My medical skills are a billion points

In addition, the man has no past medical history.

She already had a rough judgment on the man in her mind.

Wang Li looked at Xiao Chu and said, "Mr. Xiao, I have a rough judgment."

"Ok!"

"What check should I do? Let him do it!"

Xiao Chu nodded.

Wang Li was not asked to explain the basis of her diagnosis.

After all, this patient suffers from a severe stomachache, and needs to be checked as soon as possible to make a clear diagnosis and give him medication.

Although Xiao Chu already knew what his disease was.

Based on her own considerations, Wang Li prescribed urinary ultrasound and urine routine examination for the man on the computer.

And Liu Qing stood behind her, also looking thoughtful.

Xiao Chu glanced at Wang Li's checklist, but didn't make a sound.

Instead, he said to the man: "I'll prescribe you a painkiller first, to relieve your pain, and then go for an examination."

Hearing this, Liu Qing was a little puzzled.

Chapter 222 Give More Opportunities to Interns

Xiao Chu taught them before that for acute abdomen and other unexplained diseases, they must not take painkillers directly, so as not to cover up the illness.

Then why Xiao Chu didn't examine this man, but took painkillers first?

Liu Qing looked puzzled and couldn't figure it out.

Hearing that he gave himself painkillers first, the man was very grateful.

"Thank you doctor!"

The man hurriedly thanked him.

After all, his stomach hurts badly now, like there are pliers in his stomach, and he twisted his intestines again.

He is in so much pain now that he doesn't even have the strength to walk. If he is forced to go for a checkup with his stomach ache, he really won't be able to walk.

Soon, the nurse brought over a dose of Demerol and injected it into the man's muscle.

Gradually, the man felt that the pain in his stomach was getting better, and then he took the medical card and went for a checkup.

Seeing that the patient had gone for an examination, Liu Qing asked suspiciously:

"Ms. Xiao, don't you often tell us that patients with acute abdomen should not take painkillers before they are diagnosed? Then why did this patient take it in advance?"

Xiao Chu didn't answer, but looked at Wang Li.

"Wang Li, now tell me about the basis for the diagnosis of that patient."

Wang Li suddenly became a little nervous.

She knew that Xiao Chu was testing herself.

After thinking about it, he replied cautiously: "First of all, this patient's symptom is a sudden pain in the lower left abdomen. And there is no obvious organ in the lower left abdomen, so it cannot be appendicitis.

Intestinal spasms don't quite look like that either.Moreover, this patient has no medical history. When I asked him just now, he did not have diarrhea or fever.

In addition, when I gave him a physical examination, I found that he had percussion pain in the left kidney area.

Therefore, I considered that this patient had urinary stones, so I prescribed a color Doppler ultrasound and routine urine examination for him. "

"Mr. Xiao, do you think I'm thinking right?"

Before Xiao Chu could answer, Wang Li immediately said, "I know Mr. Xiao, did you already see that he is urinary calculus, that's why you gave him painkillers?"

Xiao Chu gave Wang Li a look of approval.

It seems that Wang Li has put in a lot of effort in her studies, and her analysis of the man's cause is quite correct.

"You are right. First of all, we need to have a rough judgment on the patient. Only with a basic grasp can we give the patient painkillers in advance.

If the condition is very unclear, it is not recommended to use painkillers directly, and it must be used after the patient's examination.

But this patient, according to his symptoms and physical examination, is most likely to consider urinary stones.

In addition, his stomach hurts very badly. If he is not given painkillers, he may not be able to do the examination, so he was given painkillers in advance. "

Liu Qing nodded her head half understanding.

After all, she didn't put enough effort into practice.

It is very likely that coming to the hospital for an internship is just a process.

In addition to helping Gao Yingjun write the medical records, he did very little such as dressing changes, debridement and sutures.

And Xiao Chu often sees travel photos, selfies, and food photos in her circle of friends.

Studying is dispensable to her.

Compared with Liu Qing, although Wang Li shared the same dormitory with her in university, she worked harder than her in studies.

Following Xiao Chu, he often asked questions that he didn't understand, and he competed to do the work of changing the dressing, and he had already done many cases of debridement and sutures.

Now it can be said that Wang Li's debridement and suture technique has been practiced relatively proficiently.

Moreover, clinical experience is gradually accumulating.

Therefore, in terms of the understanding of diseases, she knows a lot more than Liu Qing.

The patient's test results came out soon.

Color Doppler ultrasound showed that the left ureteral stone was about 0.6×0.3CM in diameter.

And there are red blood cells in the urine.

The patient's exact diagnosis was a left ureteral calculus.

After the patient's examination results came out, Wang Li was very happy.

The happy mood is like a grass that has been dry for a long time, being watered by rain.

After all, this is the first patient who has made a diagnosis all by herself since she practiced for several months, and the diagnosis is correct.

Before, she didn't even dare to think about it.

She sincerely thanked Xiao Chu for teaching her a lot of clinical experience.

And let her diagnose the patient alone.

