Op aanraden van mijn medestudenten verkoop ik nu mijn samenvattingen! In deze samenvatting maak ik veel gebruik van afbeeldingen, tabellen en opsommingen. Hierdoor hoef je geen lange lappen saaie en ingewikkelde tekst te lezen. In deze samenvatting staat alle stof van de boeken, colleges en leerdoe...
,Inhoud
Week 5: Acute abdominal pain ............................................................................................................... 9
Introduction......................................................................................................................................... 9
Sepsis ................................................................................................................................................. 11
Meet the expert ................................................................................................................................ 14
Anatomy: Abdominal viscera ............................................................................................................ 16
Abdominal wall .............................................................................................................................. 17
Peritoneal cavity ............................................................................................................................ 19
Small intestine ............................................................................................................................... 22
Large intestine ............................................................................................................................... 25
Liver ............................................................................................................................................... 26
Gallbladder .................................................................................................................................... 28
Pancreas ........................................................................................................................................ 29
Spleen ............................................................................................................................................ 31
Arterial supply to the abdominal viscera ...................................................................................... 32
Venous drainage ............................................................................................................................ 35
Anatomy: Embryology ....................................................................................................................... 38
The acute abdomen and acute GI haemorrhage .............................................................................. 41
Intestinal obstruction .................................................................................................................... 41
Bowel strangulation ...................................................................................................................... 43
Peritonitis ...................................................................................................................................... 43
Intraabdominal abscess ................................................................................................................. 44
Perforation of an abdominal viscus ............................................................................................... 45
Acute bowel ischaemia.................................................................................................................. 46
Major gastrointestinal haemorrhage ............................................................................................ 46
Gallstone diseases and related disorders.......................................................................................... 50
Structure and function of the biliary system................................................................................. 50
Pathophysiology of the biliary system .......................................................................................... 50
Investigation of gall bladder pathology ......................................................................................... 51
Clinical presentations of gallstone disease ................................................................................... 52
Management of gallstone disease ................................................................................................ 54
Peptic ulceration and related disorders ............................................................................................ 57
Pathophysiology of peptic disorders ............................................................................................. 57
Epidemiology and aetiology of peptic ulcer disease ..................................................................... 57
Investigation and clinical features of peptic disorders ................................................................. 59
Presenting features of peptic ulcer disease .................................................................................. 59
2
, Pancreatitis ........................................................................................................................................ 65
Acute pancreatitis ......................................................................................................................... 65
Recurrent and chronic pancreatitis ............................................................................................... 69
Appendicitis ....................................................................................................................................... 70
Anatomy of the appendix .............................................................................................................. 70
Pathophysiology of appendicitis ................................................................................................... 70
Making the diagnosis of appendicitis ............................................................................................ 72
Appendicectomy............................................................................................................................ 75
Chronic inflammatory disorders of the bowel .................................................................................. 78
Week 6: Acute abdominal pain Pt.2 ...................................................................................................... 80
Introduction....................................................................................................................................... 80
Meet the expert ................................................................................................................................ 82
Small bowel obstruction ................................................................................................................ 82
Colorectal obstruction ................................................................................................................... 83
Diagnostics..................................................................................................................................... 84
Main operative causes .................................................................................................................. 85
Disorders of the large bowel motility, structure and perfusion........................................................ 87
Modern diet and disease ............................................................................................................... 87
Irritable bowel syndrome .............................................................................................................. 88
Constipation .................................................................................................................................. 89
Sigmoid volvulus ............................................................................................................................ 91
Diverticular disease ....................................................................................................................... 91
Colonic angiodysplasias ................................................................................................................. 94
Ischaemic colitis............................................................................................................................. 94
Hernias and other groin problems .................................................................................................... 96
Lumps in the groin ......................................................................................................................... 96
Inguinal hernia ............................................................................................................................... 99
Femoral hernia ............................................................................................................................ 102
Abdominal emergencies in children ................................................................................................ 104
Abdominal emergencies in infants and young children .............................................................. 104
Abdominal emergencies in older children .................................................................................. 106
Physiology of pain............................................................................................................................ 108
Referred pain ............................................................................................................................... 108
Visceral pain ................................................................................................................................ 108
Gynaecology .................................................................................................................................... 110
Pelvic inflammatory disease ........................................................................................................ 110
3
, Ectopic pregnancy ....................................................................................................................... 111
Ovarian torsion ............................................................................................................................ 113
Evaluation of acute pelvic pain in women ...................................................................................... 114
Differential diagnosis................................................................................................................... 114
Diagnostics................................................................................................................................... 115
Week 7: Acute coma ........................................................................................................................... 118
Introduction..................................................................................................................................... 118
Examination of the comatose patient ............................................................................................. 121
Altered consciousness ..................................................................................................................... 123
Impaired consciousness .............................................................................................................. 123
Treating comatose patients......................................................................................................... 124
Herniation syndromes ................................................................................................................. 124
Metabolic coma ........................................................................................................................... 126
Non-convulsive status epilepticus ............................................................................................... 127
Altered but not lowered consciousness ...................................................................................... 127
Vegetative state........................................................................................................................... 127
Brain death .................................................................................................................................. 128
Head and brain injuries ................................................................................................................... 129
Initial assessment and care for head traumas ............................................................................ 129
Severity of brain injuries.............................................................................................................. 129
Initial assessment and treatment ................................................................................................ 131
Skull fractures .............................................................................................................................. 132
Post-traumatic intracranial complications .................................................................................. 133
The prognosis after head injury .................................................................................................. 136
Water balance, fluids and electrolytes ............................................................................................ 138
Assessing acid-base disturbance ................................................................................................. 138
Disorders of sodium concentration ............................................................................................. 138
Disorders of magnesium concentration ...................................................................................... 141
Acid base disorders ..................................................................................................................... 142
Myxoedema coma ........................................................................................................................... 150
Diabetes mellitus ............................................................................................................................. 151
Diabetic emergencies .................................................................................................................. 151
Management of hypoglycaemia .................................................................................................. 153
Psychiatry ........................................................................................................................................ 154
Somatoform disorders................................................................................................................. 154
Suicide and self harm .................................................................................................................. 155
4
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