Diagnosis... There is a diagnosis of yarn!

Zheng Ren looked at Su Yun on the stage and began to recall the medical history he had told before.

"This is other data and copy materials for existing cases." Su Yun said with a smile: "Because the incident happened quite suddenly, this case discussion was only a preview. The effect seems to be pretty good. Chang Yue, do you think I am handsome?"

Su Yun asked when he passed by Chang Yue’s side.

"If you spend half of your time on the operation..." Chang Yue took the medical record and said half of the sentence.

"I regret giving you medical records." Su Yun didn't care about Chang Yue's mouth and said with a smile: "Because you can't understand it at all."

"Abdominal pain, what's the difficulty in diagnosis?" Chang Yue disdained, stroked his glasses, and began to carefully search the medical records.

After Zheng Ren got the medical record, he also began to look.

Su Yun was talking about the key points, and the information on the medical records was more detailed.

Nausea, vomiting, abdominal pain, no bacteria or viral infections, what to consider?

His eyebrows frowned, and he had references to the countless documents he had read during this period.

"How is it, Chang Yue, tell me your opinion." Su Yun waited for a few minutes and saw that everyone had almost finished reading the medical records, he said with a smile.

"Consider kidney stones." Chang Yue gave his own answer, "Naught, vomiting, and pain in the lower left abdomen are all in line with the diagnostic criteria for kidney stones."

"What a beautiful diagnosis, I can't bear to deny this fairy tale-like diagnosis." Su Yun said with a smile: "However, this is the first case discussion in the medical team, and Director Luo is here, so you should be more serious."

Chang Yue put his hands on his glasses and a sharp light shot out from his eyes.

"The pain caused by kidney stones can be severe, and when the stone is located in certain locations, it can be similar to acute abdominal pain.

Urinary sepsis may occur when stones cause obstruction and hydronephrodisiac, and vomiting may be a prominent manifestation of severe kidney stones.

Several of the patient's symptoms suggest this diagnosis. I guess you have read the routine test sheet for urine. The red blood cells inside give you a clear hint that this is caused by kidney stones."

Chang Yue's hand stopped.

Su Yun was like a roundworm in his stomach, talking about his own diagnostic logic without any deviation.

How great would it be if this guy's mouth was not so sarcastic.

"It's a pity that these are all wrong!" Su Yun smiled and said, "You must have forgotten that I mentioned menstrual periods specifically. The red blood cells in the urine are caused by menstrual blood, and it is not considered that it is bleeding caused by urinary tract stones caused by rupture of the endometrial cells of the ureter."

"How do you know!" Chang Yue asked coldly.

"Doctor Chang, I think you must have not seen the image of enhanced CT in the patient's abdomen. The stones are in the kidneys and the ureters are smooth, so your diagnosis is 99.9% of the diagnosis is a wrong diagnosis." Su Yun blew a breath, and his black hair was floating on his forehead.

"The reason why I didn't say it was 100% is because I had to take care of your pitiful self-esteem." Su Yun said contemptuously.

Zheng Ren is really helpless. Su Yun is a stingy guy. It is a miracle that he can survive until now and not be beaten to death.

"Brother Yun, there is some problem with the electrocardiogram." Old He was still kinder. At this time, he interrupted Su Yun's words and also strangled Chang Yue's anger.

There are images of electrocardiograms in the medical record, but Su Yun did not list the electrocardiogram.

There are some heart diseases, which are manifested in the gastrointestinal tract, and nausea and vomiting. Because Su Yun had denied all gastrointestinal diseases before, Lao He saw an abnormality on the electrocardiogram at a glance.

The 12-lead electrocardiogram recorded at this visit showed supraventricular tachycardia; the electrocardiogram also showed prolonged RP interval.

The cardiac rhythm pattern recorded after adenosine administration showed termination of supraventricular tachycardia.

The patient developed sinus tachycardia after a ventricular ectopic beat and a short atrial ectopic beat. The subsequent 12-lead electrocardiogram confirmed persistent sinus tachycardia.

This is the most likely thing, Lao He thought to himself.

To perform, you must perform! As a senior anesthesiologist, Lao He is very sensitive to the heart and breathing.

As soon as he looked at him, he felt that the electrocardiogram was wrong.

"No." Before Su Yun could speak, Zheng Ren suddenly shook his head and said, "The patient's heart rhythm chart shows tachycardia and the q wave group narrows. This discovery is consistent with supraventricular tachycardia.

The patient's heart rhythm is regular, so atrial fibrillation and multifocal atrial tachycardia are unlikely. The patient has sudden tachycardia, so sinus tachycardia is unlikely.

Sinus tachycardia will have a stage of gradually increasing heart rate, rather than a sudden increase in heart rate to more than 200 beats per minute.

So I suspect that the supraventricular tachycardia of the rhythm that this patient presents is one of three types: atrioventricular reciprocating tachycardia; atrioventricular reciprocating tachycardia caused by retrograde conduction through additional pathways; or focal atrial tachycardia.

But no matter which type, the electrocardiogram changes after using adenosine, but the symptoms do not change, and the abdominal pain caused by heart disease is not considered for the time being."

Zheng Ren lowered his head, and his clear and rigorous logical analysis overturned Lao He's diagnosis.

Su Yun smiled. Lao He was already considered an old doctor with rich clinical experience when he could think of this.

But this is not enough. The patient's condition is very strange. Su Yun still has only one preliminary diagnosis.

But he didn't say it.

Don’t say it out loud and let the boss deny it. In that case, the entire stage effect will be gone, which is very disappointing.

"Director Luo, do you have any thoughts?" Su Yun's tone softened and asked Director Luo.

"The patient has taken opioid drugs orally." Director Luo said slowly: "Opioid withdrawal can explain tachycardia, agitation, nausea, vomiting and abdominal pain. However, the patient did not show opioid withdrawal such as sweating, yawning, goose bumps or dilated pupils."

"So, I'm more suspicious about the patient having serotonin syndrome."

Su Yun smiled.

He also considered serotonin syndrome.

Serotonin syndrome is a group of symptoms caused by taking serotonergic drugs or the combination of serotonergic drugs and monoamine oxidase inhibitors.

Typical cases are rare in clinical practice.

Changes in mental state and behavior, such as hypomania, agitation, and changes in motor system functions.

Symptoms such as fever, nausea, diarrhea, headache, tremor, blushing, sweating, tachycardia, shortness of breath, changes in blood pressure, and dilated pupils caused by autonomic nervous system disorders.

The patient's various manifestations are highly consistent with serotonin syndrome.
Chapter completed!