Knock knock!

The knock on the door was so pleasant to hear.

I'm going to leave work soon, and the probability of this being a returning patient is very small.

Follow-up visits are usually concentrated in the morning or early afternoon.

Zhou Can waited for the battle, waiting to earn experience points.

"Please come in!"

Dr. Ho's voice is always so gentle and strong.

The door to the exam was pushed open, and a man in his forties walked in, supported by his family. He pressed one hand against his abdomen, his expression pained.

"Ahh......h Doctor, my stomach hurts so much, help me take a look! ”

The man's face turned pale with pain, and his forehead was covered with cold sweat.

"Sit down first!"

Dr. Ho seemed very calm and calm.

"When did it start hurting?"

"It's been two days, it's been two days of pain, ahhh......hh

can make a middle-aged man hurt like this, the pain level must not be low.

"You didn't eat anything poisonous, did you? For example, poisonous mushrooms, toads, and pesticide-infused vegetables and fruits. ”

"No, definitely not. I've been eating at home for the past few days, and my wife and children are fine. ”

"Do you smoke or drink?"

"Hmm."

"Does the family have a similar medical history?"

"Nope!"

"Come, help him to the bed and lie down, and I'll do a physical examination."

Dr. Ho instructed the family to help the patient to lie flat on the bed and then began the examination.

Zhou Can also got up and looked over.

Based on the patient's tracography and the symptoms presented, he has already begun to make pathological inferences.

However, the lack of examination data, coupled with his lack of clinical diagnostic experience, makes it difficult to clarify the pathological mechanism of the patient.

Because there are so many causes of abdominal pain.

Peritonitis, gastroenteritis, gallstones, appendicitis, etc., many diseases can cause severe abdominal pain.

Dr Ho pressed the patient's abdomen with his hand.

"Ah......h Tap, tap ......

The patient immediately let out a scream.

"That's the only part that hurts, right?"

"There is also a right shoulder, and the right back also hurts, but it doesn't hurt as much in the stomach."

After Zhou Can heard this, he immediately understood that this was a radiating pain caused by severe pain in the upper abdomen.

It's like throwing a stone into a pond, centering on the point where the stone falls into the water, and it will form a circle of ripples that spread around.

It's the same with pain.

It is transmitted through the nerves to the surrounding area.

This phenomenon is medically known as radiating pain.

It is now almost certain that the initial area of pain is in the right upper quadrant.

"Did your abdominal pain come on suddenly two days ago, or did it come on slowly?"

"Suddenly appeared. Without any warning, it suddenly started to hurt, and it started to hurt. And with each pain, the pain gets worse. The pain in the back was unbearable, and I vomited a few times. ”

The patient provided another clue.

Therefore, it is still important to have a consultation.

Don't be afraid of trouble, you must ask for more relevant information.

"Since the pain is so severe, you can't delay coming to the doctor until now, right? Have you ever been seen at another hospital? ”

Dr. Ho is experienced in diagnosis and treatment, and immediately deduced some truths that the patient did not disclose based on the patient's tracing.

"Uh...... I did go to a small clinic and gave me an infusion at that time, saying that it was anti-inflammatory. It didn't work, and the owner of the clinic was afraid that something would happen and persuaded me to go to a big hospital for treatment. ”

Those small clinics give infusions to patients at every turn.

All kinds of antibiotics are overused, and small clinics are the worst to blame.

For some small colds or small symptoms, infusion by intravenous drip and antibiotics are indeed effective.

As everyone knows, this is a bit like drinking doves to quench your thirst.

This time it got better quickly, but the body's immune system was disrupted and weakened, and it was easier to get sick next time. will get sicker.

This repeats itself and eventually forms a vicious circle.

When the time comes for patients to really need antibiotic treatment, they will sadly find that there is no medicine available.

Because the virus in the patient's body has developed severe drug resistance.

Even a random cold can have a supervirus.

"In addition to abdominal pain, right shoulder and right back pain, are there any other symptoms? When I touch your belly, it feels a little hot! ”

A physical exam is the initial examination after a doctor's appointment.

This is very important.

It can help doctors discover some of the patient's hidden conditions.

Some patients may feel embarrassed or inconsequential and may deliberately conceal some symptoms. This requires the doctor's sharp eye.

"I feel feverish and chills."

"Well, first take your body temperature, heart rate, and blood pressure, relax a little, and don't be nervous. When you come to us, you will definitely do your best to heal you. ”

After Dr. He comforted the patient, without waiting for his instructions, Zhou Can had already cleverly rushed to measure the patient's blood pressure, heart rate, and body temperature.

How can these basic jobs be done by senior doctors?

Be diligent, and Dr. He will definitely be happy to see it.

The next time I ask to take him with me, the probability of agreeing will increase a lot.

"Body temperature 39.6, pulse 98/min, blood pressure 120/mmHg. Both lungs were percussed, there was no abnormality, no murmur was heard in the chest during breathing, and the breaths were about 25 breaths per minute. ”

Zhou Can took a series of measurements for the patient.

In the range of 39.1 degrees to 41 degrees, it is already a high fever.

This patient's condition was more serious and complicated than expected.

"Let's go for a blood routine and ultrasound first. If the results are not satisfactory, further CT may be done. Dr. He said this not only to the patient, but also to Zhou Can.

Zhou Can hurriedly ran to the computer to open an application for medical examination.

"Because of your complicated condition, the outpatient clinic will be closed immediately. Before the results of her examination were available, the cause was not clear, and she could not be hospitalized. It is recommended that you go to the general surgery department of the inpatient department to find a doctor after the examination, and I will explain the relevant situation to him. ”

The patient's condition may deteriorate further at any time.

Dr. Ho did not dare to take it lightly.

If the condition is not severe, the patient is usually asked to come back the next day.

After the patient left, Dr. Ho stood up and prepared to leave work.

"Xiao Zhou, how is it? Follow me for an afternoon, what are the gains? ”

"It's a big gain. I have benefited a lot from the process and treatment methods of receiving various patients, especially the medical ethics and medical style, and you have set a very good example for me. ”

"Haha, you kid has such a sweet mouth. Alright, it's time for the nurse at the guide desk to come and close the door, let's go. ”

After Zhou Can followed Dr. He out of the consultation room, he was still thinking about what kind of disease the last patient he received?

It's only 1.4 experience points away, and he's not reconciled!

Severe pain in the right upper abdomen, radiating to the right shoulder and right back, the patient's habit of smoking and drinking, coupled with the patient's high fever and chills, all these symptoms are combined, very similar to a problem with the bile ducts.

Could it be a common bile duct stone?

Zhou Can seemed to have grasped something, and his eyes became as bright as stars.

Every time a doctor diagnoses a patient, it's like doing a math problem.

After the results are calculated, there is a special sense of accomplishment.

[Pathological diagnosis experience value +0.4.] 】

The experience points that I have been looking forward to appear again.

It's just a little bit less!

Only increased by 0.4.

Under normal circumstances, clinical diagnosis, as long as the answer is correct, will increase by 1 experience point.

Why is it more than half less?