When a doctor opened a plug-in

When Chen Cang returned to the ward, the patient stopped convulsing. It seemed that the convulsions were paroxysmal.

Meng Xi took the medical record folder handed over by Chen Cang and turned over the laboratory test sheet and imaging result report.

Then he bent over and said to the patient: "I will do an examination for you. You lie flat and straighten your hips and knees."

Holding the upper ankle in his left hand, Meng Xi took out a pen in his pocket and used a blunt tip from the outside of the sole to quickly swipe from back to front to the base of the little finger, and then turned to the side of the big toe.

The patient's hallux dorsiflexion was seen, and the remaining four toes were fanned apart.

Chen Cang was taken aback, Babinski's disease was positive?!

The corners of Meng Xi's mouth rose slightly. Although he has not yet been diagnosed, he already has ideas in his heart.

The patient also seemed to be a little worried: "Doctor...what's wrong with me? Why did my hands and feet start to twitch?"

Meng Xi comforted: "It's okay, don't worry, I'll wait for Doctor Ge to bring the test sheet."

Meng Xi can actually draw a conclusion now, but to be on the safe side, he still has to wait for the test report to come out.

A group of graduate students, Gui Peisheng, dressed in white clothes, walked into the ward with notebooks, and wanted to see what heart disease can cause convulsions.

After coming in, they stood in a row next to the wall and let out the aisles on both sides of the bed. After all, they knew that they would not be able to help the patient if anything happened. Both sides of the bed and the aisle were C positions. , For the boss.

They just watch the boss show operation quietly!

Not long after, Ge Huai ran in with a long list of test sheets, before he could tear it apart.

"Director Meng, look, this is the laboratory test form."

Meng Xi took the test sheet, flipped through it, and relaxed, as expected.

Meng Xi asked Ge Huai: "What medicine did you use in the past two days?"

Ge Huai was taken aback for a moment: "The main use now is digitalis preparations, but also diuretics to prevent heart failure."

After hearing this, Meng Xi frowned and turned to ask: "How do you consider the treatment plan after the patient is admitted to the ward."

With Meng Xi's question in the room, the atmosphere suddenly became serious!

Ge Huai was speechless when asked by Meng Xi: “The patient’s electrocardiogram showed prolonged ST and low T waves, while echocardiography showed that the ventricular cavity was enlarged, the ventricular septum was thickened, the pulsation was reduced, and the mitral valve was closed. Insufficiency, pericardial effusion is obvious, so I think about the treatment of the heart, after all, at that time...the results of the test were not yet available."

Meng Xi didn't wait for Ge Huai to explain, and said directly: "Now the results are out, you can take a look, what are you thinking about?"

Ge Huai blushed. He had already seen clearly on the way, how could he not understand: "This should be caused by the combined effect of low calcium and base blood magnesium, which caused the excitement and contraction of myocardial fibers. Ou Lian, low calcium affects the electrophysiology of myocardial cells. Characteristics, and induced arrhythmia."

"Patients with chronic hypocalcemia should be the main cause of limb paresthesia or muscle spasms and even twitching of hands and feet."

The graduate students around suddenly realized it.

That's it!

Meng Xi didn't make any comments, and turned to look at Chen Cang: "How much blood calcium should be normal? What is the specific use?"

Chen Cang was taken aback, you forced me to pretend...

My physiology and biochemical indicators are taught by Mr. Fang Yonglin, this is the only perfect skill in me!

Chen Cang barely paused and blurted out: "Normal adult blood calcium is 2.25~2.75mmolL. Blood calcium has important functions in the human body. First, it is an important component of human bones and teeth. Second is to maintain the functions of nerves, muscles, and myocardium. It's normal, but it also participates in blood clotting in the end."

Meng Xi suddenly looked sideways, looking at Chen Cang's calm face, a little surprised.

The surrounding graduate students looked incredible. Has the boss rehearsed in advance?

It must be!

Since the shift today, you have pretended to be forced three times.

There are only three things...You are a bit too much in this way?

You seem to be stupid like this group of graduate students...

You definitely memorized the information, or you rehearsed it in advance, today the cliff is an act.

The students were a little bit tearful, do you feel that you are not at all in our pretense?

