"Let's be honest, why I say it is the most critical step and a half is because the most common thing is to die in the light. Of course, this refers to online chatting. If you can still go to the appointment after seeing your appearance, it is probably possible. .”
"..." Zheng Ren really wanted to kill this guy.
"Don't be nervous when you meet. Let's have a casual chat and say something to make her happy." Su Yun continued: "Then the most critical step is the second invitation. If you can make an appointment a second time, it proves that it's nothing. The problem is, as long as you don’t seek death, it should be done.”
"Uh..." Zhou Litao looked at the records on the A4 paper, his face twisted so hard that wrinkles appeared on his forehead.
"That's basically it, understand the spirit and study hard."
"Brother Yun, what about..."
"Mr. Zhou, something's wrong with the patient!" A nurse knocked on the door.
"Okay, go right away." The tangled and distressed expression on Zhou Litao's face immediately disappeared, replaced by an extremely focused and serious expression, and he folded and put the piece of paper that recorded what Su Yun said.
"Brother Yun, Boss Zheng, please wait for me a moment."
"What patient?" Zheng Ren asked.
"Tell me about a patient who suddenly lost his sense of smell." Zhou Litao said, "I asked him to do a head CT."
"Oh, go ahead." Zheng Ren knew that nothing was wrong after hearing this medical history, so he didn't bother to check.
The ability to smell is a characteristic of the olfactory cells in the nasal mucosa. Damage to the nasal mucosa, olfactory bulbs, olfactory filaments or central nervous system connections may affect the sense of smell.
Clinical manifestations include hyposmia, anosmia, anosmia, parosmia, olfactory hallucinations, and increased sensitivity to olfactory stimulation.
There are many common causes of anosmia.
Including allergic sinusitis, nasal polyps, cold virus infection, rhinitis virus infection, head trauma, sulfur dioxide, nitrogen compounds, and residual formaldehyde in the room after renovating the house, etc. can cause it.
In addition, long-term spraying of perfume can also cause loss of smell.
Zheng Ren was thinking about what caused the patient's illness. It might be formaldehyde, because it is too common for formaldehyde to exceed the standard during home decoration nowadays.
Zhou Litao ran out immediately.
"Boss, be professional." Su Yun said with a smile.
"I think only Zhou Litao can believe this." Zheng Ren said: "You don't even have a girlfriend, how dare you say this?"
"Tch!" Su Yun said: "I don't want to find one, okay? There is something that girls don't have. Girlfriends, you can just find them on the street!"
Zheng Ren was too lazy to talk to him. He was so bored waiting for Zhou Litao to come back. He didn't know how long it took. There was a talkative guy sitting next to him, saying a few words from time to time. He even wanted to read in the system library.
After waiting for a long time, Zhou Litao didn't come back. Zheng Ren felt strange.
He was really bored, stood up and pushed the door open to go out.
Seeing a nurse busy in the corridor, Zheng Ren asked, "Excuse me, where is Mr. Zhou?"
"Teacher, I just came here. I don't know who Mr. Zhou is. I'm sorry." The nurse replied immediately.
Oh, here comes the nurse who just came to 912 for further training. Zheng Ren smiled.
Su Yun saw the nurse entering the treatment room, probably to change the dressing, so he smiled and said, "I'll ask."
Zheng Ren glanced at him and saw that this guy turned around and went to the treatment room. He leaned against the door frame as if he had no bones and started talking and laughing.
It’s so familiar, Zheng Ren thought to himself.
But it was quite troublesome for him to ask something. After waiting for a few minutes, Su Yun came back with a proud look on his face.
"where?"
"The patient who just had a problem with his sense of smell had a cigarette when he went to the CT room." Su Yundao said.
"Having a seizure?" Zheng Ren wondered, "Is it epilepsy or convulsion?"
"No one has seen it. Why are you asking for such details?" Su Yun said, "We will find out when Mr. Zhou comes back."
"Where is Zhou Litao?" Zheng Ren was confused.
"It was said that it was an emergency rescue, but the convulsions were so severe that there was no way to do a CT scan."
I became restless, and there were all artifacts on the CT images. It was the same as not having it done.
This patient will probably be sent to the Department of Neurology, as there is no need to ask for anything in the CT room. If a sudden respiratory and circulatory arrest occurs, the patient will have to stay there.
But a patient with a sense of smell problem suddenly smokes...
There's something wrong with this history.
Zheng Ren started to think.
"Boss, if you can make a diagnosis now, I will be convinced." Su Yun said with a smile.
Zheng Ren also knew what he meant, just that he had a sense of smell loss and went to the CT room to have a convulsion. It is impossible to make inferences based on these two points.
But idleness was idleness. Zheng Ren went back to the room, sat down, and started counting on his fingers.
"First, when patients suffer from craniocerebral trauma, the olfactory filaments of the olfactory nerve passing through the cribriform plate can be torn, or the olfactory bulb can be shredded due to contusion."
Seeing his serious look, Su Yun found it interesting. He sat across from him and said, "Logically speaking, the patient did not suffer from trauma. Otherwise, given Zhou Litao's character, he would have lost his sense of smell after trauma."
Zheng Ren nodded, Su Yun's judgment was correct.
"The second point is that meningiomas, metastases, or infiltrative tumors of the anterior foveal artery or frontal lobe can compress the olfactory bulb and olfactory tract, causing olfactory damage."
"This is not reliable at all. If there is a meningioma, loss of smell will not be the main complaint. And if the patient himself does not know it, it will generally not be accompanied by sudden convulsions." Su Yundao.
"You can't say that. It's just a high probability. This is doubtful." Zheng Ren said: "The possibility is about 5%."
"Almost, I think it needs to be a little less, you continue." Su Yun was very interested in this kind of case discussion facing the air.
"Third, it is also ruled out that the olfactory damage caused by influenza is temporary, and convulsions rarely occur."
"Fourth, temporal lobe lesions are occasionally accompanied by temporary or paroxysmal olfactory hallucinations. Loss of smell is often accompanied by taste impairment, depending on the volatile substances in food and drinks."
"Is it a temporal lobe symptom cluster?" Su Yun asked.
"Just saying that, it should not be a symptom of the temporal lobe symptom cluster." Zheng Rendao: "Volatile substances can cause loss of smell, but convulsions and the need for rescue are too outrageous, so we will not consider it for the time being."
Su Yun found it more and more interesting to do diagnosis and differential diagnosis, just like playing an intellectual game.
"Fifth, congenital factors are not considered. Then there is the decrease or loss of olfactory function caused by neuropathy of the nasal mucosa, olfactory bulbs, and olfactory filaments. Damage to the central nervous system connection is usually not accompanied by any detectable loss of smell."
"Is the fifth point likely?"
"It's hard to say, I guess it's not big, it's because it can't be accompanied by convulsions at the same time."
"After talking for a long time, do you have a diagnosis? The biggest possibility is intracranial tumor, the possibility is less than 5%." Su Yundao.