I Can See Health

   Chapter 375 Strange Two Minus Signs (Second)

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

   This made the junior sister a little embarrassed.

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

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

   "Uh... some I don't quite understand now, but I will definitely understand in the future!" Liu Binsong clenched his fist.

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

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

  Senior Brother Lu Chen really asked... She just said it casually!

  …

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

  There are many patients and the workload is also a lot more.

   However, several interns are currently unable to do these jobs, so 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 brother of Yansan.

  Senior Brother Yansan asked for a few days off because of looking for a job and writing a dissertation.

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

   Throughout the morning, everyone hardly rested.

   Got off work near noon.

  The nurse hurried in.

   "The doctor from Teacher Cui's group is not here, your bed 31 is uncomfortable, go and see!"

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

  I saw Gu Xinyue stand up immediately, "I'm from Teacher Cui's group, I'll go right away!"

  Mr. Cui worked the night shift last night and left early today.

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

   "Old 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 for lunch together.

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

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

   About five minutes later, Gu Xinyue frowned and returned to the office.

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

   "What happened to the patient?" Lu Chen asked in confusion.

   Endocrinology patients, most of them have blood sugar.

  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, when he was admitted to the hospital yesterday, his blood sugar was 33.8mol/L. This morning's blood sugar has dropped during the ward round, and the random blood sugar is only 14mol/L. left and right, but he kept saying bloating, and the symptoms were getting worse, and now it's getting worse!"

  Lu Chen frowned slightly, is he really a diabetic ketoacidosis? !

   The blood sugar level of more than 30 points has dropped, but the condition is getting worse?

   What's the point of this...how strange?

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

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

   "Well, then I'll wait for you, don't rush to eat." Lu Chen said.

  He mainly wanted to see this "weird" patient.

   Blood sugar dropped, but symptoms got worse!

  Lu Chen opened the patient's course record.

   Patient male, 59 years old.

   was admitted to the hospital due to "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, was unable to lie on his back, accompanied by symptoms such as nausea and vomiting, and came to the emergency department of Jinghua Second Hospital. The blood sugar was checked at 32.1mol/L. Considering diabetic ketoacidosis, he was admitted. Internal medicine hospitalization.

  Past history: Hypertension and diabetes mellitus for 10 years, irregular treatment, intermittent use of hypoglycemic and antihypertensive drugs.

   Physical examination on admission: body temperature 36.6°C, pulse 142 beats/min, respiration 28 beats/min, blood pressure 140/80 mmHg, and cardiopulmonary auscultation was negative.

   After being admitted to the hospital yesterday, in accordance with the treatment principles of diabetic ketoacidosis, he was given intravenous low-dose insulin, active fluid rehydration, potassium supplementation and other treatments.

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

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

   "Which patient is uncomfortable?" Lou Jie asked while standing at the door of the office.

   "Teacher, it's the 31st bed in Teacher Cui's group." Gu Xinyue stood up immediately and walked to Lou Jie's side.

   "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."

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

  Lu Chen was still in the office, frowning and looking at the patient's medical records.

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

  Lu Chen immediately clicked on the CT image of the patient.

  Many doctors look at the CT, and the first reaction is to look at the examination report.

   But Lu Chen was different. He first looked at the CT image, and then looked at the report from the radiologist.

  Otherwise, if you read the report with a conclusion, you are likely to be influenced by the judgment of others.

   "This is a small amount of pleural effusion...and a very small amount of ascites."

  Although a normal person also has a very small amount of pleural effusion, this person also has a small amount of pleural effusion and ascites.

  Lu Chen couldn't help but take it seriously.

   In addition, the patient also has fatty liver.

  The biliary system and the pelvic cavity of both kidneys were normal.

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

   This kind of imaging is unclear, and it is difficult to distinguish whether it is caused by lesions or uneven scanning of the instrument.

  Lu Chen glanced at the CT report.

   only reported a small amount of pleural effusion, a very small amount of ascites and fatty liver, and did not describe the part of the pancreas.

  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, performing an abdominal examination on the patient.

   "Does it hurt here?"

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

   "Then pay attention, I'll take my hand away later, you can see if it hurts."

   "It's not painless." The patient still shook his head.

"The patient's abdomen is soft, there is no tenderness, and there is no rebound tenderness." Lou Jie said, "If you feel bloated, you should have been lying in bed for a day or two, and your abdomen is a little bloated. No big problem."

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

  52 (--)!

   These are two minus signs!

   If the patient only has diabetic ketoacidosis, hypoglycemia, fluid replacement, and blood sugar drop, the condition tends to be stable, the trend of the change of life value should also be (+)!

How can    be the current two (—)?

   There is one more chapter.

   Around one o'clock, everyone go to bed early!

   (end of this chapter)