MTL - I Can See Health-Chapter 44 uncomfortable woman

  Chapter 44 A woman who is uncomfortable

   "Classmate, are you this year's doctoral student?"

  Lin Cui looked at Lu Chen suspiciously.

   Everyone's eyes were fixed on Lu Chen.

  Lu Chen smiled and replied unhurriedly, "Director Lin, I am a master student of Teacher Li Yao, and I just entered the department today."

  Lin Cui frowned.

   In recent years, most of Li Yao's students have been transferred from other schools, or they have been admitted to two medical schools, and the quality of the students is relatively poor.

   I didn't expect that Li Yao would have such a great student this year, which is really surprising.

   "That was a good answer just now." Lin Cui said lightly.

   She doesn't catch a cold about everything about Li Yao.

   No matter how good her students were, Lin Cui couldn't have any good feelings in her heart.

  Although Lin Cui behaved indifferently, in the doctor's office, whether it was a student or an undergraduate doctor, everyone was shocked, and many people became filthy.

   Is this the level of knowledge that a first-year master student should have?

   There are many second- and third-year graduate students, as well as students in the second and third years of regular training, and even undergraduates majoring in cardiology.

   They asked themselves that in terms of ECG interpretation, they were definitely not as good as Lu Chen.

  …

   Five ECGs, the last one left uninterpreted.

   However, after knowing that Lu Chen was Li Yao's student, Lin Cui's interest in explaining the electrocardiogram to everyone became less and less.

   Lin Cui directly stated the diagnosis of the fifth ECG, and ended the ECG explanation hastily.

  …

   The people watching and studying also slowly dispersed.

   "Lu Chen, the coronary 6+2 phenomenon you just mentioned...what do you mean?"

   Ke Yue blinked, showing a confused look.

Lu Chen smiled and said, "What I'm talking about involves the knowledge of the electrocardiogram vector and cardiac anatomy. You must know that the electrocardiogram is not a single graphic change, but to understand its essence, so as to face the ever-changing electrocardiogram, Instead of just memorizing the ECG mechanically, it's easy to forget."

   "Oh." Ke Yue didn't realize it was clear, "Lu Chen, if you have a chance to teach me to read an electrocardiogram."

   "Okay, no problem." Lu Chen smiled, "We can discuss with each other when there is a chance in the future."

   "Thank you." Ke Yue squinted and smiled, sweeping away the haze just now.

   "Congratulations, +1 for the thank you from Ke Yue!"

   As soon as Ke Yue finished speaking, Lu Chen received another prompt from the system.

ah? That's fine too!

  Lu Chen was taken aback for a moment, doesn't this system need to cure diseases and save people in order to receive thanks?

   At present, I just promised Ke Yue verbally to teach her to read an electrocardiogram, and I actually received a thank you point!

   Several months after obtaining the system, other people thanked Lu Chen for other things, but they did not get any thanks for it.

How does the    system determine the gratitude value?

  Lu Chen is still confused, he can only wait until the system completion reaches 100% to see what changes will happen!

  …

   After checking the room, Sun Guoguo began to instruct the task of the group today.

   "Today, 5 beds, 12 beds, 16 beds, and 20 beds were discharged from the hospital. The doctor in charge of the beds should sort out the medical records in time."

   "Mr. Li Yao is accepting patients in the outpatient clinic today, and everyone who is hospitalized takes turns accepting patients."

   "Lu Chen, when you first came to the department, follow Xiao Dong to learn how to accept new patients and how to make doctor's orders."

   The daily tasks of resident physicians are to admit and treat patients, issue doctor's orders, write medical records, and organize discharge medical records.

   This cycle repeats.

   As for how much knowledge you can learn, you can only see if the instructor will tell the relevant clinical knowledge while admitting patients.

  …

   Ten o'clock in the morning.

  Lu Chen received a WeChat group invitation to join.

   is an invitation sent by Zhou Wei.

   "Jinghua Second Academy Study Guidance Group."

  Lu Chen didn't think about it, he just clicked to accept the invitation.

