Klinische lessen
Inhoudsopgave
Hoofdstuk 1: klinisch redeneren ....................................................................................................................... 8
Hoofdstuk 2: acuut coronair syndroom (p291) ............................................................................................... 10
Anamnese ......................................................................................................................................................... 10
Klinisch onderzoek ............................................................................................................................................ 10
Diagnostisch landschap .................................................................................................................................... 10
Verder onderzoek ............................................................................................................................................. 11
Diagnose ........................................................................................................................................................... 11
Behandeling ...................................................................................................................................................... 11
Hoofdstuk 3: perifeer arterieel vaatlijden (PAV) (P631).................................................................................. 12
Anamnese ......................................................................................................................................................... 12
Klinisch onderzoek ............................................................................................................................................ 12
Diagnostisch landschap .................................................................................................................................... 13
Verder onderzoek ............................................................................................................................................. 13
Diagnose ........................................................................................................................................................... 14
Behandeling ...................................................................................................................................................... 14
Opvolging ......................................................................................................................................................... 15
Hoofdstuk 4: jeuk (p733) ................................................................................................................................ 16
Anamnese ......................................................................................................................................................... 16
Klinisch onderzoek ............................................................................................................................................ 16
Differentiaal diagnose ...................................................................................................................................... 16
Verder onderzoek ............................................................................................................................................. 17
Diagnose ........................................................................................................................................................... 17
Behandeling ...................................................................................................................................................... 17
Hoofdstuk 5: enkeloedeem (P687) ................................................................................................................. 18
Anamnese ......................................................................................................................................................... 18
Klinisch onderzoek ............................................................................................................................................ 18
Diagnostisch landschap .................................................................................................................................... 19
Verder onderzoek ............................................................................................................................................. 20
Diagnose ........................................................................................................................................................... 20
Behandeling ...................................................................................................................................................... 20
Hoofdstuk 6.1: pneumonie (p321) .................................................................................................................. 21
Anamnese ......................................................................................................................................................... 21
Klinisch onderzoek ............................................................................................................................................ 21
Diagnostisch landschap .................................................................................................................................... 21
,Klinische lessen
Verder onderzoek ............................................................................................................................................. 22
Diagnose ........................................................................................................................................................... 22
Behandeling ...................................................................................................................................................... 23
Verwikkeling ..................................................................................................................................................... 23
Differentiaal diagnose ...................................................................................................................................... 23
follow up ........................................................................................................................................................... 25
Hoofdstuk 6.2: astma ..................................................................................................................................... 26
Risicofactoren ................................................................................................................................................... 26
Diagnose ........................................................................................................................................................... 26
Behandeling ...................................................................................................................................................... 26
Hoofdstuk 7: cystitis (p451) ............................................................................................................................ 27
Anamnese ......................................................................................................................................................... 27
Klinisch onderzoek ............................................................................................................................................ 27
Differential diagnose ........................................................................................................................................ 27
Diagnose ........................................................................................................................................................... 27
Verder onderzoek ............................................................................................................................................. 28
Behandeling ...................................................................................................................................................... 28
Hoofdstuk 8: heupfractuur ............................................................................................................................. 30
Anamnese ......................................................................................................................................................... 30
Klinisch onderzoek ............................................................................................................................................ 30
Diagnostisch landschap .................................................................................................................................... 30
Diagnose ........................................................................................................................................................... 30
Verder onderzoek ............................................................................................................................................. 31
Behandeling ...................................................................................................................................................... 31
Screening osteoporose?.................................................................................................................................... 32
Hoofdstuk 9.1: val geriatrie (p117) ................................................................................................................. 33
Anamnese ......................................................................................................................................................... 33
Klinisch onderzoek ............................................................................................................................................ 33
Oorzaken .......................................................................................................................................................... 33
Verder onderzoek ............................................................................................................................................. 34
Diagnose ........................................................................................................................................................... 34
Gevolgen van vallen ......................................................................................................................................... 35
Therapie............................................................................................................................................................ 36
Hoofdstuk 9.2: darmklachten ......................................................................................................................... 37
Onderzoek ........................................................................................................................................................ 37
Diagnose ........................................................................................................................................................... 37
,Klinische lessen
Hoofdstuk 10: hartstilstand (p1118 K&C) ....................................................................................................... 37
