Samenvatting algemene pathologie - 2VRK - module 6

INHOUDSOPGAVE
algemene pathologie: H1 inleiding ................................................................................................................................................................................................................................................................ 7

0. algemene inleiding ............................................................................................................................................................................................................................................................... 7

1. gezondheid .......................................................................................................................................................................................................................................................................... 7

2. ziekte ................................................................................................................................................................................................................................................................................... 7

2.1 frequentie ...................................................................................................................................................................................................................................................................... 8

Incidentie ................................................................................................................................................................................................................................................................................... 8

Prevalentie ................................................................................................................................................................................................................................................................................. 8

2.2 Etiologie (ziekteoorzaken) ............................................................................................................................................................................................................................................... 9

2.3 pathofysiologie (pathogenese) ........................................................................................................................................................................................................................................ 9

2.4 symptomen .................................................................................................................................................................................................................................................................... 9

2.5 diagnose & differentieeldiagnose .................................................................................................................................................................................................................................... 9

2.6 prognose ........................................................................................................................................................................................................................................................................ 9

2.7 ziekteverloop ................................................................................................................................................................................................................................................................ 10

2.8 Preventie ...................................................................................................................................................................................................................................................................... 10

2.9 behandeling ................................................................................................................................................................................................................................................................. 10

H2: medische diagnostiek .......................................................................................................................................................................................................................................................................... 11

1) het diagnostisch proces ..................................................................................................................................................................................................................................................... 11

1.1) anamnese .................................................................................................................................................................................................................................................................... 11

1.2) Klinisch onderzoek ....................................................................................................................................................................................................................................................... 11

inspectie .................................................................................................................................................................................................................................................................................. 11

palpatie.................................................................................................................................................................................................................................................................................... 12

percussie (aankloppen/aantikken) ............................................................................................................................................................................................................................................ 12

auscultatie ............................................................................................................................................................................................................................................................................... 12

1.3) technische diagnostiek ................................................................................................................................................................................................................................................. 13

laboratoriumdiagnostie ............................................................................................................................................................................................................................................................ 13

klinische biologie................................................................................................................................................................................................................................................................ 13

hematocriet, RBC, Hb -> anemie................................................................................................................................................................................................................................... 13

wbc formule ................................................................................................................................................................................................................................................................. 15

labo referentiewaarden om waarden te interpreteren .................................................................................................................................................................................................... 15

klinische chemie .......................................................................................................................................................................................................................................................... 15

Microbiologie ............................................................................................................................................................................................................................................................... 15

LABORATORIUMDDIAGNOSTIEK: Anatomopathologie ........................................................................................................................................................................................................ 16

Medische beeldvorming ........................................................................................................................................................................................................................................................... 16

radiologie ........................................................................................................................................................................................................................................................................... 16

Nucleaire geneeskunde ...................................................................................................................................................................................................................................................... 19

Endoscopie .............................................................................................................................................................................................................................................................................. 19

Klinische elektrofysiologie (elektrische act van weefsel aan het oppervlak detecteren) .............................................................................................................................................................. 20

H3: somatische ziekteoorzaken .................................................................................................................................................................................................................................................................. 21

1) endogene ziekteoorzaken vs exogene oorzaken .................................................................................................................................................................................................................. 21

chromosomale aandoeningen ........................................................................................................................................................................................................................................................ 21

syndroom van Down ................................................................................................................................................................................................................................................................. 21

genetische aandoeningen............................................................................................................................................................................................................................................................... 22

mucoviscidose ......................................................................................................................................................................................................................................................................... 22

symptomen ........................................................................................................................................................................................................................................................................ 22

diagnose ............................................................................................................................................................................................................................................................................ 23

behandeling ....................................................................................................................................................................................................................................................................... 23

2) exogene ziekteoorzaken ..................................................................................................................................................................................................................................................... 24

fysisch ........................................................................................................................................................................................................................................................................................... 24

mechanische kracht – traumata ............................................................................................................................................................................................................................................... 24

thermische ziekteoorzaken ....................................................................................................................................................................................................................................................... 26

veranderingen in de lichaamstemperatuur .......................................................................................................................................................................................................................... 26

elektriciteit ............................................................................................................................................................................................................................................................................... 28

straling ..................................................................................................................................................................................................................................................................................... 28

chemische ziekteoorzaken ............................................................................................................................................................................................................................................................. 28

3) congenitale aandoeningen ................................................................................................................................................................................................................................................. 28

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, oorzaken van congenitale aandoeningen ........................................................................................................................................................................................................................................ 29

