............................................................................................................................ 15
Behandeling .............................................................................................................................. 15
Primair hyperaldosteronisme (syndroom van Conn) ..................................................................... 16
Primair en secundair hyperaldosteronemie ............................................................................... 16
Hypertensie door drop .............................................................................................................. 17
Bijnierschorsinsufficiëntie (ziekte van Addison) ............................................................................. 17
Bijniercrisis (Addison crisis) ........................................................................................................... 20
Bijniercrisis................................................................................................................................ 20
Iatrogene Cushing en iatrogene bijnierschorsinsufficiëntie ............................................................ 20
Feochromocytoom ........................................................................................................................ 21
Schildklierziekten en hypogonadisme................................................................................................ 22
Interpretatie van schildklieruitslagen ............................................................................................ 22
Hyperthyreoïdie ............................................................................................................................ 22
Graves’ hyperthyreoïdie ............................................................................................................ 23
Subacute granulomateuze thyreoïditis (thyreoïditis van de Quervain ........................................ 24
Toxisch adenoom ...................................................................................................................... 24
, Hypothyreoïdie ............................................................................................................................. 24
Primaire hypothyreoïdie............................................................................................................ 24
Struma .......................................................................................................................................... 26
Schildkliernodus en schildkliercarcinoom ...................................................................................... 26
Hypogonadisme bij de man ........................................................................................................... 27
Polyglandulaire endocriene syndromen ........................................................................................ 29
PAIS1 en PAIS2 .......................................................................................................................... 30
Multiple endocriene neoplasie (MEN)-syndromen..................................................................... 30
Moeheid ........................................................................................................................................... 31
Algemene aspecten van voeding ....................................................................................................... 33
Overgewicht en obesitas ............................................................................................................... 35
Voedingsbehoefte bij specifieke ziekte en ouderen ....................................................................... 37
Gewichtsverlies en eetlust bij ouderen ...................................................................................... 38
Anemie ............................................................................................................................................. 39
Hemoglobine, hematocriet en erythrocyten .................................................................................. 39
MCV en reticulocyten ................................................................................................................ 39
Aanmaak erytrocyten.................................................................................................................... 39
Hemoglobine (Hb) ..................................................................................................................... 40
2,3-disfosfoglycinezuur............................................................................................................. 41
Afbraak erythrocyten .................................................................................................................... 42
Anemie ......................................................................................................................................... 43
Klachten en symptomen............................................................................................................ 43
Diagnostiek ............................................................................................................................... 43
Verlies van erytrocyten ............................................................................................................. 43
Gestoorde aanmaak van erytrocyten......................................................................................... 44
Verhoogde afbraak/hemolyse ................................................................................................... 48
Kind met gewichtsverlies .................................................................................................................. 53
Oorzaken matige gewichtstoename bij een zuigeling ................................................................ 53
Normaal voedingspatroon zuigeling .......................................................................................... 53
Digestie en opname van voedingsstoffen .................................................................................. 54
Coeliakie ................................................................................................................................... 54
Koorts bij een kind ............................................................................................................................ 55
Bovenste luchtweginfecties (neus, mond, keel, middenoren, trachea) ...................................... 57
Otitis media acuta ..................................................................................................................... 57
, Gastro-enteritis ......................................................................................................................... 57
Urineweginfecties ..................................................................................................................... 58
Kinderziekten.................................................................................................................................... 59
Difterie ......................................................................................................................................... 63
Kinkhoest ...................................................................................................................................... 63
Tetanus ......................................................................................................................................... 64
Polio ............................................................................................................................................. 64
Bof (parotitis infectiosum)............................................................................................................. 65
Mazelen ........................................................................................................................................ 65
Rode hond (rubella) ...................................................................................................................... 66
Haemophilus influenzae type B ..................................................................................................... 67
Pneumokokken ............................................................................................................................. 67
Meningokokken C ......................................................................................................................... 67
Humaan popillomavirus ................................................................................................................ 68
Kinderziekten buiten het RVP............................................................................................................ 69
Vijfde ziekte (Erythema infectiosum) ............................................................................................. 69
Zesde ziekte (Exanthema subitum) ................................................................................................ 71
Roodvonk (scarlatina) ................................................................................................................... 71
Waterpokken (Varicella zoster) ..................................................................................................... 72
Infectieziekten .................................................................................................................................. 73
Ziekenhuisinfectie ......................................................................................................................... 74
Wondinfectie ............................................................................................................................ 76
Schimmels, opportunistische infectie ............................................................................................ 79
Cryotockokkose......................................................................................................................... 79
Invasieve aspergillose................................................................................................................ 79
Candida..................................................................................................................................... 80
Lymeziekte.................................................................................................................................... 81
Erythema Migrans ..................................................................................................................... 82
Acrodermatitis chronica atrophicans (ACA) ............................................................................... 82
Neuroborelliose ........................................................................................................................ 82
Importziekten ............................................................................................................................... 83
Entamoeba histolytica ............................................................................................................... 85
Malaria ......................................................................................................................................... 86
Niet-infectieuze koorts...................................................................................................................... 88
