Inhaltsverzeichnis | 1 |
Klassische Anamneseerhebung mit differenzial-diagnostischen Überlegungen | 4 |
1 | 12 |
Anamneseerhebung 3 | 12 |
1.1 | 12 |
Aufnahme der persönlichen Daten 3 | 12 |
1.2 | 13 |
Abklärung eines dringend therapiebedürftigen Geschehens 4 | 13 |
1.3 | 13 |
Ermittlung der aktuellen Symptomatik 4 | 13 |
1.4 | 14 |
Verschaffung eines Systemüberblicks 5 | 14 |
1.5 | 15 |
Psychosoziale Aspekte 6 | 15 |
1.6 | 16 |
Medikamentenanamnese 7 | 16 |
1.7 | 17 |
Die Frage nach Vorerkrankungen 8 | 17 |
1.8 | 17 |
Familienanamnese 8 | 17 |
1.9 | 18 |
Auslandsanamnese 9 | 18 |
2 | 19 |
Differenzialdiagnostische Überlegungen 10 | 19 |
2.1 | 19 |
Fieber 10 | 19 |
2.1.1 | 22 |
Fiebertypen 13 | 22 |
2.2 | 24 |
Nachtschweiß 15 | 24 |
2.3 | 24 |
Schmerzen 15 | 24 |
2.3.1 | 25 |
Rückenschmerzen 16 | 25 |
2.3.2 | 26 |
Kopfschmerzen 17 | 26 |
2.3.3 | 28 |
Thoraxschmerzen 19 | 28 |
2.3.4 | 30 |
Bauchschmerzen 21 | 30 |
2.3.5 | 32 |
Extremitätenschmerzen 23 | 32 |
2.4 | 35 |
Veränderung des Körpergewichts 26 | 35 |
2.4.1 | 35 |
Gewichtszunahme 26 | 35 |
2.4.2 | 37 |
Gewichtsverlust 28 | 37 |
2.5 | 39 |
Essverhalten 30 | 39 |
2.5.1 | 39 |
Appetitlosigkeit (Anorexie) 30 | 39 |
2.5.2 | 41 |
Heißhunger 32 | 41 |
2.6 | 41 |
Übelkeit/Erbrechen 32 | 41 |
2.6.1 | 43 |
Bluterbrechen (Hämatemesis) 34 | 43 |
2.7 | 44 |
Stuhlverhalten 35 | 44 |
2.7.1 | 45 |
Diarrhoe 36 | 45 |
2.7.2 | 47 |
Obstipation 38 | 47 |
2.7.3 | 49 |
Farbveränderungen des Stuhls 40 | 49 |
2.7.3.1 | 49 |
Melaena (Teerstuhl) 40 | 49 |
2.7.3.2 | 49 |
Hämatochezie (Blutstuhl) 40 | 49 |
2.7.3.3 | 50 |
Dunkler Stuhl 41 | 50 |
2.7.3.4 | 50 |
Entfärbter bzw. heller Stuhl 41 | 50 |
2.8 | 51 |
Trinkverhalten 42 | 51 |
2.8.1 | 51 |
Polydipsie 42 | 51 |
2.8.2 | 52 |
Vermindertes Trinkverhalten 43 | 52 |
2.9 | 52 |
Urinverhalten 43 | 52 |
2.9.1 | 52 |
Polyurie 43 | 52 |
2.9.2 | 53 |
Anurie 44 | 53 |
2.9.3 | 53 |
Nykturie 44 | 53 |
2.9.4 | 54 |
Farbveränderungen des Urins 45 | 54 |
2.10 | 55 |
Atemnot (Dyspnoe) 46 | 55 |
2.11 | 56 |
Husten 47 | 56 |
2.12 | 58 |
Sputum 49 | 58 |
2.13 | 59 |
Schluckbeschwerden (Dysphagie) 50 | 59 |
Körperliche Untersuchungsmethoden mit differenzialdiagnostischen Überlegungen | 61 |
1 | 64 |
Überprüfung der Vitalzeichen 56 | 64 |
1.1 | 64 |
Blutdruckmessung 56 | 64 |
1.2 | 67 |
Pulsprüfung 59 | 67 |
1.3 | 67 |
Atemfrequenz 59 | 67 |
1.4 | 67 |
Körpertemperatur 59 | 67 |
2 | 68 |
Kopf und äußerer Hals 60 | 68 |
2.1 | 68 |
Schädel 60 | 68 |
2.1.1 | 71 |
Untersuchung der Nervenaustrittspunkte (N. trigeminus) 63 | 71 |
2.1.2 | 72 |
Palpation der Arteria temporalis 64 | 72 |
2.1.3 | 72 |
Perkussion der Schädelkalotte 64 | 72 |
2.2 | 73 |
Mund und Rachen 65 | 73 |
2.2.1 | 74 |
Lippen 66 | 74 |
2.2.2 | 75 |
Mundschleimhaut 67 | 75 |
2.2.3 | 76 |
Zunge 68 | 76 |
2.2.4 | 77 |
Rachen 69 | 77 |
2.3 | 78 |
Augen 70 | 78 |
2.3.1 | 79 |
Augenlider 71 | 79 |
2.3.2 | 80 |
Konjunktiven/Skleren 72 | 80 |
2.3.3 | 81 |
Augenbulbi (Augäpfel) 73 | 81 |
2.3.4 | 82 |
Pupille 74 | 82 |
2.3.5 | 83 |
Augenbulbi 75 | 83 |
2.4 | 85 |
Ohren 77 | 85 |
2.4.1 | 87 |
Palpation des Tragus und des Mastoids 79 | 87 |
2.4.2 | 87 |
Hörweitenprüfung 79 | 87 |
2.4.3 | 87 |
Differenzierung zwischen Schallleitungs- und Schallempfindungsstörungen 79 | 87 |
2.4.4 | 90 |
Prüfung der Tubendurchlässigkeit 82 | 90 |
2.4.5 | 91 |
Gleichgewichtstest 83 | 91 |
2.5 | 92 |
Nase und Nasennebenhöhlen 84 | 92 |
2.5.1 | 93 |
Palpation der Nasennebenhöhlen 85 | 93 |
2.6 | 94 |
Äußerer Hals 86 | 94 |
2.6.1 | 96 |
Palpation der Schilddrüse 88 | 96 |
2.6.2 | 97 |
Auskultation der Schilddrüse 89 | 97 |
2.6.3 | 98 |
Auskultation der Gefäße 90 | 98 |
2.6.4 | 98 |
Prüfung der Halswirbelsäulenmotilität 90 | 98 |
3 | 99 |
Thorax 91 | 99 |
3.1 | 99 |
Der knöcherne Thorax und Lunge 91 | 99 |
3.1.1 | 103 |
Die Suche nach schmerzhaften Bereichen 95 | 103 |
3.1.2 | 103 |
Die Beurteilung der Atemexkursion 95 | 103 |
3.1.3 | 104 |
Die Beurteilung des Stimmfremitus 96 | 104 |
3.1.4 | 107 |
Beurteilung des Klopfschalls 99 | 107 |
3.1.5 | 109 |
Prüfung der respiratorischen Verschieblichkeit der Lungengrenzen 101 | 109 |
3.1.6 | 110 |
Die Abgrenzung der Lungen von umgebenen Organen 102 | 110 |
3.1.7 | 111 |
Rasselgeräusche und pleurale Nebengeräusche 103 | 111 |
3.1.8 | 112 |
Vesikulär- und Bronchialatmen 104 | 112 |
3.1.9 | 113 |
Bronchophonie 105 | 113 |
3.2 | 114 |
Herz 106 | 114 |
3.2.1 | 115 |
Palpation des Herzspitzenstoßes 108 | 115 |
3.2.2 | 116 |
Relative und absolute Herzdämpfung 109 | 116 |
3.2.3 | 118 |
Herztöne 111 | 118 |
3.2.4 | 119 |
Herzgeräusche 112 | 119 |
3.2.5 | 120 |
Herzfrequenz 113 | 120 |
3.2.6 | 122 |
Pulsdefizit 116 | 122 |
3.3 | 122 |
Die Untersuchung der Brust 116 | 122 |
3.3.1 | 122 |
Weibliche 116 | 122 |
3.3.1.1 | 124 |
Palpation der Mamma 118 | 124 |
3.3.1.2 | 125 |
Palpation der Achselhöhle 119 | 125 |
3.3.2 | 126 |
Männliche 120 | 126 |
4 | 127 |
Abdomen 121 | 127 |
4.1 | 127 |
Verdauungsorgane 122 | 127 |
4.1.1 | 130 |
Leichte Palpation 124 | 130 |
4.1.2 | 131 |
Tiefe Palpation 125 | 131 |
