The system takes me for surgery

I have provoked someone, and I have to take a final exam after seeing a doctor!Now I really want to turn my head and go back on the spot, but this time, I may not be able to leave the department, saying: "There are also commonly used probiotics for the treatment of acute gastroenteritis, such as bifidobacteria and commonly used antibiotics such as fluoroquinolones such as norfloxacin. , The clinical effect of berberine hydrochloride in traditional Chinese medicine is also good.”

Xu Bowen nodded and said, "Very good, just follow your own diagnosis and treatment methods."

Liang Yi and Qin Hanyun glanced at each other. Based on their past experience, they could feel that this student will spend the rest of his life healing this experience.

The student went out dejectedly.

Xu Bowen reminded him when he was leaving, saying, "Bring a copy for each of your three roommates."

The student waved his hand and said, "Understood, thank you teacher."

This thank you has no sincerity at all, weak and lifeless.

Liang Yi suddenly laughed and said, "Hey, although I sympathize with him, I really want to laugh."

Qin Hanyun also laughed and said: "Maybe this is the shameless mother-in-law mentality. Almost every medical student has such a painful experience in seeing a doctor when they are sick."

Xu Bowen said: "Do you want me to take the test too?"

The general surgery nurse shouted, "Han Yun, your 32-bed patient said that he was suffering from chest tightness."

"Okay, I'll go and have a look right away." Qin Hanyun gave Liang Yi a wink and said immediately.

Liang Yi said sensiblely, "I'll go and have a look too."

Bed 32 is an old lady who is on the third day after abdominal abscess puncture aspiration and catheter drainage.

Half an hour ago, when I was walking in the corridor of the hospital, I suddenly felt chest tightness and suffocation, which was unbearable.

The old lady's expression was very painful, and she kept stroking her chest with her skinny palms, trying to make herself more comfortable. After seeing Qin Hanyun and Liang Yi, she seemed to be grabbing a life-saving straw, and moaned in pain: "Doctor Help me, I'm really hurting!"

They saw the old lady sitting upright, short of breath, and her lips were slightly purple.

Qin Hanyun held the stethoscope and heard the old lady's lung sounds were rough, the apex beat was in the normal range, the HR was 120 beats/min, the heart rate was regular, and continuous wind-like murmurs could be heard in the 3rd and 4th intercostal space on the left sternal border.

Liang Yi asked: "How about:?"

She shook her head and said, "I have heart and lung problems."

Liang Yi took the stethoscope and put it into the old lady's chest after covering the heat with his hands. He did hear rough breath sounds in both lungs, and a continuous wind-like murmur in the third and fourth intercostal spaces on the left side of the sternum.

"Check an electrocardiogram and take a film."

Electrocardiogram results are sinus rhythm, AVB, occasional premature ventricular contraction.Chest X-ray showed diffusely increased density in both lungs, prominent in the right lung field, widened right upper mediastinum, and small heart circle.

These two reports provide no valid clues at all.

After examining the old lady, the old lady's son came to the doctor's office and urged Qin Hanyun to see if there was a solution. The old lady kept shouting that she couldn't take it anymore.

The atmosphere in the office became tense.

Xu Bowen did not see any abnormality from the two new inspection reports.

Surgeons have always been weak in reasoning diagnosis of medical diseases and diseases.

That's why physicians complain that surgeons can only have flexible limbs and simple minds.

The surgeon complained about internal medicine polio, and the puncture was trembling.

He hurriedly said, "Hanyun, call the cardiology department for consultation."

Liang Yize sat in the office and meditated quietly, trying to convert the limited information into useful diagnostic information. He took out a piece of discarded A4 paper and drew on it.

Gan Xiaoyi leaned over and asked, "Senior, what are you doing?"

Liang Yi smiled and said, "Draw and draw, and see if you can find a basis for diagnosis."

"Is it possible to draw a picture like this?"

"Sometimes it works, sometimes it doesn't, and some diseases have complex signs and symptoms."

Gan Xiaoyi smiled and said, "Detective is the job of Di Renjie from the internal medicine department. We are Yuanfang from the surgery department, as long as we are in charge of the best martial arts in the world, it will be fine."

"It depends on the hospital. Some hospitals have strong internal medicine, and some hospitals have strong internal medicine. You can only be a father and a mother by yourself, and your brain will rust easily if you don't use it for too long."

"I think it's very difficult to practice both internally and externally. I'd better focus on surgery." Gan Xiaoyi said, he looked at it for a while, wondering what Liang Yi drew on the paper, and soon lost interest, saying: "Senior, you Let’s draw, I’ll watch the surgery video for a while.”

"Go."

After a while, Dr. Zhou from the Department of Cardiology came over.

According to the case characteristics of the old lady, he was an elderly woman with an acute onset; sudden palpitations, breathlessness, and no chest pain after fast walking; there were 4 unexplained syncope attacks and a history of hypertension that was not strictly controlled for more than 10 years; positive signs: Elevated blood pressure, tachycardia and shortness of breath, cyanosis of lips, orthopedic position, continuous murmurs can be heard in the 3rd and 4th intercostal space on the left side of the sternum; auxiliary examination: elevated white blood cells, hypoxemia, diffuse lung Sexual density increased and changed, right upper mediastinum widened.

Consider the diagnosis: pulmonary infection, acute left heart failure.

Qin Hanyun shook her head and said, "Hey, they are very professional. Our hearts tremble when we see it. They think it's commonplace, and they can diagnose it in minutes."

Gan Xiaoyi said: "This is the benefit of modern medicine. If there is no division of labor and cooperation, we will be miserable."

Qin Hanyun smiled wryly, and said: "That's because our internal medicine is too weak. This kind of simple diagnosis should be said to be necessary for clinicians."

Gan Xiaoyi didn't take it seriously, seeing Liang Yi still scribbling in the corner, walked over and patted him on the shoulder and said, "Senior, have you diagnosed it yet?"

Liang Yi said: "Lung infection is certain, but the specific cause of the heart has not been found yet."

"Don't think about it, let me tell you the answer, and save you some brain cells and hair." Gan Xiaoyi looked triumphant.

"What diagnosis did the cardiologist give?" Liang Yi asked.

"Dr. Chen said, lung infection, acute left heart failure, didn't you suddenly become enlightened?" Gan Xiaoyi's tone felt that Liang Yi's scribbling and drawing just now was a waste of energy, so he might as well read more Watch a video of the surgery.

Liang Yi asked, "How old is Dr. Chen?"

"I've lost my hair, so I should be in my forties? What's the matter?"

"fine."

"Don't worry, I'm an expert in this field, so I can't be wrong." Gan Xiaoyi patted his chest and assured.

"Well, I don't think it looks like acute left heart failure."

"Then what do you think it is?"

Liang Yi shook his head and said, "I don't know either."

Gan Xiaoyi smiled, and said: "I have been treated with anti-infection, cardiotonic, and diuretic, and I will know soon if there is any effect."

After taking the medicine, the old lady felt relieved.

But the next morning, the old lady suddenly developed a metamorphosis!