bookmarkrole Chapter 307
Chapter 307
Chapter 307
Difficult cases, start!
The teacher is on the top, telling about the condition.
The doctors in 10 hospitals were silent, listening carefully.
·Patient, female, 25 years old, unmarried.
Suddenly one day, the patient got up in the morning and found that he had enuresis, his trousers were wet, and there were urine-smelling, soaked sheets.
·Because I was embarrassed to go to the hospital, I asked my mother. She thought it was a kidney deficiency, so she prescribed some Chinese medicine to invigorate the kidney.
·Take traditional Chinese medicine for one month, which is ineffective. Still enuresis.
·Go to a hospital and go to the urology department. The urology department considers 3 diseases:
·1: “Urinary Tract Infection”……
·2: “Kidney function”…
·3: “diabetes insipidus”…
·4: “Urinary incontinence”……
· First rule out “urinary tract infection”: The female patient does not have any urinary tract irritation symptoms such as frequent urination, urgency, or painful urination, and has undergone a “urinary examination”, which is negative and excluded.
·Remove “kidney function”: Insufficient kidney function can sometimes lead to an increase in urine (for example, uremia, which is the early stage of renal failure, a sudden increase in urine). However, after renal function examination, the renal function was normal.
·Remove “urinary incontinence” again: “urinary incontinence” refers to bladder sphincter damage or neurological dysfunction, which leads to the involuntary outflow of urine. However, after questioning, the patient’s urine can be completely controlled during the day, but cannot be controlled after falling asleep. So exclude.
·Remove “diabetes insipidus” again: the so-called “diabetes insipidus” is a hypothalamic-neurohypophyseal disease, which leads to an increase in urine. Patients with diabetes insipidus must have at least 4000ml of urine per day (about 1500-2000ml for normal people) ). However, he was admitted to the hospital for urination and found that the urination volume was normal, and the volume of enuresis was low at night. So exclude.
·On the second day, other tests were done: blood routine, urine routine, stool routine, liver function, urinary system B-ultrasound, bladder, etc. The inspections did not find any problems.
·Physical examination: No special findings.
·(The patient is currently cured: the real answer will be announced later.)
…
The above is the description of the patient’s condition.
Teacher: “This is the case of the patient. All doctors start their own diagnosis…”
The entire conference room,
Suddenly it started to clamor.
Many doctors are very confused at this time!
“Fuck, this question is so difficult!”
“Pit!”
“This has ruled out all possibilities, we still diagnose a fart!”
“I can think of it, I checked it all above!”
“Is the first question so difficult?”
“Give us a good start at the beginning!”
Lin Feng was also a little surprised when he saw this question at this time.
This question is indeed a bit difficult.
Because all the inspections have been done and no problems have been detected yet, the next thing to consider is a more tricky angle.
The teacher smiled: “Is it difficult?”
“The difficulty is right… You are all the elites of various departments in major hospitals, and dozens of people work together, which is equivalent to a general consultation in each department…”
Lin Feng nodded.
really!
The people who come are all elites in various departments, which is equivalent to a general consultation.
The reason can always be found from various angles.
Soon, the teams in the hospitals looked for the patients and conducted close observations and physical examinations.
Each hospital takes 2 minutes,
…
Half an hour later,
10 hospital teams completed the physical examination.
Lin Feng thought about it and wrote two answers on the paper.
·Mental reasons… (Reason: In the sign-in experience, there are 3 similar cases, enuresis caused by mental illness.)
·Hyperthyroidism…(Reason: Lin Feng knows that hyperthyroidism may cause enuresis in the sign-in experience. Then he can observe the patient’s neck and find that the patient’s neck is thick, although it is not obvious, but consider hyperthyroidism. Hyperthyroidism will have a certain degree of influence Pituitary gland, then pituitary gland affects urine)
Some diseases, from the perspective of knowledge, seem to be unrelated, but in fact there is a causal relationship, but the level of medical care has not yet developed to that level.
Lin Feng handed his answer to the leader teacher.
…
20 minutes later…
All 10 hospital teams handed in their answers.
The teachers of the referee group began to gather.
Another 10 minutes passed…
The teacher announced the answer:
“Congratulations to Xiehe Hospital, this hospital, for giving the correct answer!”
0 ········Find flowers·····
“The real answer is: hyperthyroidism!”
The voice just fell,
The audience exclaimed.
“Hyperthyroidism? Where did you see hyperthyroidism?”
“Yeah, I didn’t even see it…”
“really?”
“No, even if it is hyperthyroidism, what does it have to do with enuresis?”
At this time, the teacher pressed his hand,
“Everyone be quiet…”
“Next, let me talk about the treatment process in detail…”
“After the patient checked the above-mentioned examinations, the cause was not found. A few days later, the hospital had a consultation. A doctor found that the patient’s neck was slightly thick, because it was not obvious, so I didn’t find it a few days ago…”
“So, review the thyroid function and color Doppler ultrasound…”
0 0 0
“Finally found hyperthyroidism…”
“Finally, after using hyperthyroidism treatment and taking “Propylthiouracil”, only one week later, the patient’s enuresis gradually decreased every day…Although the hyperthyroidism has not been treated, the enuresis treatment is very effective. ”
“So the final conclusion: Enuresis is caused by hyperthyroidism…”
“In this diagnosis, only the Xiehe Hospital found that the patient had hyperthyroidism…”
“So, in the first round, Union Medical College won…”
“Please stand up and let everyone know about the doctor who found hyperthyroidism in Xiehe Hospital…”
Everyone’s eyes looked over.
Doctors of Union Hospital:
“who is it?”
“I didn’t find…”
“It feels too detailed…”
At this moment,
Lin Feng stood up.
“it’s me……”
Lin Feng did not expect that with so many doctors present, none of the doctors discovered that the patient has a thick neck (although it is not conspicuous)…
In fact, what he didn’t know was that he knew that hyperthyroidism could cause enuresis, so he specially observed the patient’s neck.
Other doctors don’t know.
Therefore, other doctors will not look at the patient’s neck closely, but only look at it roughly, so they can’t find the unremarkable thickness of the patient’s neck.
this,
That’s why Lin Feng mvp the whole audience! !
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