Chapter 196 Completely different judgments, Xu Qiu's clinical thinking!
This... can't be diphtheria.
Diphtheria is a severe infectious disease that almost only exists in textbooks. It is extremely contagious and has an extremely high mortality rate. It is much more terrible than gas gangrene.
No matter whether it is Linhai City or the hospital in Tiandu, no diphtheria patient has been reported in the past ten years.
If this person has diphtheria, it can be regarded as a "living fossil of disease"...
In the clinic, Chen Qiao seemed to have returned to Clinic No. 7 of Linhai No. 1 Hospital.
Hearing that Xu Qiu was going to have a physical examination, she quickly made the bed and prepared the examination equipment.
See, touch and hear.
After a set of procedures, Xu Qiu also obtained the patient's physical condition.
His guess was correct, the patient had indeed undergone surgery on his waist!
There was a fresh seam in Wang San's fourth lumbar vertebra.
The lumbar vertebrae of normal people are connected by intervertebral discs, with the anterior longitudinal ligament in front and the posterior longitudinal ligament behind the vertebral body. The vertebral body has three bulges.
And Wang San's lumbar spine was depressed a little.
Apparently a bone had been removed.
also.
The patient had enlarged liver and spleen, enlarged lymph nodes on one side of his body, and his skin showed an unhealthy waxy yellow color.
Abnormal liver function was presumed.
Xu Qiu first rejected the theory of diphtheria.
If it was diphtheria, not to mention that the organizers would not let him out as a test question.
Moreover, in addition to the symptoms currently exhibited by patients with pharyngeal diphtheria, there are also many cases of myocarditis and peripheral nerve paralysis.
But upon closer inspection, it was discovered that the patient's heart had no murmur.
Of course there is a more important indicator.
odor!
Diphtheria is often accompanied by severe ulcers that give off a putrid smell of necrosis.
However, Xu Qiu did not smell this smell - for him, who has a master's experience in identifying smells, he can rule out diphtheria almost instantly.
Xu Qiu asked about the past medical history.
"Time is up."
At this time, the examiner's voice sounded.
There was suspicion in his eyes.
This genius's diagnostic process is somewhat unconventional...
Completely different from the director of Xiehe, and also different from the previous six groups.
Is this really a skill, or is it just a random diagnosis?
…
After Xu Qiu and others left, many people looked over, wanting to see something on Xu Qiu's face.
However,
Xu Qiu's expression remained unchanged, and she calmly returned to her position, seemingly unaffected.
Everyone else was a little confused.
He is really handsome, but he is also really pretending!
On the other side, examiner Lu Dandan came over with answer sheets.
It contains preliminary diagnosis, further examination, etc.
There are three options for initial diagnosis.
The inspection can also open three.
Lu Dandan said in a low voice: "Each team will have ten minutes to answer questions after asking about the medical history. The teams can discuss with each other. I will collect the answers after ten minutes. Remember, the answers in each round will be based on the discussion with the director of Xiehe. Judge the similarity of the processes and give a score!”
Xu Qiu nodded.
After Lu Dandan left, everyone started discussing.
Li Xue asked: "Here, do you want to rule out diphtheria first?"
Yunmei thought for a moment and said: "It must be ruled out. Although it is impossible for patients with diphtheria to be sent to us for diagnosis, but - we have to treat this as a real consultation!"
In this assessment, points are awarded based on whether they match the judgment order given by the Director of Union Medical College.
When Wang San went to see a doctor, Director Xiehe didn't know whether he had diphtheria.
therefore,
They should rule out diphtheria first before considering other diseases.
In other words, even if they know that this is not diphtheria, the first step of Director Xiehe is likely to be diphtheria. In order to score points, they have to forget that this is an exam and treat this as a real consultation!
Qin Qiyin said: "Furthermore, there was an incision on the waist. Maybe the bacteria infected the bones there, so the operation was performed to remove it."
Everyone looked at Wang Fan, it was his turn to speak.
Wang Fan smiled and moved next to Xu Qiu, "I support Brother Xu's judgment!"
Li Xue and others' eyes returned to Xu Qiu.
Yes, their participating team is not just about the relationship between the captain and the members.
The people present were basically Xu Qiu's little fans. In a sense, they completely obeyed Xu Qiu's arrangements!
Even if the opinions are completely different.
"It's not diphtheria."
Xu Qiu's plain words directly shattered the most likely guess.
Everyone looked puzzled.
Xu Qiu explained: "The taste is wrong."
"..."
Li Xue and others were silent.
Can diphtheria still smell?
Without taking a throat swab or checking for hematuria, how can we possibly judge!
If someone else said this, Li Xue and Yunmei would probably curse.
However, facing Xu Qiu, they began to doubt themselves.
Why could Xu Qiu smell it, but they didn't notice it at all? Was he still too good?
"I think so too!" Wang Fan quickly agreed.
Li Xue glared at him.
Your mother...
If Dr. Xu wants to say that this is another Trichomonas vaginalis infection, you have to shout awesome!
"Hush~ Doctor Xu, what tests are you going to do next?" Everyone rolled their eyes at Wang Fan and turned to look at Xu Qiushi, their eyes filled with anticipation.
"First do a lung CT, as well as routine blood tests and serology tests."
If you can find Xiehe, it will definitely not be a common bacterial or fungal infection.
Combined with the other party's high fever and the severity of the throat invasion, I am afraid that this bacteria is also very deadly.
Of course, there is another blood disease that can cause the above symptoms.
Leukemia!
In addition, the patient's physical condition is very poor, his skin is extremely bad, his body hair is little, his mood is very unstable, and some bones are slightly swollen and painful - could there be endocrine disorders or immune system diseases?
After thinking for a long time, Xu Qiu asked Li Xue to finish the preliminary judgment.
"1. Conditionally pathogenic bacteria or fungal infections."
This is a judgment made considering the patient's low immunity.
This kind of patient is most likely to suffer from conditionally pathogenic bacteria, that is, they do not attack normally, but will emerge when the immune system decreases and cause diseases.
"2. Leukemia."
"3. Immune system diseases."
The examinations done, "1. Lung CT; 2. Serological alanine aminotransferase test; 3. Blood routine."
...
Three hours later, the last group also completed the consultation, and after waiting for another ten minutes, they also completed the submission of the papers.
Twenty-three answer sheets fell in front of the chief examiner.
The papers and answers were only known by the chief examiner and Qiu Qingwen.
"Director Qiu, start grading." The chief examiner said.
"Okay."
The two began to mark the papers.
The answer from the director of Union Hospital was, "1. Diphtheria; 2. Tuberculosis infection; 3. Conditional pathogens"
The tests to be done were bacteriological smears, bacterial culture, and blood and urine routine tests.
Qiu Qingwen marked a few papers and nodded with satisfaction: "Not bad."
The examiner was also a little surprised, "It's very good, basically all the judgments are based on diphtheria and tuberculosis - this is a free point question, after all, judging from the performance, it looks very much like diphtheria, and it can't be ruled out without an examination!"
However, when the examiner saw a new test paper, his brows immediately wrinkled into a rope.
