I can see health
Chapter 112 is over, remember to take a look at the chapter head!
Chapter 112 The queen is over, remember to look back!
Lu Chen took a few tissues, wiped his greasy mouth, and walked quickly to the doctor's office.
"Here comes a patient with gout, in bed 30."
Walking into the doctor's office, Min Ling was already sitting in front of the computer.
"Well, I'll go to see the patient and ask about his medical history." Lu Chen nodded, grabbed his stethoscope, and walked towards bed 30.
While walking, Lu Chen recalled the concept of gout.
Gout is a disease caused by the deposition of uric acid crystals in the joints due to high levels of uric acid in the blood. The deposited crystals cause painful inflammatory attacks in and around the joints.
With the prolongation of the average life expectancy of human beings and the change of diet and lifestyle, this data shows an upward trend year by year.
The age of gout patients is gradually getting younger, the ratio of male to female is 15:1, and more than 50% of gout patients are overweight or obese.
……
Come to the ward where the 30 beds are located.
As soon as he entered the ward, Lu Chen saw a very young male patient lying on the bed.
He was about 30 years old, with a thin body and a sickly pale complexion.
Lu Chen walked to the bed, he was hugging his right leg, grinning, his face was full of pain.
Gout is not a serious disease, but it hurts like hell!
"Doctor, can you give me some painkillers first?"
Seeing Lu Chen walk into the ward, the patient quickly raised his head and said.
"The nurse is dispensing the medicine and will give you the medicine right away." Lu Chen said, "Now let me ask you about the specific process of your illness."
"Hey, I have this disease, and it happens many times a year." Xia Jinhua sighed, showing his ankles on both sides, and then stretched out his right hand.
Lu Chen saw that there was a raised lump on the skin of his ankles and right hand on both sides.
This is tophi!
Tophi is a characteristic clinical manifestation of gout. It is commonly found in the auricle, metatarsophalangeal, fingertips, metacarpophalangeals, elbow and other joints, Achilles tendon, and patella bursa.
The tophi of this patient is not small, about the size of a ping-pong ball.
"Then your medical history is really not short, the gout stone is so big." Lu Chen sighed.
It was also the first time he saw a patient with such a large tophi, and the patient was still so young.
"Oh, I used to be young and ignorant, I drank and ate seafood, and I didn't control my diet." Xia Jinhua shook his head, "At first, it happened five or six times a year. In recent years, it happened several times a month. I can't bear it. !"
In addition to genetic and environmental factors, the disease of gout is most related to personal eating habits.
Now that living conditions are better, more and more young people will suffer from gout.
At the same time, Lu Chen noticed that the patient's HP was 62 in yellow.
This value is somewhat unusual, only one step away from the red warning line.
"Can gout reduce the HP to around 60?" Lu Chen was a little puzzled.
There were also patients with gout in the ward, and Lu Chen noticed that the health of the others was around 70 or 80.
But the patient in front of him is so young, but his health is only 62, and it is hard to guarantee that his health will continue to decline.
Lu Chen asked the patient about the course of the disease in more detail, followed by a physical examination.
"Have you always looked this pale?"
From the moment he entered the door, Lu Chen noticed that the patient's complexion was a little sickly pale.
I thought it was caused by the onset of pain.
However, I feel that this "pale complexion" may be unusual.
The patient is not only pale, but the bulbar conjunctiva is also white, and the whole person is in an anemic state.
Xia Jinhua paused, and recalled: "It's been about half a year, and the colleagues next to me said that I looked a little pale."
Lu Chen frowned.
Is it chronic anemia?
"How's your diet lately?"
"Hey, ever since this gout flares up frequently, I have strictly controlled my diet." Xia Jinhua said, "I don't eat any meat dishes, and usually eat some vegetarian food."
Lu Chen frowned, anemia caused by malnutrition?
"Have you ever had anemia before? Maybe when you were hospitalized last time, did any doctor tell you that you had anemia?"
"Anemia?" Xia Jinhua was stunned, "I don't think so. Doctor, you mean, I have anemia now?"
"Not necessarily, a blood test is required to confirm the diagnosis." Lu Chen said.
Xia Jinhua nodded, and then recalled: "I have occasionally experienced fatigue and dizziness in recent months. I have never experienced it before. Could it be caused by this anemia?"
"If anemia is diagnosed, it may be caused by anemia."
……
Go back to the doctor's office.
Min Ling has already given all the doctor's orders.
"How is the patient's condition?"
"It's mainly due to pain in both ankles. I'm considering an acute attack of gout." Lu Chen paused, "But..."
"Is there anything else?" Min Ling looked back at Lu Chen.
