KLINISCHE ASPECTEN VAN GERONTOLOGIE EN GERIATRIE
INHOUDSTAFEL
KLINISCHE ASPECTEN VAN GERONTOLOGIE EN GERIATRIE .................................................................... 1
HOOFDSTUK 1 : Geriatrische patiënt ...................................................................................................... 4
1) Inleiding....................................................................................................................................... 4
Algemene veranderingen in organen ..................................................................................... 4
2) Fragiliteit en beperkte homeostase ............................................................................................ 4
Sarcopenie .............................................................................................................................. 5
lean body mass (spiermassa + vetmassa) ............................................................................ 6
nierfunctie ........................................................................................................................... 7
leverfunctie .......................................................................................................................... 7
verstoord endocrien stelsel .................................................................................................... 7
3) Polypathologie ............................................................................................................................ 9
4) Atypische klinische beelden ........................................................................................................ 9
HOOFDSTUK 2 : VOEDINGSPROBLEMEN .............................................................................................. 10
1) Spanningsveld ........................................................................................................................... 10
2) Preventie ................................................................................................................................... 10
3) Ondervoeding ➔ stimuleren van voedselinname .................................................................... 10
4) Prevalentie ondervoeding ......................................................................................................... 10
5) Risicofactoren van ondervoeding PPT ...................................................................................... 10
Algemeen calorie behoeftes ................................................................................................. 11
Verstoorde zintuigelijke functie ............................................................................................ 11
Caries + periodontitis ............................................................................................................ 12
6) Specifieke nutritionele tekorten ............................................................................................... 12
7) Artificielle voeding .................................................................................................................... 12
HOOFDSTUK 3 : Vallen; osteoporose; fracturen; OA ............................................................................ 13
1) Osteoporose.............................................................................................................................. 13
Inleiding................................................................................................................................. 13
Prevalentie ............................................................................................................................ 13
Definitie osteoporose ........................................................................................................... 13
Beïnvloedende factoren........................................................................................................ 13
Preventie en behandeling ..................................................................................................... 14
Osteoporose geneesmiddelen .............................................................................................. 14
2) Recidiverend vallen ................................................................................................................... 15
1
, Definitie................................................................................................................................. 15
Risicofactoren ....................................................................................................................... 15
Gevolgen v/h vallen .............................................................................................................. 16
3) Osteo-arthrose .......................................................................................................................... 16
Definitie................................................................................................................................. 16
Classificatie............................................................................................................................ 16
Prevalentie ............................................................................................................................ 16
Oorzaak AO ........................................................................................................................... 17
Behandeling .......................................................................................................................... 17
HOOFDSTUK 4 : Doorligwonden; huidziekten ...................................................................................... 18
1) Normale veroudering v/d huid ................................................................................................. 18
2) Pathologische ziektes v/d huid ................................................................................................. 18
Ulcera .................................................................................................................................... 18
Decubitus ulcera ................................................................................................................... 19
Infecties ................................................................................................................................. 20
Tumoren ................................................................................................................................ 20
HOOFDSTUK 5 : Infecties; incontinentie ............................................................................................... 21
1) Infecties ..................................................................................................................................... 21
Pneumonie ............................................................................................................................ 21
TBC ........................................................................................................................................ 21
MRSA (Methicilline resistente Staphylococcus Aureus) ....................................................... 21
Clostridium difficile ............................................................................................................... 21
COVID-19 & influenza ........................................................................................................... 21
Urineweginfectie ................................................................................................................... 21
Vaccinatie .............................................................................................................................. 22
2) Urine continente ....................................................................................................................... 22
HOOFDSTUK 6 : Cardiovasculaire ziektes............................................................................................. 22
1) Inleiding..................................................................................................................................... 22
2) Chronische & acute problemen ................................................................................................ 22
3) Beïnvloedbare & niet-beïnvloedbare factoren ......................................................................... 23
HOOFDSTUK 7 : Bindweefseldegeneratie ............................................................................................ 24
1) Inleiding..................................................................................................................................... 24
2) Bindweefselstructuren in spieren veranderen ......................................................................... 24
3) Pees-of spierruptuur ................................................................................................................. 24
4) Tendinose .................................................................................................................................. 24
5) Intervertrebrale discus prolabs (discus hérnia; ischias)............................................................ 24
2
, 6) Aorta aneurysma....................................................................................................................... 25
7) Hartkleplijden............................................................................................................................ 25
8) Varices ....................................................................................................................................... 25
9) Liesbreuk ................................................................................................................................... 25
10) Anale prolaps ........................................................................................................................ 25
11) Hernia diafragmatica............................................................................................................. 25
12) Colon diverticulose ............................................................................................................... 26
HOOFDSTUK 8 : Kanker ......................................................................................................................... 27
1) Inleiding..................................................................................................................................... 27
2) Bortskanker ............................................................................................................................... 27
3) Prostaatkanker .......................................................................................................................... 28
4) Colon kanker ............................................................................................................................. 28
5) Long/bronchus kanker .............................................................................................................. 28
HOOFDSTUK 9 : Diabetes mellitus ....................................................................................................... 29
1) Inleiding..................................................................................................................................... 29
2) Symptomen ............................................................................................................................... 29
3) Onderzoek ................................................................................................................................. 29
4) Behandeling .............................................................................................................................. 29
5) Hypoglycemie............................................................................................................................ 29
HOOFDSTUK 10 : Frailty ........................................................................................................................ 30
1) Zintuigen : algemene verslechteringen..................................................................................... 30
