Chapter 1846

"We can't say that. We have at least ruled out several possibilities." Zheng Ren's expression was as serious as when Su Yun and Zhou Litao taught and solved their doubts.

"What are you thinking about now?"

"The most common thing that can be pasted should be formaldehyde poisoning." Zheng Rendao: "mild poisoning has systemic symptoms such as blurred vision, dizziness, headache and fatigue. Severe poisoning can lead to pulmonary edema, hypoxia and spasm."

"No." Su Yun shook his finger. "First of all, after formaldehyde poisoning leaves the toxic environment, it is difficult for the condition to continue to progress. Let's not say that it can be relieved directly and become a person who is fine, but it is unlikely to evolve from olfactory failure to spasm and convulsion."

Zheng Ren also felt that the diagnosis was a little reluctant. Su Yun's judgment was right.

He continued to meditate, tapping his fingers on the table. Su Yun thought that if the goods were old, they would be like director Pan.

Or maybe he imitated director Pan intentionally or unintentionally.

"Not formaldehyde poisoning, not sulfur dioxide poisoning, intracranial tumors? This possibility..." Zheng Ren said softly while thinking.

"Will you talk about it during the exam? Is it annoying?" Su Yun said contemptuously, "do you want to take your fifth edition of surgery and recite it paragraph by paragraph when the whole hospital is consulted in the future?"

"Hmm..." Zheng Ren continued to meditate as if he hadn't heard Su Yun's sarcasm. "Another is illusion. He felt that he couldn't smell the taste, and then he had a sudden seizure."

"You can write fantasy novels. If there is such a situation, it doesn't appear early or late. It happens to appear in the CT room. Isn't that bullshit?" Su yundao.

"Would it be better if we took the word as epilepsy? For example, reflex epilepsy syndrome.

Almost all seizures are induced by specific sensory or complex cognitive activities, such as reading epilepsy, startling epilepsy, visual reflex epilepsy, hot bath epilepsy, card epilepsy and so on. Remove the predisposing factors and the attack will disappear. "

"You mean..." Su Yun also wondered.

"Claustrophobia is usually more obvious when doing MRI. But there are also patients who get sick when doing CT, in sci..."

"Don't show off your data. Epilepsy is possible, but can it explain olfactory failure?" Su Yun continued to find fault.

Indeed, Su Yun is right.

This belongs to pressing the gourd to float the ladle, olfactory failure and epilepsy can not come together.

Besides, claustrophobia is rare.

Zheng Renchang took a breath and continued to think.

"Hey, hey, do you want me to ask about other medical history?" Su Yun said with a smile.

"Go find Zhou Litao?"

"Who knows, ask the little nurses first, in case they can provide useful information."

"If you want to go and relax, don't ask the reason of medical history." Zheng Ren said: "in fact, epilepsy and olfactory failure can also come together."

"For example?"

"Antihypertensive drugs can improve heart function and occasionally damage the olfactory nerve."

"Too far fetched."

"Abnormal discharge of brain cells and neurons... Nerve damage..." Zheng Ren began to talk again.

"Don't think you can be more professional if you describe epilepsy as abnormal discharge of brain cells and neurons." Su yundao.

"Not so..." Zheng Ren raised his hand and said, "nerve damage is not necessarily non-traumatic. Other factors may also lead to nerve damage."

"Tumor invasion, chemical elements diffused in the air, what else do you want to say? These have just been diagnosed."

"Parasites, such as amoeba protozoa, first enter the human nasal cavity, ingest them by phagocytosis through the supporting cells of the olfactory nerve epithelium, and then pass through the sieve plate along the axonal space of the unmyelinated olfactory nerve Terminus..."

Zheng Ren said, and he was stunned.

Su Yun's eyes were also confused. He looked at Zheng Ren in surprise.

Originally, he wanted to refute, but the disease of primary amoebic meningoencephalitis does have the symptoms of olfactory loss and epilepsy. When the words came to his mouth, Su Yun swallowed them again.

Uh

"It's primary amebic meningoencephalitis!" Zheng Rendao then added: "this diagnosis is relatively reliable, with a possibility of 80%!"

"Primary amebic meningoencephalitis? How did you get in?"

"Ask President Zhou if there is a wound near the patient's nose. By the way, how old is the patient? It may be that the acne is crushed and infected with amoeba."

Zheng Renyue said that the more confident he was.

Because the previous diagnosis flaw is too obvious, as long as there is basic logic, it can be ruled out. They belong to a kind of differential diagnosis, which is to find out the sacrificial diagnosis for which the reason is denied.

"At first, there was abnormal smell, but then dizziness, headache, nausea, jet like vomiting, followed by epilepsy." Su Yun frowned and said a reason he was not sure.

"The location of infection is different, and the progress of the disease may be staggered." Zheng Ren said: "the condition is very complicated. The steps in the textbook are only a kind of probability."

Sure enough, Su Yun's words were immediately refuted by Zheng Ren.

Zheng Ren then picked up his cell phone and called out.

The phone rang at the door, and Zhou Litao then pushed the door in with his mobile phone.

"Boss Zheng, Brother Yun, I'm sorry. The patient has some emergencies and came back late." Zhou Litao said apologetically.

"Does the patient have trauma in the oronasal triangle?" Zheng Ren asked directly.

"Uh... No." Zhou Litao said, "no trauma."

Zheng Ren was disappointed, but immediately asked, "how old is the patient?"

"An old man in his sixties." Zhou Litao's subconscious answer.

Are you wrong?

"Boss Zheng, what disease are you considering?" Seeing Zheng Ren's bad face, Zhou Litao asked carefully.

"No trauma? What about rosacea?"

"Er..." Zhou Litao was stunned and thought to himself, what's the matter with boss Zheng?

"There is rosacea. The patient drinks a lot all year round. It is temporarily considered that the convulsion is caused by alcohol." Zhou Litao immediately said more to save boss Zheng from chasing his ass.

"No! It's primary amebic meningoencephalitis." Zheng Ren said, "give the patient a calm state and hurry up to do CT. By the way, we also need to do cerebrospinal fluid examination."

“……”

Zhou Litao was just busy sweating. When he came back, he was stunned by Zheng Ren. He was even more stunned than when Su Yun taught to solve his doubts.

"Rosacea, when exposed to raw water, there is a very small probability of amoeba infection. The incubation period is short and sudden attack." Zheng Ren said with certainty: "let the doctor in the inpatient department check cerebrospinal fluid immediately and do a CT."