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samenvatting H13
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Wordt zo op examen gevraagd om te verbinden: aandoening - organisme - behandeling
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aandoening organisme behandelingINFECTIES VAN DE LUCHTWEGEN
KEELPIJN
1. virale faryngitis afhankelijk van welk type: symptomatisch, geen AB
eenvouydige keelontsteking rhino,corona & parainfluanzavirus
enterovirale faryngitis coxsackie/echovirus
adenovirale faryngitis (met virale conjuctivitis) adenovirus
laryngitis parainfluenzavirus
faryngitis parainfluenzavirus
2.angina = bacteriële faryngitis/tonsillitis Streptococcus pyogenes/GAS/GABHS b-lactam AB (feneticilline) bij risico
roodvonk/ scarlet fever = complicatie pyrogene/ erytrogene exotoxine
3. infectieuze mononucleose/klierkoorts Epstein-Barr virus (EBV)
Corynebacterium dyphteriae/ > vaccin (actieve component: dyfterie toxine),
4. difterie/ kroep Corynebacterium ulcerans > dyfterie-antitoxine in combi met AB erytrhomycine (of penicilline),
> OTC medicatie (pastilles, sprays met vitC, lidocaïne, antiseptica)
VERKOUDHEID rhino,corona, parainfluenza & adenovirus symptomatisch (rust, vochtinname, congestiva (gezwollen slijmvliezen
verminderen),geen AB
HOEST
productieve/ losse hoest (slijm) geen antitussivum
bij chronische hoest & bij acute hoest met
niet-productieve/ droge hoest (geen slijm) koorts, ademhalingproblemen of pijn thv borst antitussivum
vaccin (actieve component = pertussis toxine & filamenteuze
1. kinkhoest/ pertussis/ hoest van 100 dagen Bordetella pertussis hemagglutine),
AB: macroliden (clarithromycine, azithromycine)
2. pseudokroep/ laryngitis subglottica parainfluenzavirus symptomatisch, geen AB
rhino,corona & parainfluenzavirus, Mycoplasma
pneumoniae,
3. acute bronchitis Streptococcus pneumoniae, Haemophilus influenzae symptomatisch, geen AB
> bij niet-gecompliceerde exacerbatie is 70% binnen 4w genezen zonder AB,
4. chronische bronchitis Streptococcus pneumoniae, Haemophilus influenzae > bij ernstig zieke patiënten/ zeer slechte longfunctie wél AB: amoxicilline +
clavulaanzuur
5. bronchiolitis respiratoir syncytiaal virus (RSV) passieve immunisatie: monoklonaal AL voor preventie = Palivizumab (IgG)
OF vaccin = Abrysvo
, transmissie van persoon-persoon:
Streptococcus pneumoniae, (Mycoplasma
pneumoniae,
Chlamydia pneumoniae, parainfluenza&adenovirus)
(1kennen)
transmissie via vogels:
PNEUMONIE/ LONGONTSTEKING Chlamydia psittaci
transmissie via aerosol van besmet water:
Legionella pneumophila
transmissie via de lucht:
Aspergillus fumigatus
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