Doctor of Healing

Deputy Director Zou let out a mouthful of saliva, and was also concentrating on it.

"Deputy Director Zou, what do you think is the situation?" Xie Kaike asked politely.

When meeting a doctor from a higher-level hospital, Xie Kai immediately became much more honest, without the domineering vigor he had when he was talking to Zhao Zhe.

"let me think again."

Deputy Director Zou was very embarrassed.

The patient's examination at the local hospital was complete, and all evidence pointed to intestinal polyps.

But if the polyp has blood in the stool, it seems that something is wrong.

Generally speaking, polyps will bleed, but the patient has undergone gastrointestinal endoscopy, and the description of polyps under the microscope is that the surface is smooth and there is no ulcer.

The pathological changes of polyps begin with ulcers, corroded blood vessels, and bleeding, but the situation seen under the microscope is different from the patient's symptoms.

The diagnosis of colon polyps can be taken lightly, but after that?

There are doctors around the patient, and the reason why they come to the higher-level hospital is because they do not believe in this diagnosis.

Deputy Director Zou encountered a problem.

And Lin Jiu also encountered a problem.

One of the two was drooling, the other frowned, lowered his head to write, and looked up at the patient.

The atmosphere in the drug changing room became a little weird.

It is impossible to face each other without talking, and then Deputy Director Zou is going to ask the patient to do more related examinations, and take the method of elimination to investigate bit by bit.

He thinks there is only such a way now.

"Excuse me, is your urination normal recently?" Ji Xiang's voice suddenly appeared, breaking the silence.

Deputy Director Zou and Lin Jiu were taken aback at the same time.

The patient had intestinal bleeding, Ji Xiang asked the patient to urinate...

Although similar situations are described in normal medical records, there are also descriptions of lower body in the medical records. You can't just let them take off their clothes and pants when they meet a patient.

If you do this, it is estimated that it will be on the hot search before the next day.

Xiao Jiguipei's first department is said to be urology. Does he have a physiological reflex?When knocking down a patient, the first thing to check is whether it is a urological disease?

Although Deputy Director Zou felt that Ji Xiang's question was out of his mind, he remained silent and did not stop him.

"Doctor Ji Xiang, it shouldn't be a urinary system disease." Lin Jiu didn't have so many worries. He had already written 4 pages, and his hair was about to stand on end.

"Problems with urine output should not all be caused by urology or nephrology." Ji Xiang said lightly.

"..." Lin Jiu was taken aback.

What does Ji Xiang mean?

"I had oliguria a while ago, but it has recovered recently..." the patient hesitated, "but it seems to have recovered a little too much. Recently, I drank a lot of water and urinated a lot."

As he said that, the patient blushed, "Sorry, I want to go to the bathroom."

After the patient left, the eyes of several doctors became much deeper, as if there was some problem, but frequent urination and urgency are usually caused by urinary tract infection.

However, the patient's chief complaint was blood in the stool.

Could it be diabetes?

Is it hyperkalemia?

Could it be hypercalcemia?

Countless possibilities appeared in an instant, and Deputy Director Zou looked serious, "Doctor Xiaoji, what do you think?"

"After the patient comes back, let's measure the blood pressure." Ji Xiang did not answer Deputy Director Zou's question directly, but suggested that the patient measure the blood pressure.

"Measure blood pressure? The patient said she has no history of high blood pressure." Lin Jiuze said.

"Normal physical examination, measure blood pressure and see."

"Dr. Jixiang, are you considering the blood in the stool caused by the patient's high blood pressure?"

As soon as Lin Jiuze asked this question, he himself thought it was ridiculous.

High blood pressure does not cause blood in the stool.

What does that mean?

Lin Jiu looked at Ji Xiang suspiciously.

Chapter 639 Malignant Hypertension and Snacks

"Doctor Xiaoji, what do you think about it?" Deputy Director Zou simply stopped guessing and asked directly.

"When I first saw the patient, she was drinking water and then went to the bathroom during the medical history inquiry. Just now she went to the bathroom again. I think the two should be related."

"Is it related to suspected high blood pressure? Or urinary frequency and urgency caused by urinary tract infection." Lin Jiuze asked.

As soon as the words came out of his mouth, Lin Jiu realized something was wrong.

He himself is very clear about his personality. Although the purpose of coming to chat with Ji Xiang is a bit complicated, it definitely does not include the option of offending Ji Xiang.

but!

When faced with Jixiang's "unreliable" statement, Lin Jiuze couldn't help but want to sarcasm.

This is very different from the usual harmless image of humans and animals.

How could I dislike Ji Xiang?

Lin Jiuze's heart trembled, and he immediately concentrated on suppressing all the extra thoughts.

Experts can't offend, Lin Jiu never thinks that Lao Tzu is the best in the world, otherwise he wouldn't stay after the show.

"I see that the patient's face doesn't seem very healthy."

Complexion, high blood pressure, two irrelevant words are full of slots when combined, Lin Jiu is about to move.

He forcibly endured it without complaining.

But Lin Jiuze once again doubted his own judgment in his heart.

Does Ji Xiang have super diagnostic ability, or is he just a weak chicken who makes his diagnosis by luck every time?

However, what is certain now is that Ji Xiang's surgery is top-notch.

