blenderwars Chapter 309
Chapter 309
Chapter 309
Therefore, it is imperative,
Lin Feng wants to check the heart, liver, kidney…
Ask the doctor first:
first step,
Ask heart questions:
“Have you ever had a history of heart disease? Or does your loved one have any genetic heart disease?”
Lin Feng asked the female patient seriously.
The female patient shook her head repeatedly: “No, absolutely no, no history of heart disease, no history of genetic disease…”
Lin Feng nodded.
Although there is no medical history, heart problems cannot be ruled out because the patient has fever and cough.
It is possible that the virus of pneumonia infects the myocardium and then causes “viral myocarditis.” It is possible to cause heart failure, and heart failure can lead to edema.
Wait a minute, you can do an “electrocardiogram,” “heart color Doppler ultrasound,” or “myocardial enzyme spectrum,” and you can check this thing.
…
The second step, liver:
Lin Feng continued to ask, “What about the liver and kidney? Is there hepatitis B or something?”
Speaking of this, the female patient hesitated.
“It seems there is, and it doesn’t seem to be…”
Lin Feng frowned: “What do you mean?”
Female patient: “It was a very young age. I don’t remember it clearly now. I don’t know if it is hepatitis B. I want to ask my mother…”
Lin Feng: “Then you can call quickly…”
The female patient quickly called her mother, and the phone was quickly connected.
Telephone power amplifier.
“Mom, did I have hepatitis B when I was a kid?”
“Hepatitis B, yes… Xiaoyun, what’s wrong with you? Why did you suddenly ask about this? Are you sick?” The voice on the other side of the phone suddenly became anxious.
“No, no, mom, I just remembered 08 suddenly and wanted to ask…” the female patient hurriedly comforted.
Mother is in her hometown, and she doesn’t want her to worry about it.
“That’s good… At that time, hepatitis B was serious, and you had a fever and vomiting for a few days…”
“Oh, okay, okay…”
After chatting for a few words, the female patient hung up with her mother.
Look at Lin Feng.
Lin Feng pondered.
If the mother of the female patient did not tell lies, the female patient had had “hepatitis B” when she was a child.
If hepatitis B is not treated for a long time, it will further develop into “cirrhosis” or “liver cancer.”
Whether it is “cirrhosis” or “liver cancer”, the liver cannot produce enough protein, which will cause edema.
so,
Later, a “liver function” and “hepatitis B two-and-a-half” check will be done.
…
third step,
kidney,
“Have you had kidney inheritance before? Or related medical history?”
“No.”
Lin Feng nodded.
If not, then only “kidney function” can be checked.
…
After the consultation,
Lin Feng began to open the order.
“You wait, do these kinds of checks…”
·Heart: “Electrocardiogram”, “Heart Color Doppler Ultrasound”, “Myocardial Enzyme Spectrum”…
·Liver: “Liver function”, “Hepatitis B in two and a half”…
·Kidney: “Kidney function”…
Lin Feng brushes…
billing……
Because there are a lot of inspections, Lin Feng explained.
“I think your cough may not be caused by pneumonia, but now you have lower extremity edema. It is best to find out the cause. Maybe the cough is due to this reason. It is not necessarily because of this reason… So the examination is a bit more…”
Patients trust the doctor or Lin Feng more.
“Thank you Dr. Lin, let’s go for the check up now…”
“Um.”
Lin Feng watched the couple and took the checklist to do the check…
…
Lin Feng returned to the emergency room and diagnosed 9 patients…
Then the couple came back with numerous examination results.
Lin Feng looked at it:
·ECG: Normal
·Cardiac ultrasound: normal
·Myocardial enzyme spectrum: normal
In other words,
Heart, no problem! !
Lin Feng breathed a sigh of relief.
The next step is to build a factory for the liver.
·Two and a half pairs of hepatitis B: negative (normal)
·Liver function: More than a dozen indicators are normal, except that “albumin” is only 22g/L (normally 35g/L or more).
“……………………”
Lin Feng frowned.
The albumin is one-third less!
What caused it?
There can only be two reasons:
· Reason 1: The liver produces less albumin.
· Reason 2: The albumin is lost.
However, there is no problem with liver function, so rule out cause one!
It can only be reason two!
So the question is: where will albumin be lost?
Lin Feng looked at the “kidney function” checklist.
·Renal function results: other normal values fluctuate, only one indicator “serum creatinine” is 281μmol/L (normal female 70.7～106.1μmol/L)
It is nearly 2 times higher than the normal value!
Suddenly Lin Feng’s idea aroused!
The clinical significance of the increase in blood creatinine is: renal failure, uremia, heart failure, gigantism, acromegaly, salicylate therapy, etc…
so,
Kidney, something went wrong!
This can also explain why albumin is “lost”!
Because of some kidney diseases, the permeable membrane of the kidney will become larger, and then albumin will leak out and be excreted with urine.
Now re-derive it:
The female patient had a kidney problem, resulting in high blood creatinine, resulting in leakage of albumin, and edema of the lower extremities.
