【My medical skills can add experience points】【】
Yang Chan is a very competitive woman.
She is the monitor of class 512, and her academic performance has always been one of the best in the class, so she is very proud of herself. Unexpectedly, after joining the work, Zhou Can surpassed him with mediocre grades, and the gap between the two seemed to be quite wide.
She didn't say anything, but deep in her heart she was panicked.
Only by pulling back a round can she be more comfortable.
People, especially those who are proud in their hearts, are more eager to prove that they are not inferior to others.
The relationship between Yang Chan and Zhou Can has always been delicate. In front of Zhou Can, she will always be the arrogant and domineering monitor. When Zhou Can is in trouble, she is obliged to help him without asking for anything in return.
Because she feels that she is the class monitor and has an obligation to take care of her classmates.
This time, she wants to let Zhou Can know that she is still that powerful squad leader, and her heroic demeanor is still there.
Just diagnosing sas disease is not her field of expertise.
She has already started racking her brains to deduce the cause of the patient. Whether it will be rewarded is hard to say yet.
Gao Jian is also trying to make a diagnosis.
The cause of the patient has a certain relationship with the central nervous system, and neurology is his strong point, so he has a certain advantage and is full of energy.
He also wanted to win a game against Zhou Can and regain his confidence.
In the past two years, Zhou Can has almost been overwhelmed, because Zhou Can is so good.
The better the competitor, the greater the pressure on the parties.
Compared with the two, Zhou Can is the calmest and most leisurely one. He is still conducting a deeper analysis based on the clues he found.
Just when several chief physicians were diagnosing the woman, an accident happened.
The woman originally just supported her huge head with both hands, half lying on the table. At this moment, he was lying on the table and fell asleep, snoring.
This little accident caused several doctors to look at each other in blank dismay, and then couldn't help smiling.
"Is she prone to falling asleep during the day at home?"
Zhou Can asked the family members the first question.
"Yes! This child is often sitting on the sofa watching TV, or talking to us, and suddenly falls asleep. Today, she followed us for a day's checkup at the hospital, and she may have been exhausted long ago. "
When the woman's mother looked at her daughter, her eyes were doting.
Parents must be responsible for raising their daughter so fat.
It is said that habitual children are like killing children.
When parents spoil their children too much, they don't really love them, but harm them.
"Does she sleep a lot during the day?"
Zhou Can wants to know whether the patient has daytime sleepiness.
"That's not long. My daughter sleeps very lightly during the day and wakes up easily." It seems that there is no drowsiness.
"Has she always snored this loudly?"
Zhou Can nodded and asked.
"It's not bad today. When it's severe, the door and glass of the room can feel the vibration. Doctor, my daughter snores loudly, does it mean that her lungs are strong?"
The woman's mother is actually proud of her daughter's loud snoring.
I really don't know what kind of weird parents this is.
"There doesn't seem to be any scientific basis for this!" Zhou Can tried his best to keep his tone as good as possible, otherwise his family members would be unhappy later, and it would be a bad idea to quarrel.
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【My medical skills can add experience points】【】
As far as he knew, the louder the snoring, the more blocked the airway.
It's just that the patient's mother is proud of it. If Zhou Can tells the truth, I'm afraid the family members will resent him immediately.
If it is central sleep apnea, it is usually mild intermittent snoring.
Her snoring seemed to be severe and not intermittent. Seems to favor obstructive sleep apnea.
The three chief physicians judged that this patient is likely to have mixed sleep apnea, which should be correct.
The etiological diagnosis of the mixed type is more complicated and the difficulty is much higher.
No wonder other hospitals did not work.
Suddenly, the patient's snoring stopped.
Her body began to move uneasily, and her face turned red from being suppressed a little bit. In the end, it seemed that the blocked airway was suddenly flushed open.
There was a long puffing sound from the mouth, and the exhaust gas in the body was expelled.
The patient's paused breathing then returns to normal.
Zhou Can, Director Zhang and others saw the patient's apnea with their own eyes. Apart from being shocked, they were more happy.
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Being able to see the symptoms with your own eyes is definitely helpful for diagnosis.
Just now when she resumes breathing, she needs to expel air from her mouth. Is it the nasal airway that is blocked?
This gives a direction to their diagnosis.
"When she was apnea, she didn't seem to have symptoms of the circulatory system. Such as high blood pressure, arrhythmia, myocardial infarction, etc. This is a relatively good phenomenon, at least she doesn't have to worry about causing other circulatory system diseases when she is apnea."
Zhang Bihua said.
Sleep apnea syndrome is very prone to combined symptoms of the circulatory system, respiratory system, nervous system, endocrine and metabolic systems.
The risk of these complications is even higher than sas disease itself.
"Inspiratory disorder, hypoxemia, and hypercapnia do not seem to be present, so that pulmonary hypertension and right ventricular failure will not be caused. The patient's condition should be mild, far from being extremely dangerous."
Zhou Can walked around to the patient's side while talking, carefully observing her neck.
The family members are quite snobbish, and they don't seem to trust him as a young doctor.
Standing there, just moved slightly to the side.
Zhou Can doesn't mind, he has been a doctor for so long, and he has seen all kinds of family members.
