Director Luo followed Zheng Ren. Seeing that Mao Chi had nothing to say, he immediately asked: "Boss Zheng, that patient from Massachusetts, how did you determine that there was a thyroid problem?"
The topic changed a bit too quickly. Zheng Ren was slightly startled, then smiled and said: "Director Luo, have you noticed that the patient had no mental symptoms before admission, but then he appeared inexplicably after admission?"
"It may be that the doctor made a wrong diagnosis, or the patient himself had unclear narrative or temporary amnesia." Director Luo said.
"You are right." Zheng Ren said gently: "I also thought about it at the beginning, but I couldn't find what the disease was. I simulated the patient's situation after being admitted to the hospital again, and found that we had forgotten an important thing. "
It's so important to use this adjective. Director Luo was stunned for a moment. Did he forget something
"The patient had an enhanced CT after being admitted to the hospital." Zheng Ren said with a smile, "So I focused my suspicion on the iodine-containing contrast agent."
"..." Director Luo then remembered that the first thing shown to him was the CT enhanced film.
To enhance CT, a contrast agent is needed.
The contrast agent used for enhancement will definitely not be the barium agent used for upper gastrointestinal barium dialysis, but will be iodine preparations. Regardless of whether it is inorganic iodide, organic iodide, lipiodol, or fatty acid iodide, it contains a large amount of iodine.
Director Luo has a very high IQ. In that era, anyone who could climb from the countryside to the 912 department director had a special skill. Whether it's IQ or anything else, it's the best choice.
Zheng Ren raised his head, and Director Luo immediately thought of the last thing.
Because the patient's initial diagnosis was vomiting, and the reason for admission was due to an electrical fire, no one considered thyroid storm.
High iodine load may cause the Wolff-Chaikoff effect in the patient's thyroid gland, which is a decrease in thyroid hormone secretion after giving a large amount of iodine, just like the situation encountered in imaging examinations, leading to an emergency stop of thyroid hormone synthesis.
During a previous hospitalization, the patient received a high iodine load during intravenous contrast administration for an abdominal CT examination after developing similar symptoms that were likely related to undiagnosed hyperthyroidism, which may have resulted in similar symptoms. Effect.
Therefore, the short-term suppressive effect of iodine loading on the patient's thyroid is likely to fail, and the patient will develop severe hyperthyroidism again, leading to this clinical manifestation and hospitalization.
Director Luo thought clearly, but for a moment he was immersed in his thoughts and froze in place.
"Lao Luo? What are you thinking about?" Mao Chi turned around and asked in surprise.
"Uh..." Director Luo heard Mao Chi calling him, thought again, and said with a wry smile: "Director Mao, do you think Boss Zheng's surgery was good?"
Mao Chi didn't expect Director Luo to ask this. He didn't know what he meant, so he just nodded.
"Boss Zheng's diagnosis level can only be better than surgery." Director Luo sighed.
Mao Chi's first thought was - that's impossible!
Surgeons perform surgeries all year round and spend at least 6-8 hours on the operating table every day.
Not to mention studying, I was exhausted after I stepped off the stage. I still had to write surgical records, see patients, and handle admissions. Normal life will be affected. When can I have a girlfriend is a question.
As for diagnosis…
It would be nice if we could understand common diseases, but who has the time and energy to study those rare diseases
From the perspective of doctors, the diagnosis and treatment of rare diseases is like a stunt to slay a dragon. When you meet others, you can do it yourself, which is really awesome.
But is it really useful
It is said to be a rare disease because it is so rare that only one case is not seen in a year and a half, so it is called a rare disease.
The common diseases we deal with every day are enough for people to spend a lifetime studying.
And as for diagnostic level…
Mao Chi shook his head slightly.
Anyway, if you think carefully about what Boss Zheng and Director Luo were talking about just now, you can understand it.
But Mao Chi was too lazy to think about what the hell was thyroid crisis. Regardless of diagnosis and treatment, just hearing about it made his head grow into two.
As long as you take responsibility for your part and don't feel guilty when someone comes to see you, it's enough.
As for thyroid storm, isn't there an endocrinology department and a gland surgery department? I was in 912, not a private hospital with a fancy name like International Hospital.
After walking a few more steps, Director Luo became more and more surprised as he thought about it.
At first, I admired it, but after I figured it out, I went through it again and found that it looked very simple, but it is actually quite difficult to find this factor in the patient's complicated disease information.
"Boss Zheng, your diagnostic skills..." Director Luo sighed and said, "Amazing!"
"Director Luo, please stop praising him." Su Yun followed behind and said with a smile: "It's just a thyroid crisis, it's not a big problem. Look at my equipment, is it well prepared?"
Director Luo had no choice but to nod and said, "It's really good."
"If you have the opportunity to come for a consultation, please allow me an hour next time and I will show you a miracle." Su Yun said with a smile.
Director Luo is still a relatively traditional doctor, and he can't accept Su Yun's gorgeous consultation model.
What’s the use of making it look glamorous? In the end, it is not necessary to find out the diagnosis of the disease from countless lines.
But he knew Su Yun's status in the medical team. Boss Zheng didn't say anything, so he shouldn't follow suit.
…
…
They said they should write a song soon...
Zheng Ren's cell phone rang. He glanced at it and answered the call.
"Brother Song, hello." Zheng Ren greeted gently.
"Oh, I just had an operation. It was a hybrid operating room. The lead plate was too thick and the signal was not good."
"There's something wrong with me... How about another day?"
Seeing Zheng Ren's firm refusal, Su Yun laughed and said, "Did Master Yan come with a thank you gift?"
Zheng Ren nodded.
"Call me." Su Yun said, "Director Mao, I'm afraid you won't have a chance to treat me today."
Mao Chi glared and said: "No one can compete with me to pay the bill today."
"Do you mind having a few more people?" Su Yun asked with a smile.
Of course Mao Chi wouldn't mind if he said all this.
There really aren't many people with social phobia like my boss.
"Brother Song, I'm Su Yun." Su Yun grabbed the phone and said, "The boss just saved a station. We'll rush there right away. Are you at your Tang and Song Restaurant?"
"Okay, see you later."
After speaking, Su Yun returned the phone to Zheng Ren.
Zheng Ren felt a little strange.