How much can I remember for normal blood calcium?We are still carrying the blood routine, have you all started to carry the electric ion?

Back index is one of the basic qualities necessary for clinical medical students. In the emergency department, you should know some common laboratory tests thoroughly.

Meng Xi handed the test sheet to Chen Cang: "Then look at what information you can get through the test sheet."

Chen Cang took the test sheet and read it at random, then he frowned slightly!

This may not be a simple heart attack.

Chen Cang raised his head slightly: "Mr. Meng, this may be a parathyroid heart disease!"

When he heard these words, Meng Xi couldn't help but stop.

The surrounding group of students looked at each other at a loss, their eyes exchanged quickly!

"What is this?"

"Don't look at me, I don't know anything about this!"

"I know the parathyroid glands and I know the heart disease. Why don't I know if they are piled together?"

"Look at me, look at me and I can meet?"

After watching for a long time, everyone reached a final consensus!

This guy has to install a big ratio!

It is a circle bigger than the first three combined!

Are some of our graduate students really going to be hit by a small undergraduate’s promotion???

Thinking of this, everyone felt cold on the lonely sandbar...

When Ge Huai heard what Chen Cang said, he suddenly recalled this term!

A very rare disease!

He hesitated for a while, and then quickly took the test sheet, took a closer look, pondered for a moment, and thought of all the patient's performance, the more you look, the clearer, the more you look, the more frightened!

Finally realized it!

Yes indeed!

Why didn't I think of it?

This kid is amazing!

And Chen Cang was a little stunned. He found that no one paid any attention to him. Does Chen Cang think he lacked the audience?

Shouldn't you be a little skeptical?

I'm so pretending, I have to give me a slapstick.

After waiting for a few seconds, Chen Cang was a little disappointed when no one was speaking.

This time acting forcefully, five points...failed!

However, Chen Cang still feels that he should finish the sentence: "Patients may have idiopathic hypoparathyroidism. This disease is rare, but it is mostly sporadic and is related to immunity. It can be clearly seen through laboratory indicators. It is found that although the proportion of lymphocytes in the patient is normal, this proportion is very similar to that of patients with idiopathic parathyroid lymphocytes."

"The patient's blood calcium is only 1.9, blood phosphorus rises to 1.59, and serum immunologically active parathyroid hormone is basically undetectable."

"The decrease in the patient's PTH can affect myocardial contractility. As Teacher Ge said, hypocalcemia and hypomagnesemia affect the contraction of myocardial fibers, so I guess it is hypoparathyroidism."

"And when the calcium is low, the excretion of sodium ions is reduced, and the retention of water and sodium can increase the load on the heart, and the patient's own new functions are incomplete, so...it seems that there is no problem with teacher Ge's treatment."

"But if you add some calcium supplements, such as oral vitamin D3, or Rogai calcitriol capsules, the effect may be better, and even heart failure may be relieved!"

After Chen Cang said these words smoothly in one breath, he couldn't help but sigh. It would be meaningless to pretend that he didn't slap his face...

Chen Cang's voice just fell!

The applause came from outside the door.

"Good! Good! Good!"

I saw Xia Gaofeng walking in from the outside with excitement on his face, with joy and happiness in his eyes. He is really an amazing talent, and he is really a hard-earned BMW!

To be honest, Xia Gaofeng hasn't met such a spiritually capable student for a long time.

This is not an exaggeration.

First of all, he has strong hands-on ability and good suture skills. Now, the analysis of diseases, especially the analysis of physiological and biochemical indicators, can be said to be extremely detailed.

A comprehensive analysis of these abilities can reveal a person's clinical thinking and surgical talent!

Thinking of this, Xia Gaofeng looked at Chen Cang with satisfaction: "Yes! The analysis makes sense!"

In the realm of Xia Gaofeng, many diseases are clear at a glance, and there are too many to see. The rare disease of hypoparathyroidism is not too rare for him.

But for Ge Huai, it may indeed be very rare.

What are you afraid of?

I am afraid of synthesis!

Once a group of diseases are piled together, it is difficult to prepare to distinguish the true disease of the patient.

However, Chen Cang was able to analyze hypoparathyroidism heart disease in the laboratory test sheet of the heart surgery.

It is really precious!

Hey……

It hurts to think that such students are not their own!