bookpower Chapter 654
Chapter 654
soon
The ultrasound results are out.
There is nothing wrong with the thyroid gland in female patients.
At last
After questioning, the patient decided not to delve into why he had hyperthyroidism for the time being.
Lin Feng prescribed anti-hyperthyroidism drugs to the female patient, and ended this round of consultation.
And then
Lin Feng called the next patient.
......
I don't know if it's a coincidence,
When it's time to eat at noon,
Lin Feng received a call from a classmate.
"Lin Feng... There's something I want to ask you..."
"What's wrong?"
"Recently, I had a fight with my wife..."
"Oh... You don't have to tell me that, do you? "
"Ahem... I mean, I think my wife is sick. "
"Sick?"
"Uh-huh, my wife and I have only been married for 1 year, and we are very interested in that kind of thing, but I don't know what's going on recently, I don't want to play, I can't move at every turn, and I ignore him for a little thing..."
“............"
It's so private, classmate!
"At first, I thought she was cheating, but she was at home every day, she didn't play on her phone, she just watched TV. I went out, I followed it, and I also bought things in the vegetable market and supermarket normally, this is not like cheating..."
"So, I think I'm old, is it sick somewhere..."
Lin Feng heard this,
I subconsciously thought of the female patient in the morning, and hyperthyroidism caused the game to be very interested.
No way
A patient is 'interested'.
A patient's 'interest' is low.
So it was associated.
"It may be that there is a problem with the thyroid gland, go to the hospital to draw blood, do a thyroid examination..."
And then
Explained to my classmates why I went to check my thyroid gland.
Whether it is hyperthyroidism, addition or subtraction, it may lead to a rise and decrease in 'interest'.
But
There are also special.
Some patients will have sheep hemorrhoids because of hyperthyroidism, and some female patients will have low menstrual flow, irregular menstrual bleeding, and even amenorrhea.
Why do patients with hyperthyroidism and hypothyroidism cause changes in Xingji function or Yue menstruation?
The exact mechanism is not yet clear.
Current medical treatment may be related to the following factors:
Thyroid and gonads belong to the endocrine system, are under the regulation of the hypothalamus and pituitary gland, play normal functions, if hyperthyroidism, there may be a problem with the thalamus and pituitary, so it affects the normal function of male takamaru and female follrow...
There are receptors such as estrogen, progesterone, prolactin, androgens in thyroid tissue...
Thyroid hormones and hormones are closely related to the central nervous system, and may affect each other through the central nervous system...
......
(To sum up: the couple obviously feels that the other party is abnormal, so you can check the thyroid gland.) ）
......
Afternoon
Just as Lin Feng was preparing to start the afternoon shift,
An ambulance rushed into the emergency department.
"Dr. Lin, do you have time to help pick up this patient?"
"What happened to the patient?"
"I don't know, the doctor on the car said that it was an allergy, and now there is a wheeze ..."
"Allergies? Wheez? "
Patient, female, surname Liu, 31 years old...
The family member who came with the car was her husband,
Lin Feng pushed the patient Miss Liu and quickly ran to the rescue room.
While observing.
The stridor is very strong, and if allergic is considered, it should be that the throat airway allergy causes edema, resulting in squeezing the recent channel. Laryngeal edema, or bronchospasm (asthma).
So, she may have to be intubated in this situation.
In addition, the patient is already wearing an oxygen mask, but his face is still very white and hypoxia
On the arm, there are many red spots, and the allergic state is undoubted
While observing, Lin Feng asked the patient's husband:
"What's going on? Tell me what happened before and after..."
"This..."
The husband hesitated.
It's a little hard to talk about.
Lin Feng was a little angry: "Say it quickly, it's all this time, what is there to hide?" As long as you say it, I can better judge the condition. "
"It's like this, I was playing games with my wife, playing and playing, and it was fine, but suddenly she started to gasp, she said that her throat was uncomfortable, and then a little itchy, and then said that her whole body was a little itchy, and she gasped even more, and then fainted, and later I found that she had so many rashes on her body..."
Lin Feng: ".................."
No wonder the husband is embarrassed to say, it turns out to be too private.
But
The husband explained the condition clearly in just a few words.
One of the most important and key: the female patient herself complains of itchy laryngeal and itchy whole body, which directly determines the cause of gasping - the enlargement of airway tissue caused by allergies.
Well, the main culprit came out -
「Allergies」!!
Lin Feng grabbed the female patient's hand.
At a glance,
Finish the calf!
The hands are a little cold.
And the pulse rate is not right, the pulse is very weak!
Blood pressure is very low!
・Anaphylactic shock!!
Advance the rescue room,
"Go get ready for adrenaline..."
"Connect the ECG monitor..."
"And the cannula box..."
"Quick!"
Lin Feng instructed, and the nurse moved quickly...
soon
The ECG monitor is connected,
The data comes out.
Blood pressure 80/42...
Blood oxygen: 87%
Shocked!
"Epinephrine 0.5mg! Intramuscular injection! "
Epinephrine, which can quickly relax bronchospasm through β-receptor effect and constrict peripheral small blood vessels through α-receptor effect; It also fights the mediator release of some type I allergic reactions, so it is the drug of choice for the treatment of anaphylactic shock.
"And chlorpheniramine (allergy anti-itching)..."
At this time,
The trachea box was pushed over, and the husband was next to it.
"Now I want to intubate your wife's trachea, I need your consent..."
"Agree to agree!"
The husband said in a panic.
Anesthesia, endotracheal intubation... Coherent......
With intubation, the patient's neck signs suddenly eased.
5 minutes later...
All the treatment, it's almost there.
Lin Feng had time to ask the patient's husband about the cause of the allergy:
"Did you eat anything while playing the game?"
"No..."
Exclude food allergies.
"Have you ever used latex products?"
The husband blushed a little.
"Nor ..."
That is to rule out latex allergy (I wrote a case earlier, chapters 526-527)
"During the whole process, did you come into contact with those unclean things?"
"No, no, it's all on the sheets..."
The husband blushed like a monkey.
Lin Feng is very serious, I don't think there is anything to blush, doctor, I've seen more...
He finally asked:
"When did you play the game?"
"Ahhh..."
"I mean this game today..."
"Oh... It's been more than a year..."
"More than a year? Is it pregnancy and childbirth? "
"Yes, yes, Dr. Lin, how do you know?"
Lin Feng did not answer.
Because he probably understood what an allergy was.
Basic food, outside, latex... And so on allergens have been ruled out, then the rest may be -
Amazing allergies!!
Lin Feng told his guess to the male patient.
"How is that possible?"
。