bookpower Chapter 502
Chapter 502
"Full moon face" is a medical term.
It means that some patients' faces have become rounded, like a round moon, so it is called a full moon face.
Characteristic facial obesity, the face resembles a full moon, which is the result of the accumulation of fat in the face.
"Full moon face" is usually seen in some patients who have been on glucocorticoid use for a long time.
Patients who use glucocorticoids for a long time will have another concurrent symptom -
"Buffalo back"!
"Buffalo back": the back of the neck is prominent, the back muscles are clearly raised, and it is half-moon shaped (like a hunchback).
Lin Feng glanced at the back and neck of the girl in front of him, Chen Ruizhu...
Really!
Buffalo back!
Lin Feng did not observe her carefully in front, so he did not find the face of the full moon and the back of the buffalo.
Just thought she was simply fat!
Looking closely, Lin Feng found that the girl Chen Ruizhu's chin was somewhat thick for a girl - beard.
Girls have beards.
This is also one of the manifestations of "Cushing syndrome"!
By the way, Lin Feng carefully observed the arm of the patient Chen Ruizhu.
Thin skin!
What does this mean?
It is equivalent to the edema of your legs, the skin is already as thin as translucent, very brittle, very thin.
This is also one of the manifestations of Cushing's syndrome.
Everything proves: this is "Cushing syndrome"!
So what is "Cushing syndrome"?
Here we want to mention the "adrenal glands"
(Chapters 477-478 wrote this)
The adrenal glands are endocrine gas organs that secrete many, many very critical hormones, one of which is called glucocorticoids.
When the adrenal glands secrete excessive glucocorticoids under the action of certain causes, it can cause a series of clinical symptoms, including full moon face, buffalo back, high blood sugar, low blood potassium, obesity, high blood pressure and so on.
(It corresponds to the "low blood potassium" in the front.) ）
Because it was discovered by a doctor named Cushing, it is called "Cushing syndrome".
In other words, the reason is - "glucocorticoids"!
so
Back to the girl Chen Ruizhu's main complaint - schizophrenia!
maybe
She is not schizophrenia, but "Cushing syndrome"!
Because excess glucocorticoids, acting on the brain, can completely cause psychiatric symptoms.
Next
It's validation.
There are two possibilities:
In vