Summary
Volledige samenvatting ziektemechanismen Vangoitsenhoven
- Course
- Institution
volledige samenvatting pathofysiologie ziektemechanismen gegeven door professor Vangoitsenhoven met notities uit de les
[Show more]
Seller
Follow
Gnkkuleuven
Reviews received
Content preview
ZIEKTEMECHANISMEN –VANGOITSHOVEN
H1: Inleiding ................................................................................................................................................... 4
Definities ............................................................................................................................................................. 4
Huidige doodsoorzaken....................................................................................................................................... 4
Veroudering ........................................................................................................................................................ 4
Cellulaire en moleculaire oorzaken van veroudering ..................................................................................... 4
Schade aan macromoleculen ..................................................................................................................... 4
Inadequaat herstel van schade .................................................................................................................. 5
Ontregeling van de homeostase van celaantal .......................................................................................... 7
Kan men veroudering vertragen? ....................................................................................................................... 7
H2: Inflammatie .............................................................................................................................................. 8
Inleiding .............................................................................................................................................................. 8
Pathofysiologie van de acute ontstekingsreactie ................................................................................................ 8
Vasculaire elementen van de ontstekingsreactie ................................................................................................ 8
Pathofysiologie ............................................................................................................................................... 8
Hyperemie .................................................................................................................................................. 8
Marginatie en diapedese............................................................................................................................ 8
Vorming van een vochtexsudaat ................................................................................................................ 9
Biochemische mediatoren .............................................................................................................................. 9
Histamine ................................................................................................................................................... 9
De kinines ................................................................................................................................................. 10
Het complementsysteem ......................................................................................................................... 10
Lipide-mediatoren .................................................................................................................................... 11
Cellulaire elementen van de ontstekingsreactie ............................................................................................... 11
Pathofysiologie ............................................................................................................................................. 11
Biochemische aspecten ................................................................................................................................ 12
Motiliteit en chemotaxis .......................................................................................................................... 12
Fagocytose ............................................................................................................................................... 12
Algemene weerslag van de acute ontstekingsreactie ....................................................................................... 12
H3: Thermoregulatie ..................................................................................................................................... 13
Inleiding ............................................................................................................................................................ 13
Fysiologie van de thermoregulatie .................................................................................................................... 13
Effector-apparaat ......................................................................................................................................... 13
Warmteproductie en aanpassingsmechanismen ..................................................................................... 13
Warmte-afgave en aanpassingsmechanismen ......................................................................................... 13
Sensor-apparaat ........................................................................................................................................... 14
Set-Point ....................................................................................................................................................... 14
Fysiopathologie van de thermoregulatie .......................................................................................................... 15
, Koorts ........................................................................................................................................................... 15
Hyperthermie ............................................................................................................................................... 16
Hypothermie ................................................................................................................................................. 16
H4: Voeding en metabolisme ........................................................................................................................ 17
Normale voedingsbehoeften van de mens ........................................................................................................ 17
Essentiele nutritionele behoeften ................................................................................................................ 17
Energie ..................................................................................................................................................... 17
Eiwit.......................................................................................................................................................... 17
Lipiden ...................................................................................................................................................... 18
Koolhydraten ............................................................................................................................................ 18
Vitaalstoffen ............................................................................................................................................. 18
Water en elektrolyten .............................................................................................................................. 18
Aanbevolen hoeveelheden ........................................................................................................................... 18
Factoren die de behoefte aan nutriënten beïnvloeden................................................................................ 18
Malnutritie ........................................................................................................................................................ 19
Eiwit-energie malnutritie .............................................................................................................................. 19
Marasmus-like .......................................................................................................................................... 19
Kwashiorkor-like ....................................................................................................................................... 19
Hypometabole en hypermetabole toestanden ............................................................................................ 19
Hormonen ................................................................................................................................................ 19
Metabolisme ............................................................................................................................................ 21
Eiwitkatabolisme ...................................................................................................................................... 21
Gluconeogenese ....................................................................................................................................... 21
Kanker cachexie ............................................................................................................................................ 21
Regeling van de energiebalans en obesitas ...................................................................................................... 21
Regeling van de energiebalans ..................................................................................................................... 21
Appetijt..................................................................................................................................................... 21
Energieverbruik ........................................................................................................................................ 22
Obesitas ........................................................................................................................................................ 22
Definitie en maatstaven ........................................................................................................................... 22
Etiologie van obesitas............................................................................................................................... 22
Pathogenese van obesitas ........................................................................................................................ 23
H5: Calcium................................................................................................................................................... 24
Fysiologische aspecten ...................................................................................................................................... 24
Homeostase van het serum calcium............................................................................................................. 24
