This doctor is great
Chapter 96 Pericarditis Friction, Pennant Achievement +2
Chapter 96 Pericarditis Friction, Pennant Achievement +2
36 beds, Bunraku.
"Doctor Zhou!"
Cheng Wenle greeted Zhou Mo happily.
Zhou Mo was a little surprised.
"Hey, your spirit looks good, how is the chest pain now?"
Cheng Wenle smiled and said, "Thank you Doctor Zhou. After taking the medicine given by the nurse last night, I feel much better and sleep very comfortably..."
Zhou Mo: "?????"
Bewildered.
I only prescribed ibuprofen, the effect is so strong?
Zhou Mo felt that something was wrong, so he clicked on the iPad and looked at yesterday's doctor's order to see if the doctor on duty had changed it.
That's right, ibuprofen.
The doctor on duty didn't change my doctor's order either.
Ibuprofen is so powerful?
"Did the doctor on duty yesterday visit you?"
"Doctor on duty? No, every doctor has visited..."
Zhou Mo nodded upon hearing this.
"I'll do some checks on you..."
"Okay okay."
"Does your chest still hurt?"
"It hurts, but it's not that painful, it's okay..."
As Zhou Mo asked, he held the 3m and listened to the heart and lungs of the patient Cheng Wenle.
"Huh, friction sound?"
Once in the ear,
Zhou Mo realized something was wrong.
"Swish, swish, swish~~~~"
There was a friction sound!
He didn't hear it yesterday!
"Don't breathe, let me stop..."
"Ok."
Hear it when you are breathing, it may be a pleural friction rub.
After holding your breath, without breathing, there will be no pleural friction rub, and if you hear it, it is a pericardial friction rub.
"Pericarditis!!"
Did not run, it must be pericarditis.
But the question is why there was no fricative sound yesterday?
Zhou Mo pondered for a moment, and soon his brows relaxed.
"I was wrong!"
After Zhou Mo got the golden finger, he didn't read the knowledge about the pericardium. He only remembered the description of the pericardium in the textbook.
A simple and crude understanding is: pericarditis = friction sound!
However, I didn't understand the logic inside!
Pericarditis, friction rub,
What is the logic between the two?
Pericarditis → exudate → friction rub...
Exudate is key!
At the onset of pericarditis, without exudate, there is no friction rub.
As the inflammation progresses, an exudate develops and friction sounds begin.
Inflammation continued to increase, exudate increased, and friction noise began to decrease.
After clarifying this logic,
Then the patient Cheng Wenle's current condition was clear at a glance.
Yesterday, he was indeed suffering from pericarditis, which caused chest pains, and because the disease was not progressing quickly, the exudate did not come out so quickly, which caused Zhou Mo to listen to his heart and lungs many times, but he did not find the friction sound of 'srusting'.
And ibuprofen has anti-inflammatory and analgesic effects, allowing the patient Cheng Wenle to sleep comfortably.
But this morning, the exudate appeared and increased, so Zhou Mo heard the friction sound of 'squeaky'.
"Whoo~~~~"
Zhou Mo showed a relaxed smile.
All in all!
Solve the puzzle successfully!
Zhou Mo gave the patient Cheng Wenle another electrocardiogram.
Result: No change.
However, pericarditis does not necessarily have ECG-specific changes.
Anyway, there are four diagnostic features of pericarditis: typical chest pain (back and forth pain, turning around and pulling pain, etc.), pericardial friction rub, specific changes in ECG, new or aggravated pericardial effusion.As long as two of them match.
……
Currently the patient Cheng Wenle has been diagnosed with pericarditis.
"How to deal with it?"
Zhou Mo continued to stroke.
The pericarditis of the patient in front of me is not too serious, so it is easy to deal with.
On the one hand, anti-inflammatory.
At present, the patient Cheng Wenle only has a small amount of pericardial effusion, which can be used for anti-inflammation and analgesia.
On the other hand, look for the cause of pericarditis.
Common reasons are: infection, tumor, autoimmune, endocrine, metabolic disorders, physical factors, chemical).
Only by finding the cause can better treatment be achieved.
Especially tumor tuberculosis and autoimmunity.
The diagnosis method of the tumor is still CT, which was done yesterday, but it is hard to say whether the CT teacher will ignore the existence of the tumor because he focuses on the investigation of aortic dissection.
As for immunity, you need to do an immune check.
As for Cheng Wenle's current small amount of pericardial effusion, what should I do?
It is necessary to find out the primary disease and treat it symptomatically, and then the pericardial effusion will be alleviated or absorbed.