It is commonplace to suffer a little grievance.
That is to say, his current medical status has been promoted, and he can already be treated very well in front of superior doctors. In the past during the internship, if the status did not come up, it was really a double blow.
After the family members and patients scolded him, he would always have to scold him again when he was hospitalized, and the teacher's face was sometimes as black as dust.
After reading it, Zhou Can felt a little relieved.
Director Zhang has discussed the patient's condition with Deputy Director Shi and Director Jiang. However, the three did not have a substantial diagnostic breakthrough.
"Again, did she ever complain of a headache when she got up in the morning?"
Zhou Can decided to take a closer look.
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【My medical skills can add experience points】【】
"It seems that she really has this symptom. She often said that she didn't sleep well last night and her head hurt a little." The female patient's mother replied.
"Then has she ever had enuresis?"
Zhou Can already had a further judgment in his mind.
"Uh... Well, it doesn't seem to be there!" The patient's mother replied hesitantly.
Her eyes flickered and her complexion changed quickly, indicating that she was not telling the truth.
In fact, there are other ways for doctors to judge whether family members answer questions honestly.
For example, when lying, the eyes will look to the upper left, which means that the family members or patients are trying to fool the doctor. Eyes look up to the right, which means that they are recalling the past, and the possibility of telling the truth is higher.
Just now, when the female patient's mother answered, her eyes were looking to the upper left, and her eyes were wandering. She didn't dare to look at Zhou Can at all, and she was probably lying.
"You don't need to be ashamed of your daughter when you are sick. Tell us the real symptoms, which will help us find out her cause. As long as the cause is found out, it is possible to cure her sleep apnea syndrome. When the time comes , all her symptoms will disappear and her body will return to normal."
Zhou Can was persuasive and persuasive, drawing cakes for his family members.
The two family members found that Zhou Can could accurately describe some of their daughter's secret symptoms, and they couldn't help but think highly of this young doctor.
"Director Zhang, I suggest checking the patient's thyroid function."
Zhou Can made a diagnosis suggestion to Director Zhang.
Yang Chan and Gao Jian couldn't help being shocked. They didn't expect Zhou Can to have a diagnostic breakthrough so soon.
In other words, the two of them never stayed in the same department as Zhou Can.
Otherwise, this kind of thing will definitely be commonplace.
There are quite a few chief physicians who have been beaten by Zhou Can, not to mention the two of them, Gui Peisheng, who are at the same level.
They want to compete with a monster like Zhou Can, and they are more inclined to seek abuse.
"Why do you suspect that there is a problem with thyroid function?" Director Zhang did not express his opinion immediately, but was very curious about Zhou Can's diagnosis direction.
For central sleep apnea, the direction of diagnosis should be central neuropathy. Obstructive sleep apnea should be a disease of the respiratory tract.
Zhou Can jumped out of these two lesion directions and focused on the patient's thyroid gland. This kind of thinking mode of jumping out to see the problem is extremely rare.
"There are multiple reasons! First, look at the patient's neck. According to my clinical experience in general surgery, there should be a problem with her thyroid gland."
This ability to detect lesions from the patient's shape and appearance through visual inspection requires doctors to be well-informed and have rich clinical experience.
Zhou Can has rotated regular training in multiple surgical rooms, and the amount of surgeries he has performed is even more astonishing, which will have immeasurable benefits for his future clinical diagnosis.
For example, he can detect that the patient may have a malignant tumor through the patient's complexion.
Or like now, by looking at the patient's neck, it can be found that the patient's thyroid has a lesion.
Every doctor present has the ability to find potential lesions through inspection. It's just that their inspection ability is limited and their knowledge is relatively narrow, so they can't carry out inspections in all fields like Zhou Can.
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【My medical skills can add experience points】【】
Even Director Zhang Bihua is only good at the field of obstetrics and gynecology.
Regarding diseases in the field of general surgery, Director Zhang is not a layman, but his understanding in this area is relatively shallow, at most an elementary level.
In fact, the vast majority of chief physicians are like this. They are proficient in their fields of expertise and know a little about other medical fields.
"In addition, the patient found upper respiratory secretory edema during bronchoscopy, which is actually a typical endocrine and metabolic disease. Furthermore, the patient is prone to wakefulness, fat centripetal distribution, and muscle relaxation, which are also related to endocrine and metabolic disorders. Metabolic disease. If possible, it would be better to test her bone quality, this disease will definitely lead to osteoporosis."
Zhou Can gave his multiple diagnosis basis.
Other doctors either didn't notice these clues, or they didn't pay too much attention when they found them.
"Dr. Zhou's diagnosis is well-founded and logical. I think it should be adopted. What do Director Shi and Director Jiang mean?"
Zhang Bihua looked at the other two.
"I have no opinion."
Deputy Director Shi naturally agreed with it. Zhou Can represents the Department of Gastroenterology and wears the same pair of pants as him. Now that Zhou Can showed his face, he, a doctor of gastroenterology, also had a bright face.
"Agreed! Young people are awesome! Dr. Zhou is young and promising, and his diagnostic skills are first-class, which is really admirable."
Director Jiang already had a good impression of Zhou Can, and Director Tan of the Department of Internal Medicine has always liked Zhou Can very much.
Now that Zhou Can has made substantial progress in this difficult case, Director Jiang simply added the icing on the cake and praised Zhou Can a lot.
"Director Jiang praised me so much that I couldn't find it! I just happened to have accumulated experience in the field of general surgery, so I was able to discover something." Zhou Can felt ashamed for a while.
He was embarrassed by the head doctor's public praise.
Usually low-key, he found himself quite shy in this situation.
"Since the two directors agree with Dr. Zhou Can's opinion, I will apply for an examination for the patient." Zhang Bihua did not intend to discuss with the family members this time.
I believe that as long as the brains of the family members are not broken by the door, they will definitely agree.
In fact, the faces of the two family members already showed joyful expressions of anticipation at this moment.
After consulting so many hospitals, I finally made some fresh progress today.
Usually when I go to other hospitals, in addition to CT scans, I will check bronchoscopy and various biochemical tests. The final result is that there is no result, and the real cause of the disease has never been found out, and their daughter's illness has not been cured.
"Doctor Zhou, is it enough to only check the patient's thyroid function and osteoporosis?"
Director Zhang Bihua asked such a question, which shows that she is a very open-minded and pragmatic person.
If it was a more face-saving chief physician, he might put on airs, comment a few words as a teacher, and directly approve the examination application.
He would never ask a junior doctor for his opinion in public.
"Enough is enough!"
Zhou Can nodded repeatedly.
Director Zhang issued an examination application for the patient on the spot, and the family members happily accepted it, woke up their precious daughter, and took her for an examination.
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【My medical skills can add experience points】【】
When the female patient was woken up, she was still confused and asked her parents what was wrong?
The female patient's mother directly said to her daughter, "This young doctor Zhou and several experts have found out your cause of disease! Hurry up, hurry up, let's go for an examination. Oh, it's finally the right time today, picture The doctors in Ya Hospital are still very good, much better than those in other hospitals!"
What the family members said to the patient made several experts feel very cool and comfortable.
It is also the first time since they came here for consultation, they heard their family members praise the high level of Tuya Hospital.
A difficult case here has made a major breakthrough, and everyone is happy, but Du Leng's side is still in mourning.
He failed to diagnose the results of the first two difficult cases, so he scolded his mother and left.
Now for the third intractable case, he was also confused and couldn't find any clues.
This time, Du Leng learned to be smart.
Without waiting for the family members to scold her, he quickly let go of the worthless so-called face, and said to Zhang Bihua, "Director Zhang, Director Zhang, this patient has a low-grade fever, vision, hearing loss, and leg pain. A test showed abnormally elevated liver enzymes. , lymphocytes were 52%, and atypical lymphocytes accounted for 8%. Bone marrow aspiration showed active growth. The patient's erythrocyte sedimentation rate was also checked."
After Du Leng quickly reported the patient's basic situation, he continued.
"I'm only good at diagnosis of diseases in neurosurgery and nail and breast surgery. This patient's condition is complicated, which is really beyond my ability to diagnose and treat. Please help me and a few directors to take a look."
Humans are the most adaptable animals.
Du Leng was severely beaten by the society twice in a row, and he learned to bow his head.
If he didn't lower his head, his face would be swollen today.
That is to say, the family member of this patient is a middle-aged woman who is well dressed and has a good temperament. One can tell at a glance that they are the kind of high-quality people with a superior life.
If it was replaced by a violent family member, I'm afraid they would have scolded their mothers like the previous two family members.
Even if the patient's family members are of high quality, it does not mean that she is easy to speak.
Look at her delicately made-up face, which is as cold as ice. I'm afraid she is already extremely dissatisfied with Du Leng's diagnostic ability~www.mtlnovel.com~ That lady, please bring the patient here! Let's give her a joint diagnosis. "
Zhang Bihua said to his family members.
"Okay! Then I will trouble you!"
The family members came over with the patient, and her originally cold face also warmed up a bit.
When he left, he didn't look at Du Leng again, nor did he say hello.
It shows that she is already very dissatisfied with Du Leng.
The female patient looked very young, probably not more than twenty years old. She looks like her mother, a beauty embryo.
It's just that his face was sickly pale and flushed, his eyes were dull, and his expression showed pain. It seemed that he was severely tormented by the disease.
No matter how beautiful a person is, as long as he gets sick, he will soon be tortured out of shape.
Whether it is body shape, appearance, temperament, it will be a different person from the previous beauty and health.
"Have you been treated in another hospital?"
After Zhang Bihua took the patient's information, he motioned them to sit down.
"It has been cured. My daughter has been ill for a long time, almost two years. It was just an ordinary cold, and the next day she had a fever, nasal congestion, and runny nose. At that time, I thought it was just a small cold. , drink plenty of boiled water, take a good rest, and you will get better soon. Unexpectedly, after a few days, the illness still did not recover, and I felt a little anxious at that time. The child’s father has been on business trips abroad for a long time, and my usual work is also Busy, lack of concern for children..."
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【My medical skills can add experience points】【】
The words of the family members are full of self-blame.