My medical skills add experience

Is there a perfect score for Chapter 15?
The diagnosis result represents the pathological conclusion given by the receiving doctor, and the subsequent treatment plan will also be carried out around the diagnosis result.If misdiagnosed, it can easily lead to medical accidents.

In the attitude of being responsible to the patient, since you have doubts, you cannot fill in the diagnosis opinion.

He felt that it was necessary to know whether the patient had a past medical history.

"Medical history inquiry."

After entering four words, the patient's medical history information will pop up.

"The patient has no past history of heart disease, and relatives within three generations of the family also have no history of heart disease."

This means that there is no such thing as family inheritance.

The patient's heart should have been healthy before.

"The illness has passed."

He typed four more characters.

Originally, this information should appear in the column of physical examination.But no.

Only targeted queries will display that information.

Zhou Can vaguely realized that this was probably because the examiner deliberately concealed some information.Or think that this information is not important, so it is omitted.

"Before the onset of the disease, the patient lost his job and divorced his wife. When he lived alone, he suddenly developed symptoms of chest pain and dyspnea."

Zhou Can's eyes lit up slightly when he saw the patient's information.

Always feel that something is not right.

Thinking about it now, it should not show the patient's medical history and course of disease.

Losing a job is bad enough in itself, and the mood must be low.

At this time, there is no comfort, and his wife divorced him instead, which is tantamount to making matters worse.

The greatest grief is death.

When a person is extremely sad and in extreme pain, symptoms such as chest pain and dyspnea are prone to occur.

Zhou Can's eyes became more and more determined, and his wisdom shone brightly.

"Emergency visit, chest pain, dyspnea, elevated troponin, and myocardial infarction in the electrocardiogram. From the very beginning, candidates entered the wrong circle of acute myocardial infarction with preconceived ideas."

Looking at the candidates who were complacent after completing the diagnosis results, Zhou Can couldn't help shaking his head slightly.

These candidates are afraid that they will lose points.

To find out whether a patient has myocardial infarction, the most authoritative examination is not an electrocardiogram or an X-ray, but a coronary angiography.

X-rays do not detect blood clots.

Only coronary angiography is the only authoritative and effective detection method.

This examination is usually performed by an experienced cardiothoracic physician.A needle is injected into the femoral artery at the base of the patient's thigh, and a guide wire is inserted.

Keep pushing the guide wire deep into the blood vessel, wait until the guide wire reaches the abdominal aorta, continue to push, then reach the thoracic aorta, pass through the aortic arch, and finally enter the coronary artery.

Once the guidewire is successfully placed, a catheter can be placed over the guidewire.

What are you doing?

The contrast agent is injected into the catheter, and it can reach the coronary arteries smoothly.

At this time, do X-ray again, and it can be developed.

Can clearly see whether the coronary artery is blocked, and even where the narrowing can be seen at a glance.

Zhou Can resolutely quit the diagnosis filling page, but returned to the medical examination application page.

"Application for coronary angiography examination."

He decisively submitted a new inspection application.

"Congratulations on getting the extra points for the supplementary check."

The examiner is really mean.

It has set up layers of confusion and fog for the candidates. It requires candidates to have strong concentration, high-level diagnostic ability, meticulous observation ability, and rigorous and responsible attitude to uncover all the fog and go to the hospital. Pseudo-truth.

Scolding is scolding, it is undeniable that the exam questions given by the examiner are really good.

It can find out the real elites from more than 1500 outstanding candidates to the greatest extent.

Recruit the most potential talents for Tuya Hospital.

"Okay, I believe that many candidates have already filled out the diagnosis results, now please give your treatment plan."

An imperceptible smirk appeared on the corner of the examiner's mouth.

It was clearly a scheming scheme that had succeeded, and he smiled triumphantly as he watched the candidates fall into the deep pit he had dug.

Zhou Can ignored the examiner's urging, but carefully checked the results of the coronary angiography.

Angiography results showed that the patient's coronary arteries were normal.

