radicalducati Chapter 305
Chapter 305
Difficult cases, start!
The teacher is on it, talking about the condition.
The doctors in the 10 hospitals were silent, listening quietly and carefully.
Patient, female, 25 years old, unmarried.
Suddenly, one day, the patient wakes up in the morning and finds that he is enuretic, his pants are wet, and he smells of urine, soaked sheets.
Because I was embarrassed to go to the hospital, I asked my mother, and my mother thought it was kidney deficiency, so I prescribed some Chinese medicine to replenish kidney deficiency.
Take Chinese medicine for one month, ineffective. Still enuretic.
Go to a hospital, hang urology. Urology considers 3 conditions:
·1: "Urinary tract infection" ...
·2: "Kidney function"...
3: "Diabetes insipidus"...
4: "Urinary incontinence"...
Eliminate "urinary tract infection" first: the female patient does not have any urinary tract irritation symptoms such as urinary frequency, urgency, and painful urination, and after a "urine test", it is negative and excluded.
Eliminate "kidney function": insufficient kidney function sometimes leads to increased urine (for example, uremia, that is, pre-renal failure, urine will suddenly increase). However, after renal function examination, the result is that the kidney function is normal.
Eliminate "urinary incontinence": "Urinary incontinence" refers to damage to the bladder sphincter or nerve dysfunction, resulting in urine not coming out of the mainstream. However, after questioning, the patient's urine, during the day, is completely controllable, but it cannot be controlled after falling asleep. So exclude.
Eliminate "diabetes insipidus": the so-called "diabetes insipidus" is a hypothalamic-neuropituitary lesion, resulting in increased urine, and patients with diabetes insipidus must have at least 4000ml of urine a day (about 1500-2000ml for normal people). However, when admitted to the hospital to test for urination, it was found that the amount of urination was normal, and the amount of enuresis at night was small. So exclude.
On the second day, other tests were done: blood routine, urine routine, stool routine, liver function, urinary ultrasound, bladder, etc., and no problems were found.
Physical examination: no specific findings.
(The patient is now cured: the real answer, to be revealed later.) ）
......
The above is the description of the patient's condition.
Teacher: "That's all for the patient's situation, all the doctors start their own diagnosis..."
The entire conference room,
All of a sudden, it began to make a noise.
Many doctors are confused at this time!
"Lying groove, this question is so difficult!"
"Pit!"
"This rules out all possibilities, and we also diagnose a fart!"
"I can think of it, it's all checked above!"
"Is the first question so difficult?"
"Give us a dismount at the beginning!"
At this time, Lin Feng was also a little surprised when he saw this question.
This question is indeed a bit difficult.
Because all the checks have been done and the problem has not been checked, the next thing to consider is a tricky angle.
The teacher smiled: "Isn't it difficult?" "
"That's right... You are all the elites of various departments in major hospitals, and dozens of people working together is equivalent to a general consultation in various departments..."
Lin Feng nodded.
Truly!
The people who came were all elites of various departments, which was equivalent to the general consultation.
You can always find the reason from various angles.
Soon, the teams of each hospital looked for patients separately, conducted close observation and physical examination.
2 minutes per hospital,
......
Half an hour later,
10 hospital teams, physical examination completed.
Lin Feng thought about it and wrote down two answers on the paper.
Mental reasons... (Reason: In the check-in experience, there were 3 similar cases where mental illness caused enuresis.) ）
Hyperthyroidism... (Reason: Lin Feng knew in the check-in experience that hyperthyroidism may cause enuresis, and then he could observe the patient's neck and found that the patient's neck was thick, although not obvious, but considered hyperthyroidism.) Hyperthyroidism affects the pituitary gland to some extent, and then the pituitary affects the urine)
Some diseases, from the perspective of knowledge, seem unrelated, but in fact there is a causal relationship, but the medical level has not yet developed to that extent.
Lin Feng handed his answer to the lead teacher.
......
20 minutes later...
10 hospital teams turned in their answers.
The teachers of the referee team began to summarize.
Another 10 minutes passed...
The teacher reveals the answer:
"Congratulations to Union Hospital, this hospital, gave the correct answer!"
"The real answer is: hyperthyroidism!"
The voice just fell,
The audience exclaimed.
"Hyperthyroidism? Where is hyperthyroidism seen? "
"yes, I didn't even see it..."
"Fake, huh?"
"No, even if it is hyperthyroidism, what does it have to do with enuresis?"
At this time, the teacher pressed his hand,
"Everyone be quiet..."
"Next, I will tell you about the treatment process in detail..."
"After checking the above examinations, the patient did not find the cause, and a few days later, the hospital did a consultation, and a doctor found that the patient's neck was slightly thick, because it was not obvious, so it was not found a few days ago..."
"So, review the thyroid function, and thyroid ultrasound..."
"Hyperthyroidism was finally discovered..."
"Finally, using hyperthyroidism treatment, taking "propylthiouracil", only 1 week later, the patient's enuresis gradually decreased every day... Although hyperthyroidism is not treated, enuresis treatment is very effective. "
"So the final inference: enuresis is caused by hyperthyroidism..."
"And this diagnosis, only the Union Hospital, the hospital, found that the patient had hyperthyroidism..."
"So, in the first round, Union Hospital won..."
"Please the doctor who found hyperthyroidism at Union Hospital, stand up and let everyone get to know each other..."
Everyone's gaze, look over.
Doctors of Union Hospital:
"Who is it?"
"I didn't find out..."
"It feels too detailed..."
At this time,
Lin Feng stood up.
"It's me..."
Lin Feng also did not expect that with so many doctors present, no doctor found that the patient had a thick neck (although not conspicuous)...
In fact, what he didn't know was that he knew that hyperthyroidism could cause enuresis, so he would specifically observe the patient's neck.
Other doctors don't know.
Therefore, other people's doctors will not look closely at the patient's neck at all, but only take a cursory look, so they will not find the inconspicuous thickness of the patient's neck.
this
It is the reason why Lin Feng is MVP!!
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PS: The fourth more... Enough words ~~
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