Doctor Song, are you married?

Chapter 197 197. Gastrointestinal urticaria?

8.19 is coming soon.

The skill operation competition is arranged in the afternoon, and the cultural performance is arranged in the evening.

The skills competition in the afternoon was divided into two parts.Clinical operation skills competition and clinical diagnosis competition.

The first link is the clinical skills operation competition, which is some basic clinical operations.

The operations Song Qi drew by lot were debridement and suturing and urinary catheterization.

When he saw the result of the lottery, Song Qi was quite helpless. He was mentally prepared to compete fairly with everyone.

However, with an expert in catheterization and a proficient in suturing, it is really difficult for him not to take first place!
In previous years, the No.1 in the skill operation competition was basically monopolized by the People's Hospital.

This year's No. [-] was taken away by the doctors of the district-level hospital. The management of the People's Hospital was quite surprised and shocked.

However, when they learned that Song Qi had failed in the operation test when he was admitted to the People's Hospital, they immediately regained their balance.

And Song Qi's first place was quickly interpreted as because he failed in the exam at the People's Hospital and worked hard to practice operations, and finally got No. 1 in the operation assessment!
Song Qi didn't care about this.

He didn't care about the little episode during the operation test.

As for No. 1 in this operation test, Song Qi also found it boring.

He fancy the next diagnostic contest.

That is the real test of ability.

Therefore, when the second round of the competition was announced, Song Qi secretly clenched his fists and shouted to himself, "Come on!"

The cases in this clinical diagnosis competition were all submitted by major hospitals. After careful review, the panel of judges and experts finally selected three typical cases as participating cases.

The contestants will be awarded a points system, and the one with the highest points will be awarded the No. 1 spot in the first clinical diagnosis competition.

In addition to receiving a high bonus of 1 yuan, the No. 5000 player in the clinical diagnosis competition can also be admitted to the island city's medical consultation expert group.

This is a very high-level organization.

The members of the expert group are basically composed of experts and professors with the highest authority in various subjects.

The entry threshold for this expert group is quite high. Basically, more than three experts in the group must jointly recommend, and then the expert group must go through layers of reviews before joining.

Therefore, the most attractive thing about this clinical diagnosis competition is this blockbuster qualification.

Because of this, the contestants selected by major hospitals to participate in the diagnostic competition are basically at the level of director and deputy director, and the worst one is a senior attending physician.

Therefore, when Song Qi walked onto the stage among a bunch of bald old men, there was an uproar below.

"What does this district's Integrated Traditional Chinese and Western Medicine Hospital mean? A young man was sent here to make up for it? Even if it's perfunctory, it can't be this perfunctory, right?"

"What? This young man is quite proficient in technical operations? Are you kidding me? People who are good at operation must have good clinical diagnosis ability?"

"Wait to be crushed by then! Haha!"

"That's right, why are the district's Chinese and Western doctors so incompetent at forming a team? Why don't you send their emergency room doctor Lao Xu here? I'm speechless."

The competition kicked off with everyone's expectations.

Two hosts, one male and one female, came to the stage.

The female host is Xinyi, the host of Xinyi Talks about Health!
The organizers of this show must have spent a lot of money, even inviting well-known hosts.Seeing Song Qi, Xinyi nodded slightly towards him.

Song Qi also nodded.

At this time, the host showed the first case on the big screen.

Patient gender: female, age: 54
Brief medical history: abdominal pain for 3 hours, accompanied by frequent vomiting and diarrhea.He reported that he developed abdominal pain after eating ice cream. The abdominal pain was around the umbilicus, and was a persistent dull pain that sometimes lasted for several minutes.Vomiting 6 or 7 times, non-projectile, the vomitus was stomach contents.Diarrhea 3 times, non-watery stools, no mucus, small amount. When the abdominal pain is severe, it is relieved by squatting and slight dizziness.No chest tightness, shortness of breath, or chest pain.No headaches.Conscious blood flow in both upper limbs and feeling of coldness.

Physical examination: blood pressure 90/60mmHg, abdominal softness, mild tenderness around the umbilicus, and no rebound tenderness.Moving dullness was negative.Bowel sounds were active, 8 times per minute.

She had experienced abdominal pain and syncope several times in the past.There is a history of Xiao Sanyang for more than ten years, and there is no treatment at present, and the liver function is normal.

Auxiliary examination: Blood routine showed high neutrophils and high white blood cells.Blood amylase normal range.

B-ultrasound showed no obvious abnormalities in the liver, gallbladder, spleen and pancreas.

Clinical Diagnosis: Abdominal Pain Causes

Treatment process: 40 mg of phloroglucinol, 40 mg of omeprazole, and 4 g of cefoperazone and sulbactam were administered, but the abdominal pain continued to worsen intermittently.To 6542 10mg intramuscular injection.The abdominal pain was slightly relieved, but there was still dull pain and discomfort. Afterwards, the stool was not passed, and there was blood on the wipes.

The first case, a simple abdominal pain to be investigated, seems not difficult, but since it can be selected by the expert group as a case for the competition, it must not be simple!
Song Qi looked at the big screen and wanted to laugh. Is this game tailor-made for him?
First, debridement, suturing and catheterization were performed, and then a diagnosis of the cause of abdominal pain was performed. With all conscience, he really did not bribe the question-writing team.

This case comes from the Gastroenterology Department of People's Hospital.

I was just admitted to the hospital the night before yesterday.

The doctor on the night shift did not find out the cause of the disease all night, so he had no choice but to apply for a consultation with the department the next day, but there was still no substantial progress after the consultation.It always feels like ordinary gastroenteritis, but there is no obvious effect after following the gastroenteritis treatment plan.

In addition, the patient was not very cooperative and refused many examinations. Therefore, there was no clear diagnosis.

Director Hu from the Department of Gastroenterology happened to be a member of the expert team, so he simply reported the case.

After seeing the question, Song Qi's brain started working quickly.

A middle-aged woman had abdominal pain and syncope several times in the past.But I don’t know if there are any predisposing factors?Related to eating food?

This time I reported that I had abdominal pain, vomiting, and diarrhea after eating ice cream.Is cold food a trigger?

Accompanied by slight dizziness.No chest tightness, shortness of breath, or chest pain.No headaches.Conscious blood flow in both upper limbs, feeling cold?

Physical examination: blood pressure is slightly low, and the effect is not good after anti-infection, antispasmodic, stomach protection, and anti-infection treatments.

Gastrointestinal urticaria?

An idea flashed in Song Qi's mind, and he suddenly remembered an uncommon disease.

Although the symptoms of urticaria are large erythema papules and wheals all over the body, it is accompanied by abdominal pain, diarrhea, nausea, and vomiting.Some people simply have diarrhea, abdominal pain, nausea, and vomiting, and the erythema around the body is not obvious at all.

After much thought, Song Qi wrote down his diagnosis on the tablet: consider abdominal urticaria (gastrointestinal urticaria).Angioedema?
In order to further confirm the diagnosis, selective allergen screening, autologous serum skin test and identification of Helicobacter pylori infection are recommended.If conditions permit, food challenge testing is feasible.

Conscious blood flow in both upper limbs and feeling of coldness.Should we consider whether it is cold urticaria? Be alert to whether it is accompanied by cryoglobulinemia, cold fibrinogenemia, cold agglutininemia, etc.

Please consult with a dermatologist. Second-generation non-sedating or low-sedating antihistamines are the first choice. If the treatment is effective, gradually reduce the dose.

After Song Qi wrote the answer, he pressed the submit button without hesitation.

(End of this chapter)