If the pericardial effusion increases, causing the heart to be compressed and cardiac tamponade occurs, it will be more serious at that time, and the puncture should be done quickly to drain the pericardial effusion.
……
……
It's already 10:00 when I finish working on this patient.
ding dong...
Zhou Mo received a message.
Director Niu: "I've read your paper, it's good, you can try to submit it for publication... In addition, you don't need to worry about the patient with biliary-cardiac syndrome. A department consultation..."
Zhou Mo: "(Thumb) Teacher is awesome!"
Director Niu: "The school exam will be taken soon, remember to prepare for the exam... I will ask Chen Bing to reduce one patient for you?"
(Chen Bing: "..." burst into tears!)
Zhou Mo: "No need, no need, the two patients are quite easy."
Director Niu: "You helped Chen Bing take care of those 4 patients, and there are 6 patients in total. Are you busy now?"
Zhou Mo: "Very leisurely."
Director Niu: "..."
……
get off work.
While Zhou Mo was going to change his clothes...
Just walked over to the changing place,
"Zhou Mo!"
"Awesome!!"
Xiao Tong rushed over with excitement, and ran to Zhou Mo.
Zhou Mo was confused: "What's wrong?"
Xiao Tong pushed Zhou Mo to the duty room: "Go, pennant!"
Zhou Mo was at a loss: "The pennant? What pennant?"
Xiao Tong quickly said: "Your pennant, the husband of the patient you rescued this morning sent a pennant."
Zhou Mo was surprised: "Huh?"
"Ah what... let's go! Quick!" Xiao Tong pushed Zhou Mo away, and quickly came to the duty room.
at this time,
Several senior doctors came to the duty room to watch the excitement.
The cute new medical student Gui Pei came to envy them all.
There is also a 30-year-old man holding a pennant, wearing a suit and gold-rimmed glasses, but he is very refined and has a scholarly temperament. He is not an ordinary person at first glance.
"Doctor Zhou Mo?!"
"it's me."
"Thank you!" The middle-aged man walked up to Zhou Mo quickly, took Zhou Mo's hand, shook hands vigorously, emotionally, and said gratefully: "Thank you, if it weren't for you, my wife might be dead!"
Now that he thinks about it, he feels a little scared.
He and his wife are very affectionate, and if his wife really died of bleeding, he doesn't know how to live in the future.
Zhou Mo hurriedly said: "I just saw it too, and it must be saved. If someone else comes, they will choose the same."
The middle-aged man said again and again: "No matter what I say, thank you very much. You are my wife's lifesaver and my benefactor! Are you free tonight? I'll treat you to a meal!"
Zhou Mo shook his head quickly: "No need, no need, don't bother."
Under normal circumstances, doctors will not give their phone numbers to patients and family members.
In the same way, if the patient's family members say that they treat guests to dinner, try not to accept this.
Zhou Mo quickly changed the subject: "How is your wife doing now?"
This morning, when Zhou Mo was busy with work, he was always concerned about this female patient.
Speaking of this, the middle-aged man smiled and said, "I came back from the rescue, but I am still a little weak, and I am currently hospitalized in the obstetrics and gynecology department!"
Zhou Mo nodded: "That's good, that's good."
Middle-aged man: "By the way, Dr. Zhou, when I came to the cardiology department, my wife just woke up. She said that she wanted to see you in person, and thank you for saving her life."
Zhou Mo quickly shook his hand: "No, no..."
Middle-aged man: "I want what I want..."
The next step is to send pennants and take pictures.
Zhou Mo, pennant achievement +1!
There were envious eyes all around.
"The second pennant, this is only the fourth week..."
"I'm sour."
"Envy makes me unrecognizable."
"It feels like I'm just making up the numbers."
"Same number + 1..."
"Am I in the wrong line?"
One by one hugged their heads and cried.
How miserable!
……
Soon, the middle-aged man enthusiastically pulled Zhou Mo away from the Department of Cardiology and came to the Department of Obstetrics and Gynecology.
Zhou Mo couldn't refuse even if he wanted to.
43 beds,
Zhou Mo walked into the ward and saw the female patient lying on the bed with her eyes slightly closed, her face was pale, and her Qi and blood were poor.
"Honey, Doctor Zhou is here..."
"doctor……"
When the female patient saw Zhou Mo, she immediately raised her hands and wanted to get up to thank her.
Zhou Mo was so frightened that he quickly stopped: "Don't, just lie down..."
The female patient said weakly: "Doctor, thank you, if it wasn't for you, I'm afraid..."
Zhou Mo hurriedly humbled himself.
We chatted a little more, mostly to thank Zhou Mo for his words.
