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Samenvatting Ziekteleer (E0F10A)
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Samenvatting lessen deel Verslype
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ZIEKTELEERDeel Verslype
,INHOUDSOPGAVE
1.1. Algemene terminologie ................................................................................................. 7
1.1.1. Aandoeningen ........................................................................................................ 7
1.1.2. Symptomen en klinische tekenen ........................................................................... 7
1.1.3. Symptoom – ziektebeeld – aandoening ................................................................. 7
2.1. Inzicht in de normale werking van het immuunsysteem ................................................ 8
2.1.1. Aangeboren vs. adaptieve immuniteit .................................................................... 8
2.1.1.1. Tijdslijn van normaal immuunantwoord tegen een virus: ................................. 9
2.1.1.2. Connectie aangeboren vs. adaptieve immuniteit: .......................................... 10
2.1.2. Communicatie tussen immuuncellen onderling en andere cellen ......................... 11
2.1.2.1. Cytokines ....................................................................................................... 11
2.1.2.2. Schema.......................................................................................................... 12
2.1.2.3. Koorts ............................................................................................................ 13
2.1.3. Sensoren in de aangeboren immuniteit: “pattern recognition receptors” / ppr’s ... 14
2.1.4. Adaptief immuunsysteem ..................................................................................... 15
2.1.5. Antigenen ............................................................................................................. 15
2.1.6. Besluit .................................................................................................................. 15
2.2. Enkele voorbeelden van problemen door een overactief immuunsysteem ................. 16
2.2.1. Acute Respiratory Distress Syndrome (ARDS) .................................................... 16
2.2.2. Allergie ................................................................................................................. 16
2.2.3. Inflammatoire darmziekten ................................................................................... 16
2.2.4. Auto-immuniteit .................................................................................................... 16
3.1. Inleiding ...................................................................................................................... 17
3.1.1. Anatomie van het spijsverteringsstelsel ............................................................... 17
3.1.2. Zones van het abdomen ....................................................................................... 17
3.1.3. Terminologie van ingrepen ................................................................................... 18
3.2. Symptomen en klinische tekenen ............................................................................... 18
3.2.1. Specifieke symptomen en klinische tekenen ........................................................ 18
3.2.2. Algemene symptomen en klinische tekenen ........................................................ 20
3.3. Ziektebeelden ............................................................................................................. 20
3.3.1. Passagestoornissen ............................................................................................. 20
3.3.2. Bloedingen ........................................................................................................... 21
3.3.3. Peritonitis ............................................................................................................. 22
3.3.4. Malabsorptie ......................................................................................................... 23
3.4. Aandoening van de slokdarm ..................................................................................... 24
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, 3.4.1. Onderzoekstechnieken ......................................................................................... 24
3.4.1.1. Endoscopie en echo-endoscopie ................................................................... 24
3.4.1.2. Rx-slokdarm................................................................................................... 25
3.4.1.3. 24u pH-metrie ................................................................................................ 25
3.4.1.4. Impedantiemeting .......................................................................................... 26
3.4.1.5. Manometrie .................................................................................................... 26
3.4.1.6. FDG – PET – CT ........................................................................................... 27
3.4.2. Aandoeningen van de slokdarm ........................................................................... 27
3.4.2.1. Divertikel van Zenker ..................................................................................... 27
3.4.2.2. Gastro-esophageal reflux disease (GERD).................................................... 28
3.4.2.3. Barrett slokdarm ............................................................................................ 29
3.4.2.4. Schimmelinfecties van de slokdarm ............................................................... 30
3.4.2.5. Eosinofiele oesofagitis ................................................................................... 30
3.4.2.6. Kwaadaardige slokdarmtumoren ................................................................... 30
3.4.2.7. Motorische stoornissen van de slokdarm ....................................................... 31
3.4.2.8. Vreemde voorwerpen .................................................................................... 32
3.4.2.9. Algemende behandeling slikstoornissen ........................................................ 32
3.5. Aandoening van de maag ........................................................................................... 33
3.5.1. Functies van de maag ......................................................................................... 33
3.5.1.1. Reservoirfunctie ............................................................................................. 33
3.5.1.2. Mucosale functies .......................................................................................... 33
3.5.1.3. Passagefunctie .............................................................................................. 33
3.5.2. Onderzoekstechnieken ......................................................................................... 33
3.5.2.1. Endoscopie .................................................................................................... 34
3.5.2.2. Maagledigingstesten ...................................................................................... 34
3.5.3. Aandoeningen van de maag ................................................................................ 35
3.5.3.1. Gastritis.......................................................................................................... 35
3.5.3.2. Maagzweer (ulcus) ........................................................................................ 35
3.5.3.3. Maagkanker (adenocarcinoom) ..................................................................... 36
3.6. Aandoeningen van de dunne darm ............................................................................. 36
3.6.1. Anatomie en functie van de dunne darm .............................................................. 36
3.6.2. Symptomen en klinische tekenen door malabsorptie ........................................... 37
3.6.3. Aandoeningen van de dunne darm ...................................................................... 38
3.6.3.1. Divertikel van Meckel ..................................................................................... 38
3.6.3.2. Ziekte van Crohn ........................................................................................... 38
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, 3.6.3.3. Coeliakie ........................................................................................................ 41
3.7. Aandoeningen van de dikke darm .............................................................................. 41
3.7.1. Anatomie en normale functie van de dikke darm.................................................. 41
3.7.2. Onderzoeken van de dikke darm.......................................................................... 42
3.7.2.1. Endoscopie .................................................................................................... 42
3.7.2.2. Virtuele coloscopie ......................................................................................... 42
3.7.2.3. Stoelgangonderzoek ...................................................................................... 42
3.7.2.4. Pelletstudie .................................................................................................... 42
3.7.3. Aandoeningen van de dikke darm ........................................................................ 43
3.7.3.1. Ziekte van Hirschsprung ................................................................................ 43
3.7.3.2. Acute appendicitis .......................................................................................... 43
3.7.3.3. Acute diverticulitis .......................................................................................... 44
3.7.3.4. Colitis ulcerosa .............................................................................................. 44
3.7.3.5. Dikkedarmkanker (adenocarcinoom) ............................................................. 45
3.7.3.6. Chronische constipatie .................................................................................. 45
3.7.3.7. Prikkelbare darmsyndroom ............................................................................ 46
3.8. Aandoeningen van de aars ......................................................................................... 47
3.8.1. Anaal abces en fistel ............................................................................................ 48
3.8.2. Anale wratten ....................................................................................................... 48
3.8.3. Hemorrhoïden ...................................................................................................... 48
3.8.4. Anale kloof of fissuur ............................................................................................ 50
4.1. Inleiding ...................................................................................................................... 51
4.1.1. Anatomie van de lever en galwegen .................................................................... 51
4.1.2. Functies van de lever en galwegen ...................................................................... 51
4.1.3. Samenstelling en uitscheiding van galvocht ......................................................... 52
4.1.4. Onderzoek van de lever en galwegen .................................................................. 53
4.2. Symptomen en klinische tekenen ............................................................................... 54
4.2.1. Aandacht voor de bovenbuik ................................................................................ 54
4.2.2. Specifieke symptomen ......................................................................................... 54
4.2.2.1. Icterus ............................................................................................................ 54
4.2.2.2. Hepatische encefalopathie............................................................................. 55
4.2.2.3. Ascites ........................................................................................................... 56
4.2.2.4. Verhoogde bloedingsneiging ......................................................................... 56
4.2.2.5. Pijn ................................................................................................................. 56
4.2.2.6. Stoelgangsveranderingen .............................................................................. 56
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