Vol 3 Chapter 2349: Hypomagnesemia with not low magnesium

"Surely not, do you know what chat is?" Su Yun looked at Zheng Ren scornfully.
"Boss Zheng, what kind of illness do you think?" Dr. Liang asked quickly.
"I just don't have any judgement just to hear your symptoms." Zheng Ren said, "You will bring the old lady to me for a while and do a simple examination."
"Well." Dr. Liang nodded.
Chinese medicine talks about hearing, hearing, and western medicine talks about hearing and touching. This is the most basic.
Su Yun flipped through the test sheet again and saw that Dr. Liang had done a thorough inspection of his mother. There was really nothing to say.
Except for a small problem with ECG, everything is normal, including EEG, spikes are not obvious, and it is impossible to diagnose any mental illness, let alone seizures.
Dr. Leung left the inspection report and greeted him in a hurry to pick up the old man. When he left, Su Yun asked: "Boss, really no guess?"
"The only abnormality is the electrocardiogram." Zheng Ren took out the electrocardiogram and glanced again, saying: "The PR and QT intervals are extended, the QRS wave is widened, the ST segment is decreased, and the T wave is widened. These changes will change your What do you think of? "
"Not only these, but a few waveforms can also be seen to reduce the voltage of P wave and QRS complex. Looking at that waveform, it is definitely suspected of hypomagnesemia, the standard is like a panda eating bamboo." Su Yun said, Take the report of the ion test, "But you see, blood magnesium is normal."
"Pandas are carnivores ..." Lin Yuan whispered.
"I don't know yet?" Su Yun glanced at her and said, "This, how do you explain."
The latter words are already being said to Zheng Ren.
"The serum magnesium is normal, and it is still impossible to determine that there is no lack of magnesium ions. Because serum magnesium is greatly affected by changes in pH, protein, and other factors, a single ion test can not explain any problems." Zheng Rendao.
Su Yun shrugged. "You're a bit stubborn."
"Look at the patients, there are some hypokalemias that also have existing symptoms."
"You can't die without talking about it." Su Yundao, "Diagnosis of hypokalemia is the key to identifying U waves. The general rule is that as hypokalemia gradually worsens, T waves decrease gradually, U waves increase, and U waves appear. Leads are increasing, U waves are equal to or higher than T waves of the same lead, and they are hump-like. TU fusion cannot distinguish and ST segment moves down. "
Zheng Ren did not argue with Su Yun, and he had too little information at hand. The argument at hand is a situation where no one can convince anyone.
Soon, Dr. Liang led his mother. Zheng Ren saw a medium red system panel and the diagnosis was clear-hypomagnesemia.
"Auntie, are you uncomfortable?" Zheng Ren smiled and began to inquire about his medical history.
Although there was a big pig's hoof diagnosis, Zheng Ren still asked from the beginning, nothing was too detailed, and Lin Yuan felt a bit embarrassed.
The patient's own positive medical history was only paroxysmal foot spasms and nothing else.
After Zheng Ren asked, Dr. Liang said, "Liang Zi, take your aunt to do a magnesium load test."
Dr. Liang froze and asked, "Boss Zheng, are you thinking of hypomagnesemia?"
"Well, the spasms of the wrists and feet, the changes in the electrocardiogram, and the slight tremor that constantly appears in your mother's eyes during speaking, the reflection is slightly hyperactive during examination, and there is neuromuscular tremor. These are considered hypomagnesemia, Although serum ionization is normal, the disease cannot be ruled out. "
"Okay." Dr. Liang took his old lady to check.
"Boss, it looks like it now." After checking the body, Su Yun did not object, and he thought, "But how did you get here?"
Zheng Ren is also pondering this issue.
Lin Yuan did not keep up with the thinking rhythm of Boss Zheng and Su Yun. In her opinion, only a slightly abnormal electrocardiogram plus a physical examination and a medical history gave a clear diagnosis-hypomagnesemia, which is amazing enough. Already.
As for how to get it ... I have to figure out how to diagnose it first.
"First, the consideration is that the digestive tract is lost too much." Su Yun held a mobile phone in his hand, chatting with people, and said with one heart, "Because magnesium is absorbed in the small intestine and part of the colon, when severe diarrhea, "Steel diarrhea, malabsorption, intestinal fistula, major small bowel resection, etc. can all lead to hypomagnesemia."
"Well, I just asked and had not had surgery. Normal people should not have magnesium ion absorption problems, which can be ruled out." Zheng Ren sat in a chair, his eyes narrowed, and wondered about Dr. Liang's mother's condition.
"Second, the kidneys are lost too much. Chronic pyelonephritis, tubular acidosis, polyuria of acute renal failure, or long-term application of diuretics, thiazines, and osmotic diuretics, etc., cause renal loss of magnesium and low Magnesemia. "
"I just asked, and I didn't," Zheng Rendao said. "I don't think it's a kidney problem."
"The loss is basically considered, and the next is the possibility of insufficient supplementation and inadequate intake." Su Yundao, "I think this is the most important ~ EbookFREE.me ~ but I just asked a moment, and Dr. Liang did not find out What ’s wrong with the diet at home? Some time ago, I read a report saying that vegans are prone to hypomagnesemia. Old women eat meat and should not. "
"What about drinking water?"
"Generally, no problems will occur." Zheng Ren shook his head. "Trace elements are minerals of 0.01% of the body's body weight in the region, mainly including iron, zinc, copper, manganese, selenium, iodine, fluorine, cobalt and magnesium. And These elements cannot be synthesized by the human body and must be obtained from food. "
"The human body can only absorb trace elements in the organic state. It can hardly absorb trace elements in the inorganic state. Most of the trace elements in the water are inorganic, and the content is very small."
"It has nothing to do with drinking water. People generally obtain trace elements from plants and animals."
"Boss, have you read this book?" Healthy Water "by Dr. Martin Fox of the United States." Su Yun pulled the topic away.
Zheng Ren shook his head.
"The book says that the standard for healthy water is a certain amount of hardness (ideally about 170mg / L), and a certain amount of soluble total solids ..."
"Don't say this, how did hypomagnesemia come about? This disease is rare." Zheng Ren pulled the topic back and continued to ask.
"There must be a medical history without asking clearly, boss, your clinical level is very poor. Xiaolinzi, send you to ask, to understand." Su Yun laughed.
Lin Yuan was very interested, didn't move, and didn't talk much.
The medical history enquired by Boss Zheng just now is very complete, and I don't know what to add.
And ask the medical history again? The last time a patient with an oval hole was closed with migraine is still vivid. Lin Yuan was unwilling to experience it again.
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