bookpower Chapter 538
Chapter 538
"Cold urticaria"!
This is an allergic symptom that occurs after the skin and mucous membranes are exposed to a low temperature environment.
Very rare!
"Xiao Ai, go to the cafeteria and find an ice cube..."
How to tell if it is "cold urticaria"?
Very simple.
As long as you put an ice cube on the patient's intact skin, after 5-10 minutes, local redness, swelling, itching and other symptoms appear, indicating that there is a "cold allergy".
Then you can determine "cold urticaria".
(Generally, cold allergy symptoms disappear within 30-60 minutes.) ）
Quickly delivered to the rescue room.
Add oxygen...
Anti-allergy, adrenaline...
The next thing is to wait...
Soon, Xiao Ai came back with ice cubes, Lin Feng experimented, and sure enough, urticaria appeared.
Are you sure!
"Cold urticaria"!
This disease does not need much treatment, as long as it is anti-allergic and oxygenated, it is almost fine.
It is estimated that in the future, this patient will have to bring anti-allergic drugs with him, and he will also have to move to the south to live...
No, winters in the south are colder ... (Hands are dog's head)
......
......
midday
At 12 o'clock,
Lin Feng got off work, ate, and then went to the ward to check the room.
Then, the tube bed nurse told Lin Feng a new news:
"The patient, Tan Jianye, solved his stool 20 minutes ago, but it was black and red..."
"Black?"
Lin Feng was stunned for a moment.
Bleeding?
"Go for a colonoscopy!"
Lin Feng gave medical advice.
The bed nurse nodded and then made arrangements.
......
When he went to work in the afternoon, Lin Feng went to the ward.
The colonoscopy results of patient Tan Jianye came out.
Colonoscopy: colon ulcers, venous erosions, bleeding...
However, the bleeding is not very much, Lin Feng prescribed a blood coagulation drug to the patient to see if it can stop the bleeding...
However, there is another thing that makes Lin Feng look forward to it:
The patient has colon ulcers,
In case of ulcer causing "colon perforation", there will be a steady stream of digestive juice leaking into the abdominal cavity, bacteria, acidic, all kinds of harmful things, constantly stimulating the peritoneum, abdominal pain will be very strong, and septic shock may occur at any time after severe inflammation.
So
Find the cause of the patient as soon as possible!
Aiz?
Syphilis?
Zhang Zhen at the beginning combined with the following syphilis chancre + mouth ulcers, thinking that it may be AIDS, syphilis...
But
Now colon ulcers have been discovered...
Then the answer may not be AIDS or syphilis.
It was another disease that Lin Feng had just thought of————
"Behcet's disease"!!
Behcet's disease is a rheumatological disease!
This is a very rare disease, and even the rheumatology department itself may not be able to remember this rare disease.
This is also the reason why Lin Feng did not think of it in the first place.
"Behcet's disease": is an immune disease involving multiple organs throughout the body, the cause is unknown, and it has not been clearly studied.
Presents with recurrent oral ulcers, XX ulcers, eye inflammation, and vasculitis with skin lesions.
Among them: pus in the patient's eyes, mouth ulcers, genital ulcers, three characteristics, called triad.
In addition, this disease will also involve the intestines, nervous system, etc., so the patient now presents colon ulcers, perforations... Also consistent with the characteristics of Behcet's disease.
"Open your eyes and show me..."
"(The patient opens)..."
At this time, Lin Feng really found that the patient's eyes were red, with a lot of yellow 'eye'...
This made Lin Feng feel even more that it was "Behcet's disease".
But
These need to be examined for final diagnosis.
Lin Feng informed the patient Tan Jianye of his discovery.
"What? Not syphilis? "
Patient Tan Jianye was pleasantly surprised and almost jumped out of bed!!
"It's not sure yet, a lot of inspections need to be done, there are many projects, it may cost seven or eight hundred yuan..."
"Do it, do it right away, money is not a problem!"
At this moment, where will patient Tan Jianye save this money? Let's eliminate the big problem of henchmen (syphilis) first!
Lin Feng billing:
Antinuclear antibodies, anti-endothelial cell antibodies, erythrocyte sedimentation rate, C-reactive protein...
·「 Acupuncture reaction"!
"Acupuncture reaction" is currently an important criterion for the diagnosis of "Behcet's disease".
It is also called "skin non-specific allergic reaction": method: under sterile conditions, 12~48 hours after acupuncture, a red maculopapular rash the size of a rice grain begins to appear, and then develops into blisters, pus and crusts, which subside in one to two weeks, and sometimes there are obvious marks for a month.
As long as it is positive, it can be concluded that it is Behcet's disease.
......
......
The next day,
On the forest wind is the night shift, 00:00-8:00.
Come to the hospital,
Make rounds to see how the worker Tan Jianye is inspecting.
At this time, the test results of patient Tan Jianye's AIDS and syphilis came out.
Az, syphilis, negative!
Not Az, syphilis!
·「 Acupuncture reaction": positive!
On the arm of patient Tan Jianye, the site deliberately pricked by the nurse yesterday, a widespread red maculopapular rash appeared.
Therefore, the result does not need Lin Feng to say more, the patient Tan Jianye's disease is——
"Behcet's disease"!!
But
Even though the root cause of the disease has been found,
Still can't rejoice too soon!
Because "Behcet's disease" currently has no specific drug, all drugs against it (thalidomide, colchicine, etc.) can only control symptoms and prevent damage to important organs.
There is no cure!
This patient, Tan Jianye, can only stay in the hospital for a period of time and be discharged after suppressing his condition.
What's more, this disease can easily recur!
Lin Feng couldn't help but mourn for this patient Tan Jianye, even though he escaped syphilis and Ez, he provoked Behcet's disease, which is also difficult to mess with.
Of course, one thing is lucky:
Many Behcet's disease patients have vision loss due to suppuration of the eye, but this patient, Tan Jianye, does not.
......
Lin Feng's night shift has always been blessed by the God of Night Shift~~
tonight
It seems that the emergency department is exceptionally quiet, and there are no particularly fierce patients.
"Working with Dr. Lin is easy ~~~"
A nurse said happily.
"Shut up!!"
Other doctors and nurses shouted one after another, their faces frightened.
And then
The crow's mouth effect of the emergency department is coming.
Boom————
A car, with a roar, burst outside the door of the emergency room.
"Doctor, doctor, save my dad!!"
A middle-aged man, holding his gray-haired old father, rushed into the emergency department.
The princess brought it in.
And the patient, the old man, covered his chest with his hands, looked very painful.
Lin Feng's face changed.
Chest pain, old people...
This is the patient that Lin Feng is most afraid of encountering, because it is likely to be a myocardial infarction and the mortality rate is very high.
"Quick, push the flat cart over..."
——————————————
(Guess how much a good flat car costs?) ）
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