4.1.3 | 131 |
Palpation der Leber 125 | 131 |
4.1.4 | 133 |
Palpation der Gallenblase 127 | 133 |
4.1.5 | 134 |
Palpation bei Verdacht auf Appendizitis 127 | 134 |
4.1.6 | 137 |
Palpation der Milz 131 | 137 |
4.1.7 | 139 |
Nachweis von Aszites 133 | 139 |
4.1.8 | 140 |
Mechanischer Ileus 134 | 140 |
4.1.9 | 141 |
Paralytischer Ileus 135 | 141 |
4.2 | 142 |
Urogenitalsystem 136 | 142 |
4.2.1 | 142 |
Harnsystem 136 | 142 |
4.2.1.1 | 143 |
Palpation der Nieren 137 | 143 |
4.2.1.2 | 144 |
Palpation der ableitenden Harnwege 138 | 144 |
4.2.1.3 | 145 |
Perkussion der Nieren 139 | 145 |
4.2.1.4 | 146 |
Perkussion der Harnblase 140 | 146 |
4.2.2 | 147 |
Geschlechtsorgane 141 | 147 |
5 | 148 |
Peripheres Gefäßsystem 142 | 148 |
5.1 | 148 |
Arterien 142 | 148 |
5.1.1 | 149 |
Prüfung der Hauttemperatur 143 | 149 |
5.1.2 | 149 |
Pulsprüfung 143 | 149 |
5.1.3 | 154 |
Testverfahren bei Verdacht auf Durchblutungsstörungen 148 | 154 |
5.2 | 156 |
Venen 150 | 156 |
5.2.1 | 157 |
Verdacht auf Phlebothrombose 151 | 157 |
5.2.2 | 158 |
Verdacht auf chronisch venöse Insuffizienz 152 | 158 |
6 | 160 |
Lymphknoten 154 | 160 |
6.1 | 161 |
Die Lymphknoten des Halses und Kopfes 155 | 161 |
6.2 | 162 |
Axilläre Lymphknoten 156 | 162 |
6.3 | 164 |
Inguinale Lymphknoten 158 | 164 |
7 | 166 |
Bewegungsapparat 160 | 166 |
7.1 | 166 |
Wirbelsäule 160 | 166 |
7.1.1 | 167 |
Seitenansicht 161 | 167 |
7.1.2 | 168 |
Rückseitige Ansicht 162 | 168 |
7.1.3 | 168 |
Vorderansicht 162 | 168 |
7.1.4 | 168 |
Palpation der Dornfortsätze 162 | 168 |
7.1.5 | 169 |
Palpation der paravertebralen Muskulatur 163 | 169 |
7.1.6 | 169 |
Überprüfung des Geradestandes 163 | 169 |
7.1.7 | 170 |
Perkussion der Dornfortsätze 164 | 170 |
7.1.8 | 171 |
Stauchung der Wirbelsäule 165 | 171 |
7.1.9 | 171 |
Testverfahren zur Beweglichkeit der Wirbelsäule 165 | 171 |
7.2 | 174 |
Gelenke 168 | 174 |
7.2.1 | 176 |
Schultergelenk 170 | 176 |
7.2.2 | 176 |
Ellenbogengelenk 170 | 176 |
7.2.3 | 176 |
Handgelenk 170 | 176 |
7.2.4 | 176 |
Fingergelenke 170 | 176 |
7.2.5 | 177 |
Hüftgelenk 171 | 177 |
7.2.6 | 177 |
Kniegelenk 171 | 177 |
7.2.7 | 177 |
Fuß- und Zehengelenke 171 | 177 |
7.2.8 | 178 |
Überprüfung der Temperatur 172 | 178 |
7.2.9 | 178 |
Palpation des Schultergelenks 172 | 178 |
7.2.10 | 178 |
Palpation des Ellenbogengelenks 172 | 178 |
7.2.11 | 178 |
Palpation des Handgelenks 172 | 178 |
7.2.12 | 178 |
Palpation der Fingergelenke 172 | 178 |
7.2.13 | 179 |
Palpation des Hüftgelenks 173 | 179 |
7.2.14 | 179 |
