socalfunplaces Chapter 687
Chapter 687
Immediately, Lin Feng asked again: "Then have you taken any medicine at home?" Have you taken medicine to control high blood pressure? For example, what kind of diuretics and so on, have you eaten? "
Diuretics are very effective antihypertensive drugs, but there are furosemide, hydrochlorothiazide, etc., which cause potassium to be excreted while diuretic, resulting in hypokalemia.
That's why Lin Feng opened his mouth to ask this question.
However, Lin Feng's words just fell.
The patient and his wife immediately replied: "No, I haven't taken any medicine." "
Hearsay.
Lin Feng shook his head, there was no clue at all.
He immediately said: "In that case, let's be hospitalized for potassium supplementation treatment first." By supplementing the blood potassium content to normal values, it is estimated that the patient's muscle strength can be restored. "
As for what caused the patient to have hypokalemia, wait for admission and then slowly check it.
There may be endocrine problems, such as hyperthyroidism, and some patients with hyperthyroidism will have hypokalemia with symptoms of muscle weakness in the limbs.
Of course, it cannot be ruled out that it is a neurological disease, or other diseases.
This needs to be checked before it can be determined.
For hospitalized observation, the patient naturally did not resist at all, and the expressions of the patient's couple now let them go back.
"Xiaoru, you go and arrange potassium replenishment treatment for the patient!" Lin Feng immediately arranged.
"Yes, teacher." Small as answered.
Lin Feng beckoned the patient's husband to help the patient to the bed in the consultation room, he needed to check the patient's body, and by the way, the electrocardiogram was done.
There is nothing wrong with the patient's body size and there is no obesity.
Then I listened to the bowel sound, and everything was normal.
After that, the patient's current muscle strength was tested.
Before doing the electrocardiogram, Lin Feng tested the patient's blood pressure again.
Here are some clues.
Systolic blood pressure 150mmHg
Diastolic blood pressure 93mmHg
This has reached the level of level 1 hypertension.
The mouth whispered: "Where are you just high blood pressure, you have reached the standard of first-level hypertension." "
"How is it possible!" The patient said with some surprise.
It seems that the patient does not understand anything about his situation.
Not for a while.
The ECG results came in.
Everything works fine.
But Lin Feng thought of another illness at this moment————
"Protoaldehyde disease"!!
Hypokalemia itself will lead to muscle weakness, but what diseases are behind it, whether it will be caused by neurology diseases is difficult to say, but we should also be vigilant against endocrine diseases, such as this "original aldehyde disease".
Protoaldehydeism, primary aldosteronism throughout the course.
It is due to the excessive secretion of aldosterone by the globular band of the adrenal cortex, resulting in renin vascular tension and renin system inhibition, and the main clinical manifestations are hypertension with hypokalemia, hyperaldosteronism and hyporeninemia.
Simply put, aldosterone is an endocrine hormone that causes sodium and water retention, excessive potassium excretion, and hypertension and hypokalemia.
Come to think of it.
Lin Feng immediately made a decision.
Back on the table, a series of checklists.
Liver and kidney function test, blood electrolyte, 24-hour urine electrolyte test, original aldehyde confirmation test, blood aldosterone, renin determination.
After he opened these examination lists, he said to the patient's husband: "I now suspect that the patient is due to endocrine disease caused by muscle weakness in the limbs, you first take the patient to do these examinations!" "
Seeing the many examinations above, the patient's husband asked with a confused expression: "Doctor, didn't you say just now that you should supplement potassium first, and then my wife will have nothing to do?" "
"Just now it was a simple examination, and the patient was not examined. When I measured my blood pressure just now, I found that the patient had severe hypertension and was accompanied by hyponatremia, which was very much in line with the endocrine disease I suspected, so I still had to go to the examination to rule it out. Lin Feng explained.
"Doctor, is this disease serious?" The patient's husband asked with some concern.
"No matter what kind of disease, as long as it is not treated for a long time, it will become serious. This endocrine disease is called original aldehyde, if not treated in time, it will cause the patient to have respiratory muscle weakness, then there will be respiratory failure, which is life-threatening! Seeing that the patient's husband was still here to inquire, Lin Feng said immediately.
Hearing that his life was in danger, the patient's husband hurriedly said: "What! I know, I'll take her for a check-up now! "
Xiaoru just pushed a wheelchair over, in view of the patient's current limb muscle weakness, she specially prepared it, and then helped the patient to sit in the wheelchair.
The patient's husband thanked him for a while, and then hurriedly pushed the wheelchair to take the patient for examination.
After the patient left, Xiao Rucai said: "Teacher, you just said that this patient has original aldehyde disease? "
"That's right, when I checked her body just now, I found that her blood pressure reached a value of 150/93mmHg, plus hypokalemia, what do you say?" Lin Feng said softly.
Lin Feng has already said very clearly.
Xiaoru didn't ask more.
Then.
Lin Feng looked at intern Zhang Donglai and asked, "You have been watching from the side, do you understand what I said?" "
"Ah~~, Ming: Got it. Unexpectedly, Lin Feng would ask him questions, Zhang Donglai got up a little nervously and said.
"Tell me." Lin Feng said softly.
"Yes, Dr. Lin." Zhang Donglai answered immediately.
After a pause, he spoke: "After the patient came in just now, according to the observation of both eyes, it can be judged that the limb muscles are weak, and according to the results of Dr. Lin's inquiry, the patient's hyponatremia caused by insufficient supplementation or the use of drugs can be ruled out." "
"Then a physical examination found that the patient's high blood pressure symptoms were very obvious and the value was too high. However, when the symptoms of hypertension and hyponatremia occur at the same time, an endocrine disease - protoaldehyde disease should be paid extra attention to. "
"Dr. Lin, you also took this situation into account to let the patient's family go for those examinations."
Speaking of this, Zhang Donglai stopped.
Some nervously lowered their heads, not daring to look at Lin Feng.
"Well, not bad. The theoretical knowledge is very solid. After listening to Zhang Donglai's narration, Lin Feng nodded.
Although Zhang Donglai has been watching from the side, being able to describe it clearly and methodically shows that Zhang Donglai, who is sitting next to him, is also very serious and has very solid basic theoretical knowledge.
"Thank you Dr. Lin for the compliment." Zhang Donglai hurriedly answered.
After a while.
The couple of the patients just now came to the consultation room again.