Anamnese ......................................................................................................................................................... 37
Klinisch onderzoek ............................................................................................................................................ 37
Differentiaal diagnose ...................................................................................................................................... 38
Diagnose ........................................................................................................................................................... 39
Verder onderzoek ............................................................................................................................................. 39
Behandeling ...................................................................................................................................................... 39
Hoofdstuk 11: mictieklachten bij mannen (p465, p1480 K&C) ........................................................................ 40
Anamnese ......................................................................................................................................................... 40
Klinisch onderzoek ............................................................................................................................................ 40
Diagnostisch landschap: allemaal vormen van LUTS ....................................................................................... 41
Diagnose ........................................................................................................................................................... 43
Behandeling ...................................................................................................................................................... 43
Hoofdstuk 12: persisterende neusloop (p233) ................................................................................................ 45
Anamnese ......................................................................................................................................................... 45
Klinisch onderzoek ............................................................................................................................................ 45
Differentiaal diagnose ...................................................................................................................................... 45
Verder onderzoek ............................................................................................................................................. 46
Diagnose ........................................................................................................................................................... 46
Behandeling ...................................................................................................................................................... 49
Hoofdstuk 13: ALK/ SOLK ............................................................................................................................... 50
Hoofdstuk 14: neutropene koorts (p45) ......................................................................................................... 52
Anamnese ......................................................................................................................................................... 52
Klinisch onderzoek ............................................................................................................................................ 52
Verder onderzoek VOOR AB!! ........................................................................................................................... 52
Differentiaal diagnose ...................................................................................................................................... 52
Diagnose ........................................................................................................................................................... 53
Behandeling ...................................................................................................................................................... 54
Prognose ........................................................................................................................................................... 55
Hoofdstuk 14.1: borstkanker (p275) ............................................................................................................... 56
Epidemiologie ................................................................................................................................................... 56
Symptomen ...................................................................................................................................................... 56
Familiale voorgeschiedenis............................................................................................................................... 57
Differentiaaldiagnose ....................................................................................................................................... 57
Onderzoek ........................................................................................................................................................ 57
Diagnose ........................................................................................................................................................... 58
Behandeling ...................................................................................................................................................... 59
, Klinische lessen
Screening .......................................................................................................................................................... 59
Hoofdstuk 14.2: erysipelas ............................................................................................................................. 60
Diagnose ........................................................................................................................................................... 60
Risicofactoren ................................................................................................................................................... 60
Onderzoeken .................................................................................................................................................... 60
Behandeling ...................................................................................................................................................... 60
hoofdstuk 15: IgA nefropathie (p1361 K&C) ................................................................................................... 61
anamnese ......................................................................................................................................................... 61
klinisch onderzoek ............................................................................................................................................ 61
differentiaal diagnose ...................................................................................................................................... 61
Risicofactoren ................................................................................................................................................... 61
diagnose ........................................................................................................................................................... 62
behandeling ...................................................................................................................................................... 62
Hoofdstuk 16: Peripartum cardiomyopathy (p321) ........................................................................................ 63
Anamnese ......................................................................................................................................................... 63
Klinisch onderzoek ............................................................................................................................................ 63
Diagnostisch landschap .................................................................................................................................... 64
Verder onderzoek ............................................................................................................................................. 65
Diagnose ........................................................................................................................................................... 65
Oorzaken !! ....................................................................................................................................................... 66
Timing HF in zwangerschap .............................................................................................................................. 67
Behandeling ...................................................................................................................................................... 68
Mortaliteit ........................................................................................................................................................ 69
Hoofdstuk 17.1: neusbloeding ........................................................................................................................ 70
Anamnese ......................................................................................................................................................... 70
Klinisch onderzoek ............................................................................................................................................ 70
Diagnose ........................................................................................................................................................... 70
Behandeling ...................................................................................................................................................... 70
Hoofdstuk 17.2: neusfractuur ......................................................................................................................... 72
Anamnese ......................................................................................................................................................... 72
Klinisch onderzoek ............................................................................................................................................ 72
Verder onderzoek ............................................................................................................................................. 72
Behandeling ...................................................................................................................................................... 73
Hoofdstuk 17.3: septumhematoom................................................................................................................ 73
Klinisch onderzoek ............................................................................................................................................ 73
Verder onderzoek ............................................................................................................................................. 73
