My medical skills add experience

Chapter 328 Rats have rat ways, finally found out

Zhou Can looked at the back of the mother and son leaving, moved his lips, and finally swallowed the words back to his stomach.

Sigh instead.

The only thing in this world that can get something for nothing is poverty.She and her husband slept on the poker table all day long, lazing about work, which is doomed to the current result.This kind of lazy thinking has been deeply rooted in the couple's bones. The only way to make them hardworking and motivated is to be whipped by society and persuaded by relatives and friends.

Their children are the hope of saving the family.

If the child's illness is cured, he will go to school and get three good students every year, which will be enough for the couple to see a bright hope.They feel that after they have a bright future in life, they should think about finding a job.

Zhou Can sent the mother and child's name, address and other information to director Tang Fei.

"OK!"

She just returned one expression.

It is estimated that he is very busy, after all, he is the director of a large department.The workload is much greater than that of ordinary chief physicians.

Zhou Can just sent a message to Director Tang, and a new patient came in to see the doctor.

He is like a spinning top that has been whipped, and he devotes himself to the diagnosis and treatment work.

I thought there would be fewer patients in the afternoon, but I didn't expect that there would be an endless stream of patients, one after another.

At about three o'clock, he had already seen sixteen or seventeen new patients.

I really didn't expect that there would be such a large number of consultations on the first day of the official consultation.

Fortunately, I am quite lucky, most of the patients I see are common diseases.So far, only the little girl whose symptoms are similar to a cold but not a cold has not yet been diagnosed.

After seeing the patient in his hand, Zhou Can stood up and walked to the door.

"Are you busy now?"

He said to the guiding nurse.

"If you have anything to do, just ask Dr. Zhou, no matter how busy you are, it's not as important as yours!"

Most of the guide nurses are older and belong to a marginalized group of people.

Many of them are social recruitment, graduates from technical schools and so on.

Their wages are low and their status is low.Even the most ordinary resident doctor is the object they need to curry favor with.

The invisible hierarchical relationship of hospitals is actually very similar to the ancient feudal kingdom.

Those with low status will think of currying favor with those with high status in order to obtain convenience and care at work.At least, I have a good relationship with you, so you won't make things difficult for me at work.

This is the truest thought of most people.

"Can you help me check if the patient who fainted in the morning is awake?"

Zhou Can was somewhat worried about the grandparent and grandson.

"Ward 0, right? I'll just call you and ask the nurse over there. What's the patient's name?"

The guide nurse seemed to be familiar with the nurses in the inpatient department.

The snake has its way, and the rat has its way.

Even a very low-status guide nurse has her own network of contacts.

What exists is reasonable.

They can survive in the highly competitive hospital and have their own way of survival.

"I really didn't ask the old lady's name, I only know that her granddaughter is called Chen Ziya."

At that time, the old lady fainted immediately, and Zhou Can never had a chance to ask her name.

"It's okay, I'll call and ask the nurse over there to find out."

The guiding nurse smiled and took out her mobile phone and began to look up the phone number.

"That's hard work for you!"

Zhou Can has a good impression of this guiding nurse, she handles affairs quickly and has a good attitude.

"Come on, whose turn is it to see a doctor next? Come in!"

Zhou Can looked at the patient sitting in the corridor waiting for treatment.

"It's my time, it's my time!"

A woman holding a child stood up and followed Zhou Can into the consulting room.

"Please sit down!"

Zhou Can beckoned the woman to sit down, and her eyes naturally fell on the child she was holding.

The people who come to see a doctor here are all children, and occasionally there will be babies who are a few months old, but such patients generally do not seek medical treatment from young doctors like Zhou Can, at least they will use the name of the deputy director.

Unless there is really no number, then a general outpatient number will be registered.

The child held in the woman's arms looked thin and small, and buried his head in his mother's arms, not moving much.

When Zhou Can saw the purple skin on the little boy's neck, his pupils shrank.

He was about to sit down, but stood up quickly.

"What's wrong with this kid?"

"It's just that I don't like to move very much, and I eat very little." The child's mother seemed very calm.

"Has his skin always been this color?"

The skin of the child's whole body was a little cyanotic. Zhou Can first felt that the child's body lacked oxygen.

But the child's mother was very calm, indicating that this situation is no longer a day or two.

"That's right! My son was born with reddish-purple skin. Later, as he grew up, the color seemed to get darker. Many friends and elders joked that my son was born with precious life, and Ziwei Xing came into the world! "

The woman replied with a smile.

Zhou Can was speechless for a while, really ignorant and fearless.

The cyanosis of the skin has become like this, which is obviously caused by hypoxia. How could it be that life is precious?
"His breathing seems a little heavy!"

