This Doctor is Great

Although Zhou Mo really wanted to beat up the patient Chen Zhongxin, he held back when he thought about it.

Judging from what the patient Chen Zhongxin said, "It has been a long time since I felt that running was lacking strength", the patient's anemia has been going on for a long time.

Zhou Mo: "Is your stool usually black, or what color?"

Black stool, in addition to eating fruits with black and red pigments (such as cherries, blueberries, etc.), may cause black, and most of the other reasons are blood in the stool.

When bleeding from the upper part of the stomach and intestines (stomach, duodenum, jejunum, ileum), and then through the long digestive tract (about one to two days), after pulling it out, the stool is black.

If the stool is red, it means bleeding from the second half of the digestive tract: eg colon, rectum, steel door (harmony).

(Lesson representative, give a picture of the digestive system?)

(The demarcation point of the upper and lower digestive tract in medicine is between the duodenum and the jejunum.)

Patient Chen Zhongxin: "Most of the time it's green, yellow."

Gastrointestinal bleeding was excluded.

Zhou Mo: "Is there any medical history? For example, sickle cell anemia, thalassemia, or broad bean disease, or family history, is there anyone with anemia..."

Patient Chen Zhongxin hesitated for a moment: "My uncle seems to have broad bean disease, is this related to anemia..."

Zhou Mo suddenly became serious.

Broad bean disease is hemolytic anemia.

"Hemolysis": The rupture of red blood cells and the escape of hemoglobin is called erythrocyte lysis, or hemolysis for short.

Fava bean disease is a type of glucose-6-phosphate dehydrogenase deficiency. In patients with deficiency of this enzyme, the red blood cells are very unstable, and it is manifested as hemolytic anemia after eating fava beans, but the specific mechanism of hemolysis is unknown (not studied).

In addition, broad bean disease is a genetic disease.

Zhou Mo became serious: "Have you eaten broad beans recently?"

Chen Zhongxin shook his head again and again: "I haven't eaten...

Zhou Mo asked, "What about fans and Doubanjiang..."

These may all have fava bean ingredients.

Chen Zhongxin nodded this time: "I have it...and I quite like to eat Doubanjiang."

The answer seems to be found.

Doubanjiang, causing broad bean disease hemolytic anemia.

However, this is just a guess. Since he has been hospitalized, all the tests that should be done should be done.

correct,

Zhou Mo thought of another thing.

When I just had a b-ultrasound, I seemed to smell a mothball, the kind of mothballs that are put in the closet to repel insects, and the smell is relatively strong.

Zhou Mo remembered that mothballs were related to broad bean disease.

Although it is nonsense, mothballs are not broad beans, but mothballs contain the ingredient "naphthalene", which has a certain chance of causing hemolysis of broad bean disease.

(Because the mechanism of broad bean disease has not been researched, it cannot be falsified. However, there are some cases and experience that mothballs are believed to cause broad bean disease hemolytic anemia.)

That is to say, the probability that broad bean disease is the culprit is not small.

Zhou Mo: "Wait, I'll give you a test to see if you have "broad bean disease"..."

Chen Zhongxin: "It's not right. I eat Doubanjiang after I was a child, and it's no problem."

"No problem when you were young doesn't mean no problem now..." Zhou Mo said: "And this test is not very expensive, and you don't want to be so anemic all the time. For a major event like your heart disease, you don't need to save this money. Right…"

Chen Zhongxin nodded.

really.

I've got a heart attack, and I'm saving my ass.

at this time,

The nurse has returned to the cardiology department with plasma from the blood bank.

Replenish fluids, replenish blood, and relieve anemia first.

Zhou Mo suddenly thought of a question and asked, "By the way, do you have hemorrhoids?"

Chen Zhongxin hesitated and shook his head: "No!"

Zhou Mo noticed his hesitation and realized that the problem was not that simple, so he said solemnly: "I am a doctor, and I am treating you, so I hope you don't hide it from me."

"I..." Chen Zhongxin hesitated for a moment, and finally said, "I have hemorrhoids for more than a year."

"..."

Zhou Mo wanted to scold "Why didn't you say it earlier", but he finally held back.

hemorrhoid,

Basically, the blood circulation disorder of the steel door, varicose veins, edema of the rectal mucosa of the steel door, and some tissues around the steel door continue to proliferate, thereby forming hemorrhoids.

It says it's not serious, but sometimes it can be very serious.

(Class representative, do you want a picture of hemorrhoids? Book friends should feel disgusting (Devil Laughing·jpg))

"Do you have blood in your stool sometimes?"

"meeting."

"Why didn't you say it just now?"

The patient blushed, and probably was embarrassed to tell the doctor about it.

"I'll ask a doctor from the anorectal department to come over and show you..."

As for anorectal department, Zhou Mo didn't study it, so he couldn't help the patient to diagnose.

…

Diagnose, end.

The patient is currently suspected to be: anemic heart disease.

Cause of anemia: broad bean disease, or bleeding hemorrhoids

Therefore, the examination was prescribed for the g6pd project of broad bean disease, and a doctor from the anorectal department was invited for consultation.

end diagnosis,

Senior Brother Chen Bing gave Zhou Mo a thumbs up: "If it were me just now, you might not have been diagnosed so quickly. I guess I have to invite a gastroenterology doctor to come over for consultation... You are already better than me in this regard."

Zhou Mo said modestly, "The next department I'm rotating is gastroenterology, so I studied it in advance."

Senior Brother Chen Bing: "That's also very powerful."

Next to him, Huang Yiming hides back secretly.

Done!

The next department is also gastroenterology, but I didn't study it at all!

slack off!

No, I can't drag Mexico's hind legs, after all, I am Mexico's right-hand man!

Zhou Mo asked Senior Brother Chen Bing: "By the way, Senior Brother, do you know any anorectal doctor? Call for a consultation? If possible, it may not be a single operation."

Senior Brother Chen Bing took out his mobile phone: "There is a familiar one, now send him a message."

soon,

The other party replied: "At noon, wait for me!"

Senior Brother Chen Bing: "Thank you."

Turning off the phone, he smiled at Zhou Mo and Huang Yiming and said:

"Do you know how my friend chose the anorectal department?"

Weird smile. UU reading www. uukanshu.com

Zhou Mo and Huang Yiming were curious. After all, the anorectal department deals with excrement, so I am afraid there will not be too many doctors.

Senior Brother Chen Bing said with a smile: "Once, he had dinner with several old doctors in the hospital, so he asked which department in the hospital made more money. Some said surgery, some said orthopedics, some said it was dentistry."

"At this time, a highly respected old director of the hospital said: Fart! Ophthalmology is the most profitable!"

"So he finally chose anorectal department."

"Pfft~~~~~~"

Zhou Mo, Huang Yiming, and the nurse who was eavesdropping at the nearby nurse station all laughed!

That's horrible!

Brother Chen Bing: "There are a lot of jokes about anorectal department, one of which is: Even if she is the goddess in the eyes of many men, anorectal department can get rid of her second fat."

…