Chapter 1845

"To be frank, why do I say it's the most critical step and a half? It's because the most common thing is to die at the sight of light. Of course, this refers to online chat. If you can keep your appointment with emotion after seeing your appearance, it's estimated that most of it can be done."

"..." Zheng Renzhen wants to die like this.

"Don't be nervous when you meet. Just talk and say something to make her happy." Su Yun continued: "after that, it is the most critical step - the second invitation. If you can make an appointment for the second time, it will prove that there is no problem. As long as you don't die, it should be done."

"Er..." Zhou Litao looked at the records on A4 paper, and the head lifting lines on balsam pear's face came out.

"It's basically like this. Understand the spirit and study hard."

"Brother Yun, what..."

"President Zhou, the patient has something to do!" A nurse knocked at the door.

"OK, go right away." The tangled and distressed expression on Zhou Litao's face immediately disappeared. He put on a very focused and serious expression, folded the paper recording Su Yun's words and put it away.

"Brother Yun, boss Zheng, wait for me."

"What patient?" Zheng Ren asked.

"Said a patient who suddenly lost his sense of smell." Zhou Litao said, "I asked him to have a head CT."

"Oh, go." Zheng Ren knew from this medical history that there was probably nothing wrong and was lazy to see it.

Olfactory ability is the characteristic of olfactory cells in nasal mucosa. The damage of nasal mucosa, olfactory bulb, olfactory filament or central nervous system junction may affect olfaction.

The clinical manifestations were anosmia, anosmia, anosmia, olfactory reversal, phantom smell and increased sensitivity to olfactory stimuli.

There are many common causes of anosmia.

Including allergic sinusitis nasal polyp. Cold virus infection, rhinitis virus infection Head trauma Sulfur dioxide, nitrogen compounds, and residual formaldehyde after house decoration can lead to.

Then there is a long period of perfume spray, which can lead to olfactory dysfunction.

Zheng Ren is thinking about what causes the patients. It may be the factor of formaldehyde, because it is too common for formaldehyde to exceed the standard in home decoration.

Zhou Litao immediately ran out.

"Boss, be professional." Su Yun said with a smile.

"I think Zhou Litao can believe such words." Zheng Ren said, "you don't even have a girlfriend. Have the face to say this?"

"Cut!" Su Yun said, "I don't want to find it, okay? There are no girls. Girlfriends, just look in the street!"

Zheng Ren didn't bother to talk to him. It was boring when Zhou Litao came back. He didn't know the length of time. There was a chatterbox sitting next to him. He said two words from time to time. He couldn't go to the system library to read.

After waiting for a long time, Zhou Litao didn't come back. Zheng Ren felt strange.

He was so bored that he got up and pushed the door out.

Seeing a nurse busy in the corridor, Zheng Ren asked, "excuse me, where has President Zhou gone?"

"Teacher, I just came here. I don't know who Zhou always is. I'm sorry." The nurse answered immediately.

Oh, the nurse who just came to 912 for further study, Zheng Ren smiled.

Su Yun saw that the nurse entered the treatment room and probably went to change the dressing, so he smiled and said, "I'll ask."

Zheng Ren glanced at him and saw that the goods turned around and went to the treatment room. They leaned against the door frame like no bones and began to talk and laugh.

It's really self cooked, Zheng Ren thought.

However, it was troublesome for him to ask a question. After waiting for a few minutes, Su Yun came back with a proud face.

"Where is it?"

"Said the patient with smell problems went to the CT room and smoked." Su yundao.

"Did you smoke?" Zheng Ren wondered, "is it epilepsy or spasm?"

"Nobody saw it. Why are you asking so much?" Su Yun said, "I'll know when President Zhou comes back."

"Where's Zhou Litao?" Zheng Ren wondered.

"I said it was emergency rescue. I smoked very badly. I couldn't do CT at all."

Restless, the CT image is full of artifacts. It's the same as it's not done.

It is estimated that the patient will be sent to the neurology department to save what he wants in the CT room. If there is a sudden respiratory and circulatory arrest, he will have to leave it.

But patients with smell problems suddenly smoke

There's something wrong with this medical history.

Zheng Ren began to think.

"Boss, if you could make a diagnosis now, I would be convinced." Su Yun said with a smile.

Zheng Ren also knew what he meant. He knew that one of them had olfactory failure, and then went to the CT room to convulse. It's impossible to infer from these two points.

But he was also idle. Zheng Ren went back to the house and sat down and began to count with his fingers.

"First, when the patient has craniocerebral trauma, the olfactory filament of the olfactory nerve through the sieve plate can be torn, or the olfactory bulb can be torn due to contusion."

Su Yun looked at his serious appearance and thought it interesting. Sitting opposite him, he said, "logically, the patient is not traumatic. Otherwise, with Zhou Litao's character, he will certainly say that his sense of smell will fail after trauma."

Zheng Ren nodded. Su Yun's judgment was right.

"Second, meningiomas, metastases or invasive tumors of the anterior cranial fossa artery or frontal lobe can compress the olfactory bulb and olfactory tract, resulting in olfactory damage."

"This is also unreliable. If there is a meningioma, olfactory failure will not be the main complaint. Moreover, if the patient does not know, it will not be accompanied by sudden convulsions." Su yundao.

"I can't say that. It's just a high probability. It's doubtful." Zheng Ren said, "the probability is about 5 percent."

"Almost. I think it's a little less. You go on." Su Yun is very interested in this air oriented case discussion.

"Third, the olfactory damage caused by influenza is transient, and there is no convulsion, which is also ruled out."

"Fourth, occasional temporal lobe lesions are accompanied by temporary or paroxysmal phantom smell. Anosmia combined with taste damage depends on the volatile substances in food and drinks."

"Temporal lobe symptoms?" Su Yun asked.

"It's just that. It shouldn't be a symptom of temporal lobe symptoms." Zheng Ren said: "volatile substances can lead to olfactory failure, but convulsions and rescue are too outrageous to be considered for the time being."

Su Yun feels more and more that diagnosis and differential diagnosis are still very interesting, just like playing a mental game.

"Fifth, congenital factors are not considered. Another is the decline or loss of olfactory function caused by neuropathy of nasal mucosa, olfactory bulb and olfactory filament. The damage of central nervous system junction is usually not accompanied by any detectable loss of olfactory."

"Is the fifth possible?"

"It's hard to say. It's not estimated. It's still because it can't be accompanied by convulsions at the same time."

"After talking for a long time, do you have a diagnosis? The biggest possibility is intracranial tumor, which is less than 5 percent." Su yundao.