At this time,
The news that Zhou Mo came to the obstetrics and gynecology department spread quickly.
"Beauties, I saw a handsome junior brother! Save that junior brother Zhou Mo this morning!"
"Candidly took a few photos, picture jpg, picture jpg..."
"Huh? Really?"
"Wow, this profile is so handsome!"
Obstetrics have been gossiping about it this morning.
So when Zhou Mo came, it immediately caused a burst of gossip excitement.
Many young female doctors and nurses in the obstetrics and gynecology department came out of the ward curiously and started a strong onlooker.
"Wow, this junior brother is so handsome in a white coat!"
"Hey, please hold me back."
"We are all old drivers, why are you being reserved?!"
"Jie Jie Jie~~~"
Ward,
After chatting for a while, Zhou Mo felt that it was almost done.
"Okay, you rest, I won't bother you..."
"Doctor Zhou, goodbye..."
As soon as Zhou Mo came out of the ward, he saw many doctors and nurses from the obstetrics and gynecology department watching him from all directions.
"Brothers and sisters, good morning..."
……
1 minutes later,
Zhou Mo wiped his sweat, and walked out of the obstetrics and gynecology department under the resentful eyes of several young male doctors in the department of gynecology.
"Ding dong~~~"
at this time,
Junior girl Chen Xiaomo sent a message.
"Brother, what are you doing? (Sneak peek)"
"Brother, is this you?"
"It's me, why do you have this picture."
"Wow, senior brother, you are so amazing. Now this matter has been spread all over our clinical college."
"???"
"Brother, you are popular in our school! It has been spread in several of our groups, and many female students are asking for your information!"
"What is there to inquire about..."
"Brother, when do you get off work? Watch a movie together?"
"Get off work now..."
"Huh? I'm changing clothes now, let's go to the movies? What clothes do you want to see? I have a set of jk, I just bought..."
Um? ?
If you say that, I won't be sleepy anymore!
Zhou Mo: "I'll see you later..."
……
quickly,
Zhou Mo saw Chen Xiaomo, a school girl who had dressed up a lot.
have to say,
jk, God forever!
Xiaomo Xuemei's long legs + black silk + shell shoes + black jk group + black cartoon long and wide top on white bottom!
Really top!
The movie is not good, but JK Xuemei is very good.
. .
This chapter is 3100 words, the fifth update, the last update...the official 2+X will start tomorrow
(End of this chapter)
36 beds, Bunraku.
"Doctor Zhou!"
Cheng Wenle greeted Zhou Mo happily.
Zhou Mo was a little surprised.
"Hey, your spirit looks good, how is the chest pain now?"
Cheng Wenle smiled and said, "Thank you Doctor Zhou. After taking the medicine given by the nurse last night, I feel much better and sleep very comfortably..."
Zhou Mo: "?????"
Bewildered.
I only prescribed ibuprofen, the effect is so strong?
Zhou Mo felt that something was wrong, so he clicked on the iPad and looked at yesterday's doctor's order to see if the doctor on duty had changed it.
That's right, ibuprofen.
The doctor on duty didn't change my doctor's order either.
Ibuprofen is so powerful?
"Did the doctor on duty yesterday visit you?"
"Doctor on duty? No, every doctor has visited..."
Zhou Mo nodded upon hearing this.
"I'll do some checks on you..."
"Okay okay."
"Does your chest still hurt?"
"It hurts, but it's not that painful, it's okay..."
As Zhou Mo asked, he held the 3m and listened to the heart and lungs of the patient Cheng Wenle.
"Huh, friction sound?"
Once in the ear,
Zhou Mo realized something was wrong.
"Swish, swish, swish~~~~"
There was a friction sound!
He didn't hear it yesterday!
"Don't breathe, let me stop..."
"Ok."
Hear it when you are breathing, it may be a pleural friction rub.
After holding your breath, without breathing, there will be no pleural friction rub, and if you hear it, it is a pericardial friction rub.
"Pericarditis!!"
Did not run, it must be pericarditis.
But the question is why there was no fricative sound yesterday?
Zhou Mo pondered for a moment, and soon his brows relaxed.
"I was wrong!"
After Zhou Mo got the golden finger, he didn't read the knowledge about the pericardium. He only remembered the description of the pericardium in the textbook.
A simple and crude understanding is: pericarditis = friction sound!
However, I didn't understand the logic inside!
Pericarditis, friction rub,
What is the logic between the two?
Pericarditis → exudate → friction rub...
Exudate is key!
At the onset of pericarditis, without exudate, there is no friction rub.
As the inflammation progresses, an exudate develops and friction sounds begin.
