I can see health

Chapter 206
Seeing the system prompt, Lu Chen was extremely shocked.

It turns out that the system can not only receive gratitude, but also clinical thinking insights!

And just at this moment, a clinical thinking skills book was directly given.

Although it is only a basic skill book, it is enough for Lu Chen now.

If this clinical thinking skills book is to be measured by a thank value, it will definitely surpass all current skill books and skill cards.

It is also a skill that all doctors dream of.

Lu Chen is just a "rookie" who has just entered the clinic. Perhaps he has accumulated fairly good knowledge in cardiovascular medicine, but when it comes to other departments, his knowledge reserve is a bit stretched!
With a thought, Lu Chen immediately used the "Clinical Thinking Skills Book".

After using the skill book, he didn't feel any difference.

However, according to the previous method of using the system skill book, this is not to instill all kinds of knowledge directly, but to practice by himself.

So, Lu Chen turned his attention back to the case in front of him.

……

"Are there any other teachers with different diagnostic opinions, or good suggestions for the current treatment plan?"

Wang Peng stood on the rostrum and looked around at everyone.

So far in this discussion, although there are many opinions, there are not many that are more reliable.

Among them, the HHT diagnosed by Mr. Xu Zhonghuang is one of the more reasonable diagnoses to solve the patient's gastrointestinal bleeding.

However, how to explain the patient's myocardial infarction and cerebral infarction?
Everyone in the audience whispered, but no one stood up to speak.

Lu Chen has been immersed in the insights brought to him by the clinical thinking skills book.

When he revisited the case, he saw something different from before.

The patient's thrombosis and bleeding, these two contradictory symptoms, seem to be separated, but is there any internal connection?
Lu Chen turned his head to look at Li Yao who was on the side, and said softly, "Teacher, tell me, if you use monism to explain all the patient's illnesses, would there be any connection between the patient's cerebral infarction, myocardial infarction, and gastrointestinal bleeding?"

Li Yao was taken aback when she heard Lu Chen's words, and then fell into deep thought.

Thrombosis and bleeding, these two completely opposite things, how can they be brought together?

If it was what other students said, she might not have cared so much.

But it came from Lu Chen's mouth, so Li Yao couldn't help but take it to heart.

……

"If there is no teacher to continue to speak, then the discussion of the whole school will be over, thank you everyone..."

Before Wang Peng finished speaking, Li Yao stood up suddenly.

Wang Peng's words were held back abruptly.

"Director Li, do you... have other opinions?"

Everyone passed the microphone to Li Yao's hands.

Li Yao smiled slightly, "I have some ideas, or some hints from my students, so I'll just say a few words."

"Ms. Li, please tell me." Wang Peng smiled.

Everyone present automatically ignored Li Yao's "tips from students".

Li Yao looked down at Lu Chen beside her, and then said slowly.

"According to the medical history, physical examination and related examination results, the possibility of paradoxical embolism cannot be ruled out."

As soon as Li Yao stood up, Lu Chen opened his little notebook again.

"Contradictory embolism, what is this?"

Lu Chen felt a little puzzled.

This is another new knowledge point!

"Ambivalence embolism, also known as paradoxical embolism, singular embolism."

It refers to the thrombus in the venous system and right atrium enters the left heart system from the right heart system through the traffic in the heart, causing arterial embolism in the heart, brain, kidney and peripheral blood vessels.

Common causes of paradoxical embolism are: ventricular septal defect, patent ductus arteriosus, atrial septal defect, pulmonary arteriovenous malformation, and patent foramen ovale, the most common of which is patent foramen ovale.

At this time, Director Yang from the third area of ​​the heart said slowly: "Director Li, we have also considered the diagnosis of paradoxical embolism just now, but through esophageal ultrasonography, no patent foramen ovale and other cardiac chambers were found. Internal shunt disease, so these should be ruled out."

Everyone looked at Li Yao in unison, and it was impossible for the director of the eighth district in his heart to give only this kind of explanation.
They pricked up their ears to hear what kind of explanation Li Yao could give.

And Li Yao still had a faint smile on her face.

"If intracardiac shunt disease is ruled out, is pulmonary arteriovenous malformation ruled out?"

When Director Yang heard this, he shook his head: "This disease is relatively rare, and we haven't considered it for the time being."

Li Yao smiled and continued: "Let's leave the pulmonary arteriovenous malformation aside. Let's talk about the HHT that Director Xu Zhonghuang just said."

All the people here don't know why.

Regarding HHT, Mr. Xu Zhonghuang has made it very clear just now.

What is Li Yao doing?
But when Xu Zhonghuang heard Li Yao's words, he frowned first, and then his expression froze, revealing a hint of surprise!
"Pulmonary malformation and HHT?!"

He looked up at Li Yao who was speaking, with a hint of admiration in his eyes.

At this time, only Li Yao's words continued to come from beside his ears.

"HHT, everyone knows that this disease is a genetic disease caused by the abnormal development of the blood vessel wall. The disease occurs in young and middle-aged people, and both men and women can suffer from it. Its typical lesions are bright red on the skin and mucous membranes. Or purple capillaries or small blood vessels dilate, causing skin and mucous membrane bleeding or gastrointestinal bleeding."

After hearing Li Yao's words, everyone was even more puzzled.

She did not talk about new viewpoints, but described the characteristics of HHT.

"Director Li, we all know about your HHT." Wang Peng said on stage.

"Then do you know what the pathophysiology of HHT is?" Li Yao asked with a smile.

"Ah? This..." Wang Peng was stunned for a moment.

He is a doctor of cardiology, how does he know the pathophysiology of HHT!

Li Yao smiled and said: "HHT, its basic pathological change is the incomplete smooth muscle of small arteries and small veins, and the surrounding matrix lacks elastic tissue."

"The first morphological abnormality to appear is posttelangular venule dilation. As the venule dilates, the venule curls into a mass, and finally, the capillaries connecting the arteriole to the venule disappear, and the arteriole connects directly to the venule."

"This is the reason for the formation of arteriovenous fistula. If this morphological change occurs in the blood vessels of the lungs, it is a pulmonary vascular malformation-pulmonary arteriovenous fistula!"

Before Li Yao finished speaking, Director Yang, who was in the third area of ​​his heart, was the first to react.

"HHT first causes hemorrhage, and then causes pulmonary artery malformation. Pulmonary arteriovenous fistula will form thrombus. The thrombus, along with the blood circulation, reaches the patient's coronary artery and cerebrovascular, causing myocardial infarction and cerebral infarction!"

Therefore, myocardial infarction, cerebral infarction, and digestive tract will appear in one patient!
That's all for now.

Everyone here is a doctor from a top tertiary hospital, so they understood it instantly.

One HHT, causing a chain reaction for all patients!

Lu Chen listened to Teacher Li Yao's explanation.

It's as if the layers of fog have been pushed away, and there is a feeling of heartiness and enlightenment!
"Congratulations, you have received clinical insight!"

The system's notification sounded again, but this time no skill book was received.

　one more chapter

　　
　
(End of this chapter)