There was no myocardial infarction.

Zhou Can showed a knowing smile.

"Sure enough."

The next step is simple, go to the diagnosis result page and write "The patient's heart muscle is normal, and he has symptoms similar to myocardial infarction due to violent mood swings."

After submitting the diagnosis result, the treatment plan page will pop up.

He cursed secretly in his heart, the examiner is a chicken thief.

After the previous inspection items are submitted, the score will pop up immediately, telling the candidates that the inspection items are correct.

At the step of submitting the diagnosis results, there is no prompt, and it directly jumps to the treatment plan page.

I believe that many candidates will always be kept in the dark.

Proper rhythm of being cheated to death by the examiner.

Students and examiners are natural enemies.This is Zhou Can's conclusion.

In the column of the treatment plan, he filled in "recommended psychological counseling."

Then submit.

The next step is to wait patiently for the examiner to announce the results.

"Fortunately, I upgraded the pathological diagnosis to the third level, otherwise I might fail at the first stage of the interview."

His gaze swept over the other candidates, some of whom were still filling out seriously with their heads down.

Needless to say, nine out of ten of these low-headed people fell into the pit.

The treatment plan for acute myocardial infarction is very long, and there is no more than ten or twenty minutes to finish it.

From a medical point of view, if the diagnosis is wrong, no matter how detailed the subsequent treatment plan is, it is all wrong.

This is somewhat similar to the multiplication rule.

As long as the multiplier is zero, it doesn't matter how many multiplicands there are, the result is still zero.

He was in a panic, and looked up at the nursing candidate recruitment side.

All the young and beautiful girls are very seductive.

Seeing him in a happy mood, he has the urge to fall in love.

They have also reached the interview stage and are competing for basic skills such as injections.

When I saw a doctor, I met a nurse who gave injections of horizontal vegetables, and I suffered a lot.

If you draw blood, she can prick you with more than a dozen needles because she can't find a vein.The simplest intramuscular injection can pierce your bones with one needle, guaranteed to make you want to die.

When you want to scold your mother, seeing that the other party is a young and beautiful girl, you feel a little bit unbearable.He swallowed the words that had just reached his lips.

"Candidates who have not yet submitted their diagnosis results and treatment plans please hurry up, there are still 60 seconds left."

The examiner's voice drew Zhou Can's attention back.

After the deadline was given, the candidates speeded up their filling.

"Time is up! Now you can check the pathological diagnosis score."

Candidates can't wait to check the answers.

"Ah...how come my score is only 2 points?"

"Examiner, is there a mistake in the scoring system? My inspection items are all correct, and the subsequent diagnosis results and treatment plan are also correct. Why do I only get 5 points?"

"My score is also 5 points. There must be a mistake in scoring."

……

Candidates complained one after another, and the examination room became a mess.

Candidates for nursing and medical technical training also turned their heads to look this way.

Wondering what the hell happened?

"What are you shouting about? What are you shouting about? Keep quiet for me."

The examiner shouted angrily, no one dared to challenge his authority, and told the aggrieved candidates to quiet down.

It's just the anger on their faces expressing their strong dissatisfaction.

If the examination room doesn't give a reasonable explanation, they will definitely make trouble again.

"Do you know why your scores are low? The total score for pathological diagnosis is 30 points. Most of the examinees with a score lower than 10 only answered part of the previous inspection items correctly."

When this statement came out, the whole audience was shocked.

Candidates who scored below 10 began to re-examine the questions, trying to find where they might have gone wrong.

"This, this can't be wrong! The patient has low blood pressure, elevated troponin, and an electrocardiogram showing a myocardial infarction at the same time. Isn't this acute myocardial infarction?"

Candidates who answered incorrectly were confused.

The examiner smiled slightly, "Pathological diagnosis can't just look at the appearance. It is possible that what we see and hear will deceive us. This requires us to carefully screen out the false and keep the true, so that we will not be misdiagnosed in the end. For the topic just now, there are Candidates with full marks?"

(End of this chapter)