After getting along with each other a few times, Min Ling already values Lu Chen's opinion very much.
If it is an ordinary graduate student, Min Ling can just listen to his opinion and don't need to care too much.
But Min Ling paid more attention to Lu Chen's words.
"During the physical examination, I found that the patient had obvious anemia, but the patient denied any previous history of anemia."
Min Ling nodded, and said: "I looked through the patient's previous medical records. He also lived in the hospital half a year ago. He had mild anemia at that time. The patient probably didn't care."
Lu Chen leaned over to Min Ling's computer and saw the patient's laboratory test, hemoglobin Hb105g/L.
However, other indicators of blood routine, including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), have all decreased slightly, and have not yet reached the level of microcytic hypochromic anemia.
Generally mild anemia, physical examination is more difficult to find.
What's more, the patient is currently showing obvious anemia.
"I did a blood routine check just now." Min Ling said, "Let's see the results before we talk."
"Yes." Lu Chen nodded.
……
After half an hour.
The urgent blood came out, hemoglobin HB85g/L.
Moderate anemia!
Hemoglobin dropped further.
"Looking at the blood test, it should be microcytic hypochromic anemia." Min Ling frowned.
"The patient has recently strictly controlled his diet, and he hardly ate any meat dishes." Lu Chen said, "Could it be the reason?"
Min Ling was silent for a long while before saying.
"Malnutrition can indeed cause anemia, but moderate anemia is relatively rare."
Unexplained anemia is generally more severe in male patients than in female patients.
Female patients, who have a fixed blood loss every month, are likely to be anemia caused by this reason.
But male patients do not have this route of blood loss.
Therefore, in general, male patients may have the possibility of digestive tract diseases.
"Could it be chronic gastrointestinal bleeding?" Lu Chen wondered.
Min Ling said, "Does the patient have black stools?"
Lu Chen frowned, "Occasionally, but patients didn't pay much attention."
"When the patient's gout improves, I'll arrange a gastroenteroscopy for him." Min Ling thought for a while and said.
It is very important to take a look back every time the tuba is over!
Pay particular attention to the shape and color of your stool.
If there is blood in the stool, it may be bleeding from hemorrhoids.
If it is black stools and not formed, it is likely to be gastrointestinal bleeding, including gastrointestinal ulcers, or even a possibility of gastrointestinal malignant tumors.
……
(End of this chapter)
Lu Chen took a few tissues, wiped his greasy mouth, and walked quickly to the doctor's office.
"Here comes a patient with gout, in bed 30."
Walking into the doctor's office, Min Ling was already sitting in front of the computer.
"Well, I'll go to see the patient and ask about his medical history." Lu Chen nodded, grabbed his stethoscope, and walked towards bed 30.
While walking, Lu Chen recalled the concept of gout.
Gout is a disease caused by the deposition of uric acid crystals in the joints due to high levels of uric acid in the blood. The deposited crystals cause painful inflammatory attacks in and around the joints.
With the prolongation of the average life expectancy of human beings and the change of diet and lifestyle, this data shows an upward trend year by year.
The age of gout patients is gradually getting younger, the ratio of male to female is 15:1, and more than 50% of gout patients are overweight or obese.
……
Come to the ward where the 30 beds are located.
As soon as he entered the ward, Lu Chen saw a very young male patient lying on the bed.
He was about 30 years old, with a thin body and a sickly pale complexion.
Lu Chen walked to the bed, he was hugging his right leg, grinning, his face was full of pain.
Gout is not a serious disease, but it hurts like hell!
"Doctor, can you give me some painkillers first?"
Seeing Lu Chen walk into the ward, the patient quickly raised his head and said.
"The nurse is dispensing the medicine and will give you the medicine right away." Lu Chen said, "Now let me ask you about the specific process of your illness."
"Hey, I have this disease, and it happens many times a year." Xia Jinhua sighed, showing his ankles on both sides, and then stretched out his right hand.
Lu Chen saw that there was a raised lump on the skin of his ankles and right hand on both sides.
This is tophi!
Tophi is a characteristic clinical manifestation of gout. It is commonly found in the auricle, metatarsophalangeal, fingertips, metacarpophalangeals, elbow and other joints, Achilles tendon, and patella bursa.
The tophi of this patient is not small, about the size of a ping-pong ball.
"Then your medical history is really not short, the gout stone is so big." Lu Chen sighed.
It was also the first time he saw a patient with such a large tophi, and the patient was still so young.
"Oh, I used to be young and ignorant, I drank and ate seafood, and I didn't control my diet." Xia Jinhua shook his head, "At first, it happened five or six times a year. In recent years, it happened several times a month. I can't bear it. !"
