Anneke Schutte & Willemijn Sigtermans
AVAG
MODULE 13
Immunologie en psychologische stoornissen
,Inhoud
Immunologie (8) – A ................................................................................................................................ 8
Herkomst bloedcellen ......................................................................................................................... 8
Indeling leukocyten ............................................................................................................................. 8
Ontsteking ........................................................................................................................................... 9
Immuniteit en afweer........................................................................................................................ 10
Aspecifieke afweer ........................................................................................................................ 10
Specifieke afweer .......................................................................................................................... 11
Onderdelen van het immuunsysteem ........................................................................................... 11
Stappen in de fagocytose .............................................................................................................. 11
Immuuncellen.................................................................................................................................... 11
Fagocyterende cellen .................................................................................................................... 11
B-lymfocyten ................................................................................................................................. 12
T-lymfocyten.................................................................................................................................. 12
Helper T-cellen .............................................................................................................................. 12
NK-cellen ....................................................................................................................................... 12
Regulerende cellen en mestcellen ................................................................................................ 13
Weefselspecificiteit ........................................................................................................................... 13
MHC-complex ................................................................................................................................ 13
HLA type I, II en III.......................................................................................................................... 13
Oplosbare mediatoren ...................................................................................................................... 14
Complementsysteem ........................................................................................................................ 15
Opsonisatie .................................................................................................................................... 16
C-reactive protein (CRP) ................................................................................................................ 16
Adaptieve immuunrespons ............................................................................................................... 16
Cellulaire immuunrespons ................................................................................................................ 17
Cytotoxische T-cellen..................................................................................................................... 17
Humorale immuunrespons................................................................................................................ 18
Antilichamen (immunoglobulinen) ................................................................................................... 18
Functie complement...................................................................................................................... 19
Verschillende soorten (5) immunoglobulines ............................................................................... 19
Het nut van vaccinatie ....................................................................................................................... 20
Immuniteit en zwangerschap ............................................................................................................ 21
Nidatie (innesteling) ...................................................................................................................... 21
Immunotolerantie ......................................................................................................................... 21
Perifere immuniteit ....................................................................................................................... 22
, Postpartum ........................................................................................................................................ 22
Moedermelk .................................................................................................................................. 22
Foetale en neonatale afweer ............................................................................................................ 22
In utero .......................................................................................................................................... 22
Neonaat ......................................................................................................................................... 23
Bloedonderzoek ................................................................................................................................ 23
Ontstekingsparameters ................................................................................................................. 23
BSE: bezinkingssnelheid erytrocyten............................................................................................. 24
Ontstekingsindicatoren bij zwangeren .......................................................................................... 24
(Infectie)ziekten (18) – A ....................................................................................................................... 25
Auto-immuun aandoeningen ............................................................................................................ 25
Systemische Lupus Erythematodes (SLE) ...................................................................................... 25
Antifosfolipidensyndroom (APS) ................................................................................................... 28
Myastenia gravis............................................................................................................................ 31
Reumatoïde artritis........................................................................................................................ 33
Ziekte van Kahler – Multipel myeloom ......................................................................................... 35
Syndroom van Marfan ................................................................................................................... 37
Bacteriële infectieziekten .................................................................................................................. 38
Bacteriële vaginose (module 8) ..................................................................................................... 38
Chlamydia Trachomatis (module 8) .............................................................................................. 39
Groep B-streptokokken (GBS) – streptococcus algalactiae ........................................................... 40
Gonorroe (module 8)..................................................................................................................... 44
Groep A-streptokokken ................................................................................................................. 46
Listeria monocytogenes ................................................................................................................ 50
MRSA (Meticilline-resistente Staphylococcus aureus) .................................................................. 52
Tuberculose ................................................................................................................................... 55
Virale infectieziekten ......................................................................................................................... 60
Bof (parotitis epidemica) ............................................................................................................... 60
Cytomegalie virus (CMV) ............................................................................................................... 62
Epstein-Barr virus .......................................................................................................................... 64
Exanthema subitum (zesde ziekte)................................................................................................ 65
Hepatitis A ..................................................................................................................................... 68
Hepatitis B ..................................................................................................................................... 69
Hepatitis C ..................................................................................................................................... 74
Hepatitis E...................................................................................................................................... 77
Herpes simplex (module 8)............................................................................................................ 78
