Chapter 2194

Zheng Ren was stunned when he saw the patient.

The patient's system panel is even more red than you think. What you have considered before is wrong. Patient diagnosis is a very common disease that rarely causes hypoglycemia.

"Boss Zheng, this is my client. His name is DU Liang." Lawyer Ge introduced.

"Well, come to the rescue room first." Zheng Ren took DU Liang to the rescue room and began routine consultation.

DU Liang looks about 50 years old. His whole spirit is depressed, but his speech and conversation are OK. It's normal.

His mood is normal, his memory and computing power are normal, his orientation is complete, and his insight is normal. These are no problems.

"Is there anything uncomfortable lately?" Zheng Ren asked.

"Uncomfortable..." DU Liang hesitated, shook his head, but nodded again the next second. "Doctor, I often lose my mind. When I wake up, I find that what happened some time ago is a blank, and I can't remember what happened."

"And when I wake up, my back is sore. Sometimes my whole body hurts, especially my face."

Su Yun almost laughed.

Can it not hurt? Just slap your mouth. If it doesn't hurt, I'll go to hell.

"Is there anything else uncomfortable? Is there any weight..." before Zheng Ren finished asking, DU Liang's hand began to tremble, as if out of control, so he slapped his face.

Zheng Renzhen wanted to cut his carotid sinus with a knife, but the case of the dead just made him hesitate.

"What's wrong? Mr. Zhou, measure the blood sugar at your fingertips." Su yundao.

"What's your name?" Zheng Ren asked.

"I... I don't know... Who am I?" DU Liang said vaguely, "I'm Erlang God. I remember!"

“……”

Zheng Ren shook his head, looked at the patient and began to sweat. He immediately said, "after measuring blood glucose, give 50ml, 50% glucose intravenously."

Zhou Litao began to talk busily.

Blood glucose is very low, 1.6mmol/l. Less than 3 minutes after intravenous injection of high sugar, the patient slowly recovered.

Lawyer Ge was not surprised to see this.

Compared with patients, he is more concerned about what boss Zheng thinks. When you bring people to 912, even if there is sufficient evidence, you have to bear a great relationship.

"Let me see, Mr. Zhou, you come with me." Zheng Rendao.

"OK."

Several people went out from the emergency room. Zhou Litao told a nurse to look at the patient and stop anything.

"Boss, check the abdominal CT. I suspect there is a problem with the pancreas." Su Yun said directly.

This is the organ that Zheng Ren considered to have the most possible problems before, but the diagnosis of the system panel is another matter.

"Check B-ultrasound and CT of pancreas." Zheng Ren then said, "check another lung CT."

Zhou Litao waited for boss Zheng to continue his medical order, but the medical order was over.

"Boss Zheng, nothing else?"

"Well, check these three." Zheng Rendao.

For admission examination, plain film or CT of the lung is a routine item. For this, others think that boss Zheng just improves the relevant examination without paying much attention.

Zheng Ren sits in Zhou Litao's duty room and waits for Dr. Liang in the CT room to upload the film.

More than 20 minutes later, the CT of the pancreas was uploaded.

On the whole, there is no special problem. The pancreatic capsule is complete and there is no long thing. Hypoglycemia caused by tumor is more common in islet cell tumor, which can be denied by pancreatic CT.

Soon, the lung CT came back.

A 2 in the lower right lung × The 3.5cm space occupying image is so dazzling. Ground glass like space occupying lesion indicates the fact that it is a malignant tumor.

Zheng Ren sighed. The pig's hoof was as reliable as ever. Although it is rare, a definite diagnosis can be made immediately by checking lung CT.

"Er... Is it hypoglycemia with tumor?!" Lin Yuan first said in surprise.

"Well, it's diagnosed as lung cancer with tumor hypoglycemia. Lin Yuan, call lawyer Ge." Zheng Ren said while carefully looking at the patient's lung CT.

"OK." Lin Yuanfei ran out quickly. She was afraid that boss Zheng would say something wrong when she was away.

Lawyer Ge trotted over.

"Lawyer Ge, consider that the patient is lung cancer." Zheng rentou didn't look back and said directly.

"Lung cancer?!" Lawyer Ge was stunned.

"Yes." Zheng Ren said, "before inducing hypoglycemia in patients with nonsense and abnormal behavior, it is considered that hypoglycemia with tumor is an appearance, which is not important."

"..." lawyer Ge looked confused.

I just want to win a lawsuit. Hypoglycemia is enough to win. How can I make a tumor associated hypoglycemia?

Is the client really ill, and still lung cancer? However, how does lung cancer induce hypoglycemia?

Lung cancer and hypoglycemia are two words that can't be connected in lawyer GE's mind.

Not to mention lawyer Ge, even Zhou Litao feels very strange.

"Boss Zheng, tell me more." Lawyer Ge rubbed his hands and said.

"Tumor associated hypoglycemia is usually the clinical manifestation of the primary disease or hypoglycemia after the diagnosis of the primary disease; it is very rare to find lung cancer after hypoglycemia."

"Er... But hypoglycemia..." lawyer Ge still didn't 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; Hypoglycemia caused by autoimmune diseases; Reactive hypoglycemia; Hypoglycemia caused by endocrine diseases; Hypoglycemia caused by non islet cell tumor. " Zheng Ren's series of thoughts and various professional terms confused lawyer Ge.

"It is rare for extrapancreatic tumors with hypoglycemia. Other types of tumors related to hypoglycemia include mesenchymal tumors, accounting for 64%, of which 50% occur in the abdominal cavity and hepatocellular tumor, accounting for 21%. This patient is even more rare, which is lung cancer." Zheng Rendao.

"Why does this happen..." lawyer Ge still doesn't understand.

"Lin Yuan, tell lawyer Ge why." Su Yun glanced at Lin Yuan and instructed him.

"First, consider that the symptoms of the patient are related to the secretion of insulin-like factor 2 by the tumor. IGF-2 binds and activates the corresponding receptors, so as to increase the glucose uptake of peripheral tissues and reduce the hepatic glycogen output, resulting in the decrease of glucose in the blood and the appearance of hypoglycemia."

Su Yun looked at the way Lin Yuan said one, two, three. He felt a little like his boss. He was so bookish.

"Secondly, the increased glucose utilization of the tumor itself can also cause..." Lin Yuan didn't pay attention to Su Yun's expression, but continued to explain the situation.