Chapter 199 A Horse, a Sweaty BMW! (Ask for a Monthly Pass)

When Chen Cang returned to the ward, the patient stopped convulsing. It seemed that the convulsions were episodic.

Meng Xi took the medical record folder handed over by Chen Cang, and flipped open the laboratory test list and the imaging result report.

He then bent over and said to the patient, "I'll give you an examination. You lie down and straighten your hips and knees."

Meng Xi held the upper part of the ankle with his left hand, took out a pen in his pocket, and used the blunt tip to quickly swipe from the outside of the sole of the foot to the base of the little finger, and then turn to the big toe.

The patient's hallux was dorsiflexed, and the remaining four toes were fanned apart.

Chen Cang was taken aback, is Babinski's disease positive? !

The corners of Meng Xi's mouth rose slightly. Although he had not yet been diagnosed, he already had some ideas in his heart.

The patient also seemed a little uneasy: "Doctor... What's wrong with me? Why did my hands and feet start to twitch?"

Meng Xi reassured: "It's okay, don't worry, I'll wait for Doctor Ge to bring the test sheet."

Meng Xi can actually draw a conclusion now, but to be on the safe side, he still has to wait for the test sheet to come out.

A group of postgraduate students, Ji Peisheng, walked into the ward wearing white clothes and holding a notebook with a cowardly face. They also wanted to see what heart disease could cause convulsions?

After coming in, they stood in a row next to the wall, and made way out of the aisle on both sides of the bed. After all, they knew that if the patient had any situation, they would not be able to help themselves. , for the boss.

They can just watch the big brother show operation quietly on the side!

Not long after, Ge Huai trotted in with a long list of test sheets, before tearing them apart.

"Director Meng, look, this is the test sheet."

Meng Xi took the test sheet, flipped it over, and relaxed, as expected.

Meng Xi asked Ge Huai, "What medicine have you been using these two days?"

Ge Huai was stunned for a moment: "Now I mainly use digitalis preparations and diuretics, mainly to prevent heart failure."

After hearing this, Meng Xi frowned and asked, "How do you think about the treatment plan after the patient is admitted to the ward?"

With Meng Xi's question, the atmosphere suddenly became serious!

Ge Huai was speechless when asked by Meng Xi: "The patient's electrocardiogram showed prolonged ST break and low T wave, while echocardiogram could clearly see ventricular cavity enlargement, ventricular septum thickening, decreased pulsation, and closed mitral valve. Incomplete, the pericardial effusion is obvious, so I think about the treatment of the heart, after all, at that time... the test results have not come out yet."

Meng Xi didn't wait for Ge Huai to explain, and said directly: "Now that the result is out, let's see, what are you thinking about?"

Ge Huai blushed, and he had already seen clearly on the way here, how could he not understand: "This should be the combined effect of low calcium and bottom blood magnesium, which causes the excitation-contraction of myocardial fibers, and low calcium affects the electrophysiology of myocardial cells. properties, and induced arrhythmias.”

"The patient's long-term hypocalcemia should be the main cause of limb paresthesia or muscle spasm and even tetany."

The surrounding graduate students suddenly realized.

I see!

Meng Xi didn't make any comments, and turned to look at Chen Cang: "How much calcium should be normal? What's the use?"

Chen Cang was stunned, you forced me to pretend again...

My physiology and biochemical indicators are inherited from Mr. Fang Yonglin, this is the only perfect skill on my body!

Without any pause, Chen Cang blurted out: "The normal adult blood calcium is 2.25~2.75mmol/L. Blood calcium has an important function in the human body. First, it is an important component of human bones and teeth. Second, it is the maintenance of nerves, muscles, and heart muscle. function normally, and ultimately participate in blood coagulation.”

Meng Xi suddenly looked sideways, looking at Chen Cang with a calm face, a little surprised.

The surrounding graduate students looked unbelievable, did this boss rehearse in advance!

Must be!

Since the shift today, you have pretended to be forceful three times.

It's just three things...you're going too far like this, aren't you?

You look like our graduate students are idiots...

You must have memorized the information, or you have rehearsed in advance. Today is absolutely an act.

The students were a little tearful. Is it not our feeling that you are acting like this?

How much can normal blood calcium remember? We are still back blood routine are you all starting back ionization?

