Summary
Samenvatting Blok Groen UU
- Course
- Institution
Samenvatting van werkcolleges en werkgroepen van Blok Groen gegeven aan de UU in studiejaar 2021/2022 (let op: Online onderwijs)
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By: boorlieke • 2 months ago
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Blok GroenAlgemeen .......................................................................................................................................................................... 3
Kwaliteit en veiligheid ....................................................................................................................................................... 6
Dyspnoe en hoesten ......................................................................................................................................................... 7
Klinische chemie.............................................................................................................................................................. 11
Farmacologie ................................................................................................................................................................... 15
Collaps ............................................................................................................................................................................. 17
Delier ............................................................................................................................................................................... 19
Cardiologie ...................................................................................................................................................................... 21
ECG-beoordeling ......................................................................................................................................................... 21
Pijn op borst ................................................................................................................................................................ 25
Ritmestoornissen ........................................................................................................................................................ 30
Bradycardieën + geleidingsstoornissen .................................................................................................................. 34
Tachycardieën ......................................................................................................................................................... 36
Cortonen ..................................................................................................................................................................... 41
Vaatlijden ........................................................................................................................................................................ 44
Koorts .............................................................................................................................................................................. 49
Medische microbiologie .................................................................................................................................................. 55
Buikpijn ........................................................................................................................................................................... 56
Acute buik ................................................................................................................................................................... 58
Wet BIG ........................................................................................................................................................................... 65
HBS .................................................................................................................................................................................. 66
Urologie........................................................................................................................................................................... 72
Anatomie......................................................................................................................................................................... 75
Lieskanaal .................................................................................................................................................................... 75
Hernia’s ....................................................................................................................................................................... 79
Liesbreuken ............................................................................................................................................................. 79
Buikwandbreuken ................................................................................................................................................... 81
Anatomie abdomen en thorax .................................................................................................................................... 82
Anesthesie....................................................................................................................................................................... 85
Pre-operatieve screening ............................................................................................................................................ 85
Anesthesie op operatiekamer ..................................................................................................................................... 87
Recovery en nazorg ..................................................................................................................................................... 89
Fracturen ......................................................................................................................................................................... 92
Wondzorg ........................................................................................................................................................................ 96
Moeheid / SOLK .............................................................................................................................................................. 99
Radiologie...................................................................................................................................................................... 103
1
,2
,Algemeen
Tot een werkdiagnose komen
Systeem 1 = niet-analytisch
- A vue
- Patroonherkenning / ziektescripts
Systeem 2 = Analytisch
- Stap voor stap denken
1. DD op grond van
a. Anatomie
b. Pathofysiologie
2. Hiërarchie aanbreng
a. Epidemiologie
b. Voorgeschiedenis van de patiënt
c. Contextuele kennis
Klinisch redeneren
ABCDE: Indruk van ernst
A: Ademweg
- Ademweg vrij
- CWK niet bedreigd
B: Breathing
- AF
- Trachea in midline
- Symmetrische thoraxexcursies
- Hulpademhalingsspieren, intrekkingen
- Saturatie, AH-frequentie, auscultatie longen
C: Circulatie
- Pols
- Bloeddruk
- Harttonen
- CVD
- Perifeer oedeem
D: Disability
- AVPU-score (alert, verbal, pijn, unresponsive)
- EMV
- Pupillen
E: Environment
- Temperatuur
- Kleur gelaat
- Huid/trombose
3
, SBARR
Situation
- Jezelf voorstellen
- Patiëntidentificatie
- Aanleiding om nú contact op te nemen
Background
- Voorgeschiedenis
- Reden van opname
- Ziektebeloop
Assessment
- Analyse van de situatie: Wat is er aan de hand?
Respons/recommendation
- Wat denk jij dat er nu moet gebeuren, wat verwacht je van de ander?
Repeat
- Wat is het advies dat je krijgt? Herhaal en controleer of dit klopt
Bayesiaanse statistiek
Begint met a priori kans → via diagnostische tests meer informatie → a posteriori kans
Voorbeeld Bayesiaanse statistiek
- Prevalentie van longkanker is 0,12%
- X-thorax sensitiviteit 84%, specificiteit 90% voor ontdekken
longkaker
- Kans dat PT met verdachte afwijking op X-thorax ook
daadwerkelijk longkanker heeft?
- Positief voorspellende waarde: (TP/(TP+FP)) * 100
o = 0,99% = <1%
- Kans op longkanker bij afwijking op X-thorax <1%
Testkarakteristieken
- Sensitiviteit en specificiteit zeggen iets over diagnostische
test
o Onafhankelijk van populatie
o Afhankelijk van afkapwaarde
- Positief-voorspellende waarde en negatief-voorspellende
waarde zeggen iets over diagnostische test én populatie
o Afhankelijk van prevalentie (a priori-kans)
▪ Hoe hoger de prevalentie, hoe groter de
PPV
▪ Hoe lager de prevalentie, hoe groter de
NPV
ROC-curve
- Hoe meer naar links → hoe groter Area Under Curve → hoe beter test
4
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