The two of them only whispered a few words to each other before they stopped talking.
It was a mess, and no one knew if there were any family members of the patients. Moreover, there was no way to determine the specific situation at that time just by listening to the first-aid doctor.
It was just a guess, and it couldn't be taken into account. However, if the patient's family members heard about it, the other doctors might be in trouble.
Don't cause trouble for others. That's the most basic thing.
Fortunately, the patient had woken up, so there was nothing to worry about.
Zhou Litao called the patient's family over to ask about the situation in detail. After listening for two minutes, Zheng Ren leaned over and asked, "What medicine did the patient take last night?"
"Uh …" The patient's family was stunned and tried hard to remember.
"Boss Zheng, what do you suspect?"
Zheng Ren watched as the family member rummaged through the luggage for the medicine box, so he said in a low voice, "Hyperthyroidism patients usually have a high heart rate. Oral propranolol can lower it. Recommended in all the major guidebooks.
Conversion was the first choice of medication.
However, high doses of β-blockers can weaken the effect of catecholamines, inhibit liver glycogen decomposition, reduce liver glucose output and gluconeogenesis, and can also inhibit fatty acids, reduce blood glucagon level, and reduce blood glucose production. "
In other words, if one took too much of this drug, it would cause the blood sugar level to drop.
"I know," Zhou Litao said immediately.
Actually, as soon as Zheng Ren started, Zhou Litao thought of this.
After all, Zhou Litao was not an endocrinologist. He was not very familiar with the fact that beta blockers could cause hypoglycemia.
However, if Zheng Ren was not around, he probably would not have missed it. Zheng Ren's presence gave him directions and sped up the process of asking for his medical history.
Sure enough, the family member came over with the propranolol.
Because the patient's condition was not serious and his activities were normal, there were no family members accompanying him. This morning, she heard from the clinician that the patient's heart rate was very fast last night. After taking the medicine orally for 30 minutes, there was no obvious relief, so the dosage was increased.
When Zhou Litao saw that the patient was fine, he asked the emergency physician to issue a form for him to stay in the hospital for observation.
Let's observe for a period of time first.
However, hyperthyroidism could not be admitted to the hospital.
When they were done, Zhou Litao called Zheng Ren to his duty room.
"Boss Zheng, your eyes are really sharp. Have you done endocrinology before?" Zhou Litao took out a box of Ziyun and was despised by Su Yun.
"No, I met a similar patient in Hong Kong a while ago, but it wasn't hyperthyroidism," Zheng Ren said perfunctorily.
Su Yun glanced at Zheng Ren. This answer was not serious at all.
Hypoglycemia refers to a decrease in the concentration of glucose in the blood, which eventually leads to symptoms and signs including impaired brain function.
Clinical manifestations range from behavioral changes, fatigue, and confusion to epilepsy and loss of consciousness, or functional brain failure.
Therefore, many patients with hypoglycemia were often misdiagnosed as epilepsy or even depression or mania.
Qin Lu's illness and mania were related to hypoglycemia, but he seemed to have noticed it at first glance.
This fellow was sneaky and was really not pleasing to the eye.
Unfortunately, no matter how hard he tried, he could not catch up to him. I really want to find a chance to teach him a lesson. Su Yun thought to himself as he smoked.
"By the way, Chief Zhou, how do you determine if the blood sugar is low?" Zheng Ren asked.
"When the patient came, I felt that something was wrong." Zhou Litao smiled and said, "If you want to sleep with the nurse on duty, you don't have to flirt with girls in front of others in the ward. There must be something wrong."
"Yes," Su Yun said. "I met a patient before. He had a car accident. Multiple rib fractures on both sides, bilateral hemopneumothorax, lung rupture, traumatic wet lung, and head trauma. After the surgery, he was in the ICU with a tube inserted and a ventilator assisted for three days. After the tube was removed, guess what was the first thing he said? "
Zheng Ren smiled and did not say anything.
Zhou Litao asked suspiciously, "Could it have something to do with the nurse?"
"He held the ICU matron's hand and said that he wanted to go drinking with her tonight." Su Yun laughed.
"What happened after that?" Zhou Litao had a lot of gossipy thoughts.
As the chief resident in the emergency department, listening to some gossip was considered a joy in the midst of suffering.
"After his condition stabilized a little, he was kicked out of the ICU," Su Yun said with a smile.
The condition was different, but the symptoms were similar.
"Chief Zheng, what's going on with the patients in Xiangjiang you mentioned?"
"There is a plaque in one of the pancreas's feeding arteries. The intermittent change in blood flow rate causes abnormal insulin secretion. He's a little more advanced than these two patients. It's not nonsense, but something that he has experienced in the virtual world. "Zheng Ren briefly described Qin Lu's illness.
"Tsk tsk." Zhou Litao secretly noted down the case that Zheng Ren mentioned.
Although he might not be able to meet a similar patient in his life, if he did, there would be a shadow in his heart and a little impression. At the very least, it would reduce the probability of misdiagnosis and missed diagnosis.
"Chief Zhou, if the patient isn't hypoglycemia, what are you going to check for?" Zheng Ren continued to ask.
"When hyperthyroidism patients have mental symptoms, it may be electrolyte disorders, the early stage of hyperthyroidism crisis, hypoglycemia, or autoimmune encephalitis. Checking blood sugar is the most convenient. The symptoms of the patient's deep sleep are also similar. If not, I'll check them one by one. "
Zhou Litao had a solid foundation. Zheng Ren had just finished asking when he casually said that.
Zheng Ren thought to himself that the 912 had a deep foundation. A chief resident of the emergency department was actually so powerful.
Other than the glandular surgery and endocrinology departments, it was very difficult for doctors in other departments to know the details of hyperthyroidism.
This was the role of a specialist, but there were advantages and disadvantages. The more one studied a certain direction, the less one would know about the diseases of other departments.
"Chief Zheng, you're really omnipotent," Zhou Litao said with a smile. "Do I have anything to pay attention to with this patient?"
"It's nothing. You can treat it as you see fit," Zheng Ren said with a smile. "After two days of observation, let him go to the specialist clinic. You're in the emergency department. It's enough to solve a hypoglycemia problem. By the way, tell the patient not to take the medicine casually. "
"Yes, he can take as much as he wants. It's really killing him," Zhou Litao said. "Chief Zheng, when are you going to do the live broadcast of the surgery for the patient with Gaucher disease?"
"I don't know. If there's no problem, the sooner the better," Zheng Ren said.
"I've seen your live broadcast of the surgery. You did it really well." Zhou Litao was a little envious.
If one could go to the surgery department and become a surgeon, no one would want to be in the emergency department.
However, back then, a single mistake could cause eternal regret. He was young and ignorant, so he was tricked into the emergency department.
Nowadays, the children were all smarter than the other. After graduation, there were not many people who worked in the medical industry, let alone the emergency department.
The more Zhou Litao thought about it, the more he felt that his future was bleak.
It would be great if he could be like Chief Zheng.
He could still tolerate all of this. The key was that Chief Zheng's skill level was high, and he had a girlfriend!
It was not enough to have a girlfriend. She could even pass him the money during the surgery.
Sigh … Zhou Litao let out a long sigh.
Zheng Ren and Su Yun were about to leave when they suddenly heard a series of hurried footsteps coming from the corridor.
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