Rhesus incompatibiliteit........................................................................................................................................................................................................................................................... 29

pathogenese ............................................................................................................................................................................................................................................................................ 29

.......................................................................................................................................................................................................................................................................................... 29

profylaxe van Rh-incompatibiliteit ...................................................................................................................................................................................................................................... 30

preventie & prenatale diagnostiek ................................................................................................................................................................................................................................................... 30

H4: immunologie/immuunpathologie ......................................................................................................................................................................................................................................................... 31

1) het immuunsysteem ........................................................................................................................................................................................................................................................... 31

1.1) niet-specifieke immuunsysteem ................................................................................................................................................................................................................................... 31

1.2) specifieke immuunsysteem .......................................................................................................................................................................................................................................... 32

B-lymfocyten ............................................................................................................................................................................................................................................................................ 32

1.3) immuunpathologie ....................................................................................................................................................................................................................................................... 33

2) Overgevoeligheidsreacties & allergie .................................................................................................................................................................................................................................. 34

2.1) vormen van allergische reacties ............................................................................................................................................................................................................................................... 34

onmiddelijke (type I) reactie ...................................................................................................................................................................................................................................................... 34

pathogenese type 1 allergische reactie ............................................................................................................................................................................................................................... 35

Atopische dermatitis .......................................................................................................................................................................................................................................................... 35

uitgestelde (type IV) reactie ...................................................................................................................................................................................................................................................... 36

allergische rinitis/conjunctivitis .......................................................................................................................................................................................................................................... 36

allergische astma ............................................................................................................................................................................................................................................................... 36

urticae ............................................................................................................................................................................................................................................................................... 36

voedselallergie ................................................................................................................................................................................................................................................................... 37

anafylactische reactie & shock ................................................................................................................................................................................................................................................. 37

3) auto-immuunziekten .......................................................................................................................................................................................................................................................... 38

4) stoornissen vh immuunsysteem en immuundeficiëntie ....................................................................................................................................................................................................... 38

H5: infectiologie/infectieziekten ................................................................................................................................................................................................................................................................. 39

1) infectie versus inflammatie ............................................................................................................................................................................................................................................................... 39

besmetting → infectie? .................................................................................................................................................................................................................................................................. 39

2) mediscge microbiologie ..................................................................................................................................................................................................................................................... 39

2.1) bacteriën ................................................................................................................................................................................................................................................................................. 40

bacteriekweek & antibiogram ................................................................................................................................................................................................................................................... 40

antibiotica ................................................................................................................................................................................................................................................................................ 41

Resistentie tegen antibiotica............................................................................................................................................................................................................................................... 41

2.2) virussen................................................................................................................................................................................................................................................................................... 41

anti-virale middelen ................................................................................................................................................................................................................................................................. 42

2.3) schimmels .............................................................................................................................................................................................................................................................................. 43

Antimycotica ............................................................................................................................................................................................................................................................................ 43

de belangrijke schimmels ......................................................................................................................................................................................................................................................... 43

2.4) parasieten ............................................................................................................................................................................................................................................................................... 43

de belangrijkste parasieten (bij ons) .......................................................................................................................................................................................................................................... 43

3) oorzaken & besmettingswegen ........................................................................................................................................................................................................................................... 45

4) fasen van een infectie ......................................................................................................................................................................................................................................................... 45

5) diagnose van infectieziekten ............................................................................................................................................................................................................................................... 46

6) behandeling van infectieziekten .......................................................................................................................................................................................................................................... 46

7) preventie van infectieziekten .............................................................................................................................................................................................................................................. 46

8) nosocomiale & opportunistische infecties .......................................................................................................................................................................................................................... 47

9) infectieziekten die zijn opgenomen in het standaardvaccinatieschema ............................................................................................................................................................................... 47

9.1) mazelen .................................................................................................................................................................................................................................................................................. 47

9.2) bof........................................................................................................................................................................................................................................................................................... 47

9.3) rubella (rode hond) .................................................................................................................................................................................................................................................................. 48

9.4) poliomyelitis (kinderverlamming) ............................................................................................................................................................................................................................................. 48

9.5) kinkhoest (Pertussis) ............................................................................................................................................................................................................................................................... 48

9.6) difterie (Kroep) ......................................................................................................................................................................................................................................................................... 48

9.7) tetanus (wondklem) ................................................................................................................................................................................................................................................................. 48

9.8) hpv = humaan papillomavirus!!! ............................................................................................................................................................................................................................................. 49

9.9) bacteriële meningitis & sepsis.................................................................................................................................................................................................................................................. 49

