When he saw the patient, Zheng Ren was stunned.
The patient's System panel was redder than he had imagined. All the situations he had considered before were wrong. The patient's diagnosis was a very common disease that rarely caused hypoglycemia.
"Boss Zheng, this is my client. His name is Du Liang," Lawyer Ge introduced.
"Okay, let's come to the resuscitation room first." Zheng Ren brought Du Liang to the resuscitation room and began to conduct a routine consultation.
Du Liang looked to be in his fifties. His entire person was dispirited, but his speech and manner of speaking were normal.
His emotions were normal. His memory and calculation ability were normal. His direction was complete, and his self-awareness was normal. There were no problems with these.
"Have you been feeling uncomfortable recently?" Zheng Ren asked.
"I'm not feeling well …" Du Liang hesitated for a moment and shook his head. However, he nodded in the next second. "Doctor, I often lose my mind. When I wake up, I find that what happened before is a blank slate. I can't remember what happened at all."
"Moreover, after I wake up, my back hurts. Sometimes, my entire body hurts, especially my face."
Su Yun almost laughed out loud.
How could it not hurt? It would be strange if it did not hurt after slapping his own mouth.
"Are there any other discomforts? Is there any weight … "Before Zheng Ren could finish his question, Du Liang's hand began to tremble. As if he could not control it, he slapped his face.
Zheng Ren really wanted to cut his carotid sinus with one hand, but the case of the deceased just now made him hesitate.
"You're sick just like that? Chief Zhou, test the blood sugar on your fingertips, "Su Yun said.
"What's your name?" Zheng Ren asked.
"I … I don't know … Who am I?" Du Liang said vaguely. "I'm Erlang Shen who descended to the mortal world. I remember now!"
"…"
Zheng Ren shook his head. Seeing that the patient's body was starting to sweat, he immediately said, "After testing the blood sugar, give 50ml, 50% glucose intravenously."
Zhou Litao began to busy himself.
The blood sugar was very low, 1.6 mmol/L. Less than three minutes after the intravenous injection of high glucose, the patient slowly recovered.
Lawyer Ge had seen this kind of situation before, so he was not very surprised.
Compared to the patient, he was more concerned about what Chief Zheng was thinking. He had brought the patient to the 912. Even if he had sufficient evidence, he would still have to bear a lot of responsibility.
"Let me think. Chief Zhou, come with me," Zheng Ren said.
"Alright."
As they walked out of the resuscitation room, Zhou Litao instructed a nurse to keep an eye on the patient and make sure nothing happened.
"Boss, let's do an abdominal CT scan. I suspect there's a problem with the pancreas," Su Yun said directly.
This was the organ that Zheng Ren had considered to be the most likely to have a problem, but the System's diagnosis was a different matter.
"Check the B-scan and CT scan of the pancreas," Zheng Ren said. "Also, check the lung CT scan."
Zhou Litao waited for Boss Zheng to continue giving medical advice, but the medical advice was already over.
"Boss Zheng, is that all?"
"Yes, just these three," Zheng Ren said.
When it came to admission examinations, plain films or CT scans of the lungs were routine items. Everyone else thought that Boss Zheng was just improving the relevant examinations and did not pay much attention to it.
After writing out the form and sending the patient for examination, Zheng Ren sat in Zhou Litao's on-call room and waited for Dr. Liang from the CT room to upload the scans.
Twenty minutes later, the CT scan of the pancreas was uploaded.
Overall, there were no special problems. The pancreatic capsule was intact, and there was nothing growing. Hypoglycemia caused by tumor was more common in islet cell tumors, but the CT scan of the patient's pancreas denied this possibility.
Soon, the CT scan of the lungs came back.
There was a 2 × 3.5cm space occupying image in the right lower lung. It was so dazzling. The ground-glass-like space occupying image indicated the fact that it was a malignant tumor.
Zheng Ren sighed. The System was as reliable as ever. Although it was very rare, a lung CT scan could immediately make a definite diagnosis.
"Uh … It's hypoglycemia with tumor?!" Lin Yuan was the first to say in surprise.
"Yes, it's diagnosed as lung cancer with tumor hypoglycemia. Lin Yuan, call Lawyer Ge over, "Zheng Ren said as he carefully looked at the patient's lung CT scan.
"Okay." Lin Yuan ran out quickly. She was afraid that Boss Zheng would say something when she was not around and she would give the wrong diagnosis.
Lawyer Ge ran over to him.
"Lawyer Ge, consider the patient to be lung cancer," Zheng Ren said directly without turning his head.
"Lung cancer?!" Lawyer Ge was stunned.
"Yes," Zheng Ren said. "The hypoglycemia that caused the patient to talk nonsense and behave abnormally is considered to be accompanied by tumor hypoglycemia. This is just a symptom and is not important."
"…" Lawyer Ge was dumbfounded.
He just wanted to win a lawsuit. Hypoglycemia was enough for him to win. How could there be another tumor hypoglycemia?
The client was really sick, and it was lung cancer? However, how did lung cancer induce hypoglycemia?
Lung cancer and hypoglycemia. These two words could not be connected in Lawyer Ge's mind at all.
Not to mention Lawyer Ge, even Zhou Litao felt that it was very unfamiliar.
"Boss Zheng, please explain in detail," Lawyer Ge said as he rubbed his hands.
"Hypoglycemia with tumor is usually the clinical manifestation of the primary disease first or the hypoglycemia after the diagnosis of the primary disease. It is extremely rare for hypoglycemia to appear before lung cancer."
"Uh … But hypoglycemia …" Lawyer Ge still did not understand.
"Hypoglycemia is not an independent disease, but a syndrome of low blood glucose concentration caused by many reasons.
The causes of hypoglycemia include malnutrition hypoglycemia, hepatogenic hypoglycemia, renal hypoglycemia, autoimmune disease hypoglycemia, reactive hypoglycemia, endocrine disease hypoglycemia, hypoglycemia not caused by islet cell tumors, and so on. "Zheng Ren's series of thoughts and various technical terms confused Lawyer Ge.
"Hypoglycemia with extrapancreatic tumors is rare. Other types of tumors related to hypoglycemia include mesenchymal tumors, which account for 64%, 50% of which occur in the abdominal cavity, and 21% of which are hepatocellular tumors. This patient's condition is even rarer. It's lung cancer, "Zheng Ren said.
"Why did this happen …" Lawyer Ge still did not understand.
"Lin Yuan, tell Lawyer Ge why," Su Yun glanced at Lin Yuan and instructed.
"First, consider that the patient's symptoms are related to the secretion of insulin-like factor 2 by the tumor. IGF-2 binds to the corresponding receptor and activates it, thereby increasing the glucose uptake by the peripheral tissues and reducing the liver's glycogen output, resulting in a decrease in blood glucose and symptoms of hypoglycemia."
Su Yun looked at Lin Yuan's way of explaining things and felt that he was a bit like his boss. He was too bookish.
"Secondly, the increased glucose utilization by the tumor itself can also cause …" Lin Yuan did not notice Su Yun's expression and continued to explain the situation.
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