Chapter 412 The man has stretch marks!

"Xu...doctor?"

He Hai realized what Xu Qiu was going to say, paused, and moved the microphone.

Xu Qiu looked at Hou Ning calmly and said, "What is the name of this school girl you are talking about?"

"Chen Qiao."

Sure enough it was her.

He Hai and others were also extremely surprised.

It turned out to be Chen Qiao, the intern who followed Xu Qiu before?

The other party has indeed been admitted to the Union Medical College graduate school, but it has only been a short time, just over half a year after enrolling, and he has already been favored by the instructor?

"Are you Xu Qiu?"

Hou Ning stood up, with a hint of jealousy in her eyes.

He graduated with a master's degree this year and is exactly twenty-five years old, the same age as Xu Qiu.

In Xiehe, his ability is also unique, and he has long been qualified to independently lead junior doctors.

It was he who brought Chen Qiao.

During the operation, everyone else said, "My senior is so awesome" and "My senior brother is so awesome." Only the pretty Chen Qiao looked absent-minded and blurted out, "If it were Teacher Xu, this surgery should be able to reduce the patient's body by one-third." Bleeding”.

That’s outrageous!

With his surgical ability, the bleeding is already very small, how can it be even less?

At the moment, after confronting Xu Qiu face to face, Hou Ning did not feel inferior.

He is not a candidate, so he is equal to Xu Qiu.

"Second place, what do you want to do?"

At this time, seeing Hou Ning planning to cause trouble for Xu Qiu, Yang Yuen couldn't sit still.

Hou Ning was stunned, and anger appeared on his face: "It's just a written test."

He Hai couldn't stand it anymore and planned to drive Hou Ning out.

But Xu Qiu waved her hand and said, "You can continue to take the assessment."

As he spoke, the first case he prepared appeared on the screen.

"This patient was transferred to other hospitals for three months. After I admitted him, I did two examinations and confirmed the diagnosis directly."

The applicants quickly looked over.

"Male, 16 years old, complaining of depression, restlessness, and delusions. He was diagnosed with schizophrenia and obsessive-compulsive disorder in a psychiatric hospital and was given clozapine, paliperidone, fluvoxamine, lorazepam, and diphenhydramine. Symptoms were relieved after retrieval.

He was discharged from the hospital a week later, but within a few days he relapsed.

Aripiprazole was given and the patient was discharged from the hospital for the second time.

But, something happened again a week later.

This time the boy's symptoms were more severe, and he had symptoms of fear that he had never experienced before. His emotions were on the verge of collapse, and he seemed to be a different person.

In addition, there are symptoms such as nausea and vomiting.

After being hospitalized and discharged repeatedly, he also lost more than 40 pounds, and purple strips similar to stretch marks appeared on his body..."

Just checking the medical history took five minutes.

The more Hou Ning looked, the more silent she became.

Psychiatry, brain surgery, and various systemic symptoms all appeared in the boy. It was like a hodgepodge. Xu Qiu only did two examinations?

Can it be diagnosed at a glance?

how could it be possible!

The others also looked confused.

This patient is so weird.

Just looking at the cases is confusing and complicated, and no useful information can be summarized at all.

"Let's start, let's express our opinions." He Haidao.

Everyone immediately started discussing.

Those who can make it into the top 100 are basically elites. Even if they don't have any clue about this disease, they can still talk a few correct nonsense casually.

Hou Ning put down the medical records and spoke immediately: "If there are no results for three months, then we must check the electroencephalogram, magnetic resonance and blood inflammation indicators to evaluate the possibility of autoimmune encephalitis, and do another voltage test. Gated Potassium Channel Antibody Test!”

The rest agreed.

"Yes, I took a look and found that the patient has taken four antipsychotic drugs and has been switched to multiple antidepressants, but the symptoms are still getting worse. Autoimmune encephalitis should be considered."

"What the doctors at the hospital did before was completely wrong. The antipsychotic drugs were not effective, but they did not stop taking them. Instead, they thought it was because of the dose and the effect of the drugs. At this time, it was time to consider the wrong direction of diagnosis."

A man wearing glasses shook his head: "You are wrong. From the perspective of a psychiatrist, mental illness itself lacks independence. Moreover, the therapeutic effect of drugs on mental symptoms is limited. Without adjusting the dosage of the drugs, or It is impossible to directly suspect that the diagnosis is wrong when switching to third-line drugs.”

He Hai and others nodded.

The bespectacled man has extensive clinical experience.

In my heart, I silently gave him a few points.

Yang Yuen said: "There is no need to consider autoimmune encephalitis, it is meaningless."

Hou Ning and others looked at Yang Yuen in surprise.

Are you kidding me?

Yang Yuen showed no signs of weakness, raised his chin and said: "Look carefully at the medical records.

The patient had previously undergone lumbar puncture and cerebrospinal fluid examination, and no indicators related to autoimmune encephalitis were found! "

Hou Ning looked away: "It may be an infection that is not obvious."

"Do you think his mental symptoms were all misdiagnosed? Are they all caused by encephalitis?"

"If medication doesn't work, then it's time to consider other directions."

"I think……"

During the heated debate, Yang Yuen finally said: "The key lies in the patient's sudden weight loss and stretch marks!"

"Stretch marks?"

"Yes, stretch marks are caused by fat growing too fast and fibers being expanded and broken. Skin biopsy must be given priority."

Hou Ning does not agree with this statement.

Is it really meaningful to check for a small skin mark on the thigh instead of checking for more obvious and serious encephalitis symptoms?

But just then, the ending bell of jingle bell rang.

He Hai stood up and pointed out several people: "Yang Yuen, Lei Hu..."

Hou Ning flipped through the medical records indifferently: "Why didn't you point me? Although I didn't apply for the job, you didn't skip my name directly."

He Hai laughed coldly: "You didn't pass the interview."

"What do you mean?" Hou Ning paused.

He Hai said: "The diagnosis direction is completely wrong, ignoring the most important details. You just took the old path taken by other hospitals in the past three months. According to your judgment, I'm afraid the patient is still regarded as a mental patient!"

Hou Ning couldn't accept it.

He pointed at Yang Yuen: "She is right? The symptoms of encephalitis are so obvious, and she went to see stretch marks?"

He Hai pressed the page turning pen.

The examination that Xu Qiu did at that time appeared on the next page.

"Skin biopsy."

"Sequencing report of blood sample."

The final result followed.

"The skin lesions are consistent with the infiltration of lymphocytes."

"The nucleic acid sequence of Bartonella was found in the patient's blood sample, and further sequencing confirmed that it was Bartonella henselae."

...

Hou Ning looked at the report, his face full of astonishment.

Was his diagnosis really completely wrong?