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Samenvatting UVT voorbereiding Interne geneeskunde

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UVT voorbereiding interne geneeskunde

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Interne

Vit B12  veroorzaker neuropathie

Acute glomerulonefritis  tubulesnecrose
Enkele wegen na infectie, meeste gevallen streptokok (keelinfectie) of auto-immuunoorzaak (bv.
Henoch schonlein, IgA-nefropathie)
Oorzaak/ immuuncompelxen slaan neer op glomeruli
Symptomen/ weinig urineproductie, oedeem: hoog ureum en creatinine
Beh/ furosemide, zoutloos dieet en evt antiobiotica
Diagnose: kliniek, verhoogd ureum en creat

Diarree
Reizigersdiarree  enterotoxische E. Coli diarree

Hemolytisch Uremisch Syndroom
Nav EHEC-infectie in darm met bloederige diarree, toxines van EHEC bacterie beschadigen
vaatwand van bloedvaten nier.
Gevolg: hemolytische anemie, acuut nierfalen en trombocytopenie
 Vooral bij kinderen, medisch noodgeval 6 maanden-5 jaar
Atypische HUS komt voor bij kinderen en volwassenen, auto-immuunreactie die ook op de nieren
slaat.
Behandeling/dialyse

Nefrotisch syndroom
 Grootse oorzaak minimal change
Hypo-albuminerie
Oedeem
Proteïnurie
Hyperlipidemie door activatie lever om proteïneverlies te compenseren.
Beh/ cortico’s, furosemide, ACE-remmers

Acute pyelonifritis = nierbekken ontsteking = opstijgende UWI

Acute tubelusnecrose =afsterven tubuli door hypotentie, soms medicijn geïndiceerd  acuut
nierfalen.
Diagnosticum: eiwitcylinders in de urine  specifiek voor deze zieke
Beh/ vullen!
Goede prognose, tubuli herstellen zich vanzeldf



H.pylori bacterie  verhoogde kans maag maligniteit

Maag:
Hoofdcellen maag afgifte van pepsinogeen. Pepsinogeen wordt door HCL of door pepsine zelf
omgezet in pepsine, wat in zure mileus eiwitten kan afbreken. Pepsine: afbraak eiwitten in de
maag. Niet in de darm want daar is het mileu te basisch.

Secretie gastrine door G-cellen antrum maag (bij rek antrum) duodenum, jejunum (bij stijgen PH
duodenum) naar de bloedbaan op prikkel van stijgende PH

Gastrine  parietale cel door binding op CCK-2receptor  uitscheiding HCL

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Written in
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Graag een review achterlaten, grazi mille:)

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