When Zhou Can heard the boy panting, there was a loud noise.

Explain that the boy needs to inhale hard to maintain his body's oxygen needs.In fact, this is also a manifestation of hypoxia.

When normal people do some strenuous exercise, because the oxygen in the blood is rapidly consumed, the body's demand for oxygen increases, so they will instinctively "huh" and pant.

"My friends said that my son has a strong lung capacity, which is why he breathes so heavily. My son is naturally extraordinary!"

The child's mother praised her son with a little pride.

Zhou Can was speechless again.

What is self-confidence?
This woman is probably a good example of that.

When her friends saw the child, they would definitely say something nice. Did they just say that there was something wrong with her child?I believe that there are no people with such low emotional intelligence.

Others flattered her, but she took it seriously.

"I came to see the doctor this time because the child doesn't like to move and eats less, isn't it?"

Zhou Can asked about the child's condition while measuring the child's physical signs.

"Yes! There are only two small problems. Doctor, do you think my son is born with a noble personality, so he will be like the emperor on TV, pampered and not active every day?"

The logic of this woman is really convincing.

Simply amazing.

"Well, there is such a possibility." Zhou Can actually nodded cooperatively.

This kind of person must not argue with her, otherwise it will be easy to quarrel.

According to her words, this is a more sensible approach.

The purpose of a doctor is to cure the disease, not to correct some views of the family members.

In fact, the thinking of every adult is extremely stubborn, so don't try to change it.Otherwise, not only will they not be able to change the other party, but they will also become enemies.

"Then tell me, my son doesn't like to eat, is he born with the emperor's life?"

This woman is really amazing.

"Why do you say that?" Zhou Can asked her back.

"Think about it! The emperor eats delicacies from mountains and seas every day, so ordinary food can't whet his appetite at all." The woman replied seriously.

"Yes, what you said is right. You can get more delicacies from mountains and seas for your son in the future. You see, he is really too thin. From the perspective of our doctors, this is called malnutrition."

Zhou Can persuaded the young mother from the side.

Looking at the age of 30, it should be almost the same, so why are you still so naive?I wonder if she has watched too many TV shows.

After a preliminary physical examination, Zhou Can found that the little boy had stunted growth, malnutrition, severe cyanosis, clubbed fingers, whistling sound in the intercostals when breathing, low blood pressure, and weak pulse...

There is a big problem with this kid's body.

"Has the child had a physical examination?"

"I did it once. The young doctor who did the physical examination at the community medical service station talked nonsense, saying that my child might have a serious illness, and I scolded him. I haven't taken my son for a physical examination since then. I His son is so good, how could he have a serious illness? Some doctors like to scare people, just to trick patients into buying more medicine."

The woman was still indignant when she mentioned this matter.

Zhou Can couldn't help wiping the cold sweat from his forehead.

Fortunately, I didn't argue with the woman just now.Otherwise, he would be the next person to quarrel with this woman.

"When I was measuring your child's heart rate just now, I heard a screaming sound. I will give him an echocardiogram first, and you will take him to check a two-dimensional echocardiogram."

Zhou Can said to his family.

"Okay! So do you think my son's problem is serious?"

The woman had a pleasant conversation with Zhou Can before, so she agreed very readily.

"It's hard to say, let's see if there is any problem with the heart!"

Zhou Can felt that there must be a serious problem with this child, but the doctor at the community medical service station was scolded bloody for telling the truth.How dare Zhou Can tell the truth again!
We will wait until the test results come out.

At that time, with the support of inspection data, no matter how big the truth is, I will be confident.

After the mother and son were sent away, another new patient came into the consultation room.

"Please sit down and wait for a while, I will check the results of a patient in the morning first."

After Zhou Can greeted the family members and patients, he directly searched for the little girl named Chen Ziya in the consultation system.

Tuya Hospital has now realized the information network.After the test results come out, the laboratory will transmit them to the hospital intranet, and patients or family members can print them with their ID card information.

It is much more convenient than having to rummage through a large pile of information in the window before.

The receiving doctor can directly view all the examination results of the patient in the system.It's just that many doctors will wait for the patient to come with a paper examination report before checking it.

On the one hand, doctors are very busy with their work and don't have time to see them one by one.

In addition, if the patient is not present, even if the doctor diagnoses the cause, he still has to wait for the patient to come and have a face-to-face conversation.

It is definitely not the cold and lazy doctor that the family thinks.

Zhou Can quickly found Chen Ziya's name.

After clicking on it, he found that the little girl's biochemical test results had finally come out.

The data of LDH, CK, AST, and ALT were all higher than the normal value.Among them, the value of aspartate aminotransferase is even more frighteningly high.

