"Did we line up more than a dozen numbers in the afternoon?, did the system have problems?" Just after the lunch break, Dr. Shen looked at the dozen numbers brushed out on the computer and asked in disbelief.

Usually, the outpatient volume of the TCM department will not exceed 10 people a day, and they are usually old patients, who come early in the morning to change the prescription and go back.

In the past two days, Director Lin has been on a business trip, and the number of outpatient clinics is even less, and the number of patients in a whole day can be counted on one hand.

By the afternoon, there would be no patients at all.

What's going on today?

There are more than a dozen sick numbers waiting in one afternoon?

In front of the computer, I saw that there were a queue of patients waiting for the number on the computer, a total of 12.

The two teachers of the medical guidance desk are so powerful?

Two cups of honey grapefruit tea in exchange for twelve numbers?

At noon, I was embarrassed by the straightforward nature of the tall nurse, and I thought it wouldn't have any effect, but I didn't expect there to be twelve numbers in the afternoon!

Compared to the number of outpatients in Xihua Hospital who is tens of thousands a day, twelve numbers are nothing, but compared to the Chinese medicine department, this is more than the usual number of outpatients in a whole day!

It's afternoon, and if you wake up early tomorrow morning and start early in the morning, the effect should be better.

Well, I have to go back and ask Zhao Lei, what do little girls like, he is more experienced in this!

I wanted to complete the differential diagnosis of 10 cases of cavity infarction within a week, so I could only be cheeky and open-minded.

There are patients to see, Dr. Shen is very interested, quickly put away the practice pharmacist exercise book, and specially asked Yun Tian to wipe the table again before starting to shout.

"Big Daddy, what's wrong?"

The first to come in was an older man. He was about seventy years old, supported by a man, and he had a hard time walking.

"I've been feeling weak on my left side these days. The old man replied, patting his left arm.

Weakness in the left limb?

Dr. Shen was a little surprised, this kind of patient first suspected cerebral infarction or cerebral ischemia, patients like this are generally sent directly to Shennei, and the medical knowledge is almost also a surgical number, how did he come to the Chinese medicine department?

"Come, pinch my hand and see, both hands together. Push a little harder. Although Dr. Shen was surprised, it was impossible for Dr. Shen to extrapolate until the patient's basic condition was clarified.

Once the patient was seated, Dr. Shen reached out and began to test the patient's muscle strength. To put it simply, it is to see if the patient's two hands are the same qi.

Sure enough, the force on the left is much less.

Continue to ask, and continue to have a history of hypertension and diabetes.

Dr. Shen also measured blood pressure and blood sugar on the spot, blood pressure was 130/70mmHg, and blood sugar was 4.9mmol/L.

Both results were within the normal range.

"Daddy, let's do a check-up first, and the family members will go to the emergency department to pay a deposit of 100 yuan, borrow a wheelchair and push Daddy there. Dr. Shen lowered his head and confessed while prescribing the test sheet.

When he looked up, he saw that Yun Tian was doing a physical examination for his father.

"Outpatient ......" Dr. Shen originally wanted to remind Yun Tian that outpatients generally do not need to do a complete physical examination, but he stopped halfway through his words.

According to the normal diagnosis and treatment procedures, a complete physical examination should be carried out on the patient, but now most of them are simplified, and a few examinations for the symptoms are sufficient, mainly relying on auxiliary examinations such as CT tests to make a judgment on the condition.

However, young people, it is better to do it if you want to.

"Xiaoyun, record the case after the examination. Dr. Shen explained intimately that this is an opportunity for interns to exercise.

When the patient's family borrowed a wheelchair, Yuntian just finished the physical examination.

"How's it going, have you found anything?" Dr. Shen asked Yuntian as he pressed the next round number.

"Except for the weakness of the left limb, there is nothing abnormal. It feels so weird. Yun Tian replied truthfully.

"There is nothing surprising that it is either a luminal infarction or a small infarction, or an acute insufficiency. Although the patient has limb weakness, the first thing to consider is the problem of the brain. ”

Dr. Shen instructed Yun Tian before the second patient was seated.

It's just that he completely underestimated Yuntian's strength.

Yun Tian is already checking the specific location of the brain lesion, but Dr. Shen is still only instructing Yun Tian, a patient who needs to be considered for brain lesions.

However, except for the slightly lower muscle strength in his left limb, the other nerve reflexes were normal, which felt very strange. ”

In general, patients with cerebral infarction, in addition to muscle weakness, will definitely be accompanied by weakened or abnormal nerve reflexes.

After all, the brain is the commander-in-chief, and if there is a problem in any part of the brain, there will be corresponding abnormal nerve reflexes.

Neurodiagnostic localization is based on this principle to locate the lesion of the brain.

However, in the patient just now, except for the muscle weakness of the left limb, the other nerve reflexes are normal, which does not seem to be in line with the judgment of cerebral infarction or cerebral ischemia.

"Uncle, what's wrong with you?" Dr. Shen ignored Yun Tian's doubts, patients will not be classified as sick according to the knowledge in the book, and it is normal for interns to have some questions, and they will understand slowly after reading and learning.

The second patient was seated, and Dr. Shen began the second round of consultations.

"Someone wants to kill me?" Daddy covered his mouth and glanced left and right before leaning closer to Dr. Shen and whispering.

"????" This time it was Dr. Shen's turn to be dumbfounded.

"You will also kill me, I will not look for you, but call your leaders. Daddy's face suddenly changed, and he got up and was about to go outside. The family members hurriedly followed up and persuaded them.

"My dad woke up this morning and kept saying that someone was going to kill him. ”

"It used to be normal, and nothing irritated him in the past few days, but I went to the psychiatrist in the morning and didn't find anything wrong. It is recommended that we come to the general hospital to have a look. ”

"We weren't sure what department to see, so the medical guide suggested that we come to the Chinese medicine department, so we came over. Another family member who stayed behind explained to Dr. Shen.

After waiting for a while, the family members outside said that the old man resolutely refused to come in again, and did not let Dr. Shen come closer.

"In this way, in the case of the elderly, first of all, you need to rule out acute lesions of the brain, I will prescribe a few examinations for you first, and you should take the elderly for examinations first. "Dr. Shen couldn't get close to the patient, and he couldn't do a simple physical examination, so he could only recommend an imaging test first.

A checklist was issued, and the family members were asked to take the patient for examination first.

"In an acute mental condition like this, it is possible to suspect brain lesions, cerebral infarction, and cerebral ischemia in the first place. It's too strange today, how can two patients with suspected cerebral infarction be sent to the TCM department in a row? In the past, you didn't see one such patient a month, and you are really lucky. Dr. Shen took advantage of the time to call the number and continued to guide Yuntian.

Regarding Dr. Shen's doubts, Yun Tian smiled silently, and couldn't say, today I went to the medical guidance desk to order, let me send some patients suspected of mild cerebral infarction!