Back in 2002 as a doctor

But Zhou Congwen didn't speak at all, and began to close his eyes and meditate.

A thought came to Shen Lang's mind, if only he was this strong, so that Zhou Congwen wouldn't have to figure it out!What a nasty fellow!

But Zhou Congwen's attitude of beating him to death without speaking was the same as Shen Lang, he simply ran to the emergency doctor to wait for the result.

After about 20 minutes, Shen Lang trotted back.

"Congwen, the result is out."

"Oh." Zhou Congwen closed his eyes slightly, and let out a oh without leaving a trace.

"Chest radiograph showing wires associated with median sternotomy and imaging of mitral and tricuspid valve repair. Cardiac slightly enlarged, but not problematic."

“Head CT showed—prominent ventricles and sulci with nonspecific, scattered periventricular white matter hypodensity; no intracranial hemorrhage, large infarct, or intracranial mass lesion.”

"The potassium ion is slightly higher, 5.4, and other laboratory tests are normal."

"Congwen, tell me what's going on."

"Shen Lang, are you wondering why that patient was caught by something?" Zhou Congwen revealed a playful smile.

"Yeah." Shen Lang didn't hide it, and nodded in admission.

"So let's say, your basic clinical knowledge is lacking." Zhou Congwen used gossip to pinch Shen Lang.

"..." Shen Lang didn't know what to say next, he looked at Zhou Congwen beggingly.

An old man who was delirium and never sang suddenly started to sing. According to the novel, this is a harbinger of losing his home.

No matter what others think, Shen Lang really thinks so.

But Zhou Congwen looked determined, thinking that it was all right, how could Shen Lang not be curious.

"The patient's condition, what is it called clinically?" Zhou Congwen asked calmly.

"Delirious." Shen Lang said with certainty.

"How's the patient's ECG?"

"I was still connected when I came back, so I didn't watch it."

"Go and take a look." Zhou Congwen said.

Shen Lang scratched his head, frowned and walked slowly towards the emergency room.

A lot of information echoed in Shen Lang's mind. He and Zhou Congwen saw this incident together. Zhou Congwen won't get more information than himself, but he already has the answer.

Unconvinced energy surged up from the bottom of Shen Lang's heart.

Chapter 1529 Correct Answer

Shen Lang felt something was wrong.

It felt like ten thousand ants were crawling in his heart, and it was very itchy, but when he remembered Zhou Congwen glanced at the patient and said a few words about the patient's medical history before showing a "hateful" smile, his heart immediately surged. A sense of powerlessness.

The patient in front of him really made Shen Lang very curious. It looked like the kind of seizing the house mentioned in the novel, and it seemed that at least a fancier who liked Peking Opera had seized the old man.

As for whether he sang well, Shen Lang didn't understand at all, so he felt that the words were well-spoken and very nice.

But Shen Lang knew Zhou Congwen well, seeing that Zhou Congwen was not in a hurry at all, he was sure in his heart that this guy already had a definite diagnosis.

Curiosity coupled with two contradictory effects made Shen Lang extremely tormented.

He came to the door of the emergency room, looked inside, and was stunned.

Although the patient's other vital signs were stable, the waveform on the ECG was paroxysmal supraventricular tachycardia!

This is so fatal!

Shen Lang hurried back to Zhou Congwen, and hurriedly said, "Congwen, the patient has paroxysmal supraventricular tachycardia!"

"Oh." Zhou Congwen smiled slightly, without moving.

"Hurry up and talk to the emergency doctor, what is your diagnosis?" Shen Lang was a little anxious.

Zhou Congwen looked at Shen Lang, making Shen Lang uncomfortable.

A few seconds later, Zhou Congwen asked, "Shen Lang, has the emergency doctor given appropriate treatment for the tachycardia?"

"..."

Shen Lang felt that he must have been spoiled by Zhou Congwen today.

Seeing that the electrocardiogram was abnormal, he ran back and told Zhou Congwen, but forgot to ask the emergency doctor what treatment he gave.