Palpation des Kniegelenks 173 | 179 |
7.2.15 | 181 |
Palpation der Fuß- und Zehengelenke 175 | 181 |
7.2.16 | 182 |
Beweglichkeitsprüfung bestimmter Gelenke 176 | 182 |
8 | 183 |
Nervensystem 177 | 183 |
8.1 | 183 |
Psychischer Befund 177 | 183 |
8.2 | 184 |
Körperlicher Befund 178 | 184 |
8.2.1 | 185 |
Untersuchung des Gangverhaltens 179 | 185 |
8.2.2 | 188 |
Untersuchung der Hirnnerven 182 | 188 |
8.2.3 | 192 |
Untersuchung der Reflexe 186 | 192 |
8.2.4 | 198 |
Untersuchung der Motorik 192 | 198 |
8.2.5 | 208 |
Untersuchung der Sensibilität 202 | 208 |
8.2.6 | 209 |
Spezielle Methoden 203 | 209 |
9 | 211 |
Haut und Hautanhangsgebilde 205 | 211 |
9.1 | 211 |
Haut 205 | 211 |
9.2 | 216 |
Haut- und Schweißdrüsen 210 | 216 |
9.3 | 217 |
Nägel 211 | 217 |
9.4 | 217 |
Haare 211 | 217 |
Laborchemische Differenzialdiagnose | 219 |
1 | 220 |
Hämatologische und klinisch-chemische Laborparameter 214 | 220 |
2 | 222 |
Entzündungsparameter 216 | 222 |
2.1 | 222 |
Blutkörperchensenkungsgeschwindigkeit (BSG) 216 | 222 |
2.2 | 224 |
C-reaktives Protein (CRP) 218 | 224 |
3 | 225 |
Hämatologische Untersuchungen 219 | 225 |
3.1 | 225 |
Erythrozyten 219 | 225 |
3.2 | 225 |
Leukozyten 219 | 225 |
3.3 | 227 |
Thrombozyten 221 | 227 |
3.4 | 228 |
Mittlerer korpuskulärer Hämoglobingehalt (MCH) 222 | 228 |
3.5 | 228 |
Mittleres korpuskuläres Volumen (MCV) 222 | 228 |
3.6 | 229 |
Mittlere korpuskuläre Hämoglobin-Konzentration (MCHC) 223 | 229 |
3.7 | 229 |
Hämatokrit (HKT) 223 | 229 |
3.8 | 229 |
Hämoglobin (Hb) 223 | 229 |
3.9 | 230 |
Retikulozyten 224 | 230 |
4 | 231 |
Blutausstrichdifferenzierung 225 | 231 |
4.1 | 231 |
Neutrophile Granulozyten 225 | 231 |
4.2 | 232 |
Basophile Granulozyten 226 | 232 |
4.3 | 232 |
Eosinophile Granulozyten 226 | 232 |
4.4 | 233 |
Lymphozyten 227 | 233 |
4.5 | 233 |
Monozyten 227 | 233 |
5 | 235 |
Weitere wichtige Laborparameter 229 | 235 |
5.1 | 235 |
Leberenzyme 229 | 235 |
5.1.1 | 235 |
Gamma Glutamyltransferase (g-GT) 229 | 235 |
5.1.2 | 235 |
Glutamat-Pyruvat-Transaminase (GPT) 229 | 235 |
5.1.3 | 236 |
Glutamat-Oxalazetat-Transaminase (GOT) 230 | 236 |
5.1.4 | 236 |
Glutamat-Dehydrogenase (GLDH) 230 | 236 |
5.1.5 | 237 |
Cholinesterase (CHE) 231 | 237 |
5.1.6 | 237 |
Leuzin-Aminopeptidase (LAP) 231 | 237 |
5.2 | 238 |
Pankreasenzyme 232 | 238 |
5.2.1 | 238 |
Alpha-Amylase 232 | 238 |
5.2.2 | 238 |
Lipase 232 | 238 |
5.3 | 240 |
Kardiale Diagnostik 234 | 240 |
5.3.1 | 240 |
Cardiales Troponin T (cTnT) 234 | 240 |
5.3.2 | 240 |
