When a doctor opened a plug-in

However, early the next morning, Chen Cang was woken up by the phone.

"Professor Chen, a patient transferred from the First Hospital of East University, the main manifestation is gasping, and after a long time, the limbs and perioral area will become numb, and there will even be tetany, or... come and see?"

The caller was Wu Hui, the doctor on duty in the emergency department. He didn't really want to find Chen Cang, but the director of the neurology department of the First Hospital of Dongda and the director of the neurosurgery department of the Second Provincial Hospital are now at a loss and don't know the reason.

Chen Cang hummed: "Well, I'll pass right away!"

At this time, the sky was still just bright, and there were not many pedestrians on the road.

After Chen Cang arrived at the hospital, he walked directly to the intensive care unit.

Seeing Chen Cang coming, everyone nodded and avoided.

"Dr Chen early!"

"Hello, Director Chen!"

It’s late in winter, and it’s actually past six now.

Looking at the several directors who had gathered together, Chen Cang nodded slightly to everyone.

"Dear directors, you have worked hard." Chen Cang nodded and thanked.

Everyone waved their hands one after another, their eyebrows tightened without loosening them.

"What is the situation of the patient?" Chen Cang asked.

Here, He Caiyun, director of the Neurology Department of the First Hospital of Dongda University, said: “This patient is an old patient in our department. He went back and forth four or five times last year, but he also had a rest for a while. Unexpectedly, a few days ago After receiving hospitalization, the situation suddenly worsened!"

"It's mainly panting. After a long period of breath, the extremities and the periphery of the mouth will become numb, and there will even be tetany, and there are some mental disorders!

The main diagnosis is: hyperventilation syndrome, alkalescence combined with acid replacement, hysteria waiting to be discharged."

"However, today I suddenly found that my eyes have lost the sense of light, the pupils are dilated to the side, and the reflection of light has disappeared!"

"We can't check the reason there, so we can only send it quickly!" He Caiyun said with lingering fear.

She came to the hospital at three o'clock in the morning this morning.

The patient tossed for more than two hours, but the situation got worse.

Seeing that the pupils are going to be dilated, there is no way for emergency and intensive care!

It was here that they rushed to the emergency department of the Second Provincial Hospital.

Chen Cang nodded and looked at the patient carefully. The woman was probably only in her forties. He said to Wu Hui: "Tell me about the patient's examination results."

Wu Hui nodded.

"Patient examination results: blood gas is reduced in carbon dioxide partial pressure, bicarbonate is lowered, and anion gap is increased."

The result of this check is a bit strange.

However, it is very consistent with the patient's performance.

"Are there any primitive diseases?" Chen Cang asked.

He Caiyun shook his head: "No, this is an old patient. I have been hospitalized several times. I have checked everything that can be checked, but nothing can be found!"

"Respiratory alkalosis combined with metabolic acidosis?" Chen Cang frowned directly, "This is not common!"

The two old directors, He Caiyun and Du Juanhong, also nodded.

"Have you seen the ophthalmologist?" Chen Cang asked.

"Checked! But...

After the ophthalmology consultation, the ophthalmologist in the consultation checked the fundus and intraocular pressure and found no problems!

Therefore, there is no way to confirm the diagnosis.

However, it is not without gain, at least the common causes of blindness such as glaucoma and uveitis have been ruled out."

This may be a blessing in misfortune.

"Is it optic neuritis or NMOSD? But sudden blindness in both eyes is more like vascular disease."

"Is it bilateral occipital infarction?"

"It should not be. If it is occipital lobe infarction, wouldn't it cause the pupils to disappear from light reflection?"

Several directors Du Juanhong and He Caiyun also began to discuss.

The patient's condition is really rare.

This kind of dilated pupils due to respiratory alkalosis has hardly heard of it!

However, the patient itself is a respiratory alkalosis!

There is almost no meaning in terms of diagnosis.

If you push down according to this diagnosis...

The only thing that is difficult to explain is the problem of neurology.

When several people are discussing.

Chen Cang also began to organize his thoughts.

There are many diseases of occipital cortex blindness, such as adrenal leukodystrophy and the apex of the basilar artery. Although the pupil's light reflection disappears, this situation basically does not occur!

Occipital lobe lesions can basically be excluded.

However, there are too many clinically unexpected and unexplainable situations.

So, hastily made another nuclear magnetic field!

The result of the film shows that the patient's condition is too normal!

All of a sudden, it really bothered everyone.

This does not seem to be a change in the nervous system.

Is it a disease of the optic nerve?

After some tossing, from 5 am to 10 am, there was still no result.

Outside, the patient's family members have completely panicked!

Even the conscious patients began to be afraid.

Two eyes can't see anything, so it's easy to make people anxious.

At this time, the ophthalmologist suddenly said: "Or, give hormones first!"

Compared with saving eyesight, the side effects of hormones are not taken into account.

After all, there is nothing to do now.

Chen Cang has no choice.

After all, the imaging data is normal, and the examination data is a metabolic acidosis in the late stage of respiratory alkalosis.

Chen Cang went over and over again, looking over all the patient's previous medical records.

At this moment, a voice suddenly rang behind Chen Cang.

"Did you ask about the patient's occupation?"

A word!

Chen Cang was taken aback.

It seems to be called by someone!

Then, the whole brain suddenly became unblocked.

But what surprised him even more was that the old man behind him was not someone else!

It is Mr. Zhong!

Chen Cang quickly got up and asked in surprise: "Mr. Zhong, are you here?"

The old man smiled slightly: "I'm here to apply."

"But I'll talk about it later."

"There is another thing, why did you not ask about the patient's occupation when you diagnosed."

Chen Cang blushed immediately!

For a long time, Chen Cang has been so smooth, and made him overlook many details!

"For consultation, you can't pull it down!"

"This patient, the diagnosis is correct, is still respiratory alkalosis, and also has metabolic acidosis!"

"But you confused the order. The patient is not the so-called hyperventilation syndrome. His wheezing is not the cause, but the result!"

"Patients are hyperventilation caused by acid replacement. Acid replacement is the cause, and the alkalescence is the result. The essence is acidosis!"

"Think about it, why don't you ask about the patient's occupation?"

When Chen Cang was said by Mr. Zhong, the answer in his mind was ready to come out!

Chen Cang is very proficient in poisoning!

It can cause metabolic acidosis, respiratory alkalosis, combined with toxic blindness...

Obviously: methanol!

And what is the patient's occupation?

This is especially important!

He looked at Mr. Zhong, Chen Cang blushed: "I'm sorry, I was wrong!"

...

ps: Thanks to the leader "Man Jue" for the 50000 reward, thank you.

Today, Zhongyuan Festival, according to the custom of my hometown, I went to my hometown to burn the paper. I came back later, sorry, I will make up tomorrow.