In addition to genetic and environmental factors, the disease of gout is most related to personal eating habits.
Now that living conditions are better, more and more young people will suffer from gout.
At the same time, Lu Chen noticed that the patient's HP was 62 in yellow.
This value is somewhat unusual, only one step away from the red warning line.
"Can gout reduce the HP to around 60?" Lu Chen was a little puzzled.
There were also patients with gout in the ward, and Lu Chen noticed that the health of the others was around 70 or 80.
But the patient in front of him is so young, but his health is only 62, and it is hard to guarantee that his health will continue to decline.
Lu Chen asked the patient about the course of the disease in more detail, followed by a physical examination.
"Have you always looked this pale?"
From the moment he entered the door, Lu Chen noticed that the patient's complexion was a little sickly pale.
I thought it was caused by the onset of pain.
However, I feel that this "pale complexion" may be unusual.
The patient is not only pale, but the bulbar conjunctiva is also white, and the whole person is in an anemic state.
Xia Jinhua paused, and recalled: "It's been about half a year, and the colleagues next to me said that I looked a little pale."
Lu Chen frowned.
Is it chronic anemia?
"How's your diet lately?"
"Hey, ever since this gout flares up frequently, I have strictly controlled my diet." Xia Jinhua said, "I don't eat any meat dishes, and usually eat some vegetarian food."
Lu Chen frowned, anemia caused by malnutrition?
"Have you ever had anemia before? Maybe when you were hospitalized last time, did any doctor tell you that you had anemia?"
"Anemia?" Xia Jinhua was stunned, "I don't think so. Doctor, you mean, I have anemia now?"
"Not necessarily, a blood test is required to confirm the diagnosis." Lu Chen said.
Xia Jinhua nodded, and then recalled: "I have occasionally experienced fatigue and dizziness in recent months. I have never experienced it before. Could it be caused by this anemia?"
"If anemia is diagnosed, it may be caused by anemia."
……
Go back to the doctor's office.
Min Ling has already given all the doctor's orders.
"How is the patient's condition?"
"It's mainly due to pain in both ankles. I'm considering an acute attack of gout." Lu Chen paused, "But..."
"Is there anything else?" Min Ling looked back at Lu Chen.
After getting along with each other a few times, Min Ling already values Lu Chen's opinion very much.
If it is an ordinary graduate student, Min Ling can just listen to his opinion and don't need to care too much.
But Min Ling paid more attention to Lu Chen's words.
"During the physical examination, I found that the patient had obvious anemia, but the patient denied any previous history of anemia."
Min Ling nodded, and said: "I looked through the patient's previous medical records. He also lived in the hospital half a year ago. He had mild anemia at that time. The patient probably didn't care."
Lu Chen leaned over to Min Ling's computer and saw the patient's laboratory test, hemoglobin Hb105g/L.
However, other indicators of blood routine, including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), have all decreased slightly, and have not yet reached the level of microcytic hypochromic anemia.
Generally mild anemia, physical examination is more difficult to find.
What's more, the patient is currently showing obvious anemia.
"I did a blood routine check just now." Min Ling said, "Let's see the results before we talk."
"Yes." Lu Chen nodded.
……
After half an hour.
The urgent blood came out, hemoglobin HB85g/L.
Moderate anemia!
Hemoglobin dropped further.
"Looking at the blood test, it should be microcytic hypochromic anemia." Min Ling frowned.
"The patient has recently strictly controlled his diet, and he hardly ate any meat dishes." Lu Chen said, "Could it be the reason?"
Min Ling was silent for a long while before saying.
"Malnutrition can indeed cause anemia, but moderate anemia is relatively rare."
Unexplained anemia is generally more severe in male patients than in female patients.
Female patients, who have a fixed blood loss every month, are likely to be anemia caused by this reason.
But male patients do not have this route of blood loss.
Therefore, in general, male patients may have the possibility of digestive tract diseases.
"Could it be chronic gastrointestinal bleeding?" Lu Chen wondered.
Min Ling said, "Does the patient have black stools?"
Lu Chen frowned, "Occasionally, but patients didn't pay much attention."
"When the patient's gout improves, I'll arrange a gastroenteroscopy for him." Min Ling thought for a while and said.
It is very important to take a look back every time the tuba is over!
Pay particular attention to the shape and color of your stool.
If there is blood in the stool, it may be bleeding from hemorrhoids.
If it is black stools and not formed, it is likely to be gastrointestinal bleeding, including gastrointestinal ulcers, or even a possibility of gastrointestinal malignant tumors.
……
(End of this chapter)
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