I can see the status bar

Chapter 685 Headache
In order to ask for a consultation for a patient who has been drowsy after taking sedative drugs, in theory, you should choose a psychiatric department with prescription rights instead of a psychological counseling department for consultation.After all, most of the clinical psychologists in the psychological counseling department do not have the right to prescribe, and their main tools and methods are conversations and various evaluation forms.With a comatose patient, clinical psychologists can do very little.

But the main purpose of Sun Li'en asking for a consultation is to clear up his doubts.Whether it was in Ningyuan Medical College, or in the emergency department of the fourth hospital, or in the training of Dean Wu Youqian and the old stuff, the content of clinical psychiatry was pitifully small.

There is only one key question that Sun Lien wants to solve - when Cao Zhiquan was diagnosed with somatization disorder, what symptoms did the doctors who made the diagnosis see.Based on only one "somatization disorder", Sun Li'en couldn't reversely deduce all the considerations of the receiving doctor at that time.The prompt on the status bar made Sun Lien directly lock the type of disease into a specific organ lesion, and what Sun Lien is racking his brains to figure out is what difference he saw between himself and the doctor who made the diagnosis.

"If it's an SSRI (serotonin reuptake inhibitor)...it shouldn't be a problem to use sedative drugs after a few months." Dr. Lai Qianhong said after a while of silence, "but this diagnosis... I'm not sure either. What kind of symptoms did the doctor see at the time? I can only make a judgment after the detailed diagnosis records are delivered."

Sun Li'en was silent for a while and asked, "What about his current symptoms? What is certain is that he has paroxysmal generalized muscle spasms and... cognitive decline." Relying on Cao Zhiquan's self-report and previous inquiries According to the medical history obtained by the family members, Sun Lien can only mention these two symptoms.The emergency MRI head scan at night has not been done yet, so these two items are the only ones that can be asked.

"Somatization disorder will certainly be considered, but... other problems must be ruled out." Lai Qianhong thought for a while and shook his head, "I will consider doing an MRI of the patient's head first, and then see if there are any organs. Structural disease. If the organic disease is not serious or not at all, then I will consider MCI first. Only after the option of MCI is ruled out, somatization disorder will be considered.”

MCI (mild cognitive impairment), the Chinese translation is "mild cognitive impairment".This is a state between normal and demented.Patients will suffer from mild memory impairment, but the impact on daily life is not too great.About 15% to 20% of people with MCI will eventually develop Alzheimer's disease.

"Mild cognitive impairment, right? I know that." Sun Lien finally found something he had heard in the vast blind spot of knowledge. After a few seconds of happiness, he was troubled by a new question, "You mean, you suspect that this patient may have early-onset Alzheimer's disease?"

Lai Qianhong was caught by Sun Lien's question, but he was not asked about "early-onset Alzheimer's disease", but "mild cognitive impairment". "MCI...it seems to be called this? It's Mild cognitive impairment..." He raised his head and apologized to Sun Lien with some embarrassment, "I'm not very used to the mainland names of these diseases."

"It's really called that name." Sun Li'en was a little curious, "Are you from Hong Kong? I don't think your accent sounds like it."

Dr. Lai smiled, "Of course it's not like Hong Kong. I'm from Taiwan—I graduated from a high-level medical school."

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After Dr. Lai left the office, Sun Lien turned on the computer in front of him again and began to issue medical orders.

Taiwanese doctor Sun Lien had never seen any of them before, but even if he did, he felt the same.Everyone is a colleague who works in the fourth hospital, at most it is a doctor from other places, I have never seen it before!How could it be different?Anyway, everyone is Chinese.

However, I am not familiar with the translation of professional terms in mainland China, so this is a bit troublesome.No wonder Dr. Lai used SSRI to refer to serotonin reuptake inhibitors—it is estimated that the translation of this thing in Taiwan is still somewhat different from that in mainland China.

According to Dr. Lai, the result of a brain MRI is still needed to judge.As long as the doctors at the Jingwei Center were genuine doctors and not fake laymen, they must have undergone corresponding examinations and ruled out the possibility of MCI before making a judgment on physical disorders.

In other words, Sun Lien can now be sure that Cao Zhiquan's previous MRI results should be normal or only mild lesions, and there is absolutely no sign of MCI lesions such as white matter hyperintensity.

That being the case, it is worth studying the hyperintensity of the whole cerebral cortex diffusion weighted imaging indicated by the status bar.Sun Lien has seen this prompt quite often—generally speaking, patients with cerebral ischemia, intracranial tumors, demyelinating lesions, and infectious brain abscess will often have prompts of high signal on brain diffusion-weighted imaging.

But the whole cerebral cortex... This is really unseen.While Sun Lien ordered the emergency MRI test, he called out Cao Zhiquan's emergency blood test results.Sure enough, all the indicators related to the infection were normal.

Which means...not an infectious brain abscess.Sun Li'en rubbed his chin, which was a bit prickly. Cerebral ischemia can lead to abnormal brain function in patients, resulting in mental symptoms and limited cognitive ability.But this...the doctors in the Jingwei Center should not fail to notice it.After all, the symptoms of cerebral ischemia are too obvious. As long as the doctors' brains are still functioning normally, they should basically not be misdiagnosed.

So... Could it be an intracranial tumor or a demyelinating lesion?Sun Lien first ruled out the possibility of demyelinating lesions.This lesion is very marked and marked, with glove and stocking loss of sensation in the extremities.With Cao Zhiquan's yelling and yelling about everything, it is very unlikely that he would have missed this point.

"So it's...tumor?" Sun Lien frowned and knocked on the table. The field of tumors was still unfamiliar to him.The reason is also very simple, the tumor will have the possibility of acute onset only in rare cases.Emergency admissions to tumor patients may only occur when the beds in the oncology department of this hospital are full, and patients from other hospitals have nowhere to be placed when they are transferred from other hospitals.

In other words, Sun Lien's understanding of tumors is basically similar to that of psychiatric diseases.Except for the more general content taught in school, his understanding of tumors basically comes from occasional consultations and news.

If it is a brain tumor, does the high signal in the diffusion weighted imaging of the whole cerebral cortex mean that the cancer cells have spread to the whole cerebral cortex?It shouldn't be...?Cancer cells do not have normal cell functions. If cancer cells have appeared in the entire cerebral cortex, the patient's consciousness and almost all functions controlled by the brain should be greatly damaged.In this state, let alone yelling like a mania.He shouldn't be able to say a word, and he can't do anything other than the occasional muscle spasm all over his body.

All possibilities are ruled out, but the evidence itself is here.This huge contrast in diagnosis gave Sun Lien a headache.

　After holding back for two days, I finally finished this chapter! ! ! !

　　The lottery draw is not over yet. Since the level of the winners on the 88th floor is not enough, there will be another draw at nine o'clock tomorrow night.The winning floor has been announced in the lottery post, please contact Sanguan as soon as possible for other winners.

　　
　
(End of this chapter)