radicalducati Chapter 500
Chapter 500
"Have you ever had chronic gastritis, duodenal ulcer, a type of disease that may bleed?"
ibuprofen
Although painkillers work well, adverse effects of gastrointestinal bleeding can also occur.
If the patient has a pre-existing digestive disorder, ibuprofen may be more likely to cause bleeding.
But
Soon Lin Feng shook his head again.
If it is really acute hemorrhage, with the patient's low hemoglobin content (hemoglobin 68g/L), it means that the patient has lost more than 1000ml of blood in a short period of time.
And just now, the patient came to incontinence.
If there is real blood loss, then the stool must be red.
But Lin Feng remembered that when Aunt cleaned up and scrubbed just now, the big stool was healthy yellow.
Why yellow?
This is the color caused by the secretion of bile and the excretion of bilirubin.
If it is a large amount of bleeding from the upper digestive tract, it will also vomit blood, but the patient does not, only foaming at the mouth.
Moreover, there is another corroboration: the patient is not in shock, blood pressure, heart rate, etc. are very healthy.
Not at all like acute hemorrhage.
At this time, the patient also shook his head.
"I didn't have stomach problems or anything like that before..."
So
Exclusion of major bleeding.
The reason for the rest, most likely, is: there is a problem with hematopoietic function!
However, there are problems with hematopoietic function, there will be many reasons, what tumors, red wolf spots and the like ...
Lin Feng's clever move:
"Are the patient's other reports out?"
"Not yet..." replied Xiao Ru, who was sitting at the computer.
"Wait..."
The blood draw of the patient admitted to the hospital, after all, is rescue, so many items are checked.
A few more minutes.
"Teacher, liver work and kidney work are out... Oh my God! "
"What's wrong?"
"Teacher, the patient's blood creatinine is 1020μmol/L, so high!"
Lin Feng: "!!! "
Blood creatinine is so high!
Already 10 times more!!
And then
Lin Feng smiled!
Found the reason!
Blood creatinine is a small molecule produced by the metabolism of the body's muscles, which can usually be excreted with urine through the kidneys.
And the blood creatinine is so high, it may be because the kidneys are damaged.
And 10 times more, apparently the kidneys are very poor!
Moreover, the kidneys secrete erythropoietin to promote red blood cell synthesis.
When there is a big problem with the kidneys, the secretion of hormones will also decrease, and over time, it will be anemia.
That is:
Renal failure – high creatinine >, decreased erythropoietin – > cytopenia – > anemia.
The logic is very smooth!
But
Why kidney failure?
Lin Feng asked the patient Chen Mei: "Have you taken any special medicine?" Or beauty or something, or take a lot of medicine..."
Chen Mei shook her head: "I eat normally, rarely take medicine or anything..."
Lin Feng: "Is there a history of kidney function diseases before?" "
Chen Mei still shook her head: "Nothing..."
Lin Feng groaned...
Suddenly!
Lin Feng's inspiration flashed!
An answer came to mind!
Hypertension!
The patient has high blood pressure for a long time, but there is no regular treatment, long-term high blood pressure shock, kidney damage, chronic renal insufficiency.
Hypertensive nephropathy!
Over time, kidney function gradually deteriorates, and eventually kidney failure occurs.
Kidney failure will make the body's water and toxins unable to be excreted, which will cause heart and brain dysfunction, which can be manifested as headaches, coma, convulsions and so on...
Isn't this the 'epilepsy' that the patient has just appeared?
High blood pressure - > hypertensive nephropathy - > kidney failure - > heart and brain dysfunction - > 'epilepsy'
But
It's all speculation.
Further testimony is required - ultrasound (CT is clearer)!
"Xiao Ai, push a B-ultrasound machine over..."
soon
Xiao Ai pushed a B-ultrasound and walked in.
At the bedside, Lin Feng applied couplant and gave the patient a B-ultrasound.
The first thing to do is to look at the kidneys.
At a glance,
Sure enough, the kidneys saw a big problem.
I saw that the right kidney of the patient Chen Mei was reduced.
Kidney atrophy!
This is precisely the manifestation of kidney failure.
I looked at my left kidney again.
The same!
It's still kidney atrophy!
The terminal stage of kidney failure is uremia.
There is a disease called - uremia encephalopathy!
"Uremic encephalopathy": Because the toxin cannot be excreted in time, the concentration of creatinine and urea nitrogen in the blood is very high, which leads to abnormal retention of metabolites, which will cause brain tissue metabolism disorders and edema of brain cells. Once urmic encephalopathy occurs, patients often respond indifferently, lethargy, and will not be able to answer questions, severe limb convulsions, coma, and some people show mental symptoms such as gibberish.
all
All right!
Lin Feng's guess was correct!
High blood pressure - > kidney failure - > heart and brain dysfunction - > 'epilepsy'
So far:
The answer is completely revealed!
The patient is a series of neurological changes caused by uremia encephalopathy, including epilepsy.
However, Lin Feng continued to look at the other organs.
First look at the abdomen and chest cavity for fluid - answer: no.
Then looked at the liver and gallbladder, etc. ... No big problem either...
I looked at the bladder again, there was no urine, corresponding to uremia.
"Send it to the nephrology department and do dialysis..."
At present, the only way for kidney failure is dialysis.
The meaning of dialysis is to simulate the function of the kidney, a large vein root catheter, connected to the dialysis machine, the machine can lead the venous blood out when it rotates, through the dialysis filter membrane, remove toxin molecules, excess water (simulate kidney function), clean blood and then enter the patient's blood vessels.
There are only two ways for patients to do this:
Long-term renal dialysis
Kidney transplantation
"Thank you doctor..."
The patient, Chen Mei, weakly expressed her gratitude to Lin Feng.
On the contrary, Lin Feng noticed that her husband's relationship with her was not harmonious, and when he learned of 'kidney failure', his eyes revealed depression.
This husband... Gee......
Lin Feng shook his head and smiled.
......
Back to the consultation room,
Busy.
Until noon.
Just as it was almost noon, the aunt brought the meal...
There was a great movement outside.
"Don't stop me, I'm going to die... Woo hoo..."
"I don't want to be so fat either, why do they treat me like this?"
"Woo~~~~"
One was clearly the cry of a young girl.
And the mother's crying is powerless to comfort.
Because the movement was too big, Lin Feng couldn't help but walk out.
。