The person who makes the diagnosis is not one person, but a team, Mr. Li immediately realized.
Boss, only those who have a project team and a project team leader with fund investment are called bosses.
Of course, the little doctor's flattery and fun do not count.
Mr. Li was a little confused. The boss of the rheumatology and immunology department and his subordinates were clamoring to throw the test results in his face if they could overturn his diagnosis.
I have never seen this kind of relationship.
The scientific research funds are obtained by the boss. In the project team, the boss has the final say. Is the assistant so arrogant? Could it be that he brought capital into the group
As the old saying goes, one mountain cannot tolerate two tigers. There are two bosses in a project team. Once a difficult problem is encountered, who will make the final decision
There have been such project teams, but their lifespans have not been long.
Weird, Mr. Li became more and more curious, what kind of project team is this
The assistant, or the second boss, is so arrogant.
However, judging from the tone, his words were not malicious, but seemed to be joking.
It seemed that a few like-minded middle-aged professor-level people had come together to work on a national-level scientific research project, Mr. Li guessed.
At this time, the director of the rheumatology and immunology department had finished explaining the various laboratory test values, and finally gave his own diagnostic opinion—secondary APS.
After ruling out all interference, the firm diagnosis was secondary APS and systemic lupus erythematosus.
If there was no A4 paper in front of him, Mr. Li would applaud the director of the Department of Rheumatology and Immunology for his wonderful reasoning.
The patient's condition is complex, and he can find the main problem among the many chaos, which is a reflection of the technical level of the Medical University Affiliated Hospital.
Especially the final diagnosis, he was extremely sure when he said it, and did not say those vague words at all.
But on the A4 paper, under the description of dragons and phoenixes, Mr. Li's mood was a bit complicated.
A project team and an unknown "boss" actually determined that it was secondary APS complicated by systemic lupus erythematosus based on a small number of examination reports and CT images.
It's kind of magical.
I guess the boss is not wrong. If you haven’t determined that it is secondary APS + systemic lupus erythematosus, then think about it and do relevant examinations.
The words on the A4 paper were still as bitter and mean as ever. Although he didn't point his nose and curse, Mr. Li could vaguely see a arrogant middle-aged doctor saying these words with a look of disdain.
It's a pity that he is the leading professor of rheumatism and immunity and has his own project team, so the possibility of recruiting his disciples is almost impossible.
Mr. Li sighed.
The director of the endocrinology department smiled after hearing the diagnosis of secondary APS complicated by systemic lupus erythematosus. This is the same as my own judgment. I did a lot of checks and finally turned the vague guess into reality. This complex case really tested my skills.
Hearing Mr. Li sigh, the director of the endocrinology department was startled. Could it be that the diagnosis was wrong
"Mr. Li, what's wrong?" she asked.
"Look." Mr. Li handed over the paper he had read.
The director of the Department of Endocrinology was stunned for a moment, then flipped through the A4 paper.
The harsh and harsh tone made her very angry, but she couldn't find any fault in the whole article. The tone was held in her chest and she couldn't vent it, which made her very depressed.
A doctor who points his nose and scolds is a shrew and has no technical content at all. Accusing the other party of wrong diagnosis, standing at the pinnacle of technology, and despising everything is the way to go.
But looking at the diagnosis and reasoning process written on the A4 paper, the director of the endocrinology department couldn't say a word.
His judgment was organized and logical. Although it was mixed with some speculation, the doctor who wrote the condition analysis also said that this was what his boss insisted on. He hoped that if the judgment was wrong, he would be slapped in the face with the correct diagnosis.
But their diagnosis is the same as the diagnosis made by the director of the Department of Rheumatology and Immunology of my own hospital, right? What to hit with!
"This patient has positive high-titer antinuclear antibodies, positive ACA, thrombocytopenia, and suspicious discoid erythema. However, because the specific antibody dsDNA is negative, SLE is considered a high possibility."
"At this point, the patient's diagnosis is basically clear: secondary APS, SLE is likely, bilateral adrenal vein thrombosis leads to adrenal hematoma, which in turn leads to primary adrenocortical insufficiency, and finally adrenal crisis."
The director of the Department of Rheumatology and Immunology seemed to be reciting the words written on the A4 paper. Although not every word was correct, the meaning was probably the same.
Mr. Li looked at the words on the paper and had a ridiculous illusion in his heart.
She vaguely guessed that the technical level of the medical team was no lower than that of the Medical University Affiliated Hospital, or even higher.
As the former director of the Internal Medicine Department of the Medical University Affiliated Hospital, Mrs. Li was proud, but she subconsciously did not want to admit it.
It’s just that the diagnostic level of Rheumatology and Immunology is higher than that of the Medical University Affiliated Hospital. Which hospital is it
Well, finally, treatment options are given. Don't be impatient, and don't think we are pointing fingers. The most important thing is for the patient to recover as soon as possible. Do you feel uncomfortable in your cervical spine when you put this big hat on
Mr. Li looked at the ridiculing words and couldn't laugh or cry.
Warfarin was used for anticoagulation with a target INR of 2~3, and hydroxychloroquine was added to reduce aPI production and anti-platelet aggregation. Prednisolone 40 mg Qd + methotrexate 10 mg Qw suppressed immunity.
"I recommend anticoagulation with warfarin, with a target INR of 2~3. At the same time, hydroxychloroquine is added to reduce aPI production and anti-platelet aggregation, and prednisolone 40 mg Qd + methotrexate 10 mg Qw is used for inhibition. Immunotherapy." The director of the Department of Rheumatology and Immunology finally "read" the treatment plan on the A4 paper.
If he hadn't been at least 10 meters away, Mr. Li would have felt that he really read the treatment plan on the A4 paper without even thinking about it.
this…
The director of the endocrinology department kept staring and saw this paragraph written on the A4 paper.
Eyes see the treatment plan and ears hear the same treatment plan.
Is this a coincidence
Mr. Li and the director of the Department of Endocrinology simultaneously recalled a scene from a TV series. Zhuge Liang was writing on the palm of his hand, and he and Zhou Yu coincided with each other, looking at each other and laughing.
But... the unknown medical team opposite made these judgments while lacking many necessary laboratory tests.
Mr. Li became distracted for the first time while attending a general internal medicine round.
The patient with 2-8 beds from the endocrinology department must be transferred to the rheumatology and immunology department. She didn't care about this. What she recalled in her mind was the smiling face left after turning to the last page of the A4 paper and saying everything.
The smiling face was completely opposite to the harsh words before. Mr. Li did not think that someone was looking down on the Medical University Affiliated Hospital and directly made fun of him.
She was very curious, even a little anxious. She wanted the general internal medicine rounds to end quickly, and she could go back and ask which hospital and which medical team had such a level of expertise.