I can see health

Chapter 287 Lu Chen's Rapid Progress

In the third round of competition in the province, Cheng Guowen, chairman of Jinghua Electrophysiology Society, paid great attention to it.

A total of two people from Jinghua Second Academy entered the third round.

One is Lu Chen, and the other is Lei Cui, the attending doctor in the first ward of the Cardiology Department of Jinghua Second Hospital.

Cheng Guowen provided two spare classrooms in the teaching building for the two as examination venues.

At 02:30 in the afternoon, Lu Chen came to Room 303 of the teaching building.

Lei Cui sat in room 304 next to Lu Chen for the exam.

……

The classroom in the teaching building is very empty, and a computer is placed in the middle of the field.

According to the requirements of the examination rules, two cameras were placed around the classroom.

At this point, there was still half an hour before the exam began.

Sitting in front of the computer, Lu Chen recalled all the electrocardiogram and electrophysiological knowledge in his mind.

After studying all day yesterday and this morning, he relied on the super-high comprehension ability endowed by the advanced skill card of the electrocardiogram to master the deeper electrophysiological knowledge.

In particular, Lu Chen carefully analyzed the real questions in the email Cheng Guowen sent him over the years, including the scope, form, difficulty, etc. of the test.

Originally, Lu Chen couldn't understand many real exam questions.

For example, in terms of electrophysiological pacing, etc., Lu Chen can only have a half-knowledge.

He has never had electrophysiological surgery before, but just watched one with Li Yao, and it is difficult to understand the electrophysiological principle.

However, with the advanced skill card in the electrocardiogram, Lu Chen's comprehension became stronger.

He can understand some deeper electrophysiological knowledge very thoroughly.

……

The conference room on the 3rd floor of the teaching building of Jinghua Second Hospital.

Cheng Guowen and Li Yao, as well as some electrophysiology members of the Cardiology Department, were all together.

There is a huge screen before the meeting, through which everyone can monitor the progress and ranking of the exam in real time.

"Director Shi, Lei Cui should be sure to enter the top three, right?" Cheng Guowen looked at Shi Qinghua who was on the side.

Shi Qinghua is the deputy director of Xinxin District [-], and he knows Lei Cui's learning status best.

Shi Qinghua nodded with a smile, "Lei Cui's main direction has long been electrophysiology. Her master's and doctoral studies are very thorough in this area. It should be no problem for her to enter the national competition."

"That's good." Cheng Guowen said, "If we can enter the national competition this time, we can take the initiative in the general election. If we can enter the top ten in the country, then there is a 90.00% chance that the chairman will still Stay in our Jinghua Second Hospital."

Although Li Yao is the vice chairman, she has been silent all the time.

Lu Chen is his student and has entered the third round of exams, but few people pay attention.

Everyone seems to have decided that it is impossible for Lu Chen to enter the top three.

Cheng Guowen glanced at Li Yao, wanted to say something, but swallowed it back.

……

At three o'clock in the afternoon, the exam officially begins!
Lu Chen entered the test platform.

In the third round of the exam, there are a total of [-] question and answer questions, each question is worth five points, and the exam time is two hours. After each question is completed, there will be professional personnel in the background to interpret it immediately.

Twenty questions, two hours of exam time.

From this, we can also see the difficulty of this competition!

Lu Chen clicked on the first question.

A 92-year-old male patient, 20 years after single-chamber pacemaker implantation (VVI), underwent pacemaker (VVI) replacement 8 years ago, repeated dizziness, which was obvious when changing positions, and improved after rest.The segment of the dynamic electrocardiogram is as follows. The patient's dynamic electrocardiogram may be caused by the following reasons?
Sure enough, the difficulty of the third round was more than one notch higher than the first two rounds!
Moreover, the content of this test is not the diagnosis of the electrocardiogram, but the reason for the dynamic electrocardiogram!
This is not only a test of diagnosis, but also a deep-seated principle.

Fortunately, Lu Chen had seen the real exam questions over the years before, otherwise he would have been confused.

……

Teaching building conference room.

"The exam questions this time are more difficult than the previous two years. Many cutting-edge electrophysiological knowledge, if there is no training in this area, it is actually difficult to answer."

Cheng Guowen said in a deep voice.

