MTL - My Medical Skills Give Me Experiences-Chapter 9 Why is it less than half

Boom boom boom!

The knock on the door sounded so pleasant to the ear.

I'll be off work soon, and the probability that this is a follow-up patient is very small.

Generally, follow-up patients will be concentrated in the morning or the beginning of the afternoon.

Zhou Can is on the alert, waiting to earn experience points.

"Come in!"

Dr. He's voice is always so gentle and strong.

The door of the consulting room was pushed open, and a man in his forties walked in with the support of his family. He pressed his stomach with one hand, with a pained expression on his face.

"Ah yo, ah yo...Doctor, my stomach hurts badly, please help me!"

The man's face turned pale from the pain, and cold sweat was all over his forehead.

"Sit down first!"

Dr. He appeared very calm and calm.

"When did it start hurting?"

"It's been two days, it's been two days of pain, ah..." The man kept humming miserably.

To be able to hurt a middle-aged man like this, the pain level is definitely not low.

"Didn't you eat poisonous things? Such as poisonous mushrooms, toads, vegetables and fruits with pesticides."

"No, definitely not. I have been eating at home these days, and my wife and children are fine."

"Smoking and drinking?"

"Um."

"Does any family member have a similar medical history?"

"No!"

"Come on, help him to lie on the bed, I will do a physical examination."

Dr. He instructed the family members to help the patient to lie flat on the bed, and then began to do the examination.

Zhou Can also got up and followed to watch.

According to the patient's description and symptoms, he has already begun to make pathological inferences.

It's just a lack of examination data, coupled with his inexperience in clinical diagnosis, it is difficult to clarify the patient's pathological mechanism.

Because there are many reasons that can cause abdominal pain.

Peritonitis, gastroenteritis, gallstones, appendicitis, etc., many diseases can cause severe abdominal pain.

Dr. He pressed the patient's abdomen with his hands.

"Ah yo... Take it easy, take it easy..."

The patient screamed immediately.

"That's the only place where it hurts, right?"

"There's also pain in my right shoulder and right back, but it's not as bad as my stomach."

After hearing this, Zhou Can immediately understood that it was radiating pain caused by severe upper abdominal pain.

Just like throwing a stone into a pond, with the stone falling into the water as the center, a circle of ripples will be formed and spread around.

Pain is the same.

It travels through nerves to surrounding areas.

This phenomenon is called radiating pain in medicine.

Now it can be basically concluded that the initial area of ​​pain is in the upper right abdomen.

"Did your abdominal pain come on suddenly two days ago, or did it come on slowly?"

"It happened suddenly. There was no sign, and the pain started suddenly, intermittently. And every time the pain got worse, the pain became unbearable in the back, and I even vomited several times."

The patient provided another clue.

So, asking questions is still very important.

Don't be afraid of trouble, you must ask for more relevant information.

"Since the pain is so severe, it shouldn't be possible for you to wait until now to see a doctor, right? Have you ever been treated in another hospital?"

Dr. He has rich experience in diagnosis and treatment, and immediately deduced some truths that the patient did not disclose based on the patient's description.

"Uh... I did see it in a small clinic. At that time, I was given an infusion and said it was anti-inflammatory. It didn't work. The clinic boss was afraid of accidents and advised me to go to a big hospital for treatment."

Those small clinics give patients infusions at every turn.

All kinds of antibiotics are overused, and small clinics are the most guilty.

For some minor colds or minor symptoms, intravenous infusion and antibiotics are used, and the effect is really fast.

As everyone knows, this is a bit like drinking doves to quench thirst.

This time it got better quickly, but the body's immune system was disrupted and weakened, making it easier to get sick next time. will get sicker.

So repeated, eventually forming a vicious circle.

When the patient really needs antibiotic treatment, it will be sad to find that there is no medicine available.

Because the virus in the patient's body has developed serious drug resistance.

Even a random cold can be a super virus.

"Apart from abdominal pain, right shoulder and right back pain, do you have any other symptoms? When I touched your abdomen, it felt a little hot!"

A physical examination is the initial examination after a doctor's consultation.

This is very important.

It can help doctors discover some hidden diseases of patients.

Some patients may feel embarrassed or irrelevant, and may deliberately conceal some symptoms. This requires a doctor's sharp eyes.

"I feel like I have a fever, chills."

"Well, let me measure your body temperature, heart rate, and blood pressure first, relax a bit, and don't be nervous. When we get here, we will definitely do our best to heal you."

After Dr. He comforted the patient, without waiting for his order, Zhou Can has already cleverly rushed to measure the patient's blood pressure, heart rate, and body temperature.

These basic tasks, how can the superior doctor do it himself?

Be diligent, Dr. He must be happy to see it.

The next time you ask to take him to the clinic, the probability of agreeing will increase a lot.

"Body temperature is 39.6, pulse rate is 98/min, and blood pressure is 120/mmhg. There is no abnormality in percussion of both lungs. There is no chest murmur when breathing, and the breathing rate is about 25 times/min."

Zhou Can made a series of measurements on the patient.

The range between 39.1 degrees and 41 degrees is already a high fever.

The patient's condition was more serious and complicated than imagined.

"Let's do a routine blood test and ultrasound imaging first. If the results are not satisfactory, you may need to do a CT scan." Dr. He said this to both the patient and Zhou Can.

Zhou Can hurriedly ran to the computer to apply for a medical examination.

"Because your condition is complicated, the outpatient department will be off work immediately. Before the results of your examination come out, the etiology of UU Reading www.uukanshu.com is not clear, so you cannot be hospitalized. It is recommended that you go to the general surgery department of the inpatient department after the examination. Find Dr. Fang, and I will explain the situation to him.”

The patient's condition may deteriorate further at any time.

Doctor He did not dare to take it lightly.

If the condition is not serious, the patient is usually allowed to come back the next day.

After the patient left, Dr. He stood up and got ready to leave work.

"Xiao Zhou, how's it going? Follow me for an afternoon, did you gain anything?"

"I have gained a lot. I have benefited a lot from the process of receiving various patients and how to deal with them, especially the medical ethics and medical style. You have set a very good example for me."

"Haha, you kid has such a sweet mouth. All right, it's time for the nurse at the guidance desk to come and close the door, let's go."

After Zhou Can followed Dr. He out of the consulting room, he was still thinking about what kind of disease the last patient had.

He is only short of 1.4 experience points, he is not reconciled!

The pain in the right upper abdomen radiated to the right shoulder and back. The patient also had the habit of smoking and drinking. In addition, the patient had a high fever and chills. All these symptoms were combined, which seemed to be a problem with the bile duct.

Could it be choledocholithiasis?

Zhou Can seems to have grasped something, and his eyes became as bright as stars.

Every time a doctor diagnoses a patient, it is like doing a math word problem.

After calculating the results, there will be a special sense of accomplishment.

[Pathological diagnosis experience value +0.4. 】

The experience value that I had been looking forward to reappeared again.

Just add a little less!

Only increased by 0.4.

Under normal circumstances, clinical diagnosis, as long as the answer is correct, will add 1 experience point.

Why is more than half less?