Creatinkinasen (Gesamtaktivität) = Gesamt CK 234 | 240 |
5.3.2.1 | 241 |
CK-MB 235 | 241 |
5.3.3 | 241 |
Lactat-Dehydrogenase (LDH) 235 | 241 |
5.3.3.1 | 242 |
Alphahydroxybutyrat-Dehydrogenase (a-HBDH) 236 | 242 |
5.4 | 243 |
Nierenfunktion 236 | 243 |
5.4.1 | 243 |
Kreatinin 236 | 243 |
5.4.2 | 243 |
Harnstoff 236 | 243 |
5.5 | 244 |
Lipidstoffwechsel/Harnsäure 237 | 244 |
5.5.1 | 244 |
Triglyceride 237 | 244 |
5.5.2 | 244 |
Cholesterin 237 | 244 |
5.5.3 | 245 |
Low density lipoprotein (LDL) 238 | 245 |
5.5.4 | 245 |
High density lipoprotein (HDL) 238 | 245 |
5.5.5 | 245 |
Very low density lipoprotein (VLDL)/Chylomikronen 238 | 245 |
5.5.6 | 246 |
Harnsäure 239 | 246 |
5.6 | 247 |
Proteine 240 | 247 |
5.6.1 | 247 |
Protein gesamt 240 | 247 |
5.6.2 | 248 |
Albumin 241 | 248 |
5.6.3 | 248 |
Alpha1- und Alpha2-Globuline 241 | 248 |
5.6.4 | 249 |
Beta-Globuline 242 | 249 |
5.6.5 | 249 |
Gamma-Globuline 242 | 249 |
5.7 | 250 |
Serumelektrolyte 243 | 250 |
5.7.1 | 250 |
Natrium 243 | 250 |
5.7.2 | 251 |
Kalium 244 | 251 |
5.7.3 | 252 |
Calcium 245 | 252 |
5.8 | 253 |
Tumormarker 247 | 253 |
5.8.1 | 254 |
Carcinoembryonales Antigen (CEA) 247 | 254 |
5.8.2 | 254 |
Alpha-Fetoprotein (AFP) 247 | 254 |
5.8.3 | 254 |
Prostataspezifisches Antigen (PSA) 248 | 254 |
5.8.4 | 254 |
CA 19–9 248 | 254 |
5.9 | 254 |
Phosphatasen 248 | 254 |
5.9.1 | 254 |
Saure Phosphatase 248 | 254 |
5.9.2 | 255 |
Alkalische Phosphatase 249 | 255 |
5.10 | 256 |
Leberstoffwechsel 250 | 256 |
5.10.1 | 256 |
Bilirubin gesamt 250 | 256 |
5.11 | 257 |
Glukosestoffwechsel 251 | 257 |
5.11.1 | 257 |
Glucose 251 | 257 |
BookmarkLevel: 8BookmarkPageNumber: 258BookmarkBeginBookmarkTitle: Oraler Glukose Toleranztest (OGTT) 252BookmarkLevel: 9BookmarkPageNumber: 258BookmarkBeginBookmarkTitle: Spezielles Prüfungs- und PraxiswissenBookmarkLevel: 2BookmarkPageNumber: 261BookmarkBeginBookmarkTitle: 1BookmarkLevel: 3BookmarkPageNumber: 262BookmarkBeginBookmarkTitle: Fragentraining zur Anamnese und Differenzial-diagnose 264BookmarkLevel: 4BookmarkPageNumber: 262BookmarkBeginBookmarkTitle: 2BookmarkLevel: 3BookmarkPageNumber: 271BookmarkBeginBookmarkTitle: Lösungen 273BookmarkLevel: 4BookmarkPageNumber: 271BookmarkBeginBookmarkTitle: 3BookmarkLevel: 3BookmarkPageNumber: 272BookmarkBeginBookmarkTitle: Fragentraining zur körperlichen Untersuchung und Differenzialdiagnose 274BookmarkLevel: 4BookmarkPageNumber: 272BookmarkBeginBookmarkTitle: 4BookmarkLevel: 3BookmarkPageNumber: 291BookmarkBeginBookmarkTitle: Lösungen 293BookmarkLevel: 