It can be said that his diagnosis was correct this time because Xiao Chu gave her the opportunity.

If it's another teacher, I'm afraid it's impossible for an intern to examine the patient.

Only Xiao Chu can let the interns do it so confidently and boldly.

And the reason why Xiao Chu asked an intern doctor to diagnose patients alone.

First of all, he also sees the patient's condition first.

If the patient's condition is complicated and urgent, it is absolutely impossible for an intern to diagnose him alone.

This patient with ureteral calculus, from the moment he came to the consulting room, Xiao Chu already knew the cause of his disease.

Therefore, he intends to let Wang Li more and increase his clinical experience.

Ureteral stones are just painful, but not life-threatening.

That's why Wang Li was asked to practice, and Liu Qing was ignored by him.

The patient's stones are not small, but it is still possible to pass them out on their own.

Because of taking a dose of pethidine, the man's stomach pain has been greatly relieved.

But he still had a dull pain in his lower left abdomen, but it was completely bearable.

Seeing Xiao Chu put down the color ultrasound checklist, he hurriedly asked, "Doctor, what's wrong with me? Do I need to be hospitalized?"

As for the treatment of patients, Xiao Chu naturally couldn't let Wang Li do it anymore.

He pointed to a small light spot in the ureter on the color ultrasound sheet, and said to the man:

"Your disease is the left ureteral stone, which has reached [-] centimeters. Although it is not small, it is still possible to pass it by itself. In your case, you can be hospitalized or not."

"How about not being hospitalized?"

the man asked hastily.

"If you're not hospitalized, just go back and drink more water, exercise more, and use gravity to let the stones in the ureter fall into the bladder, and everything will be fine."

"But during your strenuous activity, there's the possibility of pain again. Once the pain is severe, you may have to go back to the hospital."

Once you hear that you won’t be hospitalized, drink plenty of water and do more activities when you go home, and you may still have stomach pains in the future.

The man immediately said: "Doctor, please go through the hospitalization procedures for me, I don't want to be in that pain anymore."

"Isn't everyone saying now that if there is a stone, can it be crushed? You can just crush it for me."

Xiao Chu shook his head.

"If you are hospitalized, I will handle the hospitalization procedures for you, but in your case, it is better to use antispasmodic and analgesic drugs first, dilate the ureter, and try to let the stone come out by itself.

Ultrasonic lithotripsy in vitro is not a panacea.And your stone is in the upper part of the ureter, which is closer to the kidney.

If the stone is crushed, it may have a certain impact on the kidneys.

So I suggest that you should use medicine to expel stones first.If it doesn't work, consider extracorporeal lithotripsy. "

What Xiao Chu said was reasonable and well-founded, and he was completely thinking about the man's condition.

He nodded repeatedly after hearing this, and felt that Xiao Chu was a good doctor with a sense of responsibility.

Chapter 223 Difficult Cases

In the end, the man followed Xiao Chu's explanation, and went through the hospitalization procedures. He will be treated with medicine for the time being, and then consider crushing stones if it really fails.

After the man went to the hospital, Xiao Chu explained to Wang Li and Liu Qing the pathogenesis of ureteral calculi, as well as the diagnosis and treatment process.

The two of them nodded repeatedly, feeling that their clinical knowledge had increased a bit.

Especially Wang Li, after listening to Xiao Chu's explanation, she felt that she had benefited a lot.

He even thought in his heart that there is nothing to do in the future, so he will follow Xiao Chu to learn clinical experience and diagnose and treat patients.

Although she and Liu Qing are college classmates, and they share the same dormitory.

But her family conditions are far inferior to Liu Qing's.

Her family is from a rural area, and she wants to continue her postgraduate entrance examination, but it is not realistic.

One is that the postgraduate entrance examination is very difficult, and she has no self-confidence.

In addition, continuing to take the postgraduate entrance examination will require a lot of expenses, which is not easy for her family to bear.

In fact, Wang Li's situation is somewhat similar to Xiao Chu's.

They were all born in rural areas, and their family backgrounds are very average.After graduating from a bachelor's degree, you need to find a job in a hospital to earn money to support your family.

After Wang Li's internship is over, she is facing graduation.

Therefore, during her internship, she put in special effort to learn as much clinical knowledge as possible.

In order to have solid theoretical knowledge and clinical experience, they can find a job in their local county hospital after graduation.

Although Wang Li didn't tell Xiao Chu about her family situation, but judging from her attire, Xiao Chu could tell that Wang Li's family conditions were not as good as Liu Qing's.

I also intend to teach her more and let her learn more clinical experience.

In order to find a job, I can stand alone in the face of clinical practice.

Therefore, in the following consultation process, if there are some simple diseases, Xiao Chu will ask Wang Li to ask about the medical history and see how she handles them.

Of course, for some people, Wang Li's clinical experience is still insufficient, and some mistakes in judgment will occur.

For this situation, Xiao Chu would point out her mistakes in time.

Doctors are absolutely not allowed to make mistakes.