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Samenvatting Consultvoering van alle ziektebeelden (spreekuurtoets document)

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Dit document bevat alle belangrijke punten voor de consultvoering van alle behandelde ziektebeelden tijdens Geneeskunde Master jaar 1. Het is hét ideale document voor de voorbereiding op de voortgangstoets!

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  • January 14, 2024
  • 97
  • 2022/2023
  • Summary
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Spreekuurtoets
Voorbereiding



Inhoudsopgave

Algemeen ....................................................................................................................................................... 3
Consult ................................................................................................................................................................ 3
Reflec/everslag .................................................................................................................................................. 6
Modelstatus ........................................................................................................................................................ 7

Geneeskunde .................................................................................................................................................. 8
Angina pectoris ................................................................................................................................................... 8
Gejaagdheid/palpita/es ................................................................................................................................... 11
Buikpijn ............................................................................................................................................................. 11
Dyspneu ............................................................................................................................................................ 14
Vermoeidheid – harIalen ................................................................................................................................. 16
Hoesten door ACE remmer ............................................................................................................................... 21

Heelkunde .................................................................................................................................................... 23
Knobbel in de borst ........................................................................................................................................... 23
Pijn onderbuik bij vrouw ................................................................................................................................... 25
Sinusi/s ............................................................................................................................................................. 29
Duizeligheid ...................................................................................................................................................... 31
Tinnitus ............................................................................................................................................................. 32
Oorpijn .............................................................................................................................................................. 33
Verstopte neus .................................................................................................................................................. 34
Galstenen.......................................................................................................................................................... 35
Colorectaal carcinoom ...................................................................................................................................... 36
Slikklachten / reflux .......................................................................................................................................... 38
Diver/culi/s ...................................................................................................................................................... 41
IBD .................................................................................................................................................................... 42
PDS ................................................................................................................................................................... 44
Enkeldistorsie .................................................................................................................................................... 45
Claudica/oklachten .......................................................................................................................................... 47
Peesontsteking/ peesschede ontsteking (trigger finger)................................................................................... 50

Beweging ...................................................................................................................................................... 52
Pijn in de schouder............................................................................................................................................ 52
Pijn in de knie.................................................................................................................................................... 55

, Pijn in de elleboog ............................................................................................................................................ 56
Last van de rug ................................................................................................................................................. 57
Pijn in 1 been en rug – lumbosacraal radiculair syndroom ............................................................................... 59
Cauda equina – SPOED ..................................................................................................................................... 60
Osteoporose...................................................................................................................................................... 61
Gewrichtsklachten ............................................................................................................................................ 63
Oogklachten ..................................................................................................................................................... 64
Hoofdpijn .......................................................................................................................................................... 66
Slaapproblemen................................................................................................................................................ 70
Psychiatrie ........................................................................................................................................................ 71
Erec/ele dysfunc/e ........................................................................................................................................... 71

Levenscyclus ................................................................................................................................................. 74
Menstruele problemen ..................................................................................................................................... 74
An/concep/e .................................................................................................................................................... 74
Abnormaal vaginaal bloedverlies ..................................................................................................................... 75
Kraamvrouw met koorts ................................................................................................................................... 79
Overgangsklachten, climacterium .................................................................................................................... 80
Vaginale klachten ............................................................................................................................................. 81
Incon/nen/e ..................................................................................................................................................... 81
Prostaatklachten .............................................................................................................................................. 83
Pyelonefri/s, cys//s, UWI ................................................................................................................................ 84
Nierstenen ........................................................................................................................................................ 86
SOA ................................................................................................................................................................... 87
(Acuut) ziek kind ............................................................................................................................................... 88
Buikpijn kind ..................................................................................................................................................... 89
Gele baby .......................................................................................................................................................... 91
Luchtwegklachten kind ..................................................................................................................................... 92
Kind met vlekjes ................................................................................................................................................ 93
Sterilisa/ewens ................................................................................................................................................. 94
Seksuologie ....................................................................................................................................................... 95

SpoedcasuïsAek ............................................................................................................................................ 96
Acute buik ......................................................................................................................................................... 96
Cauda equinasyndroom .................................................................................................................................... 96
Re/nalosla/ng .................................................................................................................................................. 96

,Algemeen
Voorbereiding
- 5 minuten
- Info hardop voorlezen
- Spullen klaarleggen
- DD bedenken en hypothesetoetsende vragen – e.v.t. noteren

Mee
- Inloggegevens !!!
- Pen
- Penlight
- Reflexhamer
- Stethoscoop

Tijdens het consult
- Structuur consult
o Anamnese 8 min
o LO 8 min
o Beleid 4 min
- Handhygiëne

Denk aan
- SamenvaPng !!
- Handhygiëne
- Recept uitschrijven

Consult

Contactlegging

Agenda bespreken

Anamnese
- ALECOBO
o Aard
o LocaSe
§ En uitstraling
o Ernst (1-10)
§ En hinder dagelijks leven
o Chronologie
§ Verloop klachten
o Ontstaan
§ Trauma, werk, sport, spontaan
o Beïnvloeding
§ Toename klachten
§ Afname klachten

, § Dagelijks funcSoneren, slaap
o OpvaPng
§ Wat denkt paSënt zelf?
§ Eerder gehad?

è Samenva6ng

- Hulpvraag
o Wat maakt dat u vandaag met deze klacht een afspraak hee] gemaakt?
o Wat hoopte u te behalen toen u deze afspraak maakte?
o Toen u een afspraak maakte, had u toen een bepaalde gedachte?
o U bent hier vandaag bij de huisarts gekomen, wat hoopt/ verwacht u van mij/
vandaag?

- VerwachSngen
o E.g. wat is voor pt wel een goede slaap/ goede erecSe/ verbetering …?

- Algemene anamnese
o Voorgeschiedenis
o MedicaSe
o Allergieën
o Familieanamnese
o IntoxicaSes
o Sociale anamnese (gezin, partner, werk)

- Speciële anamnese/ hypothesetoetsing
o Recent dingen aangepast in leven (dieet, werk, thuissituaSe)
o Zaken die stress opleveren, hoe zit pt in vel
o Zwanger?

- Tractusanamnese
o Algemeen: fit, moe, gewichtsverandering, eetlust, koorts, nachtzweten, jeuk,
slaap, stemmingsveranderingen, huidproblemen
o Tr. Circulatorius: hartkloppingen, pijn op de borst, benauwdheid bij platliggen,
veel plassen ’s nachts, dikke enkels, benauwdheid bij inspanning,
etalagebenen, duizeligheid
o Tr. Respiratorius: hoesten, kortademigheid, longproblemen (VG), slijm (kleur,
hvh), piepende ademhaling, pijn bij diep zuchten (vast/ niet vast ademhaling)
o Tr. Urogenitalis: pijn of moeite bij plassen, langzame en pijnlijke urinelozing,
frequenSe, nadruppelen, straal, bloed, seksuele anamnese;
§ Bij vrouw: menstruaSe, cyclus, duur, opvliegers, tussenSjds
bloedverlies, afscheiding, contactbloedingen, verzakkingsgevoel
o CNS en zintuigen: geheugen, concentraSe, zintuigen, kracht, gevoel, trillen,
evenwicht, beroerte, hoofdpijn, duizeligheid, doof gevoel, branderige pijn,
Sntelingen
o Tr. Locomotorius:

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