2024-
2025
Klinische colleges
ademhaling
JOZEFIEN CEULEMANS
,COPD .......................................................................................................................................... 8
Inleidende theorie .................................................................................................................. 8
Symptomen ........................................................................................................................ 8
Diagnose ............................................................................................................................. 8
Casus 1 .................................................................................................................................... 8
Presentatie ......................................................................................................................... 8
Klinisch onderzoek.............................................................................................................. 8
DD/ ..................................................................................................................................... 8
Technische onderzoeken .................................................................................................... 9
Obstructieve aandoenignen ................................................................................................... 9
Stadium bepalen .............................................................................................................. 10
Exacerbaties ..................................................................................................................... 10
Symptomen en Behandeling ............................................................................................ 10
Pathogenese COPD ........................................................................................................... 11
Inactiviteit bij COPD.......................................................................................................... 11
Casus 2 .................................................................................................................................. 12
Presentatie ....................................................................................................................... 12
Klinisch onderzoek............................................................................................................ 12
DD/ ................................................................................................................................... 12
Technische onderzoeken .................................................................................................. 12
Behandeling ...................................................................................................................... 13
Benefits......................................................................................................................... 13
Diagnose ........................................................................................................................... 14
Longembolie ............................................................................................................................ 14
Casus 1 .................................................................................................................................. 14
Presentatie ....................................................................................................................... 14
Voorgeschiedenis ............................................................................................................. 14
Klinisch onderzoek............................................................................................................ 15
Vitale parameters ......................................................................................................... 15
Differentieel diagnose ...................................................................................................... 15
Onderzoeken .................................................................................................................... 16
ECG ............................................................................................................................... 16
Labo .............................................................................................................................. 16
Bloedgas ....................................................................................................................... 16
RX-thorax ...................................................................................................................... 16
1
, Diagnose bevestigen ........................................................................................................ 17
Labo .............................................................................................................................. 17
Duplex OLM .................................................................................................................. 18
CT scan .......................................................................................................................... 18
Echo .............................................................................................................................. 18
Bevestiging ................................................................................................................... 19
Besluit ............................................................................................................................... 19
Behandeling ...................................................................................................................... 19
Key message ......................................................................................................................... 19
Hoesten I .................................................................................................................................. 20
Introductie ............................................................................................................................ 20
Definitie ............................................................................................................................ 20
Verschillende soorten ...................................................................................................... 20
Functie hoesten ................................................................................................................ 20
Frequentie ........................................................................................................................ 21
Differentieel diagnose ...................................................................................................... 21
Aanpak: casussen ............................................................................................................. 21
Patiënt 1 ....................................................................................................................... 21
Patiënt 2 ....................................................................................................................... 21
Patiënt 3 ....................................................................................................................... 22
Patiënt 4 ....................................................................................................................... 22
Hoesten II ................................................................................................................................. 23
Patiënt 1: astma ................................................................................................................... 23
Bijkomende gegevens ...................................................................................................... 23
KO ..................................................................................................................................... 24
DD/ ................................................................................................................................... 24
Bijkomende testen ........................................................................................................... 24
Behandeling ...................................................................................................................... 25
Opvolging.......................................................................................................................... 25
4 weken ........................................................................................................................ 25
7 weken later ................................................................................................................ 26
Patiënt 2 ............................................................................................................................... 27
Presentatie ....................................................................................................................... 27
Bijkomende vragen........................................................................................................... 27
Bijkomende testen ........................................................................................................... 27
2
, Differentieel diagnose ...................................................................................................... 28
Diagnose: EILO .................................................................................................................. 28
Behandeling ...................................................................................................................... 28
Patiënt 3 ............................................................................................................................... 29
Context ............................................................................................................................. 29
Patiënt 4 ............................................................................................................................... 29
Respiratoire infecties - pneumonie......................................................................................... 29
Casus 1 .................................................................................................................................. 29
CAP: community aquired pneumonie .............................................................................. 30
CAP stalen in ambulante setting .................................................................................. 31
Indeling pneumonie ......................................................................................................... 31
CAP ............................................................................................................................... 31
Verwekkers ................................................................................................................... 32
Onderzoeken ................................................................................................................ 32
Behandeling .................................................................................................................. 32
Dyspnee.................................................................................................................................... 34
Casus..................................................................................................................................... 34
Context ............................................................................................................................. 34
Bijkomende gegevens ...................................................................................................... 35
Verdere evolutie ............................................................................................................... 36
Diagnose ........................................................................................................................... 36
MIP: minocycline geïnduceerde pneumonie ............................................................... 37
Dyspnee ................................................................................................................................ 37
Oorzaken .......................................................................................................................... 37
Aanpak .............................................................................................................................. 37
Alarmsymptomen ......................................................................................................... 37
Bijkomende testen bij onzekerheid ............................................................................. 38
Interstitiële en inflammatoire longpathologie ..................................................................... 38
Herhaling theorie ............................................................................................................. 38
Pathogenese ..................................................................................................................... 38
Klinische presentatie ........................................................................................................ 39
Radiologische aspecten .................................................................................................... 39
Diagnostische aspecten .................................................................................................... 39
Aanpak .............................................................................................................................. 40
Sarcoïdose ........................................................................................................................ 40