9.10) rotavirus ................................................................................................................................................................................................................................................................................ 49


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, 10) andere infectieziekten ........................................................................................................................................................................................................................................................ 50

10.1) tuberculose ........................................................................................................................................................................................................................................................................... 50

10.2) influenza................................................................................................................................................................................................................................................................................ 50

10.3) mononucleosis infectiosa ...................................................................................................................................................................................................................................................... 50

10.4) herpes simplex ...................................................................................................................................................................................................................................................................... 51

10.5) herpes zoster ......................................................................................................................................................................................................................................................................... 51

10.6) seksueel overdraagbare aandoeningen .................................................................................................................................................................................................................................. 51

aids .......................................................................................................................................................................................................................................................................................... 51

chlamydiasis ............................................................................................................................................................................................................................................................................ 52

gonorroe .................................................................................................................................................................................................................................................................................. 52

syfilis ....................................................................................................................................................................................................................................................................................... 52

trichomoniasis ......................................................................................................................................................................................................................................................................... 52

herpes genetalis ....................................................................................................................................................................................................................................................................... 52

condylomata acuminata........................................................................................................................................................................................................................................................... 52

H6: oncologie ............................................................................................................................................................................................................................................................................................. 53

1) definities .......................................................................................................................................................................................................................................................................................... 53

2) oorzaken .......................................................................................................................................................................................................................................................................................... 53

3) symptomen en diagnostiek ............................................................................................................................................................................................................................................................... 54

4) behandeling ..................................................................................................................................................................................................................................................................................... 54

H7: aandoeningen van hart, bloed en bloedvaten ........................................................................................................................................................................................................................................ 55

Pathofysiologie van de hartaandoeningen ............................................................................................................................................................................................................................................. 55

anatomie.............................................................................................................................................................................................................................................................................................. 55

Atherosclerosis .................................................................................................................................................................................................................................................................................... 55

Algemene cardiovasculaire risico’s → goed kennen!!! ........................................................................................................................................................................................................................... 56

locatie.................................................................................................................................................................................................................................................................................................. 56

coronaire arteriën (hart) ................................................................................................................................................................................................................................................................. 57

Angina Pectoris ........................................................................................................................................................................................................................................................................ 57

Acuut myocard infarct .............................................................................................................................................................................................................................................................. 57

PTCA = percutane transluminale coronaro- angioplastie = dotteren of ballondilatatie ........................................................................................................................................................ 58

CABG = coronary artery bypass graft = bypass .................................................................................................................................................................................................................... 58

Peripartum cardiomyopathie .................................................................................................................................................................................................................................................... 59

Medicatie ........................................................................................................................................................................................................................................................................... 59

carotis interna (hersenen).............................................................................................................................................................................................................................................................. 59

Syncope ................................................................................................................................................................................................................................................................................... 59

Iliaca/Femoralis/Poplitea (PERIFERE SLAGADERS = ad buitenkand vh lichaam) ............................................................................................................................................................................. 60

Arteriële insufficiëntie van de onderste ledematen .................................................................................................................................................................................................................... 60

Hartklepproblemen therapie ................................................................................................................................................................................................................................................................ 60

Infecties van het hart ............................................................................................................................................................................................................................................................................ 60

Endocarditis................................................................................................................................................................................................................................................................................... 60

Myocarditis .................................................................................................................................................................................................................................................................................... 60

Pericarditis..................................................................................................................................................................................................................................................................................... 60

Shock................................................................................................................................................................................................................................................................................................... 61

Symptomen ................................................................................................................................................................................................................................................................................... 61

Pathofysiologie van bloedvaten ............................................................................................................................................................................................................................................................ 61

Varices/spataders .......................................................................................................................................................................................................................................................................... 62

Hemorroïden ............................................................................................................................................................................................................................................................................ 62

Vulvovaginale varices ............................................................................................................................................................................................................................................................... 62

Onderste ledematen ................................................................................................................................................................................................................................................................ 62

Trombose....................................................................................................................................................................................................................................................................................... 62

Oppervlakkige tromboflebitis.................................................................................................................................................................................................................................................... 62

Diepe veneuze trombose (DVT) ................................................................................................................................................................................................................................................. 62

H8: hematologie......................................................................................................................................................................................................................................................................................... 64

aandoeningen van het bloed ................................................................................................................................................................................................................................................................. 64

Erythrocyten......................................................................................................................................................................................................................................................................................... 64

Anemie .......................................................................................................................................................................................................................................................................................... 64

