Chapter 370: Two Strange Minus Signs

After the rounds, Min Ling praised Liu Binsong again.

This made the junior sister feel a little embarrassed.

After everyone dispersed, she hurried to Lu Chen's side, bowed her head and whispered: "Brother, I'm sorry, I... I don't know, I can only tell you everything you told me."

Lu Chen smiled and shook his head: "It's okay, as long as you can understand what I mean by these differential diagnoses, that's fine."

"Uh... I don't understand some of them now, but I will definitely understand them in the future!" Liu Binsong clenched his fists.

"Okay, then I'll test you tomorrow!" Lu Chen said.

"Ah? Brother you..." Liu Binsong pouted.

Brother Lu Chen really asked... She was just talking casually!

...

After the rounds, Lu Chen began to give medical advice and write today's medical records.

There are many patients, and the workload has increased a lot.

But several interns are currently unable to do these jobs, so Lu Chen can only do it himself and teach them patiently.

Gu Xinyue was in another group in Area 1. There were two graduate students in their group, and the other graduate student was a senior student in the third year of graduate school.

The senior student in the third year of graduate school took several days off on the grounds of finding a job and writing a paper.

Lu Chen saw that Gu Xinyue was also very busy, and kept walking back and forth between the department and the office.

Everyone hardly rested throughout the morning.

It was almost time to get off work at noon.

The nurse came in hurriedly.

"Is the doctor in Teacher Cui's group here? Your bed 31 is uncomfortable. Go and see it!"

Teacher Cui's group happened to be Gu Xinyue's group.

Gu Xinyue immediately stood up, "I'm in Teacher Cui's group. I'll go right away!"

Teacher Cui left early last night and left early today.

Only Gu Xinyue and a few other interns were left in the group.

"Old Gu, I'll wait for you then." Lu Chen turned around and said to Gu Xinyue.

The two of them made an appointment to go to the cafeteria for lunch together at noon.

Gu Xinyue also wanted to ask Lu Chen about clinical research.

"Okay, I'll go see the patient first." After saying that, Gu Xinyue hurried out of the office.

About five minutes later, Gu Xinyue returned to the office with a frown.

When he passed by Lu Chen, he stopped and said, "Lu Chen, go eat first. This patient is more troublesome. I can't get off work for a while."

"What's wrong with the patient?" Lu Chen asked in confusion.

Most of the patients in the endocrinology department are dealing with blood sugar.

Except for a small number of patients with diabetic ketoacidosis, the conditions of other patients are relatively less urgent.

Gu Xinyue walked back to his seat and said, "A patient with diabetic ketoacidosis who was admitted yesterday had a blood sugar of 33.8mol/L when he was admitted yesterday. The blood sugar has dropped during the rounds this morning, and the random blood sugar is only about 14mol/L, but he has been complaining of abdominal distension, and the symptoms are progressively worsening. Now the distension is getting worse and worse!"

Lu Chen raised his eyebrows slightly. It's really diabetic ketoacidosis? !

The blood sugar level, which was as high as 30 points, has dropped, but the condition has worsened?

What is the reason... It's really strange?

"Does the patient have abdominal pain, nausea, vomiting and other symptoms?" Lu Chen said casually.

"No." Gu Xinyue shook her head, "Except for abdominal distension, everything else is fine. I have told the teacher on duty at noon. She will come over soon. Let's see how she handles it."

"Well, then I'll wait for you. There is no rush to eat." Lu Chen said.

He mainly wanted to see this "strange" patient.

Blood sugar has dropped, but the symptoms have worsened!

Lu Chen opened the patient's medical record.

The patient is a 59-year-old male.

He was admitted to the hospital due to "shortness of breath, chest tightness, and upper abdominal discomfort for half a day."

After drinking 500g of white wine yesterday, the patient had shortness of breath, could not lie flat, and had symptoms such as nausea and vomiting. He came to the emergency department of Jinghua Second Hospital. The blood sugar was 32.1mol/L. Considering diabetic ketoacidosis, he was admitted to the internal medicine department for hospitalization.

Past history: hypertension and diabetes for 10 years, no regular treatment, intermittent use of hypoglycemic and antihypertensive drugs.

Physical examination upon admission: body temperature 36.6℃, pulse 142 beats/min, respiration 28 times/min, blood pressure 140/80mmHg, negative auscultation of heart, lungs and abdomen.

After admission yesterday, according to the treatment principles of diabetic ketoacidosis, intravenous low-dose insulin, active fluid replacement, potassium supplementation and other treatments were given.

"The patient's blood sugar is slowly decreasing, and it is close to normal this morning." Lu Chen frowned and said, "Why did the symptoms suddenly worsen?"

At this time, the doctor on duty at noon came in, it was Lou Jie.

"Which bed is uncomfortable?" Lou Jie said at the door of the office.

"Teacher, it's bed 31 in Teacher Cui's group." Gu Xinyue immediately stood up and walked to Lou Jie's side.

"What disease does the patient have?" Lou Jie asked.

"Diabetic ketoacidosis." Gu Xinyue said.

"Okay, come with me to see the patient." Lou Jie nodded.

"Yes."

Then, Gu Xinyue and Lou Jie went to the bed.

Lu Chen was still in the office, frowning as he flipped through the patient's medical records.

He noticed that the patient had also undergone a chest and abdominal CT scan yesterday.

Lu Chen immediately clicked on the patient's CT image.

Many doctors' first reaction to seeing a CT scan is to look at the examination report.

But Lu Chen is different. He first needs to look at the CT images and then the report from the radiologist.

Otherwise, if you read the report with a conclusion, you may be influenced by other people's judgment.

"This is a small amount of pleural effusion... and a very small amount of ascites."

Although normal people also have a very small amount of pleural effusion, this person has a small amount of pleural effusion and ascites at the same time.

Lu Chen couldn't help but pay attention to it.

In addition, the patient also has fatty liver.

There were no abnormalities in the biliary system and the pelvic cavity of both kidneys.

"The patient's pancreas... seems to be a little unclear..." Lu Chen murmured.

This kind of unclear imaging makes it difficult to distinguish whether there is a lesion or the instrument is unevenly scanned.

Lu Chen glanced at the CT report.

It only reported a small amount of pleural effusion, a very small amount of ascites and fatty liver, and did not describe the pancreas.

Is there anything wrong with the pancreas?

Without seeing the patient himself, Lu Chen couldn't make a judgment.

He stood up and walked towards the ward of bed 31.

…

At this time, Lou Jie was examining the patient’s abdomen in front of the bed.

“Does it hurt here?”

The patient shook his head: “No. U Reading www.uukanshu.net ”

“Then pay attention, I’ll take my hand away in a while, and you can see if it hurts.”

“It still doesn’t hurt.” The patient still shook his head.

“The patient’s abdomen is soft, no tenderness, and no rebound pain.” Lou Jie said, “If you feel bloated, it should be because you have been lying in bed for a day or two without any activity, so your abdomen is a little bloated. Let’s observe it first, it shouldn’t be a big problem.”

At this time, Lu Chen was staring at the patient’s life value above his head.

52 (--)!

These are two minus signs!

If the patient only has diabetic ketoacidosis, hypoglycemia, fluid replacement, and blood sugar drops, the condition tends to stabilize, and the trend of this life value change should also be (+)!

Why is it two (--) now?