This doctor is great

Chapter 237 Complex
Almost everything that can be asked has been asked.

This female patient named Chen Xiuya has a complicated condition.

Considering that the patient had vomited blood, he could not be discharged and had to stay in the hospital for observation.

However, the patient's disease is not yet known, so he cannot be sent to the inpatient department.

"Call for a consultation..."

"In addition, do a basic examination, blood routine, liver and kidney function, electrolytes, blood coagulation function..."

quickly,

Zhou Mo called various departments and came to make a diagnosis.

Lungs, cough, and hemoptysis are called thoracic surgery.

Arthralgia, called Rheumatology and Immunology.

Soon, the thoracic surgeon came.

"It may be tuberculosis, so it is necessary, starting today, try to keep sputum every two or three hours, and send it to the laboratory for culture to see if there are acid-fast bacilli..."

"If you still cough up blood, it's best to have a bronchoscopy, and by the way, a chest CT to see what's going on."

"Yes, doctor."

"Ah?" At this time, the patient jumped up, "CT? I heard that CT radiation is a bit strong. I have recently lost my hair. Will it make the hair loss worse? Can I use X-rays?"

Women, always attach great importance to hair.

Zhou Mo shook his head: "It's better to go straight to CT. It's much clearer than chest X-ray. Even if you do it with X-ray, you'll still need CT for diagnosis..."

Hearing this, Ms. Chen could only agree.

The CT results are the fastest, and the pictures are produced on the spot.

· Chest CT results came out.

·The lungs are white, indicating that there is some inflammation in the lungs.

but,

CT showed pneumonia, which was not particularly serious.

But it can be explained: fever, chills, dry cough, limb aches and fatigue.

But coughing up blood is kind of hard to explain.

Not long after,
The blood test results came out, too.

A very strange phenomenon occurred.

White blood cell count is 2.8
Reduced!
Normal white blood cell count is 4-10! !
Zhou Mo: "..."

Zhang Mei: "........."

Confused.

what happened?

Pneumonia, shouldn't it be an increase in white blood cells?

How can it be lowered?
At this time, Zhou Mo thought of a possibility: "Teacher, some critically ill patients, especially those with severe infections, have suppressed immune levels, and the white blood cell count may not rise but fall."

"Moreover, the patient, Ms. Chen, has lost her hair for more than two months. It is possible that the condition is more serious than we thought!"

"Not just pneumonia."

Teacher Zhang Mei thought for a while, then nodded: "It's possible."

For now,

Consider severe pneumonia infection
Consider whether there is a possibility of blood system diseases, such as leukemia, because leukemia can cause a decrease in white blood cells.

but,

Still can't explain the joint pain.

The two continued to look down.

then……

Zhou Mo was shocked!
"Teacher, look, platelet!"

· Platelets, platelets 76!

Platelets, the normal value of the human body, is 100-300...

If it is less than 100, it will be called "thrombocytopenia"!
What is the function of platelets?

Coagulation! !
With fewer platelets, it is naturally easier to bleed!

With so few platelets, it is no wonder that patients cough up blood. Coupled with severe coughing, it is really easy to cough up blood vessels in the lungs and cause bleeding.

but,

Why do platelets decrease?

what is the reason?
Zhou Mo thought of "serious infection" and inhibited the production of platelets.

In addition, will there be blood system diseases?

Like leukemia?Lymphoma?
"If you want to confirm leukemia, you need to do a bone marrow aspiration..."

"If you want to confirm the lymphoma, you need to do a whole body CT again..."

Zhou Mo told Teacher Zhang Mei about his thoughts.

"Can……"

"Do you want to call the oncology department for consultation?"

"can."

Zhou Mo went to call and asked the oncology consultant to come over.

Zhou Mo: "Do you usually have night sweats?"

Night sweats are one of the typical symptoms of lymphoma.

Patient: "No..."

In addition, there are skinny...

Zhang Mei and Zhou Mo observed the patient Chen Xiuya, she was well-proportioned, not thin...

Lymphoma can be temporarily ruled out.

Teacher Zhang Mei: "The infection is so serious, first use antibiotics to suppress the inflammation..."

Zhou Mo: "Yes."

in addition,

Zhou Mo suggested: "The cause of the disease has not been found yet, so it is best to do all the checks."

"A set of rheumatism immunity, infection markers, tumor markers...it's best to do it all...bone marrow aspiration, CT..."

Teacher Zhang Mei agreed.

at this time,

The patient's parents are present.

After Zhou Mo talked to the patient's parents,
"Is it that serious?"

"This is the current consideration, so so many inspections are needed."

"Hey, the hospital really costs a lot of money every time I come to the hospital."

"That's right, it's a few thousand who went out again."

"However, if you don't do it, you can't..."

"Hey……"

Zhou Mo was listening beside him, and couldn't help but smile wryly.

For some diseases, empiric treatment is naturally possible, such as diarrhea, usually a blood routine test and fluid rehydration are enough.It doesn't take much money, just 100 or less.However, if diarrhea is accompanied by complicated symptoms, it will be a little troublesome, and the inspection will be more, and the cost will be higher, unless you don’t want to find the cause and treat the symptoms instead of the root cause.

Although the parents were nagging, they signed without hesitation.

When Zhou Mo returned to the hospital bed, Zhang Mei couldn't help frowning.

"teacher……"

"There seems to be something wrong with her condition. She has a fever and doesn't seem to be in a good mood... I don't know if her condition has progressed."

"Then do the inspection quickly... I have already got the signature."

"it is good."

The two did not dare to neglect.

Get your blood drawn!

Various checks!
Money can't be saved!

At this time, the doctor from the rheumatology and immunology department also came.

However, after a consultation and physical examination by the rheumatology and immunology department, no diagnosis was made.

"Let's do a checkup for rheumatism..."

The rheumatologist and immunologist only made this decision and went back to work in the ward.

Then, an hour passed, and the effect of the medication was not obvious.

The patient, Chen Xiuya, still had a fever, and it got even worse, her dry cough became more severe, and her sore limbs and joints still didn't get better, and the pain became even worse.

Halfway through, I coughed up blood.

Zhou Mo, Mr. Zhang Mei and some nurses saw this coughing up blood with their own eyes, and they were sure that it was indeed coughing up blood.

quickly,

Except for the bone marrow puncture not yet done, and the results of rheumatism immunity are relatively slow, all the test results have come out.

But nothing special was found.

Zhou Mo and Zhang Mei didn't find any problems, and the patient's condition didn't seem to be 'red', so they went to rescue other patients.

After more than an hour,

The patient's parents suddenly found Zhou Mo,

"Doctor, I don't know if I should tell you something..."

"Of course I have to say..." Zhou Mo said seriously.

"My daughter seems to have some rashes on her chest and back. I don't know if it's serious..."

"?!!!!"

Zhou Mo was taken aback.

This situation has never been mentioned before.

(End of this chapter)