Back index is one of the basic literacy necessary for clinical medical students, and in the emergency department, you should know some common laboratory tests well.

Meng Xi handed the test sheet to Chen Cang: "Then let's see what information can be obtained from the test sheet."

Chen Cang took the test sheet and read it at random, then frowned slightly!

It may not be a simple heart attack.

Chen Cang raised his head slightly: "Mr. Meng, this may be a hypoparathyroidism heart disease!"

When he heard this sentence, Meng Xi couldn't help but froze.

The surrounding group of students looked at each other at a loss, and their eyes exchanged quickly!

"What is this?"

"Don't look at me, how do I know what this is!"

"I know about the parathyroid glands, and I also know about heart disease. Why do I not know each other when they are piled up together?"

"Look at what, just look at me and I'll be able to do it?"

After watching for a long time, everyone reached a final consensus!

This fellow has to pretend to be a big one!

It's bigger than the first three combined!

Are our graduate students really going to be hit by the promotion of a small undergraduate? ? ?

Thinking of this, everyone felt lonely and cold in the sandbar...

When Ge Huai heard what Chen Cang said, he suddenly recalled this term!

A very rare disease!

He hesitated for a while, then hurriedly took the test sheet, took a closer look, pondered for a moment, and remembered all the symptoms of the patient.

Finally came to a realization!

Yup!

Why didn't you think of it yourself?

This kid is awesome!

And Chen Cang was a little stunned. He found that no one cared about him. Did Chen Cang think that he was missing an audience?

Shouldn't you be a little skeptical?

If I pretend to be so forceful, I have to give me a face.

After waiting for a few seconds, Chen Cang was a little disappointed to find that no one spoke.

This time pretending to be forced, five points...failed!

However, Chen Cang still felt that he should finish his speech: "The patient may suffer from idiopathic hypoparathyroidism, which is rare, but mostly sporadic, and is related to immunity, which can be clearly seen through laboratory indicators. It turned out that the proportion of lymphocytes in the patient was normal, but the proportion was very similar to this patient with idiopathic parathyroid lymphocytes."

"The patient's blood calcium was only 1.9, and the blood phosphorus increased to 1.59, and the serum immune activity parathyroid hormone was basically undetectable."

"The reduction of the patient's PTH can affect myocardial contractility. As Mr. Ge said, low blood calcium and low blood magnesium affect the contraction of myocardial fibers, so I guess it is hypoparathyroidism heart disease."

"When the calcium is low, the excretion of sodium ions is reduced, and the retention of water and sodium can increase the load on the heart, and the patient's own new functions are not complete, so ... it seems that Mr. Ge's treatment is no problem."

"But if it is supplemented with some calcium supplements, such as oral vitamin D3, or Rogai calcitriol capsules, the effect may be better, and even heart failure may be relieved!"

After Chen Cang finished the words smoothly in one breath, he couldn't help sighing, pretending not to slap his face would be meaningless...

Chen Cang's voice just fell!

The applause came from outside the door.

"Good! Good! Good!"

I saw Xia Gaofeng walked in from the outside with an excited look on his face, with joy and happiness in his eyes. He is really an amazing talent, and he is really a bloody BMW!

To be honest, Xia Gaofeng has not met such a spiritual and capable student for a long time.

This is no exaggeration at all.

First of all, he has strong hands-on ability and good suture skills. Now, the analysis of diseases, especially the analysis of physiological and biochemical test indicators, can be said to be extremely detailed.

These several abilities, comprehensively analyzed, can completely see a person's clinical thinking and surgical talent!

Thinking of this, Xia Gaofeng looked at Chen Cang with satisfaction: "Not bad! The analysis makes sense!"

At the realm of Xia Gaofeng, many diseases are clearly seen at a glance, and he has seen too many diseases. Hypoparathyroidism, which is a rare disease, is not too rare for him.

But for Ge Huai, it may indeed be very rare.

What are you afraid of disease?

Afraid of synthesis!

Once a cluster of diseases is piled together, it is difficult to prepare to identify the patient's real disease.

However, Chen Cang was able to analyze the hypoparathyroidism heart disease in the laboratory test of cardiac surgery.

Really invaluable!

Hey……

It hurts to think that such a student is not his own!