, Humaan immunodeficiëntie virus (hiv) ......................................................................................... 81
Humaan papillomavirus (module 8) .............................................................................................. 85
Humaan parvovirus B19 – Erythema infectiosum (vijfde ziekte) .................................................. 86
Influenzavirus (griep) ..................................................................................................................... 89
Mazelen (Morbillivirus) ................................................................................................................. 91
Rotavirus........................................................................................................................................ 95
RS-virus (respiratoir syncytieel virus) ............................................................................................ 97
Rubella (rodehond)........................................................................................................................ 98
Varicellazoster virus (waterpokken) ............................................................................................ 101
Parasitaire infectieziekten ............................................................................................................... 105
Lues (syfilis) ................................................................................................................................. 105
Lyme ............................................................................................................................................ 107
Malaria......................................................................................................................................... 111
Toxoplasmose .............................................................................................................................. 115
Trichomonas vaginalis (module 8)............................................................................................... 119
Schimmel infectieziekten ................................................................................................................ 120
Candida Albicans (module 8) ....................................................................................................... 120
RIVM – W ............................................................................................................................................. 121
Screening en vaccinaties ................................................................................................................. 121
HBV .............................................................................................................................................. 121
DKTP- Hib- Hepatitis B-vaccinatie (sinds 2011) ........................................................................... 124
BMR ............................................................................................................................................. 125
Pneumokokken ............................................................................................................................ 125
Meningokokken C ........................................................................................................................ 126
HPV (humaan papillomavirus) ..................................................................................................... 126
PSIE .................................................................................................................................................. 127
Koorts durante partu en postpartum – W .......................................................................................... 128
Koorts .............................................................................................................................................. 128
Endometritis .................................................................................................................................... 128
Parametritis ..................................................................................................................................... 129
Pelveoperitonitis ............................................................................................................................. 130
Salpingitis......................................................................................................................................... 130
Sepsis en toxische shocksyndroom ................................................................................................. 130
Wondinfectie perineum, buikwand ................................................................................................ 131
Mastitis ............................................................................................................................................ 131
Urineweginfecties............................................................................................................................ 133
AVAG
MODULE 13
Immunologie en psychologische stoornissen
,Inhoud
Immunologie (8) – A ................................................................................................................................ 8
Herkomst bloedcellen ......................................................................................................................... 8
Indeling leukocyten ............................................................................................................................. 8
Ontsteking ........................................................................................................................................... 9
Immuniteit en afweer........................................................................................................................ 10
Aspecifieke afweer ........................................................................................................................ 10
Specifieke afweer .......................................................................................................................... 11
Onderdelen van het immuunsysteem ........................................................................................... 11
Stappen in de fagocytose .............................................................................................................. 11
Immuuncellen.................................................................................................................................... 11
Fagocyterende cellen .................................................................................................................... 11
B-lymfocyten ................................................................................................................................. 12
T-lymfocyten.................................................................................................................................. 12
Helper T-cellen .............................................................................................................................. 12
NK-cellen ....................................................................................................................................... 12
Regulerende cellen en mestcellen ................................................................................................ 13
Weefselspecificiteit ........................................................................................................................... 13
MHC-complex ................................................................................................................................ 13
HLA type I, II en III.......................................................................................................................... 13
Oplosbare mediatoren ...................................................................................................................... 14
Complementsysteem ........................................................................................................................ 15
Opsonisatie .................................................................................................................................... 16
C-reactive protein (CRP) ................................................................................................................ 16
Adaptieve immuunrespons ............................................................................................................... 16
Cellulaire immuunrespons ................................................................................................................ 17
Cytotoxische T-cellen..................................................................................................................... 17
Humorale immuunrespons................................................................................................................ 18
Antilichamen (immunoglobulinen) ................................................................................................... 18
Functie complement...................................................................................................................... 19
Verschillende soorten (5) immunoglobulines ............................................................................... 19
Het nut van vaccinatie ....................................................................................................................... 20
Immuniteit en zwangerschap ............................................................................................................ 21
Nidatie (innesteling) ...................................................................................................................... 21
Immunotolerantie ......................................................................................................................... 21
Perifere immuniteit ....................................................................................................................... 22