So, the answer points to:
There is a problem with the female patient’s kidney!
However, there are many kidney diseases, and everything needs further examination.
Moreover, Lin Feng thought of a problem: Kidney damage may not be the first episode, it may be pneumonia infection, which leads to kidney function damage, and then leads to edema, low albumin, high blood creatinine…
so,
Thinking about it this way, it seems that what the patient should do now is to find the problem of lung disease, and kidney disease is secondary.
Lin Feng: “…………………………”
I feel like I’ve gone wrong~~~
Tragic! !
…
Lin Feng temporarily gave up the cause of kidney damage.
He set his sights on pneumonia again.
Once again, physical examination:
·Edema…
·cough……
·White phlegm…
·Recurring fever…
Then I read the checklist over and over again…
Still no problem…
Lin Feng suddenly felt tricky!
It’s too hard!
Lin Feng got up and said, “Let’s go back and look through the book to see if I can find the answer…change the medicine today…”
drug,
First of all, drugs to fight kidney damage, as well as pneumonia…
For the most serious pneumonia, Lin Feng decided to use “Cistastatin (Tai Neng)”.
This “Tai Neng” is an upgraded version of antibiotics, covering a wide range, covering almost all bacteria.
Taenon is usually used for severe infections and fatal infections.
…
This day’s work is over.
Lin Feng gets off work.
Female patients are put under the supervision of other doctors.
This is the first time that Lin Feng’s patient has been stumped, so after Lin Feng came home from get off work, he was full of this patient in his mind.
Sitting on the sofa,
Searching for hundreds of thousands of case experiences in memory.
“The patient has no rash…”
“Liver function is basically normal again…”
“The infectious disease may be very small…”
“But the patient has repeatedly recurred fever…”
Lin Feng thought of many diseases…
But then he shook his head and ruled it out.
…
I thought about it all night, but didn’t find the cause…
the next day,
Continue to work and hand in with the doctor…
result,
It was discovered that the patient had been plugged into the tube and on the ventilator.
Lin Feng’s expression changed: “What happened?”
The doctor on duty said tiredly: “There was an accident last night and was sent to the emergency room… The patient suffered from respiratory distress, CT examination revealed non-cardiogenic pulmonary edema… The fastest heart rate at that time reached 160, sinus tachycardia… …”
When Lin Feng heard this, he immediately knew the seriousness of the matter.
It seemed very dangerous last night!
Moreover, the medicine “Tai Neng” given yesterday has no effect!
What kind of disease is this?
Female patient: “Doctor Lin…”
Lin Feng approached: “How is the situation now?”
The female patient was panting and pale: “Help me…”
Compared to yesterday, she was obviously more vulnerable, like a candle in the wind.
Lin Feng’s heart ached, and he solemnly nodded his head: “Relax, the god of death has never snatched a patient from me. I will definitely work hard to find the cause of the disease… I will now find you a doctor in each department for a consultation…”
At the conference, Lin Feng has no rights.
However, in the small consultation, Lin Feng still has this kind of affection, and many doctors will give Lin Feng this face.
As soon as the female patient heard it, the light of hope suddenly appeared.
Sudden,
Lin Feng was taken aback!
He found a problem.
The female patient’s palpebral conjunctiva is hyperemia…the bulbar conjunctiva also seems to be a little edema…
Crackling~~~~~
A flash of lightning flashed through Lin Feng’s mind!
Wow~~~
Lin Feng jerked the sleeve of the patient’s gown.
Show your arms!
I saw that there were bleeding spots on the skin and mucous membranes!
This is not available yesterday!
He thought of a special disease!
“Hantavirus Pulmonary Syndrome”
Its symptoms: cough, shortness of breath, bleeding spots, exhaustion, arrhythmia…
It’s so similar to the symptoms of the patient in front of me! !
The cause of “hantavirus pulmonary syndrome” is “hantavirus.”
The “Hantavirus” can cause “hemorrhagic fever with renal syndrome”, which happens to cause kidney damage in female patients (decrease in albumin and increase in serum creatinine)!
That’s it!
The symptoms are right!
Lin Feng was excited!
Lin Feng hurriedly asked: “Ask a question, do you have mice in your house?”
When the female patient heard this, she was surprised: “Huh? How did you know that there are rats in my house? Dr. Lin? Not only do there are, but there are many more. My house lives in the basement. There are often rats. How can they be killed… Wait, Dr. Lin, Did you find the cause?”
Her sick eyes suddenly brightened!
Lin Feng nodded: “If you have a lot of mice in your house, it is very likely that it is “Hantavirus”! ”
“Hantavirus”, mice are the biggest source of infection!
“Xiao Ai…”
“Doctor Lin…”
“Immediately give Ms. Qiu a “hantavirus antibody test”, talk to the laboratory department, and join the team…”
“Yes!”
Lin Feng was relieved.
He grinned and laughed.
All the symptoms of the female patient, such as cough, pneumonia, kidney damage, respiratory failure…all corresponded!
He dared to conclude that it was definitely the “Hantavirus”, and he didn’t run away!
. .