2024-
2025
Kindergeneeskunde
PROF DR THOELEN, PROF DR MEYTS
,Praktische zaken ...................................................................................................................... 16
Inleidende les ........................................................................................................................... 16
Het kind in maatschappij ...................................................................................................... 16
Publieke gezondheidszorg voor kinderen in Vlaanderen................................................. 16
Medicolegale aspecten ........................................................................................................ 17
Wet van patiëntenrechten (WPR) .................................................................................... 17
Hoofstuk III: Rechten van de patiënt............................................................................ 17
Hoofdstuk IV: Vertegenwoordiging van de patiënt ..................................................... 17
Knelpunten WPR .......................................................................................................... 17
Casussen ........................................................................................................................... 17
Kindermishandeling en verwaarlozing ................................................................................. 18
Hoger risico....................................................................................................................... 18
Bias en rode vlaggen ........................................................................................................ 18
Hematomen en ecchymosen ........................................................................................... 18
Bloedonderzoek ........................................................................................................... 18
Brandwonden ................................................................................................................... 19
Fracturen .......................................................................................................................... 19
Niet-accidenteel hersentrauma ....................................................................................... 19
Seksueel geweld ............................................................................................................... 19
Perinatale geneeskunde .......................................................................................................... 20
Inleiding ................................................................................................................................ 20
Pre-pregnancy care .............................................................................................................. 20
Moeder tijdens zwangerschap ......................................................................................... 20
Risicofactoren ................................................................................................................... 21
Antenatale diagnose............................................................................................................. 21
Technieken ....................................................................................................................... 21
Casus 1: tweelingzwangerschap ....................................................................................... 21
Ingrepen na antenatale diagnose..................................................................................... 21
Gynaecologische condities met invloed op foetus .............................................................. 22
Zaken bij moeder die invloed hebben op foetus ................................................................. 22
Casus 2: diabetes mellitus ................................................................................................ 22
Context ......................................................................................................................... 22
Pathogenese ..................................................................................................................... 22
Neonaat ............................................................................................................................ 23
Zwangerschapsdiabetes ............................................................................................... 23
1
, Andere .............................................................................................................................. 23
Ziekte van Graves ......................................................................................................... 24
Systemische lupus ........................................................................................................ 24
Rh iso-immunisatie ....................................................................................................... 24
Autoimmune TPP.......................................................................................................... 24
Casus 3 .............................................................................................................................. 24
Maternele medicatie met invloed op foetus ....................................................................... 24
Foetaal alcohol syndroom ................................................................................................ 24
Neonatal abstinentie syndroom....................................................................................... 24
Congenitale infecties ............................................................................................................ 25
Rubella .............................................................................................................................. 25
CMV .................................................................................................................................. 25
Toxoplasmose................................................................................................................... 25
VZV.................................................................................................................................... 25
Adaptaties aan extrauterine leven ....................................................................................... 25
Ademen ............................................................................................................................ 26
Circulatie........................................................................................................................... 26
Glucose homeostase ........................................................................................................ 26
Temperatuur .................................................................................................................... 26
Detoxificatie ..................................................................................................................... 27
Neonatale resuscitatie ......................................................................................................... 27
Grootte bij geboorte ............................................................................................................ 27
Routine postnatale zorg en check ........................................................................................ 28
Voeding............................................................................................................................. 28
Screening .......................................................................................................................... 28
Hypothyroidie ............................................................................................................... 28
Fenylketonurie ............................................................................................................. 28
Saturatie ....................................................................................................................... 28
Geelzucht ...................................................................................................................... 28
Sensorische screening .................................................................................................. 29
Infectie ..................................................................................................................................... 29
Kind met koorts .................................................................................................................... 29
Red flags ........................................................................................................................... 29
Sepsis screening ........................................................................................................... 29
Behandeling ...................................................................................................................... 29
2
, Algoritme .......................................................................................................................... 30
Levensbedreigende infecties................................................................................................ 30
Bacteriële meningitis ........................................................................................................ 30
Pathogenese ................................................................................................................. 30
Kiemen.......................................................................................................................... 30
Symptomen .................................................................................................................. 30
Virale meningitis ........................................................................................................... 31
Lumbaalpunctie ............................................................................................................ 31
Behandeling .................................................................................................................. 31
Encefalitis ......................................................................................................................... 32
Toxic shock syndrome ...................................................................................................... 32
Necrotiserende fasciitis/cellulitis...................................................................................... 32
Specifieke bacteriële infecties .............................................................................................. 32
Meningococcen: sepsis en meningitis .............................................................................. 32
Pneumococceninfectie ..................................................................................................... 32
H. influenzae type B ......................................................................................................... 33
Epiglottitis..................................................................................................................... 33
Staphylococcus aureus en groep A streptococ ................................................................ 33
Impetigo ....................................................................................................................... 33
Abcessen....................................................................................................................... 33
Periorbitale cellulitis ..................................................................................................... 33
SSSS............................................................................................................................... 34
Frequent virale infecties....................................................................................................... 34
Humane herpesvirussen ................................................................................................... 34
Herpes simplex 1 en 2 .................................................................................................. 34
Varicella (3)................................................................................................................... 34
EB virus: mononucleose (5) .......................................................................................... 35
HHV6 en HHV7 ............................................................................................................. 35
Parovirus B19.................................................................................................................... 35
Enterovirus ....................................................................................................................... 35
Prolonged fever .................................................................................................................... 36
Ziekte van Kawasaki ......................................................................................................... 36
Epidemiologie ............................................................................................................... 36
Diagnose en ziektebeeld .............................................................................................. 36
Behandeling .................................................................................................................. 36
