I Can See Health

"Brother, are there any problems with these test results?" Lu Wenjun asked nervously.

"Nothing has been found yet." Lu Wenguo shook his head, "We still need to take a look at the results of the blood test. When the results of the blood test come out, let Xiaohui send them over."

"Okay." Lu Wenjun nodded.

At this time, Lu Chen took the phone from Lu Wenguo and turned to the electrocardiogram photo.

"Dad, look at this electrocardiogram, I think it's a little strange." Lu Chen pointed at the electrocardiogram and handed the phone to Lu Wenguo.

"Electrocardiogram?" Lu Wenguo was stunned. He hadn't looked at the electrocardiogram carefully yet.

As a general surgery surgeon, the most he can do is glance at the "machine report" of the electrocardiogram.

That is the result of automatic analysis by the electrocardiograph.

"Xiaochen, isn't this right bundle branch block? I remember that normal people should also have right bundle branch block, right?" Lu Wenguo took another look at the electrocardiogram, and then tentatively replied .

Although he is a veteran doctor for many years, he does not dare to make too much of an effort when it comes to electrocardiograms.

Lu Wenguo remembered that Lu Chen once saw the electrocardiogram of "idiopathic ventricular tachycardia" at a glance.

This is a figure that even the deputy chief doctor of the cardiology department made a mistake in judging.

Lu Wenjun on the side was stunned.

Why does he feel that his eldest brother cares about Xiaochen's opinion?

Although Xiaochen is very powerful and won the championship in the skills competition, he is only a student after all.

However, my eldest brother Lu Wenguo has been practicing clinically for so many years!

Is this my own illusion?

"Dad, this is indeed a sign of right bundle branch block." Lu Chen touched his chin, "However, besides the right bundle branch, there are other abnormalities."

Lu Wenguo held the mobile phone and carefully identified it again.

A long while passed.

He finally saw some abnormalities and said quickly: "Right axis deviation, right bundle branch block, high right ventricular voltage, clockwise transposition. And s1q3t3, could it be a pattern like pulmonary embolism?"

Some patients with pulmonary embolism do have signs of coma.

At first glance, it sounds quite similar.

Lu Chen was startled when he heard his father's words, but he didn't see this s1q3t3.

He took an electrocardiogram and then shook his head: "It doesn't look like lead iii."

Lu Wenguo scratched his head and took a closer look at the iii. It really didn't look like it. He was just a little far-fetched.

"Dad, look at the test results later." Lu Chen said, "Only by combining the test results can we make a more accurate judgment."

…

Huzhong Province, H County near Jiangcheng.

County People's Hospital, Emergency Department.

Liang Hui looked nervously at the emergency doctor in front of her.

"Doctor Fu, can you take a picture of my dad's blood test results for me?"

Fu Shuo frowned, "Didn't I explain everything to you just now?"

"Well, I have a relative in my family who is also a doctor. I will take photos and send them to him for review." Liang Hui explained quickly.

"Well, that's okay."

Fu Shuo is most afraid of having a relative with a doctor at home, who not only asks for reports on various laboratory tests, but sometimes also dictates treatment plans.

"Where is your relative a doctor?" Fu Shuo asked casually.

"He is also a surgeon at a county hospital." Liang Hui thought for a moment and said.

"Oh." Fu Shuo nodded.

He really didn't believe that a doctor at a county hospital could remotely detect the cause of a patient's coma.

Liang Hui quickly took all the test sheets and gave them to Lu Wenjun.

…

A certain community in Jiangcheng.

"Brother, I received the test report."

Lu Wenguo took the phone.

The photos this time include not only the test sheets, but also detailed medical records.

The patient, a 64-year-old male, was admitted to the hospital because he was comatose for 2 hours. The family members reported that the patient was a "strict vegetarian" who did not eat eggs and dairy products, but had recently developed symptoms of fatigue and anorexia without any cause. The patient had no history of specific diseases in the past.

Physical examination on admission: coma, GCS score: 8–9 points. bp 132/67mmhg, hr 115bpm, r 24/min, bmi 16kg/m2. Cardiopulmonary and abdominal examination showed no abnormalities.

Admission laboratory test report: urea creatinine 263 mmol/l, calcium 4.17 mmol/l, phosphorus 0.14 mmol/l, alkaline phosphatase 189 u/l, albumin 38 g/l, globulin 37 g/l. The 24-hour urine calcium is 2824h.

No abnormality was found in blood routine, coagulation function, free thyroid function, prostate-specific antigen (psa), carcinoembryonic antigen (cea), and ca19-9.

…

Lu Wenguo read the test report and immediately said: "The patient's vital signs are temporarily stable, and the kidney function is abnormal. However, an abnormality of this degree should not lead to coma, right?"

If the kidney function is severe and there is uremic encephalopathy, there is a possibility of coma.

However, the patient's creatinine is not particularly high, which does not support this diagnosis for the time being.

At this time, Lu Chen added: "He also has hypercalcemia."

Lu Wenguo looked at the test results again and nodded: "Well, the normal value of blood calcium is 2.25-2.75mmol/l. This person is indeed a little higher."

Lu Chen shook his head.

"Dad, this is not just higher. The electrocardiogram of this person just now shows that the right bundle branch is accompanied by a qt interval shortened by 120ms. Combined with the laboratory results, it is completely consistent with the performance of hypercalcemia."

"I have looked at all the medical records and have ruled out cerebrovascular accidents, hyperosmolar coma, and hypoglycemic coma. I think the most likely cause is coma caused by hypercalcemia."

"Coma caused by hypercalcemia?" Lu Wenguo frowned.

Lu Chen nodded, "When the blood calcium reaches about 3-4, the patient should have symptoms of mental weakness and fatigue. This can also explain why he had anorexia in the past few days."

"If the blood calcium reaches 4 or above, you may have delirium and mental confusion, and if it is close to 5, you may suffer from persistent coma."

After listening to Lu Chen's explanation, Lu Wenguo still couldn't believe it.

He has never seen a case of coma caused by high calcium.

Lu Wenjun on the side was even more surprised.

When Xiaochen talked about it, he was clear and logical.

Although he didn't quite understand it, UU Reading www.uukanshu.net, but judging from the elder brother's face, he didn't seem to have thought of it.

Is the level of medical graduate students so much higher than that of doctors in county hospitals?

At this time, Lu Wenguo thought for a while and said, "Xiaochen, please briefly explain what is causing the high blood calcium, so that I can tell your aunt and remind her doctor over there."

Lu Chen blinked and continued: "The differential diagnosis of hypercalcemia includes distant metastasis of malignant tumors, multiple myeloma, primary hyperparathyroidism, sarcoidosis and vitamin D poisoning."

Lu Wenguo coughed lightly, "Xiaochen, can you speak more plainly?"

The surgeon's knowledge reserve is really not that much.

Lu Chen paused. Wasn't he clear?

"Dad, just ask the doctor at the county hospital over there to do a chest CT scan."

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