(Thanks to my friend Xianglong Yimai monthly pass for encouragement)

The ugly daughter-in-law always wants to see her in-laws, this patient is very resistant, and Liu Banxia and Wang Huan also have to rise to the challenge. It's just that feeling the cold eyes of the patient, the two of them are also a little stunned.

This is soft and hard, and it doesn't matter if you coax or scare? If the previous examination has some effect, it is better to open your mouth now and say something.

"Girl, let me tell you the truth, none of the tests that have been done so far have detected your symptoms. Liu Banxia said.

"But you have pain in your abdomen, so there must be something we haven't checked out. Can we do a pelvic ultrasound to see if it's the pelvic appendage causing the pain?"

"Sometimes some pain is diffuse and not primary. Your boyfriend still cares about you so much, you should think about it for him and do a check-up. ”

The girl only glanced at him faintly, then lowered her head and looked at her fingers.

Liu Banxia felt that he was also a person who could speak well, but there was nothing he could do in front of this patient. This is the patient's "cold violence", I will ignore you, what can you do.

There was no way, so I went to the side and took a glass of water and handed it to the girl. The girl didn't refuse, and took it.

Such a pleasure made Liu Banxia stunned for a moment, can patients with depressive tendencies accept what others give them so smoothly?

"Anyway, if you can't check it out, you can't let it go. Tell me how it's feeling now. Liu Banxia pulled a chair, sat down opposite the girl, and stared at it so directly.

The girl frowned slightly, "It's just a little painful, one by one." Is the pelvic adnexa examination to examine the uterus and ovaries?"

Liu Banxia nodded quietly, "CT was done on the abdomen, and some symptoms were investigated." I did a colonoscopy of the intestines, and there is no problem at present, not even a polyp. ”

"So what we can suspect is the pelvic area, maybe there is some underlying inflammation. If you don't check, let alone your boyfriend, even we can't let you go. ”

"You should just get rid of our entanglement, you can rest assured that we have checked it, and we can rest assured. You're going to have to live in the future, aren't you?"

The girl's brow furrowed, and the entire examination room fell silent.

Wang Huan was a little anxious on the side, so he hoped that the girl would respond quickly, and he dared to rush out and push the ultrasound forward.

The patient's boyfriend just wanted to speak, but Liu Banxia hurriedly shook his head.

The girl stared at the disposable paper cup in her hand for a long time, raised it and took a sip, then nodded.

The depressing atmosphere in the entire consultation room swept away with the girl's nod, Wang Huan ran out first, and Liu Banxia followed.

"Brother Wang, have you noticed that the girl's performance is not particularly resistant?" Liu Banxia said.

Wang Huan was stunned for a moment and nodded, "It seems that this is really the case, that means that the girl's current performance is not depression, but neurological symptoms?"

"I think it's about the same, and the impact seems to be variable. Liu Banxia said.

"Let's do an ultrasound first, it is also possible that there is inflammation in the pelvic adnexa or a carcinoid reaction caused by an abscess. But since she has abdominal pain, I think there's still something wrong. ”

Wang Huan nodded, and his heart was a little excited. At least now that some thoughts have been clarified and new symptoms have been discovered?

This is a hard-won inspection opportunity, Wang Huan and Liu Banxia looked at it very carefully. But what makes them very depressed is that there is no problem with the ultrasound examination at present.

They just scanned not only the pelvic cavity, but also the abdominal cavity, and examined it very carefully.

"I'm feeling better now, it's not hurting much. ”

Just as the two hesitated, the patient spoke.

"It doesn't hurt much?" Liu Banxia muttered.

"Is it that if I drink less water, it will hurt, and if I drink more, it won't hurt?" said more this time.

Liu Banxia wanted to tell her that it was impossible, but he didn't dare to open his mouth. Even if the girl is not depressed, she now has neuropathy, and she needs to pay attention to it when she speaks.

"I'll auscultate again. After Liu Banxia finished speaking, he wiped off the couplant and put the stethoscope on it.

After listening for a while, he pressed the stethoscope and closed his eyes.

This auscultation took a long time, more than three minutes. Then he reached out again and rolled it slightly the patient's abdomen.

After rolling it out, he placed the stethoscope on the patient's abdomen and listened.

Even Wang Huan didn't know what he was doing, but he didn't bother him. Liu Banxia should have discovered something, otherwise he wouldn't have behaved so specially.

This auscultation took longer, and it wasn't until the girl frowned slightly that Liu Banxia took the stethoscope back.