3
2025
Klinische colleges
ademhaling
JOZEFIEN CEULEMANS
,COPD .......................................................................................................................................... 8
Inleidende theorie .................................................................................................................. 8
Symptomen ........................................................................................................................ 8
Diagnose ............................................................................................................................. 8
Casus 1 .................................................................................................................................... 8
Presentatie ......................................................................................................................... 8
Klinisch onderzoek.............................................................................................................. 8
DD/ ..................................................................................................................................... 8
Technische onderzoeken .................................................................................................... 9
Obstructieve aandoenignen ................................................................................................... 9
Stadium bepalen .............................................................................................................. 10
Exacerbaties ..................................................................................................................... 10
Symptomen en Behandeling ............................................................................................ 10
Pathogenese COPD ........................................................................................................... 11
Inactiviteit bij COPD.......................................................................................................... 11
Casus 2 .................................................................................................................................. 12
Presentatie ....................................................................................................................... 12
Klinisch onderzoek............................................................................................................ 12
DD/ ................................................................................................................................... 12
Technische onderzoeken .................................................................................................. 12
Behandeling ...................................................................................................................... 13
Benefits......................................................................................................................... 13
Diagnose ........................................................................................................................... 14
Longembolie ............................................................................................................................ 14
Casus 1 .................................................................................................................................. 14
Presentatie ....................................................................................................................... 14
Voorgeschiedenis ............................................................................................................. 14
Klinisch onderzoek............................................................................................................ 15
Vitale parameters ......................................................................................................... 15
Differentieel diagnose ...................................................................................................... 15
Onderzoeken .................................................................................................................... 16
ECG ............................................................................................................................... 16
Labo .............................................................................................................................. 16
Bloedgas ....................................................................................................................... 16
RX-thorax ...................................................................................................................... 16
1
, Diagnose bevestigen ........................................................................................................ 17
Labo .............................................................................................................................. 17
Duplex OLM .................................................................................................................. 18
CT scan .......................................................................................................................... 18
Echo .............................................................................................................................. 18
Bevestiging ................................................................................................................... 19
Besluit ............................................................................................................................... 19
Behandeling ...................................................................................................................... 19
Key message ......................................................................................................................... 19
Hoesten I .................................................................................................................................. 20
Introductie ............................................................................................................................ 20
Definitie ............................................................................................................................ 20
Verschillende soorten ...................................................................................................... 20
Functie hoesten ................................................................................................................ 20
Frequentie ........................................................................................................................ 21
Differentieel diagnose ...................................................................................................... 21
Aanpak: casussen ............................................................................................................. 21
Patiënt 1 ....................................................................................................................... 21
Patiënt 2 ....................................................................................................................... 21
Patiënt 3 ....................................................................................................................... 22
Patiënt 4 ....................................................................................................................... 22
Hoesten II ................................................................................................................................. 23
Patiënt 1: astma ................................................................................................................... 23
Bijkomende gegevens ...................................................................................................... 23
KO ..................................................................................................................................... 24
DD/ ................................................................................................................................... 24
Bijkomende testen ........................................................................................................... 24
Behandeling ...................................................................................................................... 25
Opvolging.......................................................................................................................... 25
4 weken ........................................................................................................................ 25
7 weken later ................................................................................................................ 26
Patiënt 2 ............................................................................................................................... 27
Presentatie ....................................................................................................................... 27
Bijkomende vragen........................................................................................................... 27
Bijkomende testen ........................................................................................................... 27
2
, Differentieel diagnose ...................................................................................................... 28
Diagnose: EILO .................................................................................................................. 28
Behandeling ...................................................................................................................... 28
Patiënt 3 ............................................................................................................................... 29
Context ............................................................................................................................. 29
Patiënt 4 ............................................................................................................................... 29
Respiratoire infecties - pneumonie......................................................................................... 29
Casus 1 .................................................................................................................................. 29
CAP: community aquired pneumonie .............................................................................. 30
CAP stalen in ambulante setting .................................................................................. 31
Indeling pneumonie ......................................................................................................... 31
CAP ............................................................................................................................... 31
Verwekkers ................................................................................................................... 32
Onderzoeken ................................................................................................................ 32
Behandeling .................................................................................................................. 32
Dyspnee.................................................................................................................................... 34
Casus..................................................................................................................................... 34
Context ............................................................................................................................. 34
Bijkomende gegevens ...................................................................................................... 35
Verdere evolutie ............................................................................................................... 36
Diagnose ........................................................................................................................... 36
MIP: minocycline geïnduceerde pneumonie ............................................................... 37
Dyspnee ................................................................................................................................ 37
Oorzaken .......................................................................................................................... 37
Aanpak .............................................................................................................................. 37
Alarmsymptomen ......................................................................................................... 37
Bijkomende testen bij onzekerheid ............................................................................. 38
Interstitiële en inflammatoire longpathologie ..................................................................... 38
Herhaling theorie ............................................................................................................. 38
Pathogenese ..................................................................................................................... 38
Klinische presentatie ........................................................................................................ 39
Radiologische aspecten .................................................................................................... 39
Diagnostische aspecten .................................................................................................... 39
Aanpak .............................................................................................................................. 40
Sarcoïdose ........................................................................................................................ 40
3