3
2025
Kindergeneeskunde
PROF DR THOELEN, PROF DR MEYTS
,Praktische zaken ...................................................................................................................... 16
Inleidende les ........................................................................................................................... 16
Het kind in maatschappij ...................................................................................................... 16
Publieke gezondheidszorg voor kinderen in Vlaanderen................................................. 16
Medicolegale aspecten ........................................................................................................ 17
Wet van patiëntenrechten (WPR) .................................................................................... 17
Hoofstuk III: Rechten van de patiënt............................................................................ 17
Hoofdstuk IV: Vertegenwoordiging van de patiënt ..................................................... 17
Knelpunten WPR .......................................................................................................... 17
Casussen ........................................................................................................................... 17
Kindermishandeling en verwaarlozing ................................................................................. 18
Hoger risico....................................................................................................................... 18
Bias en rode vlaggen ........................................................................................................ 18
Hematomen en ecchymosen ........................................................................................... 18
Bloedonderzoek ........................................................................................................... 18
Brandwonden ................................................................................................................... 19
Fracturen .......................................................................................................................... 19
Niet-accidenteel hersentrauma ....................................................................................... 19
Seksueel geweld ............................................................................................................... 19
Perinatale geneeskunde .......................................................................................................... 20
Inleiding ................................................................................................................................ 20
Pre-pregnancy care .............................................................................................................. 20
Moeder tijdens zwangerschap ......................................................................................... 20
Risicofactoren ................................................................................................................... 21
Antenatale diagnose............................................................................................................. 21
Technieken ....................................................................................................................... 21
Casus 1: tweelingzwangerschap ....................................................................................... 21
Ingrepen na antenatale diagnose..................................................................................... 21
Gynaecologische condities met invloed op foetus .............................................................. 22
Zaken bij moeder die invloed hebben op foetus ................................................................. 22
Casus 2: diabetes mellitus ................................................................................................ 22
Context ......................................................................................................................... 22
Pathogenese ..................................................................................................................... 22
Neonaat ............................................................................................................................ 23
Zwangerschapsdiabetes ............................................................................................... 23
1
, Andere .............................................................................................................................. 23
Ziekte van Graves ......................................................................................................... 24
Systemische lupus ........................................................................................................ 24
Rh iso-immunisatie ....................................................................................................... 24
Autoimmune TPP.......................................................................................................... 24
Casus 3 .............................................................................................................................. 24
Maternele medicatie met invloed op foetus ....................................................................... 24
Foetaal alcohol syndroom ................................................................................................ 24
Neonatal abstinentie syndroom....................................................................................... 24
Congenitale infecties ............................................................................................................ 25
Rubella .............................................................................................................................. 25
CMV .................................................................................................................................. 25
Toxoplasmose................................................................................................................... 25
VZV.................................................................................................................................... 25
Adaptaties aan extrauterine leven ....................................................................................... 25
Ademen ............................................................................................................................ 26
Circulatie........................................................................................................................... 26
Glucose homeostase ........................................................................................................ 26
Temperatuur .................................................................................................................... 26
Detoxificatie ..................................................................................................................... 27
Neonatale resuscitatie ......................................................................................................... 27
Grootte bij geboorte ............................................................................................................ 27
Routine postnatale zorg en check ........................................................................................ 28
Voeding............................................................................................................................. 28
Screening .......................................................................................................................... 28
Hypothyroidie ............................................................................................................... 28
Fenylketonurie ............................................................................................................. 28
Saturatie ....................................................................................................................... 28
Geelzucht ...................................................................................................................... 28
Sensorische screening .................................................................................................. 29
Infectie ..................................................................................................................................... 29
Kind met koorts .................................................................................................................... 29
Red flags ........................................................................................................................... 29
Sepsis screening ........................................................................................................... 29
Behandeling ...................................................................................................................... 29
2
, Algoritme .......................................................................................................................... 30
Levensbedreigende infecties................................................................................................ 30
Bacteriële meningitis ........................................................................................................ 30
Pathogenese ................................................................................................................. 30
Kiemen.......................................................................................................................... 30
Symptomen .................................................................................................................. 30
Virale meningitis ........................................................................................................... 31
Lumbaalpunctie ............................................................................................................ 31
Behandeling .................................................................................................................. 31
Encefalitis ......................................................................................................................... 32
Toxic shock syndrome ...................................................................................................... 32
Necrotiserende fasciitis/cellulitis...................................................................................... 32
Specifieke bacteriële infecties .............................................................................................. 32
Meningococcen: sepsis en meningitis .............................................................................. 32
Pneumococceninfectie ..................................................................................................... 32
H. influenzae type B ......................................................................................................... 33
Epiglottitis..................................................................................................................... 33
Staphylococcus aureus en groep A streptococ ................................................................ 33
Impetigo ....................................................................................................................... 33
Abcessen....................................................................................................................... 33
Periorbitale cellulitis ..................................................................................................... 33
SSSS............................................................................................................................... 34
Frequent virale infecties....................................................................................................... 34
Humane herpesvirussen ................................................................................................... 34
Herpes simplex 1 en 2 .................................................................................................. 34
Varicella (3)................................................................................................................... 34
EB virus: mononucleose (5) .......................................................................................... 35
HHV6 en HHV7 ............................................................................................................. 35
Parovirus B19.................................................................................................................... 35
Enterovirus ....................................................................................................................... 35
Prolonged fever .................................................................................................................... 36
Ziekte van Kawasaki ......................................................................................................... 36
Epidemiologie ............................................................................................................... 36
Diagnose en ziektebeeld .............................................................................................. 36
Behandeling .................................................................................................................. 36
3