Lin Jiu was so dazed by this weird boy, he couldn't figure out Ji Xiang's routine at all.

Deputy Director Zou was also noncommittal, and when the patient came back, Deputy Director Zou said, "Have you measured your blood pressure recently?"

"No, my blood pressure has always been normal, and I can't remember to measure it at ordinary times." The patient replied.

Deputy Director Zou asked the nurse to bring a mercury sphygmomanometer, but instead of letting the patient use the electronic sphygmomanometer at the nurse's station, he measured the patient himself.

Lin Jiu stood behind Deputy Director Zou, aiming at the mercury column in the mercury sphygmomanometer.

Although the stethoscope is not on his ear, the fluctuation of the mercury column can tell the problem.

Deputy Director Zou pinched the ball, the pressure increased, and the cuff made a creaking sound.

After the mercury column rose and then slowly fell, Lin Jiuze narrowed his eyes and watched meticulously.

As soon as it dropped below 200 mm Hg, the mercury fluctuated.

Lin Jiu's heart tightened.

Did Ji Xiang "guess" right again? !

Impossible, the patient is young, and she says she has no history of hypertension.

Teachers generally have 1-2 physical examinations a year, and high blood pressure should not be missed.

At this moment, Lin Jiuze even began to wonder if his eyes were a little blurry, and he misread the fluctuation of the mercury column.

When the mercury column drops below 190 mm Hg, the fluctuation becomes more obvious.

"Huh?" Deputy Director Zou was puzzled softly.

Soon, Lin Jiu determined that the patient's high pressure was at least 185 mm Hg, and the low pressure was 130 mm Hg.

This already belongs to the category of malignant hypertension.

A young patient with no past history and an initial diagnosis of blood in the stool, how could his blood pressure be so high? !Add the frequent urination that the patient just said...

These symptoms, signs and examinations made Lin Jiuze fall into a weird vortex from which he could not extricate himself.

These symptoms are rather scattered and do not connect together at all.

"The blood pressure is so high." Deputy Director Zou said with a frown, "Have you never felt it? When was the last time you measured your blood pressure?"

"No, I don't have a history of hypertension, nor a family history." The patient was a little confused, "The last time... I don't remember."

"What about the physical examination?"

"I said the blood pressure was normal, but the medical examiner simply wrote down the number and fooled it."

"Is it wrong?" one person asked.

Deputy Director Zou took another measurement, and the measured blood pressure was similar to the last time.

The electronic blood pressure was measured again, and the high pressure also fluctuated around 190 mmHg.

High blood pressure, from oliguria to polyuria, Lin Jiuze's brain CPU has been spinning rapidly, and the converted heat is almost smoking above his head.

He quickly wrote in the notebook, and looked up at the patient after writing.

Finally, a rare diagnosis appeared in the notebook—hyperaldosteronism.

Lin Jiuze looked up, and the anxiety and confusion in his eyes finally turned into calm.

It's it!

However, hyperaldosteronism is due to the tumor or hyperplasia of the adrenal cortex resulting in increased aldosterone secretion. The patient had abdominal CT, and no tumor or hyperplasia of the adrenal gland was seen.

but……

Lin Jiu looked at the purified water in the patient's hand.

Everything is so weird.

"Please check blood potassium to see if there is any problem with potassium ions." Ji Xiang said.

"Oh? Doctor Xiaoji, what do you suspect?" Deputy Director Zou asked.

"I smell licorice on the patient's body." Ji Xiang said something that seemed irrelevant to the diagnosis.

Licorice?

Deputy Director Zou was stunned, and Zhao Zhe was also stunned, what does this mean.

"Do you usually cough?"

The patient and the family members of the patient looked at Ji Xiang in surprise. Before they could answer, Xie Kai said disdainfully, "Is there any relationship between cough and blood in stool? Zhao Zhe, you work with this kind of person?"

"Old Xie!" Zhao Zhe shouted in a low voice.

"Why, am I wrong?" Xie Kai said with a look of disdain, "I didn't ask the medical history like that."

"It seems to be related. Do you usually cough? What medicine do you take to relieve cough?" Ji Xiang ignored Xie Kai, but looked at the patient with a gentle smile on his face.

"When I was a child, my lungs were not good, and I always coughed. The doctor said that I had chronic bronchitis. The cough was severe in winter. Isn't this going to Hainan for the winter vacation?" the patient said.

What she said was a bit long-winded, but Ji Xiang was not in a hurry, but smiled and looked at the patient waiting for her to continue.

"I have only taken compound licorice tablets for cough medicine since I was a child. The effect is quite good, and I don't cough after taking it."

No wonder the patient didn't cough during the physical examination. It turned out that she had been taking medicine.

"It's not easy to prescribe compound licorice tablets now." Ji Xiang began to chat with patients about daily routines.

"Yes, I used to be able to buy it in pharmacies outside when I was in school, but now I need a doctor's prescription, and I can't buy it in pharmacies, so I have to go to the hospital." The patient was a little distressed, "I always count and eat."

"Then what else do you eat besides compound licorice tablets?"

"No, it's three-point poisonous medicine, I only take this one." The patient replied with certainty.

"Oh, I'm not talking about medicine. It's..." Ji Xiang hesitated slightly, "Snacks."

Several doctors cast puzzled eyes.