Inflammation continued to increase, exudate increased, and friction noise began to decrease.
After clarifying this logic,
Then the patient Cheng Wenle's current condition was clear at a glance.
Yesterday, he was indeed suffering from pericarditis, which caused chest pains, and because the disease was not progressing quickly, the exudate did not come out so quickly, which caused Zhou Mo to listen to his heart and lungs many times, but he did not find the friction sound of 'srusting'.
And ibuprofen has anti-inflammatory and analgesic effects, allowing the patient Cheng Wenle to sleep comfortably.
But this morning, the exudate appeared and increased, so Zhou Mo heard the friction sound of 'squeaky'.
"Whoo~~~~"
Zhou Mo showed a relaxed smile.
All in all!
Solve the puzzle successfully!
Zhou Mo gave the patient Cheng Wenle another electrocardiogram.
Result: No change.
However, pericarditis does not necessarily have ECG-specific changes.
Anyway, there are four diagnostic features of pericarditis: typical chest pain (back and forth pain, turning around and pulling pain, etc.), pericardial friction rub, specific changes in ECG, new or aggravated pericardial effusion.As long as two of them match.
……
Currently the patient Cheng Wenle has been diagnosed with pericarditis.
"How to deal with it?"
Zhou Mo continued to stroke.
The pericarditis of the patient in front of me is not too serious, so it is easy to deal with.
On the one hand, anti-inflammatory.
At present, the patient Cheng Wenle only has a small amount of pericardial effusion, which can be used for anti-inflammation and analgesia.
On the other hand, look for the cause of pericarditis.
Common reasons are: infection, tumor, autoimmune, endocrine, metabolic disorders, physical factors, chemical).
Only by finding the cause can better treatment be achieved.
Especially tumor tuberculosis and autoimmunity.
The diagnosis method of the tumor is still CT, which was done yesterday, but it is hard to say whether the CT teacher will ignore the existence of the tumor because he focuses on the investigation of aortic dissection.
As for immunity, you need to do an immune check.
As for Cheng Wenle's current small amount of pericardial effusion, what should I do?
It is necessary to find out the primary disease and treat it symptomatically, and then the pericardial effusion will be alleviated or absorbed.
If the pericardial effusion increases, causing the heart to be compressed and cardiac tamponade occurs, it will be more serious at that time, and the puncture should be done quickly to drain the pericardial effusion.
……
……
It's already 10:00 when I finish working on this patient.
ding dong...
Zhou Mo received a message.
Director Niu: "I've read your paper, it's good, you can try to submit it for publication... In addition, you don't need to worry about the patient with biliary-cardiac syndrome. A department consultation..."
Zhou Mo: "(Thumb) Teacher is awesome!"
Director Niu: "The school exam will be taken soon, remember to prepare for the exam... I will ask Chen Bing to reduce one patient for you?"
(Chen Bing: "..." burst into tears!)
Zhou Mo: "No need, no need, the two patients are quite easy."
Director Niu: "You helped Chen Bing take care of those 4 patients, and there are 6 patients in total. Are you busy now?"
Zhou Mo: "Very leisurely."
Director Niu: "..."
……
get off work.
While Zhou Mo was going to change his clothes...
Just walked over to the changing place,
"Zhou Mo!"
"Awesome!!"
Xiao Tong rushed over with excitement, and ran to Zhou Mo.
Zhou Mo was confused: "What's wrong?"
Xiao Tong pushed Zhou Mo to the duty room: "Go, pennant!"
Zhou Mo was at a loss: "The pennant? What pennant?"
Xiao Tong quickly said: "Your pennant, the husband of the patient you rescued this morning sent a pennant."
Zhou Mo was surprised: "Huh?"
"Ah what... let's go! Quick!" Xiao Tong pushed Zhou Mo away, and quickly came to the duty room.
at this time,
Several senior doctors came to the duty room to watch the excitement.
The cute new medical student Gui Pei came to envy them all.
There is also a 30-year-old man holding a pennant, wearing a suit and gold-rimmed glasses, but he is very refined and has a scholarly temperament. He is not an ordinary person at first glance.
"Doctor Zhou Mo?!"
"it's me."
"Thank you!" The middle-aged man walked up to Zhou Mo quickly, took Zhou Mo's hand, shook hands vigorously, emotionally, and said gratefully: "Thank you, if it weren't for you, my wife might be dead!"
Now that he thinks about it, he feels a little scared.
He and his wife are very affectionate, and if his wife really died of bleeding, he doesn't know how to live in the future.
Zhou Mo hurriedly said: "I just saw it too, and it must be saved. If someone else comes, they will choose the same."