4BookmarkPageNumber: 291BookmarkBeginBookmarkTitle: 5BookmarkLevel: 3BookmarkPageNumber: 293BookmarkBeginBookmarkTitle: Fragentraining zu Labor und Differenzialdiagnose 295BookmarkLevel: 4BookmarkPageNumber: 293BookmarkBeginBookmarkTitle: 6BookmarkLevel: 3BookmarkPageNumber: 306BookmarkBeginBookmarkTitle: Lösungen 308BookmarkLevel: 4BookmarkPageNumber: 306BookmarkBeginBookmarkTitle: AnhangBookmarkLevel: 2BookmarkPageNumber: 307BookmarkBeginBookmarkTitle: 1BookmarkLevel: 3BookmarkPageNumber: 308BookmarkBeginBookmarkTitle: Sachverzeichnis 311BookmarkLevel: 4BookmarkPageNumber: 308BookmarkBeginBookmarkTitle: 2BookmarkLevel: 3BookmarkPageNumber: 309BookmarkBeginBookmarkTitle: Literaturverzeichnis 317BookmarkLevel: 4BookmarkPageNumber: 309BookmarkBeginBookmarkTitle: 3BookmarkLevel: 3BookmarkPageNumber: 310BookmarkBeginBookmarkTitle: Über die Autorin 319BookmarkLevel: 4BookmarkPageNumber: 310BookmarkBeginBookmarkTitle:BookmarkLevel: 1BookmarkPageNumber: 102BookmarkBeginBookmarkTitle: Allm_310ff.pdfBookmarkLevel: 1BookmarkPageNumber: 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708.654PageMediaBeginPageMediaNumber: 326PageMediaRotation: 0PageMediaRect: 0 0 539 737PageMediaDimensions: 539 737PageMediaCropRect: 28.3465 28.3465 510.654 708.654PageLabelBeginPageLabelNewIndex: 1PageLabelStart: 1PageLabelNumStyle: UppercaseRomanNumeralsPageLabelBeginPageLabelNewIndex: 11PageLabelStart: 1PageLabelNumStyle: DecimalArabicNumeralsTitle: 3830493215Subject:Keywords:Author: HmailCreator: PDFCreator 3.3.0.2468Producer: PDFCreator 3.3.0.2468CreationDate: Mon Nov 19 16:33:04 2018ModDate: Mon Nov 19 16:33:04 2018Tagged: noForm: nonePages: 326Encrypted: noPage size: 482.308 x 680.308 ptsPage rot: 0File size: 2747097 bytesOptimized: noPDF version: 1.4 | 258 |
Oraler Glukose Toleranztest (OGTT) 252 | 258 |
Spezielles Prüfungs- und Praxiswissen | 261 |
1 | 262 |
Fragentraining zur Anamnese und Differenzial-diagnose 264 | 262 |
2 | 271 |
Lösungen 273 | 271 |
3 | 272 |
Fragentraining zur körperlichen Untersuchung und Differenzialdiagnose 274 | 272 |
4 | 291 |
Lösungen 293 | 291 |
5 | 293 |
Fragentraining zu Labor und Differenzialdiagnose 295 | 293 |
6 | 306 |
Lösungen 308 | 306 |
Anhang | 307 |
1 | 308 |
Sachverzeichnis 311 | 308 |
2 | 309 |
Literaturverzeichnis 317 | 309 |
3 | 310 |
Über die Autorin 319 | 310 |
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Allm_310ff.pdf | 1 |
Inhalt | 320 |
Klassische Anamneseerhebung mit differenzial-diagnostischen Überlegungen | 323 |