"Go and ask, I'm going out to smoke a cigarette, and you can find me after you ask."

After finishing speaking, Zhou Congwen walked out of the corridor of the emergency department.

Shen Lang was speechless, he had countless questions in his heart, and asked the emergency doctor as quickly as possible.

Soon Shen Lang trotted out to find Zhou Congwen with the answer.

Zhou Congwen was sitting by the flower bed at the entrance, smoking a cigarette.Although the weather was cold and his breath was cloudy, he didn't seem to feel cold.

"Congwen, here it is." Shen Lang said simply.

Zhou Congwen threw a cigarette to Shen Lang, "Tell me, what do you think."

"I don't have any ideas, no thoughts at all." Shen Lang told Zhou Congwen that he had nothing to hide, and told the truth.

"Let's put it this way, what did you see when the patient pushed past us just now?" Zhou Congwen asked.

"I saw the patient's lips cyanotic, and heard him sing Peking Opera."

"The patient's eyes are a bit protruding, have you noticed?" Zhou Congwen asked.

"..." Shen Lang shook his head.

He put the gun in his mouth, frowning, took out the lighter, lit it, but was blown out by the wind.

Unbuttoning his coat, Shen Lang buried his head in the clothes and hit him three times, but still no fire.

Zhou Congwen smiled and stretched out his hand to light a cigarette for Shen Lang.

"What's on your mind?" Zhou Congwen asked.

"I was wondering how you found out." Shen Lang was sobered up by the cold wind at this time, he said with a frown.

"Then I'll tell you directly." Zhou Congwen sat down again with a smile, "When I saw the patient, I noticed that his conjunctiva was edematous, a little bloodshot, and his eyeballs protruded. Although it's not a particularly typical one, I can barely tell come out."

"Hyperthyroidism?" Shen Lang frowned and looked at Zhou Congwen.

"What you just said is not in the past history, then it is not." Zhou Congwen said, "If you can believe it, the patient has ruled out diseases such as hyperthyroidism."

Shen Lang was silent, pondering over what Zhou Congwen said with a cigarette in his mouth.

"Since it's not hyperthyroidism, the patient's eyes still have..."

"Congwen, are you considering increased intracranial pressure?" Shen Lang asked.

"I have this consideration, so I waited for the CT. The CT report is all right, and the matter will become clearer." Zhou Congwen said, "Did you know that there is a clinical symptom called diplopia."

Double vision refers to the abnormal phenomenon that when two eyes see an object, it feels as two objects.

There are many reasons for double vision, and diseases of cranial nerves or the brain itself may cause double vision.

As long as one or several of the six muscles that control eyeball movement are inflamed, traumatized or neurologically impaired, the movements of the eye muscles will be uncoordinated.

"In general, diplopia is a symptom described by the patient himself, but if you see more, you will find that the symptoms of some patients are consistent with those of the patient just now."

"Diplopsis, does that have anything to do with the patient's singing...?" Shen Lang asked suspiciously.

Zhou Congwen stretched out his hand and wrote "one" on the snow beside him.

Then, he wrote another "two".

"Second point, you said the patient had fecal incontinence, right?"

"Yes! The smell is very strong. I think the patient's family members are a little confused. The doctor in the emergency department took a look and told the nurse that they need a one-time medium sheet to help the patient spread it."

"Well, you can think of it as incontinence, but from another perspective, could it be diarrhea?" Zhou Congwen asked.

Shen Lang stared at Zhou Congwen in a daze. From double vision to diarrhea, it had nothing to do with the patient being "lodged", at least that's what Shen Lang thought.

"Third." Zhou Congwen wrote another number on the snow.

"The electrocardiogram showed paroxysmal supraventricular tachycardia, and the patient had a history of rheumatic heart disease valve replacement."

Shen Lang nodded, his expression becoming more and more bewildered.

"The serum ions are still normal, only the potassium ions are slightly higher, which is near the upper limit of the normal value, which can not only rule out the mental symptoms caused by ion disturbances, but also..."