The middle-aged man said again and again: "No matter what I say, thank you very much. You are my wife's lifesaver and my benefactor! Are you free tonight? I'll treat you to a meal!"
Zhou Mo shook his head quickly: "No need, no need, don't bother."
Under normal circumstances, doctors will not give their phone numbers to patients and family members.
In the same way, if the patient's family members say that they treat guests to dinner, try not to accept this.
Zhou Mo quickly changed the subject: "How is your wife doing now?"
This morning, when Zhou Mo was busy with work, he was always concerned about this female patient.
Speaking of this, the middle-aged man smiled and said, "I came back from the rescue, but I am still a little weak, and I am currently hospitalized in the obstetrics and gynecology department!"
Zhou Mo nodded: "That's good, that's good."
Middle-aged man: "By the way, Dr. Zhou, when I came to the cardiology department, my wife just woke up. She said that she wanted to see you in person, and thank you for saving her life."
Zhou Mo quickly shook his hand: "No, no..."
Middle-aged man: "I want what I want..."
The next step is to send pennants and take pictures.
Zhou Mo, pennant achievement +1!
There were envious eyes all around.
"The second pennant, this is only the fourth week..."
"I'm sour."
"Envy makes me unrecognizable."
"It feels like I'm just making up the numbers."
"Same number + 1..."
"Am I in the wrong line?"
One by one hugged their heads and cried.
How miserable!
……
Soon, the middle-aged man enthusiastically pulled Zhou Mo away from the Department of Cardiology and came to the Department of Obstetrics and Gynecology.
Zhou Mo couldn't refuse even if he wanted to.
43 beds,
Zhou Mo walked into the ward and saw the female patient lying on the bed with her eyes slightly closed, her face was pale, and her Qi and blood were poor.
"Honey, Doctor Zhou is here..."
"doctor……"
When the female patient saw Zhou Mo, she immediately raised her hands and wanted to get up to thank her.
Zhou Mo was so frightened that he quickly stopped: "Don't, just lie down..."
The female patient said weakly: "Doctor, thank you, if it wasn't for you, I'm afraid..."
Zhou Mo hurriedly humbled himself.
We chatted a little more, mostly to thank Zhou Mo for his words.
At this time,
The news that Zhou Mo came to the obstetrics and gynecology department spread quickly.
"Beauties, I saw a handsome junior brother! Save that junior brother Zhou Mo this morning!"
"Candidly took a few photos, picture jpg, picture jpg..."
"Huh? Really?"
"Wow, this profile is so handsome!"
Obstetrics have been gossiping about it this morning.
So when Zhou Mo came, it immediately caused a burst of gossip excitement.
Many young female doctors and nurses in the obstetrics and gynecology department came out of the ward curiously and started a strong onlooker.
"Wow, this junior brother is so handsome in a white coat!"
"Hey, please hold me back."
"We are all old drivers, why are you being reserved?!"
"Jie Jie Jie~~~"
Ward,
After chatting for a while, Zhou Mo felt that it was almost done.
"Okay, you rest, I won't bother you..."
"Doctor Zhou, goodbye..."
As soon as Zhou Mo came out of the ward, he saw many doctors and nurses from the obstetrics and gynecology department watching him from all directions.
"Brothers and sisters, good morning..."
……
1 minutes later,
Zhou Mo wiped his sweat, and walked out of the obstetrics and gynecology department under the resentful eyes of several young male doctors in the department of gynecology.
"Ding dong~~~"
at this time,
Junior girl Chen Xiaomo sent a message.
"Brother, what are you doing? (Sneak peek)"
"Brother, is this you?"
"It's me, why do you have this picture."
"Wow, senior brother, you are so amazing. Now this matter has been spread all over our clinical college."
"???"
"Brother, you are popular in our school! It has been spread in several of our groups, and many female students are asking for your information!"
"What is there to inquire about..."
"Brother, when do you get off work? Watch a movie together?"
"Get off work now..."
"Huh? I'm changing clothes now, let's go to the movies? What clothes do you want to see? I have a set of jk, I just bought..."
Um? ?
If you say that, I won't be sleepy anymore!
Zhou Mo: "I'll see you later..."
……
quickly,
Zhou Mo saw Chen Xiaomo, a school girl who had dressed up a lot.
have to say,
jk, God forever!
Xiaomo Xuemei's long legs + black silk + shell shoes + black jk group + black cartoon long and wide top on white bottom!
Really top!
The movie is not good, but JK Xuemei is very good.
. .
This chapter is 3100 words, the fifth update, the last update...the official 2+X will start tomorrow
(End of this chapter)
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