"By the way, urinary tract irritation symptoms and bladder contracture are most common in tuberculosis patients, as well as low-grade fever and ascites. How do you judge urinary tuberculosis?" Su Yun asked.
"Yes." Zheng Ren nodded, "From what you said, everyone should judge that it is not urinary tuberculosis."
"After relevant examinations, it is not urinary tuberculosis." Su Yundao said, "The patient has multiple system involvement, and it is necessary to consider whether he has autoimmune diseases. However, he only has a low-titer positive ANA, a small amount of protein in the urine, and a slight decrease in complement. In addition, there is no further update. Lots of evidence.”
"What about kidney biopsy?" Zheng Ren asked with a frown.
"It is said that the patient's family refused. It is incredible for them to find a teratoma due to a history of nausea and vomiting. As for the kidneys, I guess they can't understand it." Su Yun smiled bitterly.
"and after?"
"The last hospital-wide consultation and multi-disciplinary ward round considered that although the patient did not meet the diagnostic criteria for systemic lupus erythematosus, Lao Gu believed that the patient was a young woman with multiple systems involved and was still leaning towards systemic lupus erythematosus. He... insisted." Su insisted. After Yun finished speaking, he sighed slightly.
The ability to explain one's diagnosis against all opinions is a capable person, and Zheng Ren recognized it.
The general hospital-level people Su Yun befriended were all of good quality, not to mention their character. In the foreseeable future, one by one will become professors and leaders. This ancient professor is one of them.
"However, the patient developed palpitations on the first day after taking the medicine, with a heart rate of 120 beats/min, and the third heart sound galloping rhythm could be heard at the apex of the heart."
The gallop rhythm is a kind of extra heart sound during diastole. It is combined with the first heart sound and the second heart sound to form a rhythm similar to that of a gallop, so it is called gallop rhythm.
When the heart muscle is severely damaged, galloping rhythm occurs.
When Zheng Ren heard Su Yun say this in a heavy tone, his mood dropped.
Excessive doses of cyclophosphamide may damage the myocardium or kidneys. If gallop rhythm occurs after taking the drug, it is cyclophosphamide's fault.
Facts have proved that Professor Gu's persistence was wrong.
This is the shortcoming of diagnostic treatment, or the uncontrollability, especially the side effects that often occur when rheumatology and immunology departments perform diagnostic treatment.
Zheng Ren has undergone several diagnostic treatments, all of which were successful in the end.
It was not because the diagnostic treatment was reasonable, but because Zheng Ren relied on the system panel to perform reverse calculations, and he gained some confidence.
The diagnostic treatment used by Professor Gu not only failed to make a clear diagnosis, but also caused severe drug reactions, leading to myocardial damage.
When Su Yun said this, the situation was already clear.
The patient developed abdominal pain and diarrhea for unknown reasons and came to 912 for treatment, thinking that it might be caused by teratoma.
However, after the operation, I found that the disease was not cured, but rather worsened. After consultation with the whole hospital, everyone was at a loss. After using the treatment plan of the rheumatology and immunology department, heart failure has begun...
This is a typical case where the more treatment the more serious the problem becomes.
While talking, the two came to the gynecology department. The patient is still hospitalized in the gynecology department, but if the correct diagnosis and treatment cannot be found, the patient may go to the ICU soon.
"Professor Gu is very courageous." Zheng Ren finally said with certainty.
"Courage is one thing, but the main thing is high level." Su Yundao said, "How about I say that you must have a friend in the rheumatology and immunology department in the hospital? Once I had any disease and suspected a problem with the rheumatism and immune system, I would go to him to solve it. "
"Why haven't I heard it from you?" Zheng Ren felt that this name was unfamiliar to him.
"Isn't it because of you? There are some patients who know the diagnosis as soon as they think about it, so I never looked for him. I didn't expect that this guy would have an accident today."
Passing by the doctor's office, I saw that the door was tightly closed, and I knew that this was a consultation in the whole hospital.
Zheng Rendao, "Do you know which ward the patient is in?"
Su Yun looked at Zheng Ren in surprise, as if he were looking at an idiot.
Did I ask the wrong question
Zheng Ren has been thinking about the patient's situation. If systemic lupus erythematosus is a wrong diagnosis, what might be the diagnosis
In fact, Zheng Ren himself was also considering systemic lupus erythematosus.
Su Yun sighed, "Boss, isn't your mouth under your nose? Do you dare to ask?"
“…”
"Hold on."
Su Yun blew a breath, his black hair flying in front of his forehead, and he looked down on Zheng Ren.
He went directly to the nurse's station, and then Zheng Ren faintly heard a few laughs.
This guy is really flirtatious.
Zheng Ren sighed in his heart. When going to unfamiliar places in the future, whether it is taking Su Yun or Chang Yue with him, it seems to be a very good choice.
At least you don’t have to ask for directions yourself.
Soon, Su Yun came back, "In the innermost room, the patient's family members are not very good-tempered. They are brewing now and are about to explode. Do you... want to go in together?"
The brewing period and outbreak period mentioned by Su Yun are the accumulation of emotions caused by patients being hospitalized and unable to recover for a long time.
In other words, the patient's family members are about to collapse emotionally.
This is now. If the Dahuangya gang had been active a few years ago, "high-quality customers" like them would have been targeted long ago.
It may not be necessary to use force to encourage the medical staff who understand the weaknesses of the hospital and the weaknesses of human nature. If they are gently provoked, it will start a prairie fire.
The two came to the door of the ward. Su Yun knocked on the door, then pushed the door open and went in.
Zheng Ren followed him. Anyway, this guy is good-looking. He is a female patient. He is probably a female escort.
As long as she is a woman, there is nothing wrong with putting Su Yun ahead.
After entering the ward, Zheng Ren did not listen to how Su Yun communicated with the patient's family, but took the time to observe the patient's system panel.
The patient was young, pale, thin, and his cheeks were sunken.
The system panel is red and there are many and detailed diagnoses.
Zheng Ren quickly checked all the diagnoses and threw aside the unimportant diagnoses. He was looking for the most important diagnosis that caused the patient's condition to delay recovery.
Soon, Zheng Ren saw what he wanted to see.
Systemic lupus erythematosus!
Professor Gu’s diagnosis is correct!
But the question immediately arises: why did the correct diagnosis and standard medication eventually lead to myocardial damage and type I respiratory failure in the patient
This is a bit incredible.
Zheng Ren looked at the system panel, frowning in thought.
He only knew half of the patient's condition, but Zheng Ren checked, simulated and reconstructed one by one based on the diagnosis on the system panel.
Soon, he had further thoughts about the patient's condition.
This is not the first time that Zheng Ren has reversed the patient's condition based on the diagnosis of Big Pig's Hoof, but it is a relatively complicated one.
When Zheng Ren thought about it at the end, he felt a little happy and emotional.
Professor Gu was indeed a young talent. Even though he was a few years older than Su Yun, he was able to stick to his own opinion and diagnose the patient's disease as systemic lupus erythematosus. He was truly extraordinary.