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Samenvatting Medische Diagnostiek
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Medische Diagnostiek Leerdoelen uitgewerkt, met extra stof. Leerjaar 2018/2019 Hogeschool Inholland, Life Science and Chemistry
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Medische diagnostiekFiguur 1, Streptococcus pneumoniae
1
,Inhoud
Uit te leggen hoe de diagnostiek:.......................................................................................................6
Principe en maken van Gram preparaat.........................................................................................6
Beoordelen kweek inclusief componenten en groei op de platen..................................................6
Determinatie inclusief welke organismen waarom op welke platen groeien.................................6
Antibiotica gevoeligheidsbepaling van bacteriën in sputum en pussen in zijn werk gaat: kunnen
uitleggen welke celtypen er aanwezig kunnen zijn in Gram-preparaten van sputum en pussen,
wat de morfologische kenmerken hiervan zijn en deze kunnen benoemen in een foto................7
Resistentebepaling.........................................................................................................................7
Preparaat na gramkleuring:............................................................................................................7
De normale structuur en functie van huid, slijmvliezen en ademhalingsstelsel te benoemen en aan
te geven welke normale micro-organismen hierin voorkomen..........................................................7
Huid....................................................................................................................................................7
De luchtwegen....................................................................................................................................8
Normale flora..................................................................................................................................8
Pathogene bacteriën in luchtwegen...............................................................................................8
De morfologische kenmerken, diagnostiek en deze pathogenen te herkennen op agarplaten en
foto’s..................................................................................................................................................9
Haemophilus influenza...................................................................................................................9
Klebsiella pneumonia......................................................................................................................9
Verschillende microbiële ziekten van de huid te beschrijven inclusief kenmerken van de
aandoening en van de pathogene bacteriën (Streptococcen , Staphylococcen en Pseudomonas)
hierbij...............................................................................................................................................11
Furunkel........................................................................................................................................11
Karbunkel.....................................................................................................................................11
Impetigo (krentenbaard)..............................................................................................................11
Erysipelas.....................................................................................................................................12
Scalded skin syndrome.................................................................................................................12
Fasciitis.........................................................................................................................................12
Dermatitis.....................................................................................................................................13
Otitis externa...............................................................................................................................13
Staphylococcen van Streptococcen te onderscheiden op basis van morfologie, virulentiefactoren
en te relateren aan verschillende huidziekten..................................................................................14
Uit te leggen wat de functie is van de virulentiefactoren:................................................................15
M proteïne....................................................................................................................................15
TSST-1...........................................................................................................................................15
2
, Hemolysine...................................................................................................................................15
Streptokinase................................................................................................................................16
Hyaluronidase...............................................................................................................................16
DNase...........................................................................................................................................16
Pharingitis.....................................................................................................................................16
Diphterie.......................................................................................................................................16
Bronchitis......................................................................................................................................16
Pneumonie...................................................................................................................................16
Tuberculose..................................................................................................................................17
Hematologie en hemostase..................................................................................................................18
Bloedgroepsystemen en (erytrocyten)transfusieonderzoek te beschrijven en uit te voeren op basis
van aangeleverde labuitslagen.........................................................................................................18
Rhesus D bloedgroepen................................................................................................................18
Immuunglobinen..........................................................................................................................18
Bloedtransfusie.............................................................................................................................20
De ontwikkeling van de hematopoëtische stamcel tot erytrocyt, leukocyt en trombocyt te
beschrijven.......................................................................................................................................23
De functie en morfologische kenmerken van erytrocyten, hemoglobin, leukocyten en trombocyten
te beschrijven...................................................................................................................................24
Leukocyten...................................................................................................................................24
Trombocyten................................................................................................................................24
Erytrocyten...................................................................................................................................25
Hemoglobine................................................................................................................................25
De vier fasen van de hemostase en de anticoagulante functie van actief proteïne C, antitrombine
en TFPI te beschrijven.......................................................................................................................25
1. Vasoconstrictie.........................................................................................................................25
2. Primaire hemostase..................................................................................................................25
4. Fibrinolyse................................................................................................................................26
Actief proteïne C (APC).................................................................................................................26
Antitrombine................................................................................................................................26
TFPI...............................................................................................................................................26
De diagnostiek van de primaire en secundaire hemostase en de fibrinolyse te beschrijven............27
Fibrinolyse....................................................................................................................................27
Afwijkingen in de primaire en secundaire hemostase en de fibrinolyse te beschrijven en te
herkennen op basis van aangeleverde labuitslagen.........................................................................28
Primaire hemostase......................................................................................................................28
Diagnostiek...................................................................................................................................28
3
, Secundaire hemostase..................................................................................................................29
Diagnostiek...................................................................................................................................29
Afwijkingen in hemoglobine en erytrocyten te beschrijven en te herkennen op basis van
aangeleverde labuitslagen................................................................................................................30
Hemoglobine................................................................................................................................30
Erytrocyten...................................................................................................................................30
Volledig bloedbeeld opstellen, reticulocyten telling (= indicatie tempo aanmaak nieuwe RBC),
directe antiglobuline test (Coombs test), haptoglobine, bilirubine en onderzoek naar lever functie,
Onderzoek om niet-hemolytische oorzaken van de bloedarmoede uit te sluiten zoals, nierfalen,
loodvergiftiging, lage vitamine niveaus (vitamine B12, vitamine C of foliumzuur) of ijzergebrek....30
Anemie.........................................................................................................................................31
Klinische chemie...................................................................................................................................34
Aan de hand van een aangeleverde dataset een kwaliteitscontrole uit te voeren (op basis van
juistheid, precisie, de Levey-Jenningskaart en de Westgardregels)..................................................34
Kwaliteitsbewaking.......................................................................................................................34
Juistheid........................................................................................................................................34
Precisie.........................................................................................................................................34
Levey-Jenningskaart.....................................................................................................................34
De westgardregels........................................................................................................................35
Foutenbronnen in de (pre-)analytische fase te benoemen en te herkennen in aangeleverde
labuitslagen......................................................................................................................................36
Point-of-caretesten en hun voor- en nadelen te benoemen............................................................36
Voordelen.....................................................................................................................................36
Nadelen........................................................................................................................................36
De enterohepatische kringloop te beschrijven en klinisch chemische testen te relateren aan
leveraandoeningen...........................................................................................................................37
Enterohepatische cyclus...............................................................................................................37
Klinisch chemische testen.............................................................................................................37
De ijzerstofwisseling, het cholesterolmetabolisme en het glucosemetabolisme te beschrijven......38
Ijzerstofwisseling..........................................................................................................................38
Cholesterolmetabolisme...............................................................................................................39
Glucosemetabolisme....................................................................................................................40
Afwijkingen in de ijzerstofwisseling, het (endogene en exogene) cholesterolmetabolisme en het
glucosemetabolisme te beschrijven en te herkennen op basis van aangeleverde labuitslagen.......41
Cholesterol...................................................................................................................................41
De relatie tussen het glucose- en cholesterolmetabolisme te kennen.............................................41
De anatomie en fysiologie van de nieren en het endocriene systeem te beschrijven......................42
Endocriene systeem......................................................................................................................42
4
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