Chapter 2347 Hypomagnesemia without Low Magnesium Ions

"Surely not, do you know what chatting is?" Su Yun looked at Zheng Ren with contempt.

"Boss Zheng, what kind of illness do you think?" Dr. Liang asked hastily.

"Just from your symptoms, I don't have any judgment yet." Zheng Ren said, "You can bring the old lady to me for a quick check-up later."

"Yes." Dr. Liang nodded.

Chinese medicine talks about seeing, hearing, asking, and Western medicine talks about seeing, touching, tapping, and listening. These are the most basic.

Su Yun went through the test sheet again, and saw that Dr. Liang had done a comprehensive examination on his mother, so there was really nothing to say.

Except for a small problem with the ECG, everything else is normal, including the EEG, and the spikes are not obvious. It is impossible to diagnose any mental illness, let alone epilepsy.

Dr. Liang left the inspection report, greeted him, and hurried to pick up the old man. After he left, Su Yun asked: "Boss, do you really have no guesses?"

"The only abnormality is the electrocardiogram." Zheng Ren took out the electrocardiogram, looked at it twice, and said, "PR and QT interval are prolonged, QRS wave is widened, ST segment is decreased, and T wave is widened. You will notice these changes. Remember what?"

"Not only these, there are a few waveforms where the voltage of the P wave and QRS complex can be seen to decrease. Looking at the waveform, it must be hypomagnesemia. The standard is like a panda wanting to eat bamboo." Su Yun said, Picking up the ion test report, "But you see, the blood magnesium is normal."

"Pandas are carnivores..." Lin Yuan whispered.

"I don't know yet?" Su Yun glared at her and said, "How do you explain this?"

The following words were already spoken to Zheng Ren.

"Serum magnesium is normal, but it still cannot be judged that there is no shortage of magnesium ions. Because serum magnesium is greatly affected by changes in pH, protein, and other factors, a single ion detection can't explain anything." Zheng Rendao.

Su Yun shrugged, "Your statement is a bit blunt."

"Look at the patient, and some hypokalemia will also show existing symptoms."

"Can you die if you don't talk nonsense?" Su Yun said, "The key to diagnosing hypokalemia is to identify the U wave. The general rule is that with the gradual aggravation of hypokalemia, the T wave gradually decreases, the U wave increases, and the U wave appears. The number of leads increases, the U wave is equal to or higher than the T wave in the same lead, showing a hump shape, T-U fusion cannot be distinguished, and the ST segment moves down."

Zheng Ren didn't argue with Su Yun, because he had too little information. The current debate belongs to the kind of situation where no one can convince anyone.

Soon, Dr. Liang brought his mother over. Zheng Ren saw a medium red system panel, and the diagnosis was clear—hypomagnesemia.

"Auntie, what's wrong with you?" Zheng Ren smiled and began to ask about the medical history.

Although there was a diagnosis given by a big pig's hooves, Zheng Ren still asked from the beginning, detailing everything, so detailed that Lin Yuan felt a little long-winded.

The positive medical history described by the patient himself was only paroxysmal foot cramps, and nothing else.

After Zheng Ren finished asking, he said to Dr. Liang, "Liang Zi, you take Auntie to do a magnesium load test."

Dr. Liang was taken aback for a moment, and asked, "Boss Zheng, do you think it's hypomagnesemia?"

"Well, the spasm of the wrist and foot, the changes in the electrocardiogram, and the slight tremors in your mother's eyes during the speech, the slight hyperreflexia during the physical examination, and neuromuscular tremors. These are considered to be hypomagnesemia, Although serum ion tests are normal, the disease cannot be ruled out."

"Okay." Dr. Liang took his old lady for an examination.

"Boss, it looks quite similar now." After checking the body, Su Yun did not express any objection, he thought deeply, "But how did it come about?"

Zheng Ren was also thinking about this issue.

Lin Yuan didn't keep up with Boss Zheng and Su Yun's thinking rhythm. In her opinion, only a slightly abnormal ECG, physical examination, and medical history can give a clear diagnosis-hypomagnesemia, which is amazing enough up.

As for how it came about... I'd better figure out how to diagnose it first.

"First, consider that there is too much loss in the digestive tract." Su Yun held the mobile phone in his hand, chatting with people, and said with one mind, "Because magnesium is absorbed in the small intestine and part of the colon, when severe diarrhea, Steatorrhea, malabsorption, intestinal fistula, and post-subtotal small bowel resection can all lead to hypomagnesemia."

"Well, I just asked, and I haven't had surgery. Normal people shouldn't have the problem of magnesium ion absorption disorders, and this can be ruled out." Zheng Ren sat on the chair, narrowed his eyes, and was also thinking about Dr. Liang's mother's condition.

"Secondly, the kidneys lose too much. Chronic pyelonephritis, renal tubular acidosis, acute renal failure with polyuria, or long-term use of loop diuretics, thiazides, and osmotic diuretics cause renal loss of magnesium to cause low magnesium levels. Magnesemia."

"I just asked, but no." Zheng Ren said, "I don't think it's a kidney problem."

"Loss is basically taken into consideration, and the next step is the possibility of insufficient supplementation and insufficient intake." Su Yundao, "I think this is the most important point."

"But I asked just now, and Dr. Liang didn't find any problems with the diet at home. A while ago, I read a report saying that vegans are prone to hypomagnesemia. The old lady eats meat, so it shouldn't happen. "

"Where's the drinking water?"

"Generally, there will be no problems." Zheng Ren shook his head, "Trace elements are minerals that make up 0.01% of the body weight in a region, mainly including nine kinds of iron, zinc, copper, manganese, selenium, iodine, fluorine, cobalt, and magnesium. These elements cannot be synthesized by the human body and must be obtained from food."

"The human body can only absorb trace elements in an organic state, and can hardly absorb trace elements in an inorganic state. Most trace elements in water are in an inorganic state, and the content is very small."

"It has nothing to do with drinking water. People generally get trace elements from plants and animals."

"Boss, have you read a book? "Healthy Water" by American Dr. Martin Fox." Su Yun dragged the topic away again.

Zheng Ren shook his head.

"The book says that the standard of healthy water is to have a certain amount of hardness, the ideal value is around 170mg/L, and a certain amount of total dissolved solids..."

"Don't talk about that, how did hypomagnesemia come about? This disease is rare." Zheng Ren brought the topic back and continued to ask.

"There must be a medical history that I didn't ask clearly. Boss, your clinical level is very poor. Xiao Linzi, I sent you to ask, and you have to ask clearly." Su Yun said with a smile.

Lin Yuan thoughtfully did not move, nor did he speak much.

The medical history inquired by Boss Zheng just now is very complete, and I don't know what to add.

And ask about the medical history? The patient with patent foramen ovale and migraine was still vivid in his memory last time, but Lin Yuan was unwilling to experience it again.