"Hmm...... At least more than 10 years. ”

"How's it being controlled?"

"Alas, he took his medicine very irregularly. When his blood pressure was normal, he stopped, went up, and he ate for a few more days. Recently, however, he heard that a good friend of his had passed away because of high blood pressure, and he has been taking medicine for the past month. ”

"Is it still the same medicine?"

"Yes, it's still the original drug, he thinks, this drug has a good blood pressure lowering effect, and he has never changed the drug."

"Have you noticed any recent changes in your father? This includes mental state, activity and diet, among others. ”

"Hmm...... Dean Lin, when you asked, I remembered some questions. Mr. Wu seemed to be reminded by Lin Lin's question.

"I found that in the last two weeks, I have been depressed and have not been interested in anything. He used to have a wide range of interests, what kind of calligraphy, playing erhu, drinking tea, he would come a few times almost every day, and I really haven't seen him do these things recently. ”

"Otherwise...... Oh, by the way, he's usually used to get up in the morning and go for a walk in the downstairs community, but lately, he has barely gone out. Of course, he's been eating less lately. ”

"Hey, when Dean Lin asked like this, I do think that he doesn't eat much, it doesn't seem to be a problem of bad appetite, it seems that he is not interested in eating something that he usually likes to eat."

"Sometimes, I want to take him out for morning tea and dinner, but he doesn't want to go. Before, he loved to go. Wu Cheng said a lot at once. Zhang Yin listened to it and seemed to have some understanding.

"Uncle Wu, what do you feel uncomfortable about lately?" Lin Lin asked the patient instead.

"Hmm...... I feel tired, sleepy, don't want to move, and don't have an interest in anything. Especially when I go for a walk, it's too far away from before, and if I walk a little farther, I don't feel strong enough. ”

"Do you eat very little at home?"

"Less than before, I can't say. Anyway, I want to lie in bed when I have nothing to do, and I feel that every day is not as good as a day. ”

"Your usual hobbies are very good, such as calligraphy, such as playing erhu, such as drinking tea, they are all good habits and hobbies, why have you stopped recently?"

"Hey, I'm just lazy, I don't want to move, and I'm not interested." In the process of answering, the patient appeared uninterested and listless.

"Uncle Wu, I'll check it for you."

"Okay, thank you!" This is the first time that Uncle Wu has taken the initiative to say words of thanks.

Zhang Yin handed the multi-functional percussion hammer to Lin Lin, and Lin Lin put it in the pocket of her white coat. Then he stretched out his hand and said, "Give me a stethoscope." ”

When Zhang Yin heard this, she hurriedly handed her stethoscope to Lin Lin.

Lin Lin's hands are light and powerful, and the "drum sound" in the chest cavity and the "real sound" in the heart can be clearly distinguished by the people next to him, including Wu Cheng and Wan Yaowen.

Obviously, the patient's heart has expanded to the lower left!

After the percussion, Lin Lin conducted a careful cardiopulmonary auscultation for the patient.

Lin Lin found that the patient had a mild murmur in the aortic valve area, a relatively slow heart rate, and an irregular heart rhythm. Lin Lin raised her wrist and looked at her watch, listening to it while looking at the time while counting in her heart.

Han Bin and Zhang Yin both felt strange, which play was this Dean Lin singing? How can I be so familiar with the internal medicine system examination and attach so much importance to it?

A minute later, Lin Lin stopped auscultating her heart and lungs and turned to examine her abdomen. The same is looking, touching, knocking, listening, not missing a step, but also very patient and serious.

These examination techniques, including Han Bin, have almost forgotten about them, at least they can't be as proficient as Lin Lin.

After the examination of the internal medicine system, Lin Lin began to do the examination of the nervous system. From advanced nerve activity, cranial nerves to other aspects of the examination, Lin Lin is methodical, smooth and light, making people have a pleasing feeling.

Not only Han Bin, but all the doctors present have to admire, Lin Lin's skills are very solid, and they can't reach them. The doctors, who originally despised Lin Lin, began to change their attitudes.

After doing the physical examination, Lin Lin said to Wu Cheng: "Mr. Wu, I will discuss it with Director Han." ”

"Okay, thank you very much, Dean Lin." was originally worried about whether the young Lin Lin could take care of his father's illness. From the whole process, the smart Wu Cheng has already felt that Lin Lin is different.

Back in the office, everyone was still sitting in the same place.

"Dean Lin, please speak." Han Bin said to Lin Lin.

In fact, this is also a kind of "trade rule". The invited doctors will make individual speeches and accept questions from the doctors in the invited departments.

"Okay, thank you, Director Han, thank you. What I say next, if there is anything wrong, please criticize and correct it in a timely manner. Lin Lin was also polite and began his analysis.

"This patient has the following characteristics."

"First, this time it was subacute, and the trigger for the onset was that I heard that a friend of his had died of high blood pressure. Originally, there were also patients with high blood pressure, but the original irregular medication was changed to regular medication. ”

"Second, the patient has been taking antihypertensive zero since he was found to have hypertension, and he has not changed his medication during this period. The difference is that the original he took the medication intermittently, and once his blood pressure was normal, he stopped taking the medicine immediately. If your blood pressure is high, take the medicine again. ”

"And this time, he took blood pressure zero without interruption."

"Thirdly, the patient's symptoms are mainly characterized by depressed mood, decreased interest, mental fatigue, and worsening fatigue after activity. During the whole process, the patient did not experience weakness in the limbs, dizziness, headache and other symptoms. ”

"The decrease in the patient's food intake is closely related to these symptoms."

"In terms of physical examination. The patient did have a mild anemia, and on the internal medical examination, the patient's heart was enlarged to the lower left, and a soft, windy murmur could be heard in the tricuspid valve auscultation area. In addition, the patient's heart rate is relatively slow, at 51 beats per minute, and the heart rhythm is irregular, and 3 premature beats can be heard in one minute. ”

"The patient's abdomen was flat and soft, in the abdominal aorta area, and no unusual murmurs were heard." Speaking of this, the doctors present suddenly realized: it turned out that Dean Lin had noticed the abdominal aorta!

"The neurological examination showed no positive signs."

"In terms of laboratory tests, Dr. Zhang has introduced them in detail just now, and I will not repeat the same. However, there are a few indicators that need our attention. ”

"Among them, the patient's urea nitrogen and creatinine increased simultaneously, and the glomerular filtration rate decreased, reaching 53%. In addition, serum sodium, potassium, and albumin are mildly low or low in the normal range. ”