"What kind of disease is this?"

After reading the results of the biochemical test, he quickly screened the diseases that might match the number in his mind.

But he racked his brains and still couldn't find a disease that matched these symptoms.

At this moment, he really hated the book when it was time to use it.

Basic medical knowledge is vast, and it is almost impossible to learn all of it.The main reason is that a doctor's energy and time are limited.

Learning is a long process.

He still insists on reading every day, and is trying to catch up on basic medical knowledge every day.

This can't be rushed, it can only accumulate over time.

Otherwise, why do doctors become more popular as they get older?Because some doctors really live to learn.Well-informed and experienced, their diagnostic efficiency is indeed much higher than that of young doctors.

There is a much lower chance of misdiagnosis and missed diagnosis.

"White blood cells and platelets are reduced, and there is also protein in the urine. Now the aspartate aminotransferase is also scary high. Could it be poisoning?"

There is this possibility.

Because symptoms similar to those of the little girl have also begun to appear in the little girl's grandmother.

The grandparent and grandson ate poisonous food and were poisoned. This possibility is real.

At this time, the door of the consulting room was pushed open, and the receiving nurse poked her head in.

"Doctor Zhou, I have already asked what you asked me to ask. The old lady has woken up and her symptoms have been relieved. She is worried about her granddaughter's condition and asked to come to see you."

It's good that people are already awake.

"Tell that old lady that you don't need to come here. I am diagnosing her granddaughter. When the time comes to find out the cause, I will take the initiative to find her."

Zhou Can was still a little worried about what kind of infectious disease the grandfather and grandson had.

If transmission occurs at that time, it will cause serious harm to other patients and their families.

Besides, the little girl's illness has not been found out yet, so it's useless to come to him.

If it is really poisoning, infectious diseases can be ruled out.

"If it wasn't poisoning, then what could be the reason?" Zhou Can couldn't help but brighten his eyes after thinking hard.

How did you forget about this?

If there is no food poisoning, there is another possibility, that is viral infection.

As long as one of the grandparents and grandchildren is infected with the virus, it is possible to infect the other.

The more I think about it, the more it makes sense.

Either way, it's always a good idea to check first.

Serological testing is a more efficient way to screen for virus infection.

He immediately issued an inspection application form, and then gave the patient a serological test.

After treatment, continue to see other patients.

When it was close to 04:30, he took the time to look at the results of Sun Ziya's serum test.

Fortunately, the result has come out.

Igm antibody and IgG antibody were positive.

These two data are elevated, and the antibody is positive, which means that the patient is likely to be really infected with a certain virus drug.

Under normal circumstances, after a patient is infected with a pathogenic microorganism, the body will produce specific antibodies against the pathogenic microorganism, and IgM and IgG will be positive.

Zhou Can couldn't help being excited. Now that the diagnosis can be basically confirmed, the patient is very likely to have a virus infection.

A cold is usually an infection of the influenza virus, which is also a viral infection.

But Zhou Can directly ruled out the influenza virus infection.Because the patient's examination data is obviously inconsistent with influenza.

Elevated IgM can be seen in macroglobulinemia and primary biliary cholangitis.

Significantly elevated IgG is common in autoimmune diseases.

Both monoclonal increases, and other immune blood proteins decreased significantly, it is likely to be multiple myeloma.

Zhou Can insisted on his own direction of diagnosis, that is, he determined that the patient was likely to be infected with a virus.And it's a relatively rare virus.

If it was a common viral infection, it would not bother him at all, and it would have been diagnosed 800 years earlier.

"I'm afraid I have to check the information!"

After he couldn't figure out which virus the patient was infected with, he decided to learn from his predecessors.Didn't Director Dai also bring the Children's Clinical Handbook with him when he first came to the clinic, and secretly flipped through the book when he encountered an undiagnosed disease?

What he encountered now was an extremely difficult case, and there was no shame in checking the information.

Thanks to the rapid development of smart phones and the Internet, doctors no longer need to sneak into the outpatient room with thick medical books to check information.

Just use your mobile phone to find relevant information on the Internet.

However, there is a lot of medical knowledge, and it is still faster and more convenient to look up some specialized medical classics.

After some searching, a relatively rare disease name came into his vision.

Novel bunyavirus.

Patients infected with this virus will experience various symptoms in their bodies.These include fever and thrombocytopenia syndrome.

"It should be that the disease is correct! If an etiology test can be done, the diagnosis result will be more accurate."

Looking at the time, Zhou Can suppressed his urgency to tell the patient the diagnosis, and then applied to the laboratory for an etiology test.In fact, this is also a blood test.Only this time the new bunyavirus was isolated directly from serum.

(End of this chapter)