Vorming en turn-over van het bot ................................................................................................................ 25
Hormonale controle van de calciumhomeostase ......................................................................................... 25
Parathyroidhormoon of parathormoon ................................................................................................... 25
Vitamine D ................................................................................................................................................ 26
Pathofysiologie van de calciumhomeostase ..................................................................................................... 26
Hypocalcimie ................................................................................................................................................ 26
Definitie .................................................................................................................................................... 26
Oorzaken .................................................................................................................................................. 26
Symptomen .............................................................................................................................................. 27
Behandeling.............................................................................................................................................. 27
Hypercalcimie ............................................................................................................................................... 27
Definitie .................................................................................................................................................... 27
Oorzaken .................................................................................................................................................. 27
Symptomen .............................................................................................................................................. 28
Behandeling.............................................................................................................................................. 28
,H6: Ademhaling ............................................................................................................................................ 30
Inleiding ............................................................................................................................................................ 30
Pathofysiologie van hypoxie en hypercapnie .................................................................................................... 30
Hypoxie ......................................................................................................................................................... 30
Oorzaken .................................................................................................................................................. 30
Symptomen en begeleidende verschijnselen........................................................................................... 30
Hypercapnie.................................................................................................................................................. 31
Oorzaken .................................................................................................................................................. 31
Symptomen en begeleidende verschijnselen........................................................................................... 31
Belangrijkste vormen van longpathologie ........................................................................................................ 32
Obstructieve aandoeningen ......................................................................................................................... 32
Astma ....................................................................................................................................................... 32
Chronisch obstructief longlijden (COPD) .................................................................................................. 33
Restrictieve aandoeningen ........................................................................................................................... 34
Interstitieel longlijden .............................................................................................................................. 35
Pneumonie ............................................................................................................................................... 35
Vasculaire aandoeningen ............................................................................................................................. 35
Pulmonale hypertensie ............................................................................................................................ 35
LOngstuwing en longoedeem................................................................................................................... 36
Longembool.............................................................................................................................................. 36
Diagnose: longfunctieproeven .......................................................................................................................... 37
Metingen van de statische longvolumes ...................................................................................................... 37
Metingen van de dynamische longvolumes (ventilatie) ............................................................................... 37
H7: Cardiovasulair......................................................................................................................................... 38
Syncope ............................................................................................................................................................. 38
Circulatoire oorzaken ................................................................................................................................... 38
Syncope door arteriolaire vasodilatatie ................................................................................................... 38
Cardiale vormen van syncope .................................................................................................................. 40
Andere circulatoire oorzaken van syncope .............................................................................................. 40
Niet-circulatoire oorzaken ............................................................................................................................ 40
Hartfalen ........................................................................................................................................................... 40
Definitie ........................................................................................................................................................ 41
Symptomen .................................................................................................................................................. 41
Pathofysiologie ............................................................................................................................................. 41
Hartfalen met een gedaalde ejectiefractie .............................................................................................. 41
Hartfalen met een bewaarde ejectiefractie ............................................................................................. 41
Compensatoire mechanismen ................................................................................................................. 42
Behandeling .................................................................................................................................................. 42
Shock ................................................................................................................................................................. 42
Indeling op basis van pathogenese............................................................................................................... 42
Shock door relatieve hypovolemie ........................................................................................................... 42
Cardiogene shock ..................................................................................................................................... 43
Algemene fysiopathologie van shock ........................................................................................................... 43
Symptomen .................................................................................................................................................. 44
, H1: INLEIDING
DEFINITIES
Het begrip ‘Activiteit’
• Evolutie van een ziekte: schadelijk agens + terrein (omgevingsfactoren + genetisch)
• Normale O2 spanning
o 100 mmHg
o 85-jarige: 60 mmHg is normaal, wat niet normaal is bij 20-jarige
HUIDIGE DOODSOORZAKEN
1. Kanker
2. Hart- en vaatziekten
VEROUDERING
= progressieve, algemene afname eerst in functionele reserves en nadien in de functie van een
organisme
= geen ziekte, maar risico om ziekte te ontwikkelen is toegenomen
CELLULAIRE EN MOLECULAIRE OORZAKEN VAN VEROUDERING
• Omgevingsfactoren en gedrag + genetische factoren -> bepalen levensduur
• Vroegtijdige veroudering (progeria)
• 3 processen van veroudering
o Schade door oxidatieve stress (of andere factoren)
o Inadequaat herstel van schade
o Ontregeling van de homeostase van celaantal
SCHADE AAN MACROMOLECULEN
Oxidatieve stress
• ROS (reactieve oxygen species): waterstofperoxide, hydoxylradicaal, superoxide radicaal
o Onstabiel -> schade aan belangrijke biologische moleculen
o Fysiologische processen
o Ontstaat bij verbruik van O2 in de mitochondriën -> inherent aan normaal
metabolisme
o Bescherming
§ Antioxidatieve enzymes: superoxide dismutase (SOD), catalase, glutathione
peroxidase
§ Antioxidantia: vitamine C en E
,Glycatie en glycoxidatie
• = niet-enzymatische reacties tussen suiker en macromolecule waarbij ‘advanced glycation end
products (AGEs)’ gevormd worden
• AGEs veranderen structuur en functie van langlevende eiwitten, vb vertroebeling ooglens
Mitochondriale schade
• Mitochondria = belangrijkste bron van ROS -> daar meeste schade
• MtDNA: niet beschermd door histonen -> toenemende schade met leeftijd -> kunnen minder
ATP genereren -> celfunctie daalt
Somatische mutaties
• Door omgevingsfactoren en oxidatieve stress
• Beperkte herstelmechanismen
INADEQUAAT HERSTEL VAN SCHADE
DNA herstel
• Herstelmechanismen minder efficiënt met leeftijd ->
meer schade
• Genetische defecten van herstelmechanismen ->
premature veroudering = progeria
Turnover van eiwitten
• Beschadigde eiwitten -> proteolyse -> vervangen
door nieuw eiwit
• Ombouw van eiwitten vermindert met de leeftijd ->
vooral effect op langlevende eiwitten
,
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Gnkkuleuven. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.62. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81113 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now