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Samenvatting Klinisch redenren - inwendige aandoeningen

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klinisch redeneren inclusief: theorie en praktijk, theorie en praktijk respiratoir 2e bach, theorie cardio ( diabetes) 2e bach nog bekijken: praktijk cardio, extra teksten klinisch redeneren

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  • May 26, 2020
  • 22
  • 2019/2020
  • Summary
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Klinisch redeneren: inwendige aandoeningen
THEORIE
Roken voor 25j  luchtcapaciteit wordt kleiner

,Longfunctie: volledig inadEmen en explosief uitademen
tiffeneaux index: FEV1/FVC <0,7 (grens)
hogere TGV, RV




hyperinflatie  hoger
longvolume  dyspnoe
Exacerbation door acute inflammatie van de long  bijna zeker dat P
volgend jaar weer een
opstoot krijgt = predictor of
mortality!
Treatable traits
Autogene drainage (probleem met ophoesten
sputum), longfunctie, medicatie (stab. Longfunctie),
AHoefeningen (spierzwakte)
we kunnen de longfunctie niet verhogen

, Evaluation
Moeheid en dyspnoe = 2 belangrijkste symptomen  meer ventilatie nodig voor zelfde
activiteit
opstoten: snellere daling longcapaciteit
werken aan inactiviteit! Anders vicieuze cirkel
Body structure and function
 lung function:
- measure of severity of the airflow obstruction (reference values)
- information on maximal voluntary ventilation (FEV1 x 37,5)
 muscle function:
- peripheral and respiratory muscles
- lower limb more affected
- intepretation based on reference values
 sputum + effective cough
- anamnesis (recurrent infections)
- evaluation
activities
 exercise capacity ( = max. a patient can do)
1) cardiopulmonary exercise test
- safety
- what is the exercise limitation
- interpretation of exercise capacity
- Hrmax = 220 – HR; VEmax = FEV1 x 37,5
2) functional exercise capacity: 6MWT
- interpretation of functional capacity (reference values)
- standardized encouragement is important
3) constant work load test (70% Wmax)
- endurance capacity
- drives treatment
- sensitive outcome

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