This doctor is great

Chapter 195 Shocked to the point of numbness!Patients who eat roundworms!

In addition to hypokalemia,
There are also blood ketone bodies, which exceed 5mmol/L, which is obviously acidosis.

(Although it is not diabetes, but because of low blood sugar for too long, the body starts to break down fat, produces ketone bodies, and causes ketoacidosis. Reducing sugar intake is also one of the ways to lose weight, but be careful of ketoacidosis )

(Hypokalemia, which also affects metabolic balance, leads to ketoacidosis.)
Obviously, this uncle is "hypokalemia + ketoacidosis".

At this moment,
Uncle asked: "Doctor, my whole body has been a little sore recently, is it related to this disease?"

Li Dongmei thought for a while, then nodded: "There is indeed a little possibility..."

Because acidosis is easy to cause osteolysis, while inhibiting the reabsorption of calcium by renal tubules.

Finally, it leads to osteoporosis...

However, this should take the long term.

The elderly feel osteoporosis. It may be that the body itself has a little osteoporosis. It has nothing to do with the low potassium + ketoacidosis in just two or three days.

"Wait a minute, I'll prescribe some medicine for you, calcium supplementation, and potassium ion supplementation..."

For the problem of ketoacidosis, Uncle has already eaten something, supplemented with sugar, and solved the problem of hypoglycemia, and then it will be relieved slowly.

And what about hypokalemia?
Li Dongmei: "I'll prescribe you some "Potassium Chloride" later, just drink it with a drink. "

The classic "potassium chloride"!
Cheap and easy to use!

but,

When Li Dongmei gave the doctor's order like this,
Teacher Zhang Luojia: "..."

Zhou Mo: "..."

Prescribing potassium chloride at this time is absolutely not acceptable.

Zhou Mo: "Wait..."

Zhang Luojia saw Zhou Mo stop him, so he didn't speak, but just sat and watched Zhou Mo's performance.

Zhou Mo whispered to Li Dongmei: "I think it would be better to prescribe Potassium Citrate. "

Li Dongmei: "???"

Suddenly at a loss.

Suddenly nervous.

Did I prescribe the wrong medicine?
Li Dongmei hurriedly looked at Zhou Mo for help.

Zhou Mo smiled and said to Uncle A: "Uncle A, I'm sorry, potassium chloride is super nasty, and the effect is so-so, why don't I replace it with another medicine, potassium citrate , how? Your situation has dragged on for a long time now, I think potassium citrate is more suitable."

Zhang Luojia watched from the side with a smile.

She is very satisfied with the "potassium citrate" opened by Zhou Mo.

Uncle had an intuition that there was something wrong, so he sized Zhou Mo up, his eyes fluctuated: "I know you, you've been on TV...then do as you say."

Zhou Mo hurriedly said, "Thank you, Uncle."

Quickly prescribed "Potassium Citrate", and then told me how to use it.

Uncle Ah left with the medicine list and went to the pharmacy to get the medicine.

Li Dongmei couldn't help but asked Zhou Mo curiously: "Why can't potassium chloride be used?"

She was so curious about this question!
After all, potassium chloride is cheaper, and potassium supplementation is commonly used as a 'hard dish'.

Zhou Mo shook his head: "Did you watch this uncle's urine routine just now?"

Li Dongmei shook her head.

Zhou Mo opened the urine routine in the system and pointed to the pH (ph) inside.

"This uncle's pH value is 7.5 (alkaline), which belongs to alkaline urine (normal people are generally between 5.0 and 6.5, which is acidic)."

"But uncle is obviously suffering from acidosis."

"why is that?"

"This is called "paradoxical alkaline urine"! "

Paradoxical alkaline urine?

Li Dongmei thought about it, and finally remembered what it was.

Li Dongmei frowned: "No, isn't "paradoxical alkaline urine" only found in hyperkalemia? "

Zhou Mo shook his head: "It's not certain, hypokalemia is also possible..."

One of the criteria for judging ketoacidosis is the concentration of bicarbonate, mild bicarbonate <15mmol/L; moderate bicarbonate <10mmol/L; severe bicarbonate <5mmol/L,

The patient is ketoacidosis, so there is not enough "bicarbonate" in the body.

Hydrogen ions decrease, so potassium ions have to replace it and exchange with sodium ions, resulting in increased excretion of potassium from the kidneys, and the pH value of urine can be measured after the acid is reduced, so the urine is alkaline, which is called "abnormal alkalinity" sexual urine".

This is a bit different from normal acid urine.

It is also a place that will stump many doctors.

Zhou Mo explained it again, and then: "Why is the medicine "Potassium citrate" prescribed?Because the uncle himself lacks bicarbonate, if the patient is supplemented with "potassium chloride", then the chloride ions will increase, and the concentration of bicarbonate will further decrease (combined together), and the acidosis will be aggravated! "

At this time, the potassium in the cells will be transported out of the cells, and then excreted through the kidneys, which will increase the loss of potassium. "

"Supplementing potassium chloride at this time will actually make potassium ions—the more you supplement, the lower it will be!"

"The best way is to supplement "potassium citrate"! "

This is why it is said that medicine is very complicated, sometimes the same thing, there will be opposite conclusions.Maybe what Zhou Mo said above may not be right, and it may be the other way around.

"So it is."

Li Dongmei frowned, feeling a headache.

It seems that I have to go back and review more.

But he couldn't help looking at Zhou Mo in amazement, feeling that Zhou Mo really knows everything, and nothing can trouble him.

Zhou Mo: "Okay, the next patient..."

Li Dongmei: "Oh oh oh~~~~"

In a panic, he pressed the calling machine.

Teacher Zhang Luojia continued to stay behind, leisurely thinking about things, her thesis experiment...

It's cool to have a student like Zhou Mo around.

……

Not long after,
A strange patient came to the consulting room.

Still have abdominal pain.

(Abdominal pain: emmm, is my chance of playing too high?)
The patient is a young woman.

Walk in with your stomach covered.

The main complaint is a piercing pain in the stomach, which has started to hurt intermittently since yesterday.

"Do you have diarrhea?"

"Nauseous? Vomiting?"

"Did you eat anything unclean?"

Quite a few questions were asked, followed by a physical examination.

At last,
The female patient burst out: "Doctor, in order to lose weight a month ago, I bought a roundworm egg and ate it. I don't know if it has something to do with it."

Zhou Mo: "!!!!"

Li Dongmei: "!!!!"

clang~~~
The book in Teacher Zhang Luojia's hand fell to the ground.

Zhang Luojia: "!!!!!!"

What the hell!

Awesome man! !
I have seen so many patients, but this patient is the most awesome.

Everyone wished that there were no parasites in their stomachs, but it turned out that this beautiful girl in front of her was lucky enough to eat parasites on her own initiative!

Stunned dog!

The eyes are popping out!
My jaw dropped to the floor!
Still a woman who loses weight is amazing. The last woman who lost weight took cosmetic medicine and ate her intestines like snakeskin.

This woman is even more awesome, eating roundworms!
Shut up!

It's a big guy! !
"Don't you know it's dangerous?"

"What if the bugs eat through your belly?"

Li Dongmei said a little angrily.

.

(End of this chapter)