The    study guide group has a total of 497 people.

After    Lu Chen joined, the entire group became four hundred and ninety-eight.

   "What kind of study group is this, why are there so many people?"

   "Isn't it some nasty group chat?"

   After joining the group chat, Lu Chen saw messages like "seeking guidance" popping up in the group.

   "Cardiology department, ask for guidance!"

   "Nephrology, seek guidance!"

   "Respiratory Medicine, ask for guidance!"

  …

   Strangely, the chat messages in the group are only medium, there is only such information asking for guidance, and there is no other reply.

  Although Lu Chen felt that this group was weird, he didn't care.

  …

   At eleven o'clock in the morning, Lu Chen treated his first patient.

   pushed the electrocardiogram and came to the twelve beds.

  The patient is a middle-aged woman in her forties.

   Dressed plainly, with a straw hat in his hand, and a morbid blush on his face.

   "Doctor, I'm not feeling well."

  The woman lay on the bed and pointed to the position of her heart.

   "Auntie, do you feel your heart is beating fast or slow? Is it chest pain or tightness?"

   "Neither, it's just that I don't feel well in my heart."

   Feeling uncomfortable is one of the most common "symptoms" in cardiology.

   But what is the discomfort, whether it is chest pain or chest tightness, patients often cannot describe it.

   In addition to being unwell, the woman did not have any other symptoms.

   After asking the medical history, start the physical examination.

   Blood pressure 110/80mmHg, normal.

  Lu Chen took out his Yuyue stethoscope, placed it on the apex of the patient's heart, and started auscultation.

   Auscultation is in a certain order, starting from the mitral valve auscultation area, followed by the pulmonary valve auscultation area, the aortic valve auscultation area, the second aortic valve auscultation area, and the tricuspid valve auscultation area.

  The auscultation area of ​​the mitral valve is the strongest point of the apex of the heart, also called the apex area, which is normally 0.5-1cm medial to the fifth intercostal space at the level of the midclavicular line.

   Auscultation examination completed.

   There was no obvious murmur in each valve, but Lu Chen noticed something abnormal.

   That is arrhythmia.

   However, auscultation alone cannot determine the nature of the arrhythmia.

  Lu Chen took an electrocardiogram.

   ECG showed: sinus bradycardia, premature atrial beats, and ST segment downslope depression, T wave flattening and QT interval shortening, the measurement value was 280ms.

   There is a problem with the electrocardiogram, and the problem is not small.

   However, this ECG change is not specific.

   Because clinical diagnosis depends not only on ECG, but also on symptoms, signs and auxiliary examinations.

   "Doctor, when will I be discharged from the hospital?"

   This simple woman sat on the bed, carrying her red cloth bag in her arms, her eyes filled with anxiety.

   "Auntie, you have just been admitted to the hospital. We don't know your specific condition yet. No one can say for sure about the treatment." Lu Chen frowned.

  These patients, when they first entered the hospital, they were thinking about the time of discharge, thinking that the hospital is a place where medicine is given to the sick as soon as they arrive?

   "We must first find out the cause, then treat the symptoms, and finally observe the efficacy of the drugs."

   "Then check it out." The woman said anxiously, "I still have a lot of things to do at home. I have two grandchildren to take care of, and there is farm work waiting for me in the field. I can't live without me at home."

   "Auntie, where are your family members?" Lu Chen continued, "Did you come to the hospital by yourself?"

The    woman nodded, "I came alone and had a fight with my family."

   "A quarrel?" Lu Chen raised his brows.

  A quarrel seems to have nothing to do with clinical medicine, but it is often a very important piece of information.

   Quarrels are related to internal and external injuries caused by fights, emotional drinking of drugs (rat poison, pesticides), etc.

   "Did you have any trauma, or eat anything special?"

   "No." The woman shook her head, "I just quarreled with my husband, there was no fight, and I didn't do anything else."

  Lu Chen nodded and truthfully recorded the patient's condition in the medical record.

   (end of this chapter)