"Yes, if you haven't experienced electrophysiological surgery or pacemaker implantation yourself, it's very difficult to analyze this kind of problem." Shi Qinghua nodded, "Based on imagination alone, the difficulty will be increased several times."

Li Yao frowned.

The meaning of what everyone said is very clear.

As a senior attending doctor, Lei Cui has done many electrophysiological surgeries, but Lu Chen is different. A student who doesn't even have a license to practice medicine, can he do this kind of problem?
The answer is obviously impossible!
……

Room 303.

Lu Chen began to analyze the fragments of the dynamic electrocardiogram.

This ECG is characterized by variable pacing intervals with an unstable baseline.

However, the shortest pacing interval is 1000 ms (60 beats/min), which is in line with the default lower limit pacing frequency setting of the pacemaker under normal circumstances, considering that the lower limit frequency of the pacemaker is 60 beats/min.

"The electrocardiogram showed disorganized myoelectric signals during the long pacing interval, and no pacing pulses appeared."

After analyzing for about 8 minutes, Lu Chen had the answer in his mind.

"First of all, it should be considered that the pacemaker inhibits the release of ventricular pulse after sensing the myoelectric signal, and the myoelectric interference signal causes the pacing rhythm to reset, resulting in a ventricular long interval of up to 2813ms."

Lu Chen wrote down the answer, and after clicking Confirm, he entered the next question.

……

Teaching building conference room.

"Well, Dr. Lei Cui answered the questions very quickly. The first question has been completed, and the analysis is very correct. This dynamic electrocardiogram is due to the misperception of the pacemaker." Cheng Guowen is very satisfied with Lei Cui's performance.

At present, Lei Cui's answering speed and correct rate are among the best among all ten doctors.

Shi Qinghua smiled from ear to ear.

If Lei Cui can maintain this state of doing questions, then there is absolutely no problem in getting the top three!
Except for Li Yao, few people noticed Lu Chen's answering status.

Lei Cui took 5 minutes for the first question, and Lu Chen took 8 minutes for the first question.

Li Yao was surprised to find that although Lu Chen took a lot longer than Lei Cui, the content of his answers was very detailed.

Is this really a student new to electrophysiology?
Li Yao looked a little dazed, because she knew Lu Chen's level too well.

When Lu Chen first arrived in the eighth district of the heart, at most he could only be regarded as a student with solid basic knowledge, and he knew nothing about electrophysiology.

But now, Lu Chen's knowledge reserve is even more than that of ordinary attending doctors!

It all happened in these three months...

……

Lu Chen doesn't know what's going on outside the court, he is now concentrating on reading the second question.

The second question, female, 84 years old.

Abdominal discomfort accompanied by nausea and vomiting in the past 4 days. The electrocardiogram showed: sinus rhythm, third-degree atrioventricular block, junctional escape rhythm, and acute inferior wall myocardial infarction.

Emergency coronary angiography showed that the proximal right coronary artery was completely occluded, and a stent was implanted in the right coronary artery, and a temporary pacemaker was implanted (parameter settings: voltage: 5.0V, sensing sensitivity: 3.0mV).

The ECG monitoring for 3 days after the operation is as follows. What is the diagnosis of the ECG monitor?
Lu Chen frowned slightly, this was another question about pacing and electrophysiology.

Fortunately, he has already familiarized himself with the scope of the exam in advance. During this period of time, he has done intensive training on pacing and electrophysiology, and now he can calmly deal with these questions.

Lu Chen clicked on the big picture of the electrocardiogram.

"The fifth heartbeat in the monitoring chart is a sinus capture, and ventricular pacing pulses can be seen after the escape interval."

"False fusion waves and different degrees of true fusion waves can be seen in the monitoring graph and conventional ECG, and the pulse signal is located in different positions of the QRS."

Lu Chen spent 7 minutes on the second question.

This time, Lei Cui took 6 minutes.

……

After ten questions.

In the conference room, besides Li Yao, someone finally noticed Lu Chen's performance.

"Look at Lu Chen, his answering speed is not slow?"

Cheng Guowen looked at the live test on the screen in surprise.

Shi Qinghua nodded: "It's pretty fast, but I don't know how he answered the first few questions..."

Although the real-time ranking will appear on the screen, each person's answering speed is different, and there is a certain lag.

At present, the real-time results only count the results of the first six questions.

(End of this chapter)