Chapter 198: : 1 horse, 1 sweat BMW!

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When Chen Cang returned to the ward, the patient stopped pumping. It seemed that the convulsions were paroxysmal.
Meng Xi took the medical record folder handed by Chen Cang, and opened the test sheet and the imaging result report.
Then he bent down and said to the patient, "I'll give you a check. You lie flat and straighten your hips and knees."
Meng Xi held the upper part of her ankle with her left hand, and took a pen out of her pocket with her blunt tip from the outside of the sole of the foot from the back to the base of the little finger, and then turned to the side of the thumb.
I saw the patient with dorsiflexion of the toes and the other four toes were fanned apart.
Chen Cang froze, Babinski's disease was positive? !!
The corners of Meng Xi's mouth rose slightly, although he had not yet been diagnosed, but he was already thinking.
The patient also seemed a little hesitant: "Doctor ... what happened to me? How could I start to twitch my hands and feet?"
Meng Xi calmed down, "It's okay, don't worry, I'll wait for Doctor Ge to bring the test sheet."
Meng Xi can actually give a conclusion now, but to be on the safe side, still have to wait for the test sheet to come out.
A group of graduate students, Pei Peisheng, walked into the ward in a white shirt holding a notebook with a gaze, and also wanted to see what heart disease can cause convulsions?
After coming in, one by one stood honestly next to the wall and let out the aisles on both sides of the bed. After all, they knew what to do. Once there was any situation, the patients could not help themselves. The sides of the bed and the aisle were C For the big brother.
They just watch the big show show quietly on the side!
Not long after, Ge Huai trot in with a long list of test sheets, but hadn't had time to tear them apart.
"Director Meng, look, this is a test sheet."
Meng Xi took the test sheet, flipped it over, relaxed, and it was so.
Meng Xi asked Ge Huai, "What medicine did you use these two days?"
Ge Huai slightly hesitated: "The main ingredients used are digitalis preparations, diuretics, and heart failure prevention."
After hearing this, Meng Xi frowned suddenly and turned to ask: "How do you consider the treatment plan after the patient is admitted to the ward."
With the question from Meng Xi in the room, the atmosphere suddenly became serious!
Ge Huai was dumbfounded by Meng Xi's question: "The patient's ECG showed prolonged ST breaks and low T waves, and the echocardiogram could clearly see enlarged ventricular cavity, thickened ventricular septum, reduced pulsation, and closed mitral valve. Incomplete, the pericardial effusion is obvious, so what I considered was mainly the treatment of the heart. After all, ... the test results were not yet available. "
Meng Xi did not wait for Ge Huai to explain, and said directly: "Now the results have come out. Look at it. What are you thinking about?"
Ge Huai blushed, and on the way, he had seen clearly how he could not understand: "This should be the combined effect of low calcium and blood magnesium, which caused the excitement of myocardial fibers-contraction of the European Union. Low calcium affects the electrophysiology of myocardial cells. Characteristics and induced arrhythmias. "
"Patients with chronic hypocalcemia should be the main cause of limb paresthesia, muscle cramps, and hand, foot and twitching."
The surrounding graduate students suddenly realized.
That's it!
Meng Xi did not make any evaluation, and turned to look at Chen Cang: "How much should the calcium be normal? What is the use?"
Chen Cang was shocked, and you forced me to pretend again ...
Mr. Cheng Fang Yonglin, my physiological and biochemical indicator teacher, this is my only perfect skill!
Chen Cang barely paused, blurting out: "The blood calcium of normal adults is 2.25 ~ 2.75mmol / L. Blood calcium has important functions in the human body. First, it is an important component of human bones and teeth. Second, it is to maintain nerves, muscles, and myocardium. Functions normally, and eventually participates in blood coagulation. "
Meng Xi stared suddenly, looking at Chen Cang with a calm face, a little surprised.
The graduate students around were intrigued. Did the big man rehearse beforehand!
It must be!
Since the shift today, you have pretend to be forced three times.
Nothing more than three ... You are a bit too much in this way?
You look like our group of graduate students is stupid ...
You have definitely memorized the information, or you have rehearsed in advance, today the cliff is an act.
The students are crying, are you not pretending to be in this way?