, Postpartum ........................................................................................................................................ 22
Moedermelk .................................................................................................................................. 22
Foetale en neonatale afweer ............................................................................................................ 22
In utero .......................................................................................................................................... 22
Neonaat ......................................................................................................................................... 23
Bloedonderzoek ................................................................................................................................ 23
Ontstekingsparameters ................................................................................................................. 23
BSE: bezinkingssnelheid erytrocyten............................................................................................. 24
Ontstekingsindicatoren bij zwangeren .......................................................................................... 24
(Infectie)ziekten (18) – A ....................................................................................................................... 25
Auto-immuun aandoeningen ............................................................................................................ 25
Systemische Lupus Erythematodes (SLE) ...................................................................................... 25
Antifosfolipidensyndroom (APS) ................................................................................................... 28
Myastenia gravis............................................................................................................................ 31
Reumatoïde artritis........................................................................................................................ 33
Ziekte van Kahler – Multipel myeloom ......................................................................................... 35
Syndroom van Marfan ................................................................................................................... 37
Bacteriële infectieziekten .................................................................................................................. 38
Bacteriële vaginose (module 8) ..................................................................................................... 38
Chlamydia Trachomatis (module 8) .............................................................................................. 39
Groep B-streptokokken (GBS) – streptococcus algalactiae ........................................................... 40
Gonorroe (module 8)..................................................................................................................... 44
Groep A-streptokokken ................................................................................................................. 46
Listeria monocytogenes ................................................................................................................ 50
MRSA (Meticilline-resistente Staphylococcus aureus) .................................................................. 52
Tuberculose ................................................................................................................................... 55
Virale infectieziekten ......................................................................................................................... 60
Bof (parotitis epidemica) ............................................................................................................... 60
Cytomegalie virus (CMV) ............................................................................................................... 62
Epstein-Barr virus .......................................................................................................................... 64
Exanthema subitum (zesde ziekte)................................................................................................ 65
Hepatitis A ..................................................................................................................................... 68
Hepatitis B ..................................................................................................................................... 69
Hepatitis C ..................................................................................................................................... 74
Hepatitis E...................................................................................................................................... 77
Herpes simplex (module 8)............................................................................................................ 78
, Humaan immunodeficiëntie virus (hiv) ......................................................................................... 81
Humaan papillomavirus (module 8) .............................................................................................. 85
Humaan parvovirus B19 – Erythema infectiosum (vijfde ziekte) .................................................. 86
Influenzavirus (griep) ..................................................................................................................... 89
Mazelen (Morbillivirus) ................................................................................................................. 91
Rotavirus........................................................................................................................................ 95
RS-virus (respiratoir syncytieel virus) ............................................................................................ 97
Rubella (rodehond)........................................................................................................................ 98
Varicellazoster virus (waterpokken) ............................................................................................ 101
Parasitaire infectieziekten ............................................................................................................... 105
Lues (syfilis) ................................................................................................................................. 105
Lyme ............................................................................................................................................ 107
Malaria......................................................................................................................................... 111
Toxoplasmose .............................................................................................................................. 115
Trichomonas vaginalis (module 8)............................................................................................... 119
Schimmel infectieziekten ................................................................................................................ 120
Candida Albicans (module 8) ....................................................................................................... 120
RIVM – W ............................................................................................................................................. 121
Screening en vaccinaties ................................................................................................................. 121
HBV .............................................................................................................................................. 121
DKTP- Hib- Hepatitis B-vaccinatie (sinds 2011) ........................................................................... 124
BMR ............................................................................................................................................. 125
Pneumokokken ............................................................................................................................ 125
Meningokokken C ........................................................................................................................ 126
HPV (humaan papillomavirus) ..................................................................................................... 126
PSIE .................................................................................................................................................. 127
Koorts durante partu en postpartum – W .......................................................................................... 128
Koorts .............................................................................................................................................. 128
Endometritis .................................................................................................................................... 128
Parametritis ..................................................................................................................................... 129
Pelveoperitonitis ............................................................................................................................. 130
Salpingitis......................................................................................................................................... 130
Sepsis en toxische shocksyndroom ................................................................................................. 130
Wondinfectie perineum, buikwand ................................................................................................ 131
Mastitis ............................................................................................................................................ 131
Urineweginfecties............................................................................................................................ 133
