Chapter 2151
It is not a single person who makes the diagnosis, but a team, Li Lao immediately realized.
Bosses are called bosses only when there is a project team and project team leaders with funds invested.
Of course, the kind of little doctor who flatters and makes the director happy doesn't count.
Mr. Li was a little confused. The boss of the Rheumatology and Immunology Department and his subordinates clamored that if they could overturn his diagnosis, they would throw the test results on his face.
I have never seen this kind of relationship.
The scientific research fund is won by the boss. In the project team, the boss has an uncompromising position. The assistant is so arrogant? Is it to bring money into the group?
As the old saying goes, one mountain cannot accommodate two tigers. There are two bosses in a project team. Once a difficult problem is encountered, who will make the decision?
This kind of project team has also existed, but the life span is not long.
Weird, Mr. Li became more and more curious, what kind of project team is this?
The assistant, or the second boss is so arrogant.
But judging from the tone, his words were not malicious, but seemed to be joking.
It seems that a few like-minded middle-aged professor-level people are getting together to do a national-level scientific research project, Mr. Li guessed.
At this time, the director of the Department of Rheumatology and Immunology had finished talking about the values of various laboratory tests, and finally gave his own diagnosis—secondary APS.
After excluding all interferences, the firm diagnosis was secondary APS and systemic lupus erythematosus.
If there is no A4 paper in front of him, Mr. Li will applaud and applaud the wonderful inference made by the director of the Department of Rheumatology and Immunology.
The patient's condition is complicated, and he can find out the main problem among the many, which is the embodiment of the technical level of the Affiliated Hospital of Medical University.
Especially the final diagnosis, when he said it with great certainty, he didn't say those vague words at all.
But on the A4 paper, under the description of the flamboyant handwriting, Mr. Li's mood is a bit complicated.
A project team, an unknown "boss", actually determined that it was secondary APS complicated by systemic lupus erythematosus based on a small amount of inspection reports and CT images.
It's kind of magical.
[I guess the boss is not wrong. If you have not determined that it is secondary APS + systemic lupus erythematosus, then think about it and do a related examination. 】
The words on the A4 paper were as bitter and mean as ever. Although he didn't point his nose and curse, Mr. Li could vaguely see a proud middle-aged doctor saying these words with a disdainful expression on his face.
It's a pity that he is the leading professor of rheumatism immunity and has his own project team, so there is almost no possibility of recruiting him.
Old Li sighed.
The director of the endocrinology department smiled after hearing the judgment of secondary APS complicated with systemic lupus erythematosus. This is the same as my own judgment, I did a lot of checks, and finally turned my vague conjecture into reality. This complicated case really tested my level.
Hearing Mr. Li sigh, the director of the endocrinology department was taken aback. Could it be that the diagnosis was wrong?
"Old Li, what's the matter?" she asked.
"Look." Mr. Li handed over the paper he had read.
The director of the endocrinology department froze for a moment, then flipped through the A4 paper.
The acrimonious tone made her very angry, but she couldn't find any flaws in the whole text. The tone was held in her chest and she couldn't vent it, which made her very depressed.
When a doctor points to his nose and scolds his mother, he is a shrew and has no technical content. Accusing the other party of diagnosing mistakes, standing at the apex of technology, and despising everything is the kingly way.
But looking at the diagnosis and reasoning process written on the A4 paper, the director of the endocrinology department couldn't say a word.
His judgment was orderly and logical. Although there were some speculations mixed in, the doctor who wrote the condition analysis also said that this was what his boss insisted on. He hoped that if he made a wrong judgment, he could hit him in the face with a correct diagnosis.
But his diagnosis is the same as that of the director of the Department of Rheumatology and Immunology in his own hospital, why not? What to smash with!
"This patient is positive for high-titer antinuclear antibody, ACA positive, thrombocytopenia, and suspicious discoid erythema, but because the specific antibody dsDNA is negative, the possibility of SLE is considered."
"So far, the patient's diagnosis is basically clear: secondary APS, SLE is highly likely, bilateral adrenal vein thrombosis leads to adrenal hematoma, and then leads to primary adrenal insufficiency, and finally adrenal crisis."
The director of the Rheumatology and Immunology Department seemed to be reading the words written on the A4 paper. Although not a single word was good, the meaning was probably the same.
Looking at the words on the paper, Mr. Li felt an absurd illusion out of thin air.
She vaguely guessed that the technical level of that medical team was no lower than that of the Affiliated Hospital of Medical University, or even higher.
As the former director of the Department of Internal Medicine of the Affiliated Hospital of Medical University, Mrs. Li is proud of herself, and she subconsciously does not want to admit it.
It's just that the diagnostic level of rheumatic immunity is higher than that of the Affiliated Hospital of Medical University. Which hospital is it?
【Well, finally, give a treatment plan. Don't be impatient, and don't think that we are pointing fingers. The most important thing is for the patient to recover as soon as possible. Do you feel that your cervical spine is uncomfortable when you put on this big hat? 】
Seeing the teasing words, Mr. Li couldn't laugh or cry.
【Warfarin anticoagulation, target INR 2~3, and hydroxychloroquine to reduce aPI production and anti-platelet aggregation, prednisolone 40 mg Qd+ methotrexate 10 mg Qw to suppress immunity. 】
"I recommend anticoagulation with warfarin, with a target INR of 2~3. At the same time, hydroxychloroquine is added to reduce aPI production and anti-platelet aggregation, prednisolone 40 mg Qd+ methotrexate 10 mg Qw for inhibition Immunotherapy." The director of the Department of Rheumatology and Immunology finally "read" the treatment plan on the A4 paper.
If he hadn't been at least 10 meters away from this side, Mr. Li felt that he had read the treatment plan on the A4 paper without even thinking about it.
this……
The director of the endocrinology department kept staring, and also saw this passage written on the A4 paper.
Eyes see the treatment plan, ears hear the same treatment plan.
Is this a coincidence?
At the same time, Mr. Li and the director of the endocrinology department had a scene in the TV series, Zhuge Liang wrote with his palms, and Zhou Yu coincided with each other, and they looked at each other and laughed.
But... the unknown medical team on the opposite side made these judgments while lacking many necessary laboratory tests.
For the first time, Mr. Li lost his mind when he participated in the internal medicine round.
The patient with 2-8 beds received from the Department of Endocrinology will definitely be transferred to the Department of Rheumatology and Immunology. She doesn't care about this. What she recalls in her heart is the smiling face left after turning to the last page of the A4 paper and finishing all the words.
The smiling face was the exact opposite of the harsh words before, Mr. Li didn't think that someone despised the Affiliated Hospital of Medical University, and directly mocked him.
She was very curious, even a little anxious, and wanted to end the general internal medicine round as soon as possible, and went back to ask which hospital and which medical group had this level.