Doctor of Healing

Chapter 342 Review Paper

Soon, members of the expert group appeared one after another.

Zhou Tianbo didn't leave, he followed She Yong with a faceless face, and greeted every member of the expert team, but he was always thinking about Ji Xiang who could make the system send out an alarm.

It should be that there is a problem with the electronic review system, Zhou Tianbo is partial to this point.

"Professor Zhou, are you really here to see the results of that Gui Peisheng named Ji Xiang?" She Yong asked when no one was around.

"Master, I did come to see his grades." Zhou Tianbo admitted, "I knew he could get at least 480 points in the test, but I didn't expect it to be a perfect score."

"There must be a problem with the system. For the questions of the current medical license exam, there are a lot of multiple-choice questions in the back, and the answers are all ambiguous. Let alone a regular training doctor, even if you are asked to answer it again, can you get to 550? It's hard to say." She Yong said.

Zhou Tianbo took a deep breath.

Soon, twelve experts sat down in the small conference room of the Health and Medical Commission.

"Teachers, the system called the police, so I have to ask all the teachers to review it. I'm really sorry." She Yong said politely first.

"How many points?" One person asked.

"Full score."

"!!!"

"!!!"

All the old experts in the room stared at She Yong with wide eyes.

"So troublesome teachers." She Yong said, "According to the standard answer, I double-checked it, and it is indeed correct. Teachers, take a look first."

The old experts are not unhappy, life is flat, and today's major events rarely happen.

They began reviewing the questions and finalizing the correct answer.

In Zhou Tianbo's view, the previous single-choice questions are not difficult, but the latter multiple-choice questions should be ambiguous.

but!

The No.30 eight-question expert group began to discuss it.

"Who came up with No. 30 eight questions." An old expert said dissatisfied.

Zhou Tianbo quickly found No. 30 eight questions on the young master's computer.

The question is the medical history—female, 38, the patient went to the local doctor seven days ago due to sudden upper abdominal pain. When she was admitted to the hospital, the blood amylase increased significantly, and the urine amylase increased. After being transferred to our hospital, she had oliguria for 2 days. Now the blood test Amylase was basically normal, and urinary amylase was slightly elevated.

Urine protein (+), urine sugar increased significantly, no pyuria. (Clinical requirements fasting water, the patient's special situation, did not drink contrast medium) Supplement: The volume of the kidney is about 12x7x5CM3.
Next is a CT scan of the upper abdomen.

Selected answers include cerebral infarction, sudden cardiac death, acute pancreatitis, etc.

Isn't this a sub question?Zhou Tianbo thought of the answer when he saw the answer and combined with the patient's medical history.

Both blood and urine amylase are high, so what if it is not acute pancreatitis.

He is not a doctor who specializes in gastroenterology or hepatobiliary and pancreatic surgery. He couldn't understand the CT of his upper abdomen, so he didn't see it either.

If he were to answer the question, he would definitely choose acute pancreatitis directly.

"Let me tell you my opinion." An old man with white beard and hair knocked on the table.

The others looked up at this one.

Zhou Tianbo knew that this was the retired old director of the Department of Hepatobiliary and Pancreatic Surgery at the Imperial Cancer Hospital, so his speech should be representative.

"The patient's abdominal pain symptoms, combined with elevated amylase, have a high probability of pancreatitis.

It should be noted in the abdominal CT that the tail of the pancreas is full, the space between the head of the pancreas is unclear, and the kidney adjacent to the pancreas is enlarged;

It should be noted that the bilateral kidneys of the patient were enlarged on CT, which was caused by oliguria; the gallbladder was full, and there were stones inside and outside the patient; it may be the cause of pancreatitis; the posterior abdominal wall near the pylorus seemed to have thickened mucosa, and chronic gastritis was not except.

Combined with the medical history, it is considered that chronic bile reflux may exist; in addition, acute pancreatitis causes more renal failure than systemic inflammatory response syndrome, and the patient in this case is considered to be related to pancreatic lesions involving the kidneys.The patient's inferior vena cava is thickened, and whether there is cardiac insufficiency at the same time. "

"So." The old man paused for a moment, and his tone became more emphatic, "If I had to choose, I would choose sudden cardiac death."

"Boom~~~" There was a commotion in Xiaoshi's classroom.

Zhou Tianbo was a little confused.

If you change this question, pancreatitis is the first option, and renal insufficiency is the second option. In any case, sudden cardiac death is not an option.

But the old expert's analysis was clear and logical, and he couldn't tolerate Zhou Tianbo saying "no".

"Old Sun, the standard answer is sudden cardiac death, do you think it's right?" asked another person.

"Well, I've seen similar patients." The old man was a little unhappy, and he said in a deep voice, "I didn't give all the medical records, and just added a brief medical history to a film. Is this an exam? This is embarrassing!"

"This kind of question, I show it to my doctoral students, and the wrong choice may be more than 80%."

"!!!"

"Forget it." The old man shook his head, "The answer on the recheck paper is correct. I mean there is something wrong with this question. It's too difficult, the difficulty has exceeded the outline, clinical... Hey, if you don't believe it, let each family in the imperial capital The directors of large tertiary hospitals have a look, and it is estimated that few of them can answer correctly."

Indeed, what he said was to the point.

"This examinee is right." One person smiled, "Since the answer is correct, let's continue."

Zhou Tianbo's heart was pounding, he had a vague feeling that this matter seemed to be different from what he thought.

He knew that Jixiang was definitely not right.

That young man... why is there so much clinical experience!

The attitude of the expert group is obviously rigorous and serious.

If the question just now hadn't been explained in detail by Elder Sun, everyone present would have been misled.

Who is the person who made the question is really boring.

Because the expert group is all top experts, they got serious and quickly got the correct answers to some "digging holes" questions.

There was no difference between the answer and the standard answer in the test paper, and Jixiang passed the test paper review a little bit.

No matter how difficult the question maker finds in the question bank and how many traps are dug in the question stem, Ji Xiang can find the correct answer.

Soon, come to the big topic behind.

Soon, the dispute arose again.

This is an essay question. A patient with cerebral infarction was admitted to the hospital for treatment. The family members of the patient refused thrombolysis, which missed the best time.

The muscle strength of the patient's left upper limb was grade 0, and the muscle strength of the left lower limb was grade Ⅰ

At that time, he was given aspirin, atorvastatin, low molecular weight heparin, edaravone and other drugs. After 2 days of treatment, the muscle strength of the patient's limbs improved for a while, and the muscle strength of the left upper and lower limbs reached grade IV.

After the disease relapsed, low molecular weight heparin was stopped, and clopidogrel was added as a dual antiplatelet agent.

CTA of the neck and brain showed occlusion of the right carotid artery and right vertebral artery, occlusion of the starting end of the left internal carotid artery, and severe stenosis of the starting end of the left vertebral artery.

However, the patient had a severe allergic reaction during the carotid artery stenting procedure.

The patient suffered respiratory and cardiac arrest, and was rescued successfully.

The problem came out-what drug or operation caused the patient's allergic reaction.

(End of this chapter)