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Cursus spijsvertering en stofwisseling
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In dit document heb ik alle hoorcolleges uitgewerkt en hierin staan ook alle team-based learnings volledig uitgewerkt. Complete samenvatting van het blok.
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Cursus: Spijsvertering en StofwisselingAantekeningen hoorcolleges
Esmée Peters
Geneeskunde Jaar 3
VUMC
2023-2024
,Inhoudsopgave
Week 1 ..........................................................................................................................................................................4
Hoorcollege 1.2 – Oesophaguscarcinoom (patiënt) .................................................................................................4
Hoorcollege 1.3: Maligniteiten van de maag ...........................................................................................................5
Hoorcollege 1.4 – Goedaardige aandoeningen van slokdarm en maag ................................................................. 12
Hoorcollege 1.5 – Meet the Expert: voeding en voedingssupplementen en diëten ................................................. 19
Hoorcollege 1.6 – Immunologie van de tractus digestivus incl. coeliakie .............................................................. 23
Hoorcollege 1.7 - Planetary health - Preventie van obesitas: one health approach .............................................. 28
Hoorcollege 1.8 - Bariatrische chirurgie (patiënt) ................................................................................................. 29
Week 2 ........................................................................................................................................................................ 32
Hoorcollege 2.1 – Beeldvorming van de tractus digestivus, radiologische technieken .......................................... 32
Hoorcollege 2.2 – Maligniteiten van de galwegen (patiënt) ................................................................................... 38
Hoorcollege 2.3 – Wat is gezonde voeding? Toxische stoffen in voeding ............................................................... 41
Hoorcollege 2.4 – Lab interpretatie & diagnostiek (leverfunctiestoornissen) ........................................................ 45
Hoorcollege 2.5 – MTE: Obstructie icterus, galsteenlijden en pancreatitis ........................................................... 54
Hoorcollege 2.6 – Virale en metabole leverziekten (o.a. ASH; NASH) (patiënt) .................................................... 56
Hoorcollege 2.7 – Levercirrose, ascites, portale hypertensie & diagnostiek en behandeling van HCC ................ 63
Hoorcollege 2.8 – Acute buik, inclusief appendicitis .............................................................................................. 70
Week 3 ........................................................................................................................................................................ 73
Hoorcollege 3.1 – Colon maligne (patiënt) ............................................................................................................ 73
Hoorcollege 3.2 – Van poliep tot kanker ................................................................................................................ 74
Hoorcollege 3.3 – IBD (patiënt) ............................................................................................................................. 79
Hoorcollege 3.4 – IBD: pathofysiologie en behandeling m. Crohn en colitis ulcerosa .......................................... 80
Hoorcollege 3.5 – Meet the Expert: Diarree en malnutritie ................................................................................... 88
Hoorcollege 3.6 – KR quiz ...................................................................................................................................... 90
Hoorcollege 3.7 – Pancreatitis (patiënt) ................................................................................................................ 91
Hoorcollege 3.8 – Pancreascarcinoom en peri-ampulaire tumoren (patiënt) ........................................................ 95
Week 4 ........................................................................................................................................................................ 97
Hoorcollege 4.1 – Levertransplantatie ................................................................................................................... 97
Hoorcollege 4.2 – Microplastic in het gastro-intestinale kanaal ........................................................................... 99
Hoorcollege 4.3 – Maagkanker: klinische toepassingen van moleculaire diagnostiek ........................................ 100
TBL: Week 1 ............................................................................................................................................................ 103
Toetsvragen........................................................................................................................................................... 103
Casussen ............................................................................................................................................................... 105
,Week 2 ...................................................................................................................................................................... 108
Toetsvragen........................................................................................................................................................... 108
Casussen ............................................................................................................................................................... 110
Week 3 ...................................................................................................................................................................... 115
Toetsvragen........................................................................................................................................................... 115
Casussen ............................................................................................................................................................... 117
, Week 1
Hoorcollege 1.2 – Oesophaguscarcinoom (patiënt)
Complicaties
- Gillis: lymfevocht worden afgevoerd en lopen de borstkas in. Potentiaal dodelijke
aandoening → MCT-dieet
- N. laryngeus recurrens beschadiging? Heesheid.
Helft van de mensen met klachten komt in aanmerking voor curatieve behandeling. De helft
hiervan is 20% in leven na 5 jaar
- 2750 nieuwe patiënten per jaar krijgen de diagnose slokdarmkanker, in verschillende
stadia
- Grootst groeiende incidentie
- Verschillende typen
o Adeno: vaker bij mannen
▪ Meest voorkomende type slokdarmkanker
▪ Brandend maagzuur zien we vaker bij mannen, vet zit meer rond de buik,
dit drukt op de maag, en daardoor stroomt het maagzuur gemakkelijker de
slokdarm in. Bij vrouwen is deze verdeling iets normaler/gelijkmatiger en
hebben dus daardoor minder last van deze vorm van slokdarmkanker.
o Plaveisel: vaker bij vrouwen.
▪ Gerelateerd aan roken en alcohol drinken
▪ Vaker in Azië dan in de Westerse wereld
o De rest
- Meer bij mannen dan bij vrouwen
Wereldwijd zien we een stijging van obesitas en slokdarmkanker.
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