How much can normal blood calcium remember? Do we all start back ionizing while we are still carrying blood?
The back index is one of the basic literacy necessary for clinical medical students. In the emergency department, you should be familiar with some common test orders.
Meng Xi handed the test sheet to Chen Cang: "Then you see what information you can get through the test sheet."
Chen Cang took the test sheet and read it at will, and frowned slightly!
This may not be a simple heart attack.
Chen Cang looked up slightly: "Ms. Meng, this may be a hypoparathyroid heart disease!"
When he heard this sentence, Meng Xi couldn't help it.
The surrounding group of students were at a loss, and their eyes exchanged quickly!
"What is this?"
"Don't look at me, why do I know what this is!"
"I know the parathyroid glands, I know the heart disease, why don't I know them when they are stacked together?"
"Ah, what can I do?"
After watching for a long time, everyone reached a final consensus!
This is a big match!
It's a circle bigger than the first three together!
Are some of our graduate students really being hit by a small undergraduate? ? ?
Thinking of this, everyone was cold for a long time in a lonely sandbar ...
When Ge Huai heard what Chen Cang said, he suddenly remembered the term!
An extremely rare disease!
First hesitated for a while, then quickly took the test sheet, and took a closer look, pondering for a moment, thinking of all the patient's performance, the more you see the more clear, the more you see the more shocked!
Finally realized suddenly!
Yes indeed!
Why didn't you think about it?
This kid is amazing!
And Chen Cang was a little hesitant. He found that no one paid attention to himself. Does Chen Cang feel that the audience is missing?
Shouldn't you be a little questioning?
I'm so pretentious, I have to give me a face.
After waiting for a few seconds, Chen Cang couldn't help feeling disappointed when no one spoke.
This pretend, five points ... fail!
However, Chen Cang still felt that he should finish his words: "Patients may have idiopathic hypoparathyroidism, which is rare, but mostly sporadic and related to immunity. It can be clearly seen through laboratory indicators. It turns out that although the proportion of patients' lymphocytes is normal, this proportion is similar to that of patients with idiopathic parathyroid lymphocytes. "
"The patient's blood calcium was only 1.9, his blood phosphorus rose to 1.59, and his serum immunoactive parathyroid hormone was almost undetectable."
"The reduction of PTH in patients can affect the contractility of myocardium, and as Mr. Ge said, hypocalcemia and hypomagnesemia affect the contraction of myocardial fibers, so I guess it is hypoparathyroidism."
"And when the calcium is low, the excretion of sodium ions is reduced, the retention of water and sodium can increase the load on the heart, and the patient's new functions are incomplete, so ... it seems that there is no problem with Mr. Ge's treatment."
"But if you add some calcium supplements, such as oral vitamin D3, or Roga full calcitriol pills, the effect may be better, and even heart failure may be relieved!"
After Chen Cang spoke these words smoothly in one breath, he couldn't help sighing. He wouldn't be meaningless if he didn't show his face ...
Chen Cang's words just fell!
Applause came from outside the door.
"OK! OK! OK!"
I saw Xia Gaofeng walked in with excitement from his face, his eyes filled with joy and joy. He was really an amazing talent. It was really a BMW with a lot of sweat!
To be honest, it has been a long time since Xia Gaofeng hasn't met such a spiritually capable student.
This is no exaggeration.
First of all, it has a very strong hands-on ability and a good suture foundation. However, the analysis of diseases, especially the analysis of physiological and biochemical laboratory indicators, can be said to be extremely detailed.
A comprehensive analysis of these several abilities ~ EbookFREE.me ~ can completely see a person's clinical thinking and surgical talent!
Thinking of this, Xia Gaofeng looked at Chen Cang with satisfaction: "Yes! The analysis makes sense!"
At the height of Xia Gaofeng, many diseases were clear at a glance, too many were seen, and a rare disease such as hypoparathyroidism was not too rare for him.
But it may indeed be rare for Ge Huai.
What are you afraid of?
I'm afraid of synthesis!
Once a group of illnesses piles up, it is difficult to prepare to identify the patient's actual illness.
However, Chen Cang was able to analyze the hypoparathyroidism heart disease in the test sheet of cardiac surgery.
It is really valuable!
Hey……
The thought of such students is either their own or the heartache!