socalfunplaces Chapter 534
Chapter 534
Afternoon
Keep going to work.
Lin Feng just carried a wolfberry teacup and walked into the consultation room.
Another regular training doctor, Yan Haoyu, ran over.
"Brother Feng, help, help me see a patient..."
"Well..."
Lin Feng is still very kind and generous to his own people.
"Tell me about the patient."
"It's like this... A junior high school student came over yesterday... This is his second visit to the emergency room..."
Patient, Chen Xue, 15 years old,
Due to paroxysmal abdominal pain for 3 days, come to the emergency department...
·3 days ago without obvious triggers, there was pain in the right upper quadrant and periumbilical cord, labor pain, obvious pain, several times a day, lasting about a few minutes to half an hour, accompanied by nausea and nausea...
"Yesterday, I came to the emergency department, when I was diagnosed with gastroenteritis, and then I arranged for hospitalization, and gave anti-infection, stomach protection, and antispasmodic treatment, but the effect was not obvious."
"By the way, he has 1 month of money, and he has been so painful, but it is relatively light, and the needle is intravenous antibiotics in the back, and the symptoms are better..."
When Yan Haoyu introduced,
The two had already arrived at the ward.
On the hospital bed, 15-year-old Chen Xue is lying on the bed, playing mobile games, which is estimated to be the glory of the king.
"Dr. Lin will help you see..."
"When I finish this game, first..." said Chen Xue impatiently.
Syllable~~~
His mother angrily slapped it directly: "Let you play!" "
Then said to Lin Feng flatteringly: "Doctor Lin, please help me see my child, what is the problem..."
She knows Lin Feng, a very powerful doctor, so she is also very happy that Lin Feng can help her son see a doctor.
Lin Feng nodded.
Pulse: Pulse pressure, heart rate and everything else are fine.
And can play games, obviously in good spirits.
Do a physical examination.
・Suspicious tenderness in the right upper abdomen and periumbilical area, and nothing else painful...
"Show me the results of the examination..."
Blood count: elevated white blood cells and neutrophils,
Urinalysis, nothing abnormal...
Chest x-ray/plain abdominal x-ray is not abnormal...
There are no obvious abnormalities in the abdomen and urinary system...
Lin Feng: "How do you think about it?" "
Yan Haoyu: "What I was thinking about yesterday was gastroenteritis?" Pancreatitis? Cholecystitis? ...... Therefore, on the routine stomach protection and antispasmodic treatment... But the effect does not work... Now I just don't know why..."
Lin Feng nodded.
did not speak,
Ponder.
This patient, the characteristics of the case: paroxysmal abdominal pain, abdominal pain was committed a month ago, this time it is aggravated. The remission period is as usual, the antispasmodic effect is not good, the right upper abdomen and periumbilical pain are painful, the white blood cells are slightly increased, and there are no obvious abnormalities in various examinations...
Pain in the abdomen, the possibility of etiology is very many.
Lin Feng's considerations are as follows:
Type 1 diabetes.
However, most of the abdominal pain of type 1 diabetes can not be terminated on its own, and it definitely needs to be treated, and the laboratory tests must be abnormal, not met, and excluded.
Abdominal heart attack? Non-conformity, exclusion...
Aortic dissection? Non-conformity, exclusion...
Marfan syndrome (genetic disease)? According to: slender and uneven limbs, fingers, toes, non-compliance, exclusion ...
Abdominal epilepsy?
This is a type of epilepsy with episodic transient abdominal pain as the main clinical manifestation, and the symptoms are very similar to the patient's.
Features: Pain is more intense, such as colic or knife cuts, and there will be impaired consciousness when it occurs.
Lin Feng asked, "Has something similar happened before?" It's from childhood to adulthood..."
The mother shook her head: "My son has always been in good health, sports baseball, just appeared once last month, and has not appeared since." "
Lin Feng nodded,
Combined with the fact that the patient is now active in playing games despite abdominal pain, this proves that it is not "abdominal epilepsy".
next
Porphyria
This is a group of porphyrin metabolism disorders caused by the lack or decrease of enzyme activity in the heme synthesis pathway.
