This Doctor is Great

Chapter 114: I don't understand nephrology? Talent, add some to me!

Zhou Quan was torn apart.

Zhou Mo said that he was not free and had no chance to talk about buying papers.

And Huang Yiming, who turned out to be a native of Tianlong, bought him with money? I'm afraid it won't be enough for other people's pocket money a month.

"what to do?"

"I want to wait for another paper, but I don't know how long it will take."

Zhou Quan thought for a while and thought of a way that was not a solution.

Squatting and guarding Zhou Mo, you must meet and talk with Zhou Mo. According to his friends from the Cardiology Department, Zhou Mo is financially difficult, and his only breakthrough is Zhou Mo.

At this moment,

The students under his command came over: "Teacher, I have a patient here, I'm not sure, can you help me take a look?"

Zhou Quan suddenly became impatient: "I don't understand? Don't you read more books? I usually let you recharge your batteries in your spare time. Otherwise, if you don't understand anything like this, you can only ask the teacher. Are you trash?"

In a bad mood, scolded.

student:"………………"

On the surface, he dared not to express his anger, but he had already scolded Zhou Quan more than a dozen times in his heart: "If you hadn't arranged so many beds for us, or if you hadn't asked us to help you with your thesis, could we be so busy? Free time? I have to have it, I have been in the hospital for half a year, and I am busy every day until night, I go back to bed tired and study a fart!"

"Also, after Lao Tzu graduated from his undergraduate degree, he spent 3 years of training in this hospital, 3 years of special accompaniment, 6 years of being a bull and a horse, the hospital still doesn't hire me, and has been working as a freelancer for 6 years, with one year for others. It's not even better than... I'll go back and accompany me to the end, the hospital doesn't want me yet, I'm going to go out to find a job... I'm not even a human being on a horse now!"

The resentment in his heart has already made him have zero affection for this hospital.

Zhou Quan didn't know what the students thought, and even if he knew, he would be full of disdain.

17:00,

Zhou Quan got off work and sat on the iron chair outside the Cardiology Department early, waiting to see when Zhou Mo would leave.

[In other words, the best app for reading aloud and listening to books at present, Mimi Read, install the latest version. 】

...

At this time,

Zhou Mo finished writing the last patient's information, as well as the current patient's admission information.

Leaving the duty room and came to the ward.

In his heart, he gave the patient a new stroke.

Myocardial infarction was ruled out first, because just now, the patient's troponin blood drawing results came out, and there was no problem.

come to the ward,

Getting ready to step through the door,

Dududu~~~

The wife of the patient Zheng Zhengquan rang the bell of the nurse station.

His wife was overjoyed when she saw Zhou Mo.

"Doctor Zhou, my husband doesn't seem to be right. He said that his chest is getting more and more painful..."

Needless to say, Zhou Mo saw that the patient Zheng Zhengquan was clutching his chest at this time, his forehead was sweating from the pain, and his breathing was even more slow, as if he was being pressed.

"what happened?"

Look at the ECG monitor.

The patient's vital signs are fine.

At this time, the nurse also Xiaolin ran over.

Zhou Mo hurriedly ordered: "Make him an electrocardiogram!"

Thinking at the same time, what makes it hard to breathe?

Severe pneumonia, pulmonary embolism, heart failure, myasthenia gravis...etc.

First of all, with severe pneumonia, Zhou Mo took a stethoscope and listened to the patient's chest.

There were no rales in the lungs.

Severe pneumonia was excluded.

"Hey, wait..."

Zhou Mo noticed a problem. When his stethoscope was placed on the chest of the patient Zheng Zhengquan, the patient Zheng Zhengquan frowned and took a breath.

Zhou Mo was stunned.

Seriously asked, "Are you in pain here?"

Gently press the patient's chest.

Sure enough, the patient Zheng Zhengquan frowned again, and at the same time took a breath, as if he was taking a breath of cold air.

"pain?"

patient nods

Zhou Mo was shocked and thought of a disease!

"Why didn't I think of it?"

Just now, Zhou Mo pressed his fingers on the patient's chest, but did not use force, but poked a little. With the hardness of the human rib, it is impossible to touch the heart and lungs of the patient below the rib.

so!

The painful place is the soft tissue in the chest!

Not the heart and lungs in the chest cavity!

The emergency department must have made a mistake. They only thought that there were problems with the heart and lungs, and then they could not find the cause, so they were sent to the Cardiology Department for admission.

"Why don't you say you're these chest pains?"

Zhou Mo said to the patient Zheng Zhengquan dumbfoundedly.

Zheng Zhengquan endured bitter tears and complained: "I was a little dazed at the time...I only want to understand after you ask..."

Zhou Mo: "…………"

However, since it was determined that the pain was caused by the soft tissue in the chest, Zhou Mo didn't panic.

Not fatal!

Zhou Mo has enough time to take his time.

Let's use this cause first to describe the patient's symptoms:

First, the patient struggles to breathe, possibly due to inflammation of the chest wall (chest pain may be due to inflammation of the soft tissue of the chest wall after exercise.)

Because each breath aggravates the pain, the patient does not dare to take a deep breath, which creates the illusion of laborious breathing.

"wrong!"

Zhou Mo suddenly thought of what the patient said about the left side, the left hand and the left foot, and he had no strength.

There is no way to explain the inflammation of the soft tissue in the chest alone.

"rhabdomyolysis?"

Zhou Mo thought of a word.

The noun explanation is a bit complicated, and it is almost the same as the literal meaning.

Its etiology is very complex. At present, there are more than 190 known causes, and more than 40 genetic related causes. The common causes are excessive exercise, muscle crush injury, ischemia...

The patient Zheng Zhengquan complained that after playing volleyball and drinking beer yesterday, the possibility of rhabdomyolysis is not small.

However, after all, most of him now look at cardiology, and he is not very familiar with rhabdomyolysis.

"Forget it, call a nephrologist over for consultation..."

Zhou Mo still didn't make a direct consultation call, but asked Brother Chen Bing or Teacher Huang Li.

"That patient of yours is not a cardiologist?"

"yes……"

"..."

Senior Brother Chen Bing was speechless. How many are these? Zhou Mo's luck, I don't know if it's good or bad.

"Brother, I suspect rhabdomyolysis, so do you know a nephrologist?"

"Yes, but yes, I'll make a phone call to ask, but now I'm off work~www.readwn.com~ I'm afraid people won't come." Brother Chen Bing said while calling.

Internal medicine is not surgery. Surgery has high performance in operations, but internal medicine is not.

Get through, chat a few words, and hang up.

Senior Brother Chen Bing spread his hands: "He's off work, you should find the on-duty consultation doctor in the Nephrology Department."

Zhou Mo had no choice but to call the consulting doctor.

It is 17:20 now, and the consultation doctor of the nephrology department is not expected to come, and it may be delayed until tomorrow to the doctor of the next consultation class.

really!

Zhou Mo waited all the way until 19:00,

The consultant nephrologist has not arrived yet.

"Forget it, don't wait, I'll do it myself..."

What?

I don't understand the kidney?

System, give me some points! !

Zhou Mo first asked the nurse to draw blood from the patient and send it for liver and kidney function tests.

Then start brushing.

Searched 2 guides and read it again.

"Ding...you read "2022 AAST Clinical Consensus: Rhabdomyolysis"..."

"Ding...you read the "2021 EAST Practice Guide: Management of Rhabdomyolysis"..."