Chapter 1714： Professional analysis

Diagnosis... There is a diagnosis of wool!

Zheng Ren looked at Su Yun on the stage and began to recall his previous medical history.

"Here is other data and copying materials of existing cases." Su Yun said with a smile: "Because things happen more suddenly, this case discussion is only a rehearsal. The effect seems to be good, Changyue, you said I am handsome and handsome?"

Su Yun’s case was asked when he walked past Changyue.

"If you spend half of your time on surgery, you can use it..." Chang Yue took the medical record and said a half sentence.

"I regret to give you medical records." Su Yun didn't care about Chang Yue's mouth gun. He smiled and said: "Because you simply can't understand."

"Abdominal pain, what is the diagnosis?" Chang Yue disdain, caressed the glasses, began to look carefully at the medical records.

After Zheng Ren got his medical record, he began to look.

Su Yun is the key point to say that the medical records are more detailed.

Nausea, vomiting, abdominal pain, no bacterial or viral infections, what to consider?

His eyebrows wrinkled, and there were cases in the brains of countless documents that he had seen during this time.

"How, Changyue, talk about your views." Su Yun waited for a few minutes, seeing everyone almost finished reading the medical records, he said with a smile.

"Considering kidney stones." Chang Yue gave his own answer, "nausea, vomiting, and pain in the lower left abdomen, which are consistent with the diagnostic criteria for kidney stones."

"It's a wonderful diagnosis. I can't bear to deny this fairy tale diagnosis." Su Yun said with a smile: "However, this is the first case discussion of the medical team. Director Luo is also, you still have to Be serious."

Chang Yue’s hand is placed on the glasses, and the eyes are shining sharply.

"The pain caused by kidney stones can be severe, and stones can behave like acute abdominal pain when they are in certain locations.

Urinary sepsis may occur when stones cause obstruction and hydronephrosis, and vomiting may be a prominent manifestation of severe kidney stones.

Several of the patient's performance suggests this diagnosis, and I estimate that you have looked at the urine routine test. The red blood cells inside give you a clear hint that this is caused by kidney stones. ”

Chang Yue’s hand stopped.

Su Yun is like a locust in his stomach, saying that it is entirely his own diagnostic logic, without any deviation.

If the mouth of this goods is not so harsh, how good it should be.

"Unfortunately, these are all wrong!" Su Yun said with a smile: "You must have forgotten my special mention of the menstrual period. The red blood cells in the urine are considered to be caused by menstrual blood. I don't consider the rupture of the ureteral cells caused by urinary calculi. The resulting bleeding."

"How do you know!" Chang Yue asked coldly.

"Chang doctor, patient CT enhanced imaging of the abdomen, I think you must not understand. Stones in the kidneys, ureter is smooth, so your diagnosis 99.9% is a wrong diagnosis." Su Yun blew, the forehead black hair floating It’s floating.

"The reason why I didn't say it is 100% is because I have to take care of your poor self-esteem." Su Yun said slyly.

Zheng Renzhen is particularly helpless. Su Yun’s teeth are sharp and can be lived until now, and it’s a miracle.

"Cloud brother, the ECG is a bit problematic." Lao He was still kind. At this time, he interrupted Su Yun’s words and killed Chang Yue’s anger.

There are images of ECG in the medical records, but Su Yun did not list the ECG.

There are some heart diseases that manifest in the gastrointestinal tract and nausea and vomiting. Because Su Yun had all neglected the gastrointestinal diseases, he would see an abnormality on the electrocardiogram at a glance.

The 12-lead ECG recorded at the time of the visit showed supraventricular tachycardia; the electrocardiogram also showed an extension of the RP interval.

The rhythm pattern recorded after administration of adenosine showed termination of supraventricular tachycardia.

The patient developed sinus tachycardia after a ventricular ectopic beat and a transient atrial ectopic beat. The subsequent 12-lead ECG confirmed persistent sinus tachycardia.

Here is the most likely, the old congratulations.

To behave, be sure to perform! Laohe, a senior anesthesiologist, is very sensitive to the heart and breathing.

When he looks at him, he feels that the electrocardiogram is wrong.

"No." Without waiting for Su Yun to speak, Zheng Ren suddenly shook his head and said: "The patient's heart rhythm map shows tachycardia, and the Q wave group is narrowed. This finding is consistent with supraventricular tachycardia.

The patient's rhythm rules, therefore atrial fibrillation and multifocal atrial tachycardia are unlikely. The patient is a sudden tachycardia, so sinus tachycardia is unlikely.

Sinus tachycardia has a phase in which the heart rate gradually increases, rather than a sudden increase in heart rate to more than 200 beats/min.

Therefore, I suspect that the supraventricular tachycardia in which the patient has a heart rhythm rule is one of the following three types: atrioventricular nodal reentry tachycardia; atrioventricular reentry tachycardia caused by retrograde conduction through an additional path; Focal atrial tachycardia.

However, regardless of the type, the electrocardiogram changed after the use of adenosine, but the symptoms did not change, and the abdominal pain caused by the heart disease was temporarily ignored. ”

Zheng Ren lowered his head, and the clear and very rigorous logic analysis overturned the diagnosis of Laohe.

Su Yun smiled, and Lao He could think of it here. It is already a clinically experienced old doctor.

But this is still not enough. The patient's condition is very weird. Su Yun has only a preliminary diagnosis for the time being.

But he doesn't say it.

Don't say it to the boss to give a denial. In that case, the entire stage effect is gone, very disappointing.

"Director Luo, what do you think about it?" Su Yun's mouth temperature and down, asked Director Luo.

“The patient has taken oral opioids.” Director Luo said slowly: “Opioid withdrawal can explain tachycardia, agitation, nausea, vomiting and abdominal pain. However, the patient does not sweat or yawn. The appearance of opioid withdrawals such as goose bumps or pupil dilatation So, I now suspect that patients have serotonin syndrome."

Su Yun smiled.

He also considered serotonin syndrome.

Serotonin syndrome is a group of symptoms caused by taking a serotonergic drug or a combination of a serotoninergic agent and a monoamine oxidase inhibitor.

Typical clinical cases are rare.

Mental state and behavioral changes such as mild mania, agitation, and changes in motor system function.

Symptoms of fever, nausea, diarrhea, headache, tremors, blushing, sweating, tachycardia, shortness of breath, changes in blood pressure, and dilated pupils caused by autonomic dysfunction.

The patient's various manifestations are highly consistent with serotonin syndrome.

With the judgment of Director Luo, Su Yun’s confidence increased greatly. The boss's goods, at most, think of this degree.