The main clinical symptoms include photosensitivity, digestive symptoms, and psychoneurologic symptoms.
What does it mean to be sensitive to light?
Just afraid of the sun!
After being exposed to the sun, non-inflammatory blisters, bullae, erosions, crusts, ulcers can be seen... An obvious disease.
In addition, red changes can be found in the urine in sunlight.
A very interesting disease.
Obviously, the patient in front of him is a junior high school student, there is no such situation.
So rule out "porphyria".
next
Ascariasis,
Features: Drill-top pain...
Lin Feng: "When it hurts, what is the pain method?" Does it hurt like a drill top? "
As soon as Lin Feng's words came out,
The patient student, who was originally angry, turned his head, and ignored people because he was disturbed to play games, couldn't help but look up at Lin Feng.
"Yes, it feels like something is drilling..."
Lin Feng and Yan Haoyu looked at each other.
Ascariasis!!
Lin Feng asked his mother: "Did he have a history of roundworms before?" Or went to eat for the rest of my life or something..."
Mom nodded repeatedly: "I ate sang fish last month, his father likes to eat this, take him to eat..."
Lin Feng nodded: "The answer is out, ascariasis... Give him two pieces of "Abundadin"... If there is an effect, it means that it is indeed ascariasis... If it doesn't work, continue to check the others..."
"Amondadine": also known as "SmithKline", is a broad-spectrum anthelmintic drug of imidazole derivatives and one of the most basic and extensive anthelmintic drugs.
Yan Haoyu breathed a sigh of relief: "Thank you Brother Feng..."
Lin Feng patted Yan Haoyu's shoulder, and then left the ward.
It takes 5 minutes,
After diagnosing a patient!
Because the abdominal diseases are more complicated and involve more knowledge, this is still a bit difficult for Yan Haoyu, a regular trainee.
But if you change to Lin Feng, it will be much simpler.
Then there is a question: why did the B ultrasound in front not find roundworms?
In fact, it is normal, B ultrasound found roundworms not only need the strength of B ultrasound doctor, but also luck. If you are unlucky, you may not find out.
......
After a busy day,
Lin Feng was preparing to go home and spread out the corpse to rest.
"Brother Feng, the patient in the afternoon, thank you big guy... Do you have time, let's go to dinner together..."
Yan Haoyu invited.
Dine?
Lin Feng thought about it, and he hadn't eaten with his colleagues for a long time.
And agreed.
Came to a restaurant.
The Cantonese restaurant that Lin Feng likes to eat is quite a lot of people.
Many of the guests inside are with Cantonese accents, and it is estimated that they are also from Guangdong Province.
Order food.
Soon, the dishes came up.
Stuffed tofu, steamed grouper, white-cut chicken, white-cut pork hands...
"Come, toast (tea), thank you Brother Feng for taking care of you for more than a year..."
Yan Haoyu is very grateful, if it were not for Lin Feng's support, guidance, and surgery, I am afraid that he would not have been able to stay in Harmony Hospital after his internship.
To some extent, Lin Feng is his benefactor.
"There is no need to say more about these kind words, come, do it..."
The two chatted about work, as well as hospital gossip...
At this very moment,
A relatively loud voice made a noise to Lin Feng's side.
Lin Feng and Yan Haoyu couldn't help but look over.
"Come, it's hard to get together today, I specially bring you a bottle of good things!"
At the table next to it, a large group of people came.
Probably seven or eight.
It's all men.
One of them, a proud-looking man, was holding a bottle of wine.
Wine.
"I tell you, this bottle of wine I have treasured for many years, and it contains a lot of expensive things, deer antler velvet, epimedium, ginseng... It's a very nourishing kind..."
"This good thing, men drink it, the waist is not sore, the legs are not painful, and you can also boost the man's heroism!"
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