Chapter 2253

The patient's routine clinical examinations were all right, including imaging data. It would be impractical to do all the checks from beginning to end.

"What about bipolar disorder caused by changes in thyroid function?" Su Yun asked.

"In your words, there is still no way to explain the existence of Wang brilliant." Zheng Ren continued to slide the mouse wheel bit by bit and looked down at the big medical record carefully.

Bipolar disorder is only a possibility, and Zheng Ren believes that it is unlikely to be bipolar disorder.

"Boss, what do you do by looking at the big medical records so carefully?" Su Yun asked.

"The medical record was written by Zhong min. she is more meticulous." Zheng Ren said simply.

Clinicians write major medical records. In the past, when they wrote them by hand, a standard major medical record took at least 1 hour.

Now there are electronic medical records, many of which are options, which is much more convenient than handwritten medical records.

But because of this, many default options are not carefully read and filled in by doctors. After all, the time is limited every day, there are too many things to do, and there are not enough clinical staff. Just fool around in unimportant places.

Zhong min is a standard physician. Because the former physicians did not have surgery, they spent a lot more time writing medical records and seeing patients than surgeons, so the medical records should be written in a relatively detailed manner.

In addition, her own character is still delicate, especially after being frightened by the disappearance of magic pen signature once, she is serious to a harsh degree.

Just talking about the writing of medical records, Zheng Ren thinks he can't catch up with Zhong min, let alone Chang Yue.

"The reflection of both eyes to light is normal, and the conjunctiva is slightly yellow. Is this meaningful, boss?" Su Yun asked.

I have seen the test sheet. The tests such as bilirubin are normal and can basically rule out jaundice diseases.

Moreover, hepatic encephalopathy may also have mental symptoms, but the situation of the patient is thousands of miles away from hepatic encephalopathy.

"A simple one is meaningless. The corners of the eyes are 1mm red and swollen with peeling." Zheng Ren then saw another patient sign described by Zhong min.

Su Yun didn't hate Zheng Ren, but sat aside seriously and read the medical record written by Zhong min with Zheng Ren.

Lin Yuan was puzzled. Generally speaking, grass-roots hospitals are facing the diagnosis and treatment of common diseases. Although she hasn't been to Haicheng, I think she should only do some minor surgery.

The detailed description of medical records is like a literary master of realism describing a passer-by in concise language. It's meaningless!

But boss Zheng and Brother Yun looked at the medical record silently. Lin Yuan had an illusion that he should have missed something.

At this moment, she seemed to feel a solemn atmosphere.

Conjunctiva, sclera is yellow, canthus has little red swelling, what problem is this?

She also began to look at the medical records together. Occasionally, boss Zheng's hand would pause slightly, but the relevant places were only some common and unworthy small problems.

For example, pale lips, occasional bleeding gums and so on.

It was written in the medical record... Suddenly, Lin Yuan had a very bad feeling.

She has read sister Yue's medical record, which is more detailed than the current medical record. It can even be said to be a detailed description.

I won't write medical records like this in the future!

She vaguely saw that the future was dark. She didn't want to sit in the office and write medical records every day. She wanted to have surgery and become a world-famous surgeon.

Nausea, no vomiting, progressive weight loss, weight loss of 2.3kg within 1 year.

The description was too detailed. Lin Yuan's head hurt for a while.

Even Lin Yuan recalled that he had seen the doctor in Haicheng write in front about how to treat patients with oral ulcer and several ulcer surfaces.

The patient suspects that it is a mental disease. What does it mean to write about oral ulcer?! Lin Yuan felt a pang in his heart.

Are all the people under boss Zheng abnormal? Writing a big medical record is so strict.

No, it's not strict. It can be described as harsh.

Immediately, Lin Yuan saw the line "diet change history for 3 months" in the medical record summary. She has been speechless for a long time. If she had to describe each medical record in this way, she would rather go home in a few days.

"Su Yun, ask Zhong min what it means to change her diet." Zheng Ren suddenly said.

"Well, it's already very clear. It's estimated that President Wang has never met a similar patient." Su Yun said softly. He picked up his mobile phone, didn't look for the telephone directory, and directly dialed a mobile phone number.

Clear? What is clear!

The cold hairs on the back neck of Lin Yuan suddenly stood up.

How is it clear? What do you see makes clear the existence of Wang brilliant?

Little redness and swelling in the corners of the eyes? mouth ulcer? Or dietary changes.

For a moment, Lin Yuan felt powerless in his heart. The things I was proud of collapsed so fast in front of two evils, boss Zheng and Brother Yun, that it was too fast to accept.

"Zhong min, you wrote the medical record sent by President Wang just now."

"The patient's name is Han Cuijuan's medical record."

"Look, you wrote a sentence about diet change. What do you mean?"

"OK, you and Mr. Wang said that there are already eyebrows on this side. When I discuss it with the boss, I'll tell you the diagnosis right away."

With that, Su Yun hung up the phone.

"Zhong Min said that the patient began to have a heavy mouth three months ago and the food was too salty." Su yundao.

"Well, the diagnosis is clear. Carbamazepine can't be stopped. Olanzapine 10mg is taken orally once a day. Vitamin B12 is injected intramuscularly at 1mg / D for the first 6 days, 1mg per week for the next 6 weeks, and then 1mg per month." Zheng Ren directly said treatment.

"Boss, it's too lax."

"The inspection still needs to be done, which is needless to say?"

"Check vitamin B12 and homocysteine." Su Yun asked.

"Well, the positive rate of blood vitamin B12 is not high. We must check homocysteine." Zheng Ren said, "check it now and tell president Wang that we'll wait for the results."

Lin Yuan silently looked at Su Yun and called again. He recalled the diagnostic criteria of vitamin B12 deficiency in his mind.

"Boss Zheng, vitamin B12 deficiency is generally manifested as giant cell anemia, glossitis and neuropsychiatric symptoms." Lin Yuan whispered doubt.

"Well, there are some small details. Not every patient with vitamin B12 deficiency will have glossitis and megaloblastic anemia." Zheng Rendao.

“……”

"For example, glossitis is the most common, but the diagnosis says that the mucosa of the tongue, mouth and digestive tract is inflamed. If conditions permit, it is ideal to make a gastroscope for the patient."

"Ah?" Lin Yuan was stunned.

"Gastroscope is most likely to show gastric mucosal atrophy and chronic inflammation, and intestinal metaplasia is found in 50% - 60% of biopsy epithelium."