Pathologie erythrocyten.................................................................................................................................................................................................................................................................. 64

Anemie: verminderde aanmaak rbc .......................................................................................................................................................................................................................................... 64


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, Anemie: verhoogde afbraak rbc ................................................................................................................................................................................................................................................ 65

Anemie: verlies van rbc............................................................................................................................................................................................................................................................. 65

Polycythemie ........................................................................................................................................................................................................................................................................... 65

Leukocyten .......................................................................................................................................................................................................................................................................................... 65

Aandoeningen leukocyten .............................................................................................................................................................................................................................................................. 66

Leukocytose ............................................................................................................................................................................................................................................................................. 66

Leukopenie .............................................................................................................................................................................................................................................................................. 66

Agranulocytose ........................................................................................................................................................................................................................................................................ 66

Leukemie ................................................................................................................................................................................................................................................................................. 66

Lymfomen ................................................................................................................................................................................................................................................................................ 66

Trombocyten ........................................................................................................................................................................................................................................................................................ 67

Pathologie van de trombocyten ...................................................................................................................................................................................................................................................... 67

Trombocytose .......................................................................................................................................................................................................................................................................... 67

Trombopenie ............................................................................................................................................................................................................................................................................ 67

Medicatie om bloedstolling te beïnvloeden ..................................................................................................................................................................................................................................... 67

H9: pneumologie ........................................................................................................................................................................................................................................................................................ 68

alveolaire hypoventilatie....................................................................................................................................................................................................................................................................... 68

Luchtweginfecties ................................................................................................................................................................................................................................................................................ 69

Pneumonie..................................................................................................................................................................................................................................................................................... 69

Klassieke pneumonie ............................................................................................................................................................................................................................................................... 69

Atypische pneumonie ............................................................................................................................................................................................................................................................... 70

COPD & asthma ................................................................................................................................................................................................................................................................................... 70

Asthma ................................................................................................................................................................................................................................................................................................ 71

Etiologie = oorzaak/ontstaan .......................................................................................................................................................................................................................................................... 71

Symptomen van asthma ................................................................................................................................................................................................................................................................. 71

Diagnose of astma ......................................................................................................................................................................................................................................................................... 71

Behandeling van asthma: niet-medicamenteus .............................................................................................................................................................................................................................. 71

Behandeling van asthma: medicamenteus ..................................................................................................................................................................................................................................... 72

alarmsymptomen ........................................................................................................................................................................................................................................................................... 72

astma tijdens de zwangerschap ...................................................................................................................................................................................................................................................... 73

COPD................................................................................................................................................................................................................................................................................................... 73

2 manifestaties van COPD .............................................................................................................................................................................................................................................................. 73

Symptomen van COPD ................................................................................................................................................................................................................................................................... 73

Behandeling van COPD .................................................................................................................................................................................................................................................................. 73

Pneumothorax ..................................................................................................................................................................................................................................................................................... 75

perfusiestoornissen ............................................................................................................................................................................................................................................................................. 75

longembolie en longinfarct ............................................................................................................................................................................................................................................................. 75

Longembolie en longinfarct: risicofactoren ............................................................................................................................................................................................................................... 75

longembolie ............................................................................................................................................................................................................................................................................. 75

Diffusiestoornissen .............................................................................................................................................................................................................................................................................. 75

Longoedeem .................................................................................................................................................................................................................................................................................. 76

Neonataal RDS ............................................................................................................................................................................................................................................................................... 76

tbc ....................................................................................................................................................................................................................................................................................................... 76

mucoviscidose ..................................................................................................................................................................................................................................................................................... 76

H10: gastro-enterologie .............................................................................................................................................................................................................................................................................. 77

mond ................................................................................................................................................................................................................................................................................................... 77

slokdarm .............................................................................................................................................................................................................................................................................................. 77

reflux en oesofagitis ....................................................................................................................................................................................................................................................................... 77

slokdarmspasmen ......................................................................................................................................................................................................................................................................... 78

maag.................................................................................................................................................................................................................................................................................................... 78

maag & duodenale peptische ulcera → ulcus pepticum .................................................................................................................................................................................................................. 78

symptomen .............................................................................................................................................................................................................................................................................. 79

diagnose .................................................................................................................................................................................................................................................................................. 79

complicaties ............................................................................................................................................................................................................................................................................ 79

behandeling ............................................................................................................................................................................................................................................................................. 79

gastritis .......................................................................................................................................................................................................................................................................................... 80

maagcarcinoom ............................................................................................................................................................................................................................................................................. 80


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