Zhou Congwen said, seeing that Shen Lang's expression was a little stiff, as if frozen by the cold wind, he smiled, "To put it simply, these conditions are sufficient, now you can think about what the patient's disease is."

Shen Lang squatted in the snow, looking at the one, two, three, four, five written by Zhou Congwen on the snow, pondering for a long time.

Zhou Congwen was not in a hurry, and looked at Shen Lang quietly.

The smoke of the cigarette gradually faded away, but Shen Lang didn't notice it. It seemed that he was concentrating on one thing for the first time, forgetting himself completely.

After a full 5 minutes, Shen Lang looked up at Zhou Congwen and asked, "Digoxin poisoning?"

Zhou Congwen was very pleased.

Shen Lang is not a rotten wood, he carved a few times by himself, and he was able to find the correct answer.

With regard to the few conditions just now, it is generally impossible for doctoral students who have worked with me for about two years to have a definite diagnosis, but Shen Lang was able to find the answer in a very short time.

To say that Shen Lang is still talented, it is not in vain that I have led him to walk on the "right path" after so much gossip.

"Shen Lang, how did you guess it?" Zhou Congwen asked.

"I have been reading books, okay, and you said it so carefully, I have seen similar patients in the chest pain center. You almost said the answer, if I still can't guess it, I will be stupid."

Chapter 1530

"You got the answer right, congratulations." Zhou Congwen said with a smile.

Shen Lang didn't expect his "Meng" answer to be correct, but he still looked at Zhou Congwen very happily.

"sharp."

"I read a book." Shen Lang was a little proud, but he always felt that something was wrong, so he said subconsciously, "Then tell the emergency doctor immediately!"

"The drug concentration test of digoxin takes a long time, and it is Chinese New Year, so it is estimated that the laboratory department cannot do it." Zhou Congwen said.

"Then what should we do?" Shen Lang asked in a daze.

He suddenly remembered that Zhou Congwen saw the patient's supraventricular tachycardia just now, instead of being in a hurry, he left after knowing that the emergency department had given symptomatic treatment, and went out to smoke.

"What should I do?" Zhou Congwen squinted at Shen Lang with disdain.

Shen Lang was stunned, scratched his head, and said rather embarrassedly, "Suddenly stunned, digoxin poisoning is treated symptomatically, just don't take digitalis drugs, and it will recover in 2-3 days."

"That's right." Zhou Congwen smiled, "So the patient's situation is not that complicated. Think about it carefully, and don't just think about taking the house or changing the shape if you have nothing to do."

"How can you say that you are a doctor, and these strange words will make people laugh."

"Go back and read more books."

Zhou Congwen babbled and stood up.

"You follow along, I'll go and see Director Han."

"Congwen, how did you analyze digitalis poisoning?" Shen Lang's mind was still on the patient, "The patient's symptoms are not the most typical manifestations of digitalis poisoning."

"Details, you have to pay attention to all kinds of details when you gossip, the devil is in it."

Shen Lang was thoughtful, watching Zhou Congwen's back leave, instead of going directly to the emergency department, he sat where Zhou Congwen was sitting just now and stared at the words one, two, three, four written on the snow.

Shen Lang already had a little understanding of Zhou Congwen's thinking, but if he went back to the time when he was standing in the corridor of the emergency department, he glanced at the patient himself, combined with some fragmented information, he could diagnose digitalis poisoning...

Shen Lang knew that he would definitely not be able to do it.

Not only now, even if I have five or ten more years of clinical experience, study hard every day and see patients, I still can't do it.

Zhou Congwen demonstrated a powerful logic, rooted in a profound theoretical foundation, and then logically analyzed to obtain the logical ability to make a correct diagnosis.

Really strong, Shen Lang frowned and looked at the writing on the snow, his consciousness suddenly returned to two years ago.At that time, Zhou Congwen couldn't see anything strange, just like himself, just dawdling in mediocrity.

Why did he suddenly become enlightened?

To get enlightened, Shen Lang thought of this and knocked his head with his hands, as if he wanted to use physical force to enlighten himself.