3
INHOUDSTAFEL
KLINISCHE ASPECTEN VAN GERONTOLOGIE EN GERIATRIE .................................................................... 1
HOOFDSTUK 1 : Geriatrische patiënt ...................................................................................................... 4
1) Inleiding....................................................................................................................................... 4
Algemene veranderingen in organen ..................................................................................... 4
2) Fragiliteit en beperkte homeostase ............................................................................................ 4
Sarcopenie .............................................................................................................................. 5
lean body mass (spiermassa + vetmassa) ............................................................................ 6
nierfunctie ........................................................................................................................... 7
leverfunctie .......................................................................................................................... 7
verstoord endocrien stelsel .................................................................................................... 7
3) Polypathologie ............................................................................................................................ 9
4) Atypische klinische beelden ........................................................................................................ 9
HOOFDSTUK 2 : VOEDINGSPROBLEMEN .............................................................................................. 10
1) Spanningsveld ........................................................................................................................... 10
2) Preventie ................................................................................................................................... 10
3) Ondervoeding ➔ stimuleren van voedselinname .................................................................... 10
4) Prevalentie ondervoeding ......................................................................................................... 10
5) Risicofactoren van ondervoeding PPT ...................................................................................... 10
Algemeen calorie behoeftes ................................................................................................. 11
Verstoorde zintuigelijke functie ............................................................................................ 11
Caries + periodontitis ............................................................................................................ 12
6) Specifieke nutritionele tekorten ............................................................................................... 12
7) Artificielle voeding .................................................................................................................... 12
HOOFDSTUK 3 : Vallen; osteoporose; fracturen; OA ............................................................................ 13
1) Osteoporose.............................................................................................................................. 13
Inleiding................................................................................................................................. 13
Prevalentie ............................................................................................................................ 13
Definitie osteoporose ........................................................................................................... 13
Beïnvloedende factoren........................................................................................................ 13
Preventie en behandeling ..................................................................................................... 14
Osteoporose geneesmiddelen .............................................................................................. 14
2) Recidiverend vallen ................................................................................................................... 15
1
, Definitie................................................................................................................................. 15
Risicofactoren ....................................................................................................................... 15
Gevolgen v/h vallen .............................................................................................................. 16
3) Osteo-arthrose .......................................................................................................................... 16
Definitie................................................................................................................................. 16
Classificatie............................................................................................................................ 16
Prevalentie ............................................................................................................................ 16
Oorzaak AO ........................................................................................................................... 17
Behandeling .......................................................................................................................... 17
HOOFDSTUK 4 : Doorligwonden; huidziekten ...................................................................................... 18
1) Normale veroudering v/d huid ................................................................................................. 18
2) Pathologische ziektes v/d huid ................................................................................................. 18
Ulcera .................................................................................................................................... 18
Decubitus ulcera ................................................................................................................... 19
Infecties ................................................................................................................................. 20
Tumoren ................................................................................................................................ 20
HOOFDSTUK 5 : Infecties; incontinentie ............................................................................................... 21
1) Infecties ..................................................................................................................................... 21
Pneumonie ............................................................................................................................ 21
TBC ........................................................................................................................................ 21
MRSA (Methicilline resistente Staphylococcus Aureus) ....................................................... 21
Clostridium difficile ............................................................................................................... 21
COVID-19 & influenza ........................................................................................................... 21
Urineweginfectie ................................................................................................................... 21
Vaccinatie .............................................................................................................................. 22
2) Urine continente ....................................................................................................................... 22
HOOFDSTUK 6 : Cardiovasculaire ziektes............................................................................................. 22
1) Inleiding..................................................................................................................................... 22
2) Chronische & acute problemen ................................................................................................ 22
3) Beïnvloedbare & niet-beïnvloedbare factoren ......................................................................... 23
HOOFDSTUK 7 : Bindweefseldegeneratie ............................................................................................ 24
1) Inleiding..................................................................................................................................... 24
2) Bindweefselstructuren in spieren veranderen ......................................................................... 24
3) Pees-of spierruptuur ................................................................................................................. 24
4) Tendinose .................................................................................................................................. 24
5) Intervertrebrale discus prolabs (discus hérnia; ischias)............................................................ 24
2
, 6) Aorta aneurysma....................................................................................................................... 25
7) Hartkleplijden............................................................................................................................ 25
8) Varices ....................................................................................................................................... 25
9) Liesbreuk ................................................................................................................................... 25
10) Anale prolaps ........................................................................................................................ 25
11) Hernia diafragmatica............................................................................................................. 25
12) Colon diverticulose ............................................................................................................... 26
HOOFDSTUK 8 : Kanker ......................................................................................................................... 27
1) Inleiding..................................................................................................................................... 27
2) Bortskanker ............................................................................................................................... 27
3) Prostaatkanker .......................................................................................................................... 28
4) Colon kanker ............................................................................................................................. 28
5) Long/bronchus kanker .............................................................................................................. 28
HOOFDSTUK 9 : Diabetes mellitus ....................................................................................................... 29
1) Inleiding..................................................................................................................................... 29
2) Symptomen ............................................................................................................................... 29
3) Onderzoek ................................................................................................................................. 29
4) Behandeling .............................................................................................................................. 29
5) Hypoglycemie............................................................................................................................ 29
HOOFDSTUK 10 : Frailty ........................................................................................................................ 30
1) Zintuigen : algemene verslechteringen..................................................................................... 30
3
