I Can See Health

After checking the room, Min Ling praised Liu Binsong again.

This made the junior sister feel a little embarrassed.

After everyone dispersed, she quickly came to Lu Chen's side, lowered her head and whispered softly: "Senior brother, I'm sorry, I... I don't know how, I can only tell you what you told me."

Lu Chen smiled and shook his head: "It's okay, as long as you can understand what I mean by these differential diagnoses, that's fine."

"Um... I don't understand some things now, but I will definitely understand them in the future!" Liu Binsong clenched his fists.

"Okay, then I will take a test on you tomorrow!" Lu Chen said.

"Ah? Senior brother, you..." Liu Binsong pouted.

Senior Brother Lu Chen really asked... She just talked casually!

…

After checking the room, Lu Chen began to give medical orders and write down today's medical records.

There are many patients and the workload is also much higher.

However, several interns are currently not qualified for these tasks. Lu Chen can only do it himself and teach them patiently.

Gu Xinyue is in another group in District 1. There are two graduate students in their group, and the other graduate student is the senior fellow of the third year of graduate school.

Brother Yan San took several days off on the pretext of looking for a job and writing a thesis.

Lu Chen saw that Gu Xinyue was also very busy, walking back and forth in the department and office.

Throughout the morning, everyone barely rested.

Get off work near noon.

The nurse hurried in.

"Is the doctor from Teacher Cui's team here? Your bed 31 is not comfortable. Go and have a look quickly!"

Teacher Cui's group happened to be Gu Xinyue's group.

Gu Xinyue stood up immediately, "I'm from Teacher Cui's team, I'll go right away!"

Teacher Cui left early last night and today.

Only Gu Xinyue and a few other interns were left in the team.

"Lao Gu, then I'll wait for you." Lu Chen turned around and said to Gu Xinyue.

The two of them made an appointment to go to the cafeteria to eat together at noon.

Gu Xinyue also wanted to ask Lu Chen about clinical research.

"Okay, I'll go see the patient first." After saying that, Gu Xinyue hurriedly walked out of the office.

About five minutes later, Gu Xinyue returned to the office with a frown.

When passing by Lu Chen, he stopped and said, "Lu Chen, you go to eat first. This patient is more troublesome. I won't be able to get off work for a while."

"What's wrong with the patient?" Lu Chen asked confused.

Most patients in the endocrinology department have blood sugar problems.

Except for a small number of patients with diabetic ketoacidosis, the condition of other patients is relatively less urgent.

Gu Xinyue walked back to her seat and said: "A patient with diabetic ketoacidosis who was admitted to the hospital yesterday had a blood sugar of 33.8mol/L. When he was admitted yesterday, the blood sugar has dropped during the ward check this morning, and the random blood sugar was only 14mol/L. But he keeps complaining about abdominal bloating, and the symptoms are getting worse, and now the bloating is getting worse!”

Lu Chen raised his eyebrows slightly, is he really suffering from diabetic ketoacidosis? !

The blood sugar level has dropped to over 30, but the condition has worsened?

What's the point of this... is it really strange?

"Does the patient have symptoms such as abdominal pain, nausea, and vomiting?" Lu Chen asked casually.

"No." Gu Xinyue shook her head, "Except for abdominal distension, everything else is fine. I have told the teacher on duty at noon that she will come over immediately and let's see how she handles it."

"Well, then I'd better wait for you. I'm not in a hurry to eat." Lu Chen said.

He mainly wanted to see this "strange" patient.

Blood sugar dropped, but symptoms worsened!

Lu Chen opened the patient's medical history record.

The patient is male, 59 years old.

He was admitted to the hospital because of "shortness of breath, chest tightness, and upper abdominal discomfort for half a day."

After drinking 500g of liquor yesterday, the patient developed shortness of breath, could not lie down, and was accompanied by nausea, vomiting and other symptoms. He came to the emergency department of Jinghua Second Hospital and found that his blood sugar was 32.1mol/L. He was considered to have diabetic ketoacidosis and was admitted to the hospital. Hospitalization in internal medicine department.

Past history: Hypertension and diabetes for 10 years without regular treatment, and taking anti-hyperglycemic and anti-hypertensive drugs intermittently.

Physical examination upon admission: body temperature 36.6°C, pulse 142 beats/min, respiration 28 breaths/min, blood pressure 140/80mmHg, and auscultation of the heart, lungs, and abdomen was negative.

After being admitted to the hospital yesterday, according to the treatment principles of diabetic ketoacidosis, he was given intravenous low-dose insulin, active fluid replenishment, and potassium replenishment.

"The patient's blood sugar is slowly declining. As of this morning, it is close to normal." Lu Chen frowned and asked, "Why did the symptoms suddenly worsen?"

At this time, the doctor on duty at noon walked in, it was Lou Jie.

"The patient on which bed is uncomfortable?" Lou Jie stood at the door of the office and asked.

"Teacher, this is bed 31 of Teacher Cui's group." Gu Xinyue stood up immediately and walked to Lou Jie.

"What's the patient's disease?" Lou Jie asked.

"Diabetic ketoacidosis." Gu Xinyue said.

"Okay, you come with me to see the patient." Lou Jie nodded.

"Um."

Afterwards, Gu Xinyue and Lou Jie went to the hospital bed.

Lu Chen was still in the office, frowning as he looked through the patient's medical records.

He noticed that the patient also had a CT scan of the chest and abdomen yesterday.

Lu Chen immediately clicked on the patient's CT image.

When many doctors see a CT scan, their first reaction is to read the examination report.

But Lu Chen was different. He first needed to look at the CT images, and then look at the report from the radiologist.

Otherwise, if you go to the report with conclusions, you may be affected by other people's judgments.

"It's a small amount of pleural effusion...and a very small amount of ascites."

Although normal people also have a very small amount of pleural effusion, this person also had a small amount of pleural effusion and peritoneal effusion.

Lu Chen couldn't help but pay attention to it.

In addition, the patient also had fatty liver disease.

No abnormalities were found in the biliary system and the renal pelvis.

"The area around the patient's pancreas... seems to be somewhat unclear..." Lu Chen murmured.

This kind of unclear imaging makes it difficult to distinguish whether there is a lesion or is caused by uneven scanning of the instrument.

Lu Chen took a look at the CT report sheet.

Only a small amount of pleural effusion, a very small amount of ascites, and fatty liver were reported, but the pancreas was not described.

Is the pancreas okay?

Without seeing the patient himself, Lu Chen couldn't make a judgment.

He stood up and walked to the 31-bed ward.

…

At this time, Lou Jie was in front of the hospital bed, conducting an abdominal physical examination on the patient.

"Does it hurt here?"

The patient shook his head: "It doesn't hurt. UU read www.uukanshu.net"

"Then please pay attention. I will take my hand away later and see if it hurts."

"It doesn't hurt." The patient still shook his head.

"The patient's abdomen is soft, with no tenderness or rebound tenderness." Lou Jie said, "If you feel abdominal distension, it should be because you have been lying in bed for a day or two without moving, and there is some bloating in the abdomen. Let's observe it first. It should be No big deal.”

At this time, Lu Chen was staring closely at the health value on the patient's head.

52(--)!

These are two minus signs!

If the patient only has diabetic ketoacidosis, after lowering blood sugar and replenishing fluids, the condition becomes stable after the blood sugar drops. The trend of changes in the health value should also be (+)!

How could it be the two (--) now?