Chapter 2150 If I Am Wrong, You Must Tell Me

"Old Li, what's the matter?"

"No, the rounds are about to start." Mr. Li asked in a low voice, looking at the words on the A4 paper.

"Well, there's still a minute."

There are very strict rules for internal medicine rounds, and you must start when the time comes, and there is no saying that you are late.

When the gate closes, no one can enter. If you really miss it, then wait to go back and be scolded by the director for 4 hours.

Soon, the rounds began, and Dr. Wang from the Department of Endocrinology began to introduce the condition.

While listening to the medical briefing, Mr. Li looked at the words on the A4 paper. The person who writes should have some understanding of the patient's condition, and it is very detailed.

The test items listed on the problematic test sheet are almost the same as the pre-hospital medical history reported by Dr. Wang.

It's a bit interesting, Mr. Li thinks the patient's family is very caring. The doctor who went to consult is probably an experienced old doctor, and he couldn't make a mistake by omitting what should be omitted between the lines, and what should be detailed.

It was just a pre-hospital condition analysis, and a feeling of cherishing talent rose in Mr. Li's heart.

This is talent. It would be a pity if you spend half your life in a small hospital and attribute all your talents to mediocrity.

Let's wait and see, if his final diagnosis can be close, I might as well ask the doctor what he thinks.

If he is really a good young talent, he can give him a chance himself.

Thinking to himself, Mr. Li turned to the second page.

[The CT before admission showed that the bilateral adrenal glands had solid space-occupying. I think the level of the Affiliated Hospital of Medical University should not be so low. The patient was really sent to the Department of Urology for surgery. 】

this child.

Mr. Li helped the holding mirror, and after seeing this sentence, he was not angry, but showed a knowing smile.

She looked at the CT, and it did look like a real placeholder. If it is a doctor in a small hospital, it may be considered a malignant tumor. But after she read it, she thought it was a hematoma. The 64-slice CT enhancement that came back later also confirmed this.

This child still has talent, but watching movies is not that simple. It's just that the tone of voice is a little sharp, and it's still less polished.

[I guess the augmentation has been done, it is judged that there is no blood supply, and the diagnosis is a hematoma. If you have already made a clear judgment, you can ignore this paragraph. 】

If you want to take advantage of it, first rub its edge. Old Li thought leisurely that this kid still doesn't know how many masters there are in the world, and he thinks that his little ability is great.

If it was my student, maybe I would have to scold him for a period of time, to wear off the arrogance on my body first.

Thinking of this, Mr. Li smiled awkwardly. I'm not that kind of person, and I pretend to be stern, but it's hard to scare people.

But there are many ways to wear down your temper, and it doesn't have to be training.

[Combined with skin pigmentation, decreased cortisol, increased ACTH, decreased aldosterone, increased renin levels, and decreased androgen levels, the diagnosis of primary adrenal insufficiency is clear. 】

Well, that statement is true.

[Have you already done the differential diagnosis? If you haven't done it, don't do it. It's an immune system disease. It's too late to ask me for rheumatism immune consultation. 】

Oh, it turned out to be a doctor from the Department of Rheumatology and Immunology, Mr. Li thought to himself.

Generally, doctors with high levels of rheumatology and immunology are responsible for dealing with various difficult and miscellaneous diseases. It is inevitable that they will have a sense of arrogance in their hearts, thinking that other people will not see a doctor.

Is it a rheumatic immune disease? I thought about it myself, let's see what he said first.

However, Mr. Li was not in a hurry, but stopped his gaze here and listened carefully to the consultation opinions of other departments.

Differential diagnosis of adrenal tuberculosis, fungal infection, solid tumor, etc., one by one, is methodical. Mr. Li is still very satisfied with the doctors he has trained.

It is well-founded and methodical, just like solving a mathematical problem.

Finally, Dr. Wang expressed his opinion and suggested a consultation with the Department of Rheumatology and Immunology.

"Thrombophilia is a type of disease that is prone to thromboembolism due to genetic defects such as anticoagulant proteins and fibrinolytic proteins, or the presence of acquired risk factors for thrombosis." The director of the Department of Rheumatology and Immunology sat on the seat, flipping He began to speak with the medical record.

"Acquired thrombophilia, also known as acquired hypercoagulable state, causes include antiphospholipid syndrome, pregnancy or oral contraceptives, perioperative and traumatic obesity, neoplastic disease, diabetes mellitus, paroxysmal nocturnal hemoglobinuria, and renal disease syndrome, antiphospholipid syndrome is the most common."

"Combined with the patient's medical history, antiphospholipid syndrome should be considered first clinically."

Well, just as he thought, Mr. Li turned the A4 paper in his hand to the next page, ready to see if the rheumatologist and immunologist from another hospital had also made a correct diagnosis.

[APS, it is estimated that the technical strength of the Affiliated Hospital of Medical University will not miss this place. Although the patient had a history of oral contraceptive use and a history of multiple miscarriages, this was only a trigger for exacerbated APS. 】

The little guy was very interesting, and Mr. Li became more and more interested.

Next, some laboratory tests were displayed on the A4 paper, some of which he knew, and some of which had not been released when he wrote this information.

The inspection results that did not come out were analyzed according to whether there were problems or no problems.

[Now, are you sure it is primary APS or secondary APS? 】

Mr. Li looked at this passage with great interest, and the director of the Rheumatology and Immunology Department also began to say this after analyzing the inspection report.

[It's secondary, don't think too hard about it. 】

It's too arrogant. Although the analysis is well-founded, Mr. Li still made a judgment for the person who wrote this material.

[Judging according to the 2006 Sydney APS classification standard, the time is very long, and the patient cannot survive that long. 】

Mr. Li looked at the words written on the paper, and listened to the words of the director of the rheumatology and immunology department.

"This patient has thrombocytopenia, splenic vein, renal vein, bilateral adrenal vein thrombosis, lupus anticoagulant factor test positive, anticardiolipin antibody > 120 RU/ml."

The guesses on the paper were basically correct. He hadn’t reported back when he obtained the data of the lupus anticoagulant factor test. Can it be right just by guessing? Mr. Li was a little puzzled, but he felt that this child was a little unstable.

[Are you wondering how I guessed right? 】

Whether it is forward or reverse, there must always be an objective basis. The words on one page disappeared, and Mr. Li turned to the next page.

It's really unbearable to break here!

[Actually, I am not sure, but the boss said that judging from the video data, it can show that it is secondary APS. For this, we argued for 5 minutes, and I couldn't convince him. If your final inspection results can prove that the boss's statement is wrong, you must tell me, and I will throw the inspection results in his face. 】

Well……

Old Li was taken aback.