What the hell!
"Look, I'd say it's underexposure. The conditions are not enough, and some lesions that cause slight changes in interstitial pneumonia cannot be seen." Sister Zhao made the film and uploaded it with a smile.
Director He stood behind stupidly, looking at the dense and diffuse mosaic changes in the density of the ground glass that appeared on the image data, and he was stunned.
How is this going? !
Interstitial pneumonia? The patient does not have any past medical or work history, so where does interstitial pneumonia occur? The possibility of interstitial pneumonia among such a young bank worker is too low.
At 34 years old, his age does not support the diagnosis of interstitial pneumonia.
And it progressed too fast. Within two or three months, my limbs were already weak to a certain extent.
This is impossible!
"Director He, the patient should not need to be referred." Sister Zhao looked at the image and began to upload, "It may be hypersensitivity pneumonitis, a rare condition. It is difficult to measure allergens, and the patient may have to be Check everything you touch."
After hearing that Director Zhao diagnosed hypersensitivity pneumonitis, Director He didn't have any objections. Just thinking about checking for countless possible allergens made her head turn into two.
An enhanced CT image completely defeated Director He. She left the CT room feeling a little disappointed and walked back slowly.
Director Zhou asked her to call and tell the department, but Director He forgot about it. Her eyes were filled with diffuse frosted glass images.
What a deal! This interstitial inflammation is so small that it cannot be seen with the resolution of ordinary CT.
Hypersensitivity pneumonitis refers to a group of diffuse interstitial granulomatous lung diseases caused by repeated inhalation of various antigenic organic dusts and low molecular weight chemicals in susceptible people.
Farmer's lung caused by repeated inhalation of hay containing thermophilic actinomycetes is a major clinical cause of the disease.
Director He has considered this disease, but what allergens can a bank employee be exposed to? Are you allergic to money
If you are allergic to money, can it be diagnosed as a disease of poverty? Are there really people who are poor and sick? Director He also knew it was impossible. But when I thought it was impossible, the enhanced CT image appeared in front of me.
Director He was thinking aimlessly as he walked slowly back to the department.
How did Mr. Zheng find out? Forget it, no matter how he figured it out, it would be impossible to find the allergen in the end.
Director He sighed, this "troublesome" patient still could not be transferred away.
The next step is to check for allergens! Director He became even more depressed when he thought of this. She felt that she was beginning to suffer from depression.
Returning to the ward, Director He opened the door and entered the doctor's office. Seeing that the patient's family members were also there, she remembered that she had not notified Director Zhou about uploading the imaging data.
But it seems that it is no longer needed now.
"Boss Zheng considers that it may have something to do with it. Throw it away, or send it to his parents' house or another friend's house. In short, just don't let the patient come into contact with it again." Mr. Wang said seriously.
"Really...really?" the patient's family asked in confusion.
Director He didn't understand what happened.
From what Mr. Wang said, he should have found the allergen. But why so fast? If you walk back by yourself, no matter how slow you are, you won't find the allergen.
It takes time to send the film, let alone such trivial matters as diagnosis and finding the source. Are you really allergic to money and want to throw away all your money
"Mr. Wang, what is the patient's allergy to?" Director He asked directly without caring about anything else.
"Boss Zheng is thinking that he is allergic to down quilts. He just asked the patient's family and he said that they did buy a duvet at an off-season discount a while ago." Mr. Wang replied with a smile.
The doctor is happiest when the condition is clearly diagnosed and everything is fine.
"Boss Zheng has given me a treatment plan. You can decide on the details. I'm still busy, so I'll leave first." Mr. Wang handed an A4 piece of paper to Director He.
Director He saw that it said - first do a test for antigen-specific IgG antibodies in duck or goose feathers. If confirmed, give 40 mg of prednisolone orally once a day. Continue for 1 month, then reduce once every 2 weeks, gradually tapering off.
There are also some tests that need to be done, such as bone density, to avoid long-term stimulation of glucocorticoids that may lead to lower bone density and complications.
Furthermore, proton pump inhibitors such as omeprazole should be used in combination to avoid other complications.
These are all routine, and it is reasonable to use glucocorticoids to control allergies.
It’s just that the determination of this allergen is too bizarre…
…
…
"Boss, have you ever seen bird lovers' asthma or bird allergies?" Su Yun asked.
"No, but it is on the medical certificate. For this relatively complicated manifestation of pulmonary allergy, the first thing to consider is allergy to bird feathers." Zheng Ren said with a smile, "Mr. Zhou, if nothing happens, I will gone."
Zhou Litao looked at Boss Zheng stupidly, thinking that if it were him in his place and he diagnosed a bird allergy, he would definitely start showing off a long time ago.
But look at Boss Zheng, he smiles slightly and doesn’t care.
It was like being diagnosed with appendicitis and not taking it seriously at all.
"Don't mention it, Boss Zheng." Zhou Litao said quickly: "Is the patient new to down quilts? Isn't this just a coincidence?"
"The time it takes for symptoms to appear after contact with a new duvet or pillow can range from three weeks to five years. Over time, breathing difficulties will worsen, and patients will experience night sweats, dry cough, weight loss and fever." Zheng Renxiao road.
"Have you ever stayed in a high-end hotel?" Su Yun asked.
"Lived there."
"Some people stay in high-end hotels... Let me ask you, to judge whether a hotel is high-end or not, what do you see first when you enter?" Su Yun said, and the topic changed again.
"..." Zhou Litao was startled. Didn't he mention bird allergy in the previous sentence? Why are you talking about the hotel
He does know what Brother Yun means. Most high-end hotels have down pillows. But whether the hotel is high-end or not, this kind of thing...
"Look at the trash can." Su Yundao said, "Excluding other factors, if you look at the trash can at first glance, if it is not covered with plastic bags, garbage bags, etc., this hotel should be of good quality."
"..." Zhou Litao's thinking couldn't keep up with Su Yun's speed.
"Is this an explanation from the legend that luxury means trouble, and the more trouble there is, the more luxurious it is?" Zheng Ren asked with a smile.
"Of course!" Su Yundao said.
"Uh... Brother Yun, what's going on with the bird allergy?"
"Eh? You haven't forgotten it yet." Su Yun glanced at Zhou Litao, looking a little surprised, but actually full of contempt.