Inhoudsopgave
Hoofdstuk 1: klinisch redeneren ....................................................................................................................... 8
Hoofdstuk 2: acuut coronair syndroom (p291) ............................................................................................... 10
Anamnese ......................................................................................................................................................... 10
Klinisch onderzoek ............................................................................................................................................ 10
Diagnostisch landschap .................................................................................................................................... 10
Verder onderzoek ............................................................................................................................................. 11
Diagnose ........................................................................................................................................................... 11
Behandeling ...................................................................................................................................................... 11
Hoofdstuk 3: perifeer arterieel vaatlijden (PAV) (P631).................................................................................. 12
Anamnese ......................................................................................................................................................... 12
Klinisch onderzoek ............................................................................................................................................ 12
Diagnostisch landschap .................................................................................................................................... 13
Verder onderzoek ............................................................................................................................................. 13
Diagnose ........................................................................................................................................................... 14
Behandeling ...................................................................................................................................................... 14
Opvolging ......................................................................................................................................................... 15
Hoofdstuk 4: jeuk (p733) ................................................................................................................................ 16
Anamnese ......................................................................................................................................................... 16
Klinisch onderzoek ............................................................................................................................................ 16
Differentiaal diagnose ...................................................................................................................................... 16
Verder onderzoek ............................................................................................................................................. 17
Diagnose ........................................................................................................................................................... 17
Behandeling ...................................................................................................................................................... 17
Hoofdstuk 5: enkeloedeem (P687) ................................................................................................................. 18
Anamnese ......................................................................................................................................................... 18
Klinisch onderzoek ............................................................................................................................................ 18
Diagnostisch landschap .................................................................................................................................... 19
Verder onderzoek ............................................................................................................................................. 20
Diagnose ........................................................................................................................................................... 20
Behandeling ...................................................................................................................................................... 20
Hoofdstuk 6.1: pneumonie (p321) .................................................................................................................. 21
Anamnese ......................................................................................................................................................... 21
Klinisch onderzoek ............................................................................................................................................ 21
Diagnostisch landschap .................................................................................................................................... 21
,Klinische lessen
Verder onderzoek ............................................................................................................................................. 22
Diagnose ........................................................................................................................................................... 22
Behandeling ...................................................................................................................................................... 23
Verwikkeling ..................................................................................................................................................... 23
Differentiaal diagnose ...................................................................................................................................... 23
follow up ........................................................................................................................................................... 25
Hoofdstuk 6.2: astma ..................................................................................................................................... 26
Risicofactoren ................................................................................................................................................... 26
Diagnose ........................................................................................................................................................... 26
Behandeling ...................................................................................................................................................... 26
Hoofdstuk 7: cystitis (p451) ............................................................................................................................ 27
Anamnese ......................................................................................................................................................... 27
Klinisch onderzoek ............................................................................................................................................ 27
Differential diagnose ........................................................................................................................................ 27
Diagnose ........................................................................................................................................................... 27
Verder onderzoek ............................................................................................................................................. 28
Behandeling ...................................................................................................................................................... 28
Hoofdstuk 8: heupfractuur ............................................................................................................................. 30
Anamnese ......................................................................................................................................................... 30
Klinisch onderzoek ............................................................................................................................................ 30
Diagnostisch landschap .................................................................................................................................... 30
Diagnose ........................................................................................................................................................... 30
Verder onderzoek ............................................................................................................................................. 31
Behandeling ...................................................................................................................................................... 31
Screening osteoporose?.................................................................................................................................... 32
Hoofdstuk 9.1: val geriatrie (p117) ................................................................................................................. 33
Anamnese ......................................................................................................................................................... 33
Klinisch onderzoek ............................................................................................................................................ 33
Oorzaken .......................................................................................................................................................... 33
Verder onderzoek ............................................................................................................................................. 34
Diagnose ........................................................................................................................................................... 34
Gevolgen van vallen ......................................................................................................................................... 35
Therapie............................................................................................................................................................ 36
Hoofdstuk 9.2: darmklachten ......................................................................................................................... 37
Onderzoek ........................................................................................................................................................ 37
Diagnose ........................................................................................................................................................... 37
,Klinische lessen
Hoofdstuk 10: hartstilstand (p1118 K&C) ....................................................................................................... 37
