The reason is that it is too contradictory. The man's description of his symptoms was accurate. However, the actual condition he displayed was not consistent with the symptoms he described... For example, If every disease were compared to a ball of yarn. The damaged brainstem is a red ball of yarn. And mild concussions are green balls of yarn. When a doctor diagnoses a disease, he picks at the exposed wool and eventually traces it back to the ball itself. This is well judged. The red and green lines can be seen through at a glance.
But the situation of this man is - it should be very simple, but the red and green are entangled together, it is very confusing! At this time, Xu Qiu suddenly thought of the changes in the patient's face before and after CT scan. He seemed to understand something and asked: "Comrade policeman, did he go to the toilet before checking?" The policeman was shocked, "How do you know that this test didn't say you should hold in your urine?" Hearing this, Xu Qiu's eyes flashed with helplessness. He understood it all. Xu Qiu leaned on the chair and did not expose it directly, but said: "It's nothing serious, just rest for a few days and it will be fine." Brother Jin Lian immediately breathed a sigh of relief. The skinny man was furious and said: "What a bastard doctor you are, my brain stem has been damaged! Can't you see the test results above!" Xu Qiu immediately asked: "What are the symptoms of brain stem damage?" "Needless to say? I have dizziness, nausea, vomiting, indirect blurred vision, and I will also suffer from indirect coma!" Xu Qiu smiled: "You are quite professional, are you a doctor?" The skinny man's expression changed. His momentum immediately weakened, and he said: "I...I'm very dizzy now, and I've vomited several times!" Xu Qiu: "I walked around in the toilet a lot and even scratched my throat. Can I not faint or vomit?" The policeman's face immediately became serious. Xu Qiu returned the checklist to the man and said, "I read some tricks on the Internet to extort money. Have you actually used them?" The man's face immediately turned pale. He waved his hands and said, "Forget it, let's settle this matter. Let me go!"
At this time, two policemen held him up instead. Blackmail is already another sentencing standard. Brother Jinlian held Xu Qiu's hand gratefully and said, "Brother, you are so perceptive. I almost went bankrupt! In the future, my brother and I will come to you if we are injured!" Xu Qiu waved his hand. When he noticed that the other person's muscles were relaxed, he already suspected that the other person was pretending to be sick. However, many times, doctors are more willing to believe in patients... even though human nature is sometimes not so bright. … … After going to work in the afternoon, the emergency department became busy again. At three o'clock, a joint consultation between the emergency department, imaging department and respiratory surgery was held. Xu Qiu was also taken to see the world as He Hai's follower. "This patient is a bit complicated. The outside hospital diagnosed him with suspected lung cancer, lung abscess, and infection. But the infection has not been identified with any bacteria... Follow me and learn more!" He Hai said with his hands behind his back. Xu Qiu nodded and followed him into the conference room. As soon as he entered the door, he felt several unfriendly glances. Most of them are young doctors from the respiratory surgery department. There is also a dazzling resident doctor among them. Xu Qiu whispered: "Can residents also participate?" He Hai was also a little surprised, "It's a bit strange, how did the resident doctor sneak in?" In joint consultations, difficult cases are discussed. Anyone who is qualified to say a few words is at least a deputy director. But as soon as he thought of this, He Hai suddenly fell silent. Xu Qiu, have you forgotten that you are also a resident doctor? ! … After everyone is seated, the joint consultation begins. An attending stood up and introduced the patient. "Male, 63 years old, was admitted to the hospital the day before yesterday due to right side chest pain for more than ten days and cough and sputum for two days. Past history of cerebral infarction for seven years... Physical examination and chest CT revealed right lung infection and right pleural effusion.
Out-of-hospital diagnosis of lung cancer and lung abscess. Treatment with "cefazolin, levofloxacin, ambroxol, and terbutaline" was used, but no significant improvement was seen. The enhanced CT scan performed at admission yesterday showed a cavity in the right lung, accompanied by flat air and fluid levels, indicating lung infection. The patient's cough and sputum worsened on the day of admission, and the sputum was difficult to cough up... Physical examination:… Auxiliary inspection:..." After the introduction, everyone quietly looked at the patient information on the table. What troubles everyone now is the type of infectious bacteria. Bacteria, fungi, or other microorganisms? At this time, Ding Huan, who had read the medical records early and was ready to speak, stood up and said confidently: "Everyone, I think it's Streptococcus constellation + a variety of anaerobic bacteria infection. Change to a large dose of penicillin, combined with fentanyl Azole should make things better.” The director of respiratory surgery nodded: "Like. The patient has multiple bubble-like cavities instead of cavities, which means high tension! The peripheral wall is thick and smooth, with compressive atelectasis of the lung tissue, a fluid level within the lesion, and patchy exudation in the ipsilateral lung... These manifestations are more consistent with the results of a variety of bacterial infections! " Xu Qiu also nodded. Indeed, judging from the current performance, Ding Huan is right. Mixed infection of streptococci + anaerobic bacteria should indeed be the first choice. But as soon as he nodded, he noticed that Ding Huan across from him looked a little arrogant. Xu Qiu is happy. Is this little resident doctor here to show off his power? Xu Qiu didn't care and ignored the hostility of the other party. Ding Huan was excited and said, "Before I came, I asked the laboratory department to do the pus properties, microbial culture, and drug sensitivity test. The results should be out now." He made a phone call and urged the laboratory department. A few minutes later, a female doctor from the laboratory department brought the list with an unhappy look on her face. "Don't occupy emergency resources indiscriminately. If such a patient is expedited, will I have a break at noon?" She cursed angrily and slammed the door before leaving. Everyone in the conference room was embarrassed. He Hai sighed. Offending the doctor in the laboratory department... really don't want to do it? I'm afraid that if Ding Huan wants to expedite it in the future, the examination will be put at the back! "How is the list?" asked the director of respiratory surgery. He diagnosed this patient.
He told Ding Huan to give the examination list and diagnosis results to the other party to show off. Naturally, he couldn't let the place be ruined by a doctor in the laboratory department. At this time, Xu Qiu silently shook his head. The words that the doctor in the laboratory said before leaving, "This kind of patient must be rushed", actually announced the ending... Sure enough. After reading the examination list, Ding Huan's face became extremely bad, and his voice was hoarse: "Microbial culture, drug sensitivity, and the nature of drainage do not support streptococcal infection..." At this moment, the expression of the director of respiratory surgery was also a bit ugly. Damn, this is his diagnosis! How could it be wrong! Xu Qiu, who was sitting not far away, was also curious. His first judgment was actually a mixed infection of streptococci + anaerobic bacteria. But obviously, this diagnosis was rejected. So, he opened the patient's information again and read it carefully. Suddenly, Xu Qiu noticed something, and his eyes suddenly lit up!