"How about we make a magic trick?" Liu Banxia asked with a smile as he looked at the patient.

seems to be a little disgusted with the current Liu Banxia, the girl's frowning brows did not relax in the slightest, and she didn't pay attention to him.

As if he hadn't seen it, Liu Banxia took out his flashlight and shone it on the girl's face.

It was obvious that the expression on the girl's face was very unbeautiful, and she twisted her head to the side.

"And let's do magic. The smile on Liu Banxia's face was even bigger.

"I can change the color of my urine and make it darker. Anyway, you didn't have a urine test, so let's go for a drink. What if I can't diagnose your illness and get all the tests done for free today?"

"Banxia, you mean ......"

As soon as he heard him say this, Wang Huan's eyes became shining. Because there are really not many conditions that can be diagnosed by direct observation in the urine, and acute intermittent porphyria is the most prominent case.

And this is not a strange case for the emergency center, didn't there be a child who was also affected by this disease a few days ago?

But he was a little entangled, because the symptoms he showed were plausible.

First of all, although the main manifestation of this disease is abdominal pain, it is colic, not dull pain, so it is often confused with acute abdomen.

Secondly, the disease responds significantly to photoreceptors. Although Liu Banxia shook the patient's eyes with a flashlight just now, it seems that it was only because he shook it more frequently that it caused the patient's disgust.

The lights in the clinic are very bright now, and if you were sensitive to light, you would not have been able to undergo such a long examination without any response at all.

However, what surprised him was. He thought that Liu Banxia would not pay attention to such an unreasonable little request, but the patient agreed.

Not to mention him, even the patient's boyfriend was shocked. Even if Liu Banxia is a doctor and wants to take his girlfriend to play the magic of urine test, it won't be like that.

The next test is very simple, two glasses of urine, one to the laboratory, and one for the patient's boyfriend to take outside to bask in the sun.

It was five minutes before the patient's boyfriend rushed back, and the color of the urine had changed.

Complex abdominal pain patient task completed

Gain 200 XP and 100 Diagnostics Skill Mastery

The task reward was dry, and Liu Banxia was a little sad when he saw it. However, there is no way, because of the particularity of the diagnosis process of this case, it is understandable to give less.

"It's really AIP, is this really possible?" Wang Huan was not calm.

"Doctor, is AIP my disease?" the patient asked.

Liu Banxia nodded, "AIP is the abbreviation, and the full name is acute intermittent porphyria, which is a dominant genetic disease. Most of the onset is between 20 and 40 years, and women are more likely than men. ”

"There are many triggers, such as dietary changes, mood or stress, and then there are medications. When it comes to you, it's medicine. The use of sulfonamides can easily induce this disease. ”

"And the disease that has landed on you makes the diagnosis a little more difficult. You tolerate it so well that what should have been normal colic is a dull ache in your senses. ”

"This may also have something to do with your neuropathy, and the manifestations of this disease are also very different, and you can't generalize. ”

"Doctor, can this acute VIP be cured?" the patient's boyfriend asked anxiously.

"Hmm...... , this is AIP. It cannot be cured, but it can be controlled by conditioning. Liu Banxia said.

"She was induced by sulfonamides this time, and it would be good to avoid sulfonamides, barbiturates, griseofulvin, chloroquine, estrogen and other drugs in the future. ”

"And it's also crucial for sugar intake later in life, with more carbohydrates and protein. Let's go to the hospital first, drink a glass of Coke and nibble on a big chicken leg for a while, which was how we controlled a small patient last time. ”

"Doctor, this ...... This...... You're not kidding, are you?" the patient's boyfriend asked with a wry smile.

He felt that Liu Banxia was again, he came to the hospital for treatment, and he saw what kind of VIP disease, it was quite serious, and then he drank Coke and ate chicken legs?

Isn't it over at home, what are you doing in the hospital?

Liu Banxia nodded very seriously, "If you are afraid of spending less money, we can also prescribe some chlorpromazine to stabilize your spirit, hang a few bags of glucose to supplement calories, and then drop some methemosanthin." ”

"Silly boy, there's only a little left to save money. If you can control what you eat and drink, what are you doing with so much mess in your body? The reason why she was admitted to the hospital was to monitor her physical indicators. ”

"Don't worry, as long as the body adjusts, there will be no effect. In the future, according to the doctor's advice, the chance of recurrence in normal life is also very low, and it is not as terrifying as imagined. ”

Although he was criticized by Liu Banxia, the guy was left with only Silly Le, and the doctor seemed to be very reasonable.