Anamnese ......................................................................................................................................................... 37
Klinisch onderzoek ............................................................................................................................................ 37
Differentiaal diagnose ...................................................................................................................................... 38
Diagnose ........................................................................................................................................................... 39
Verder onderzoek ............................................................................................................................................. 39
Behandeling ...................................................................................................................................................... 39
Hoofdstuk 11: mictieklachten bij mannen (p465, p1480 K&C) ........................................................................ 40
Anamnese ......................................................................................................................................................... 40
Klinisch onderzoek ............................................................................................................................................ 40
Diagnostisch landschap: allemaal vormen van LUTS ....................................................................................... 41
Diagnose ........................................................................................................................................................... 43
Behandeling ...................................................................................................................................................... 43
Hoofdstuk 12: persisterende neusloop (p233) ................................................................................................ 45
Anamnese ......................................................................................................................................................... 45
Klinisch onderzoek ............................................................................................................................................ 45
Differentiaal diagnose ...................................................................................................................................... 45
Verder onderzoek ............................................................................................................................................. 46
Diagnose ........................................................................................................................................................... 46
Behandeling ...................................................................................................................................................... 49
Hoofdstuk 13: ALK/ SOLK ............................................................................................................................... 50
Hoofdstuk 14: neutropene koorts (p45) ......................................................................................................... 52
Anamnese ......................................................................................................................................................... 52
Klinisch onderzoek ............................................................................................................................................ 52
Verder onderzoek VOOR AB!! ........................................................................................................................... 52
Differentiaal diagnose ...................................................................................................................................... 52
Diagnose ........................................................................................................................................................... 53
Behandeling ...................................................................................................................................................... 54
Prognose ........................................................................................................................................................... 55
Hoofdstuk 14.1: borstkanker (p275) ............................................................................................................... 56
Epidemiologie ................................................................................................................................................... 56
Symptomen ...................................................................................................................................................... 56
Familiale voorgeschiedenis............................................................................................................................... 57
Differentiaaldiagnose ....................................................................................................................................... 57
Onderzoek ........................................................................................................................................................ 57
Diagnose ........................................................................................................................................................... 58
Behandeling ...................................................................................................................................................... 59
, Klinische lessen
Screening .......................................................................................................................................................... 59
Hoofdstuk 14.2: erysipelas ............................................................................................................................. 60
Diagnose ........................................................................................................................................................... 60
Risicofactoren ................................................................................................................................................... 60
Onderzoeken .................................................................................................................................................... 60
Behandeling ...................................................................................................................................................... 60
hoofdstuk 15: IgA nefropathie (p1361 K&C) ................................................................................................... 61
anamnese ......................................................................................................................................................... 61
klinisch onderzoek ............................................................................................................................................ 61
differentiaal diagnose ...................................................................................................................................... 61
Risicofactoren ................................................................................................................................................... 61
diagnose ........................................................................................................................................................... 62
behandeling ...................................................................................................................................................... 62
Hoofdstuk 16: Peripartum cardiomyopathy (p321) ........................................................................................ 63
Anamnese ......................................................................................................................................................... 63
Klinisch onderzoek ............................................................................................................................................ 63
Diagnostisch landschap .................................................................................................................................... 64
Verder onderzoek ............................................................................................................................................. 65
Diagnose ........................................................................................................................................................... 65
Oorzaken !! ....................................................................................................................................................... 66
Timing HF in zwangerschap .............................................................................................................................. 67
Behandeling ...................................................................................................................................................... 68
Mortaliteit ........................................................................................................................................................ 69
Hoofdstuk 17.1: neusbloeding ........................................................................................................................ 70
Anamnese ......................................................................................................................................................... 70
Klinisch onderzoek ............................................................................................................................................ 70
Diagnose ........................................................................................................................................................... 70
Behandeling ...................................................................................................................................................... 70
Hoofdstuk 17.2: neusfractuur ......................................................................................................................... 72
Anamnese ......................................................................................................................................................... 72
Klinisch onderzoek ............................................................................................................................................ 72
Verder onderzoek ............................................................................................................................................. 72
Behandeling ...................................................................................................................................................... 73
Hoofdstuk 17.3: septumhematoom................................................................................................................ 73
Klinisch onderzoek ............................................................................................................................................ 73
Verder onderzoek ............................................................................................................................................. 73
