: 1198th: Professor Chen, do you think about it?

After Chen Cang simply asked a few words about the patient's condition.
Just start a detailed physical examination for the patient.
to be frank!
Things like physical examination are addictive.
As a predecessor said, a physical examination is only possible once and not countless times!
Of course, the dummy model is definitely not as fun as real people!
Especially when touching the lymph nodes and palpating, the dummy can't bring back at all!
The patients are different. The lymph nodes are large and round. Occasional groaning sounds can give the medical examiner an intuitive understanding.
Because of this, Chen Cang's face suddenly changed after palpation, and his eyebrows frowned slightly.
Hey?
I go!
Does an assessment come up with such a difficult question?
During his speech, Chen Cang began to ask about the medical history.
just……
The more Chen Cang asked, the more interesting it felt!
I did not expect to encounter such a challenging and confusing problem!
For a time, for the sake of insurance.
Chen Cang took the stethoscope again, first auscultated the heart, then the abdomen ...
After some inspection, Chen Cang took a deep breath!
Giving a deep look at the patient!
The patient smiled slightly and gave Chen Cang a deep look.
Quite a battle of wisdom and bravery, the narrow road meets the determination of the brave to win.
The three examiners looked at each other at this time, feeling a little puzzled.
Professor Chen like this ... Is he making a show to the camera?
Thereby deceiving the camera?
Is it necessary to be so serious?
However, at this time, Chen Cang heard a murmur in his abdomen!
Suddenly, Chen Cang's face changed!
He closed his eyes and began to think again, and turned back to start asking about the medical history!
But this time, Chen Cang asked more and more meticulously!
The more you ask, the more you discover some problems!
"Acute chest pain?"
Chen Cang immediately raised his eyebrows.
"How many years have you had high blood pressure?"
The man smiled: "Heirloom, it has been 30 years, but I haven't been taking medicine well. This time, my heart was suddenly uncomfortable, so I hurried over."
The patient's mood was not heavy either.
After all, he has been hospitalized, and the doctor said the situation has eased somewhat.
He also took the initiative to register as a model for this intermediate exam.
Be aware that these "model" patients are generally volunteers and have no income, so those who come here are generally very cheerful in character!
The patient's eldest brother is nearly forty years old, bald, five short stature, is a small executive of a private company, and life is not too slow.
After this hospitalization, he even said optimistically that he doesn't need to travel a lot, and can even take a rest for a while.
The patient was diagnosed with angina pectoris and high blood pressure. He is a plaque in the carotid artery after smoking and drinking for a long time.
Therefore, the attending doctor is worried that unstable plaque may cause a series of troubles such as cerebral infarction and myocardial infarction.
When Chen Cang asked the question, the patient could not tell him the diagnosis, only the symptoms, to put it plainly, that is, the patient had to "fight the wisdom" with the assessment doctor!
But at this time, Chen Cang suddenly asked:
"Did you have a cold recently? Fever, or are there any rashes on your body!"
Suddenly, the man froze, recalled carefully, and quickly said:
"Yes, some! This kind of thing happened before the hospitalization, but because it was not obvious, I didn't care. It was mainly because of my heart discomfort that I came to the hospital!"
Hearing this, Chen Cang suddenly frowned, and at the same time, his eyes sharpened a bit.
He turned and looked at the three examiners: "Give me the latest imaging results and physiological and biochemical tests."
The three were stunned for a moment, and Xu Aiming quickly handed it out.
Chen Cang took out the physiological and biochemical factors such as blood routine, liver and kidney function, troponin, and infectious diseases.
Chen Cang saw the test sheet very quickly. After reading it, he dropped it directly.
He found that perhaps the test now has no meaning.
He put down the test sheet and picked up the video results.
Because the test report is real-time data!
What does that mean?
It is your vital signs and various indicators at this moment, even if you drink a bowl of water and pour a bubble of urine, there will be pulsation, but it will not be so large.
but……
Meal will not change much, what if I take medicine?
He felt the patient's liver had an abnormal reaction.
During the speech, he picked up the ultrasound of the abdomen and the ultrasound of the heart and looked at it. After reading it again, it did not seem to be much different. It was basically normal.
There are no chest radiographs ... no ... wait!
Chen Cang stared at the chest radiograph carefully. After a few glances, he put it down and took out the chest CT.
After reading it, Chen Cang took a deep breath.
This hospital ... is too courageous, and the assessment is too difficult!
Chen Cang felt that if he was not aware of the abnormal response of the patient's liver and abdominal murmur, he could not find such hidden signals!
Chen Cang couldn't help but shook his head, it seemed that the evaluation of the attending physician was very difficult!
Even such a serious and complicated patient was evaluated.
Thinking of this, he wrote seriously in the patient's diagnosis column:
Admission diagnosis:
1. Kawasaki disease?
2. Vasculitis (possible aorticitis)
3. Hypertension level 3 (extremely dangerous group!)
4. Aura dissection aura
5. Angina
6. Liver injury (hepatitis may)
Chen Cang wrote six diagnostics!
And one by one is more dangerous.
treatment method:
1. Improving relevant examinations as soon as possible after admission, urgently checking liver function and improving angiography.
2. Special nursing routine, low-salt and low-fat diet.
...
After writing, Chen Cang handed it to the three examiners and sighed.
This question is really difficult!
I almost didn't do it myself.
At this time, the three examiners suddenly froze after reading.
The three looked at each other and looked at each other, two eyes ...
Can't help but take out the answer in his hand and froze for a moment.
This……
It seems to be different from the diagnosis of the doctor in charge!
Thinking of this, Xu Aiming couldn't help but ask: "Professor Chen, or ... do you think about it again?"
"Yes! Actually ... Are you thinking about it?"
"Yes, do you say that the patient has other possibilities? For example, it is just ordinary hypertension or something? On the treatment plan ..."
After Chen Cang heard it, he immediately looked upset.
Immediately ... awkwardly but politely sighed. UU reading books www.uukanshu. com
It seems that after all, he walked through the back door!
Thinking of this, Chen Cang added an article to the disposal plan:
"Schedule surgery as soon as possible!"
After writing, Chen Cang was relieved and looked at the patient with respect.
This brother is a great man.
I am at this point and insist on providing medical staff with a training opportunity ...
So touching.
but!
Chen Cang looked at the examiner's profound eyes and the patient's wise eyes, Chen Cang wondered.
Is it ... this is a trap?
Should I make a special choice?