I can see health

Chapter 375 Strange Two Minus Signs (Second)

After checking the house, Min Ling praised Liu Binsong again.

This made the junior sister a little embarrassed.

After everyone dispersed, she hurriedly came to Lu Chen's side, bowed her head and said softly, "Senior brother, I'm sorry, I...I can't, I can only tell you everything you told me."

Lu Chen smiled and shook his head: "It's okay, as long as you can understand what I mean by these differential diagnoses, that's fine."

"Um...some things I don't understand now, but I will definitely understand them in the future!" Liu Binsong clenched his fists.

"Okay, then I will test you tomorrow!" Lu Chen said.

"Ah? Brother, you..." Liu Binsong pouted.

Senior brother Lu Chen really asked... She just said it casually!
……

After checking the room, Lu Chen began to give the doctor's orders and write today's medical records.

There are more patients and more workload.

However, several interns are temporarily unable to do these jobs, so Lu Chen can only do it himself and teach them patiently.

Gu Xinyue is in another group in the first district. There are two graduate students in their group, and the other graduate student is a senior of Yansan.

Brother Yansan asked for leave for several days on the grounds of looking for a job and writing a thesis.

Lu Chen saw that Gu Xinyue was also very busy, walking back and forth between the departments and the office.

Throughout the morning, everyone hardly rested.

Close to noon off work.

The nurse hurried in.

"Is the doctor from Mr. Cui's group here? Your bed 31 is not feeling well. Go and have a look!"

Teacher Cui's group happened to be Gu Xinyue's group.

Seeing that Gu Xinyue stood up immediately, "I'm from Teacher Cui's group, I'll go right away!"

Teacher Cui had the night shift last night and left early today.

Only Gu Xinyue and a few other interns remained in the group.

"Lao Gu, I'll wait for you." Lu Chen turned to Gu Xinyue and said.

The two of them made an appointment to go to the cafeteria for lunch together.

Gu Xinyue also wanted to ask Lu Chen about clinical research.

"Okay, I'll go see the patient first." After speaking, Gu Xinyue hurried out of the office.

About 5 minutes later, Gu Xinyue returned to the office frowning.

When passing by Lu Chen, he stopped and said, "Lu Chen, go eat first, this patient is troublesome, and I won't be able to get off work for a while."

"What happened to the patient?" Lu Chen wondered.

Most of the patients in the Department of Endocrinology have blood sugar problems.

Except for a small number of patients with diabetic ketoacidosis, the condition of other patients is relatively less urgent.

As Gu Xinyue walked back to her seat, she said, "A patient with diabetic ketoacidosis who was admitted to the hospital yesterday had a blood sugar of 33.8 mol/L when he was admitted to the hospital yesterday. His blood sugar has dropped during the ward check this morning, and his random blood sugar is only 14 mol/L. Left and right, but he kept complaining about abdominal distension, and the symptoms were progressively worsening, and now the distension is getting worse!"

Lu Chen frowned slightly, is he really suffering from diabetic ketoacidosis? !

The blood sugar of more than 30 points has dropped, but the condition has worsened?
What is the reason for this...is it really strange?

"Does the patient have abdominal pain, nausea, or vomiting?" Lu Chen casually asked.

"No." Gu Xinyue shook her head, "Except for abdominal distension, everything else is fine. I have already told the teacher on duty at noon, and she will come right away, let's see how she handles it."

"Well, then I'll wait for you, and there's no rush to eat." Lu Chen said.

He mainly wanted to see this "strange" patient.

Blood sugar dropped, but symptoms got worse!

Lu Chen opened the patient's course record.

The patient is 59 years old.

He was admitted to the hospital because of "shortness of breath, chest tightness, and upper abdominal discomfort for half a day".

After drinking 500g of white wine yesterday, the patient developed shortness of breath, could not lie flat, accompanied by nausea, vomiting and other symptoms. He came to the emergency department of Jinghua Second Hospital, and the blood sugar was 32.1mol/L. Considering diabetic ketoacidosis, he was admitted. Hospitalized in Internal Medicine.

Past history: Hypertension and diabetes for 10 years without regular treatment, taking hypoglycemic and antihypertensive drugs intermittently.

Admission examination: body temperature 36.6°C, pulse 142 beats/min, respiration 28 beats/min, blood pressure 140/80mmHg, cardiopulmonary abdominal auscultation was negative.

After being admitted to the hospital yesterday, according to the treatment principles of diabetic ketoacidosis, he was given intravenous small doses of insulin, active rehydration, and potassium supplementation.

"The patient's blood sugar is slowly decreasing. By this morning, it was close to normal." Lu Chen frowned, "Why did the symptoms suddenly get worse?"

At this time, the doctor on duty at noon came in, and it was Lou Jie.

"Which bed is the patient uncomfortable?" Lou Jie asked standing at the door of the office.

"Teacher, it's bed 31 of Teacher Cui's group." Gu Xinyue immediately stood up and walked to Lou Jie's side.

"What is the patient's disease?" Lou Jie asked.

"Diabetic ketoacidosis." Gu Xinyue said.

"Okay, you go to see the patient with me." Lou Jie nodded.

"Ah."

Afterwards, Gu Xinyue and Lou Jie went to the hospital bed.

Lu Chen was still in the office, frowning and flipping through the patient's medical records.

He noticed that the patient also had a CT of the chest and abdomen yesterday.

Lu Chen immediately clicked on the patient's CT image.

When many doctors see CT, their first reaction is to read the examination report.

But Lu Chen was different. He had to look at the CT images first, and then the report from the radiologist.

Otherwise, if you read the report with conclusions, you may be influenced by other people's judgments.

"It's a small amount of pleural effusion ... and a very small amount of ascites."

Although normal people also have a very small amount of pleural effusion, this person also had a small amount of pleural effusion and peritoneal effusion.

Lu Chen couldn't help paying attention.

In addition, the patient also has fatty liver.

No abnormalities were found in the biliary system and bilateral renal pelvis.

"The area around the patient's pancreas... seems to be somewhat unclear..." Lu Chen murmured.

This kind of imaging is unclear, and it is difficult to distinguish whether there is a lesion, or it is caused by the uneven scanning of the instrument.

Lu Chen glanced at the CT report.

Only a small amount of pleural effusion, a very small amount of ascites, and fatty liver were reported, and the pancreas was not described.

Is the pancreas okay?
Without seeing the patient himself, Lu Chen couldn't make a judgment.

He stood up and walked to the 31-bed ward.

……

At this time, Lou Jie was in front of the hospital bed, performing abdominal physical examination on the patient.

"Does it hurt here?"

The patient shook his head: "It doesn't hurt."

"Then pay attention, I will take my hand away later, and you can see if it hurts."

"It's not painless." The patient still shook his head.

"The patient's abdomen is soft, with no tenderness or rebound pain." Lou Jie said, "If you feel bloated, it must be because you have been lying on the bed for a day or two, and your abdomen is a little bloated if you do not move. Observe first, it should be Not much of a problem."

At this time, Lu Chen was staring at the life value above the patient's head.

52 (--)!
These are two minus signs!

If the patient is just diabetic ketoacidosis, hypoglycemic, rehydration, after the blood sugar drops, the condition tends to be stable, the trend of the change of life value should also be (+)!

How could it be the two (——) now?

　There is one more chapter.

　　It will be around one o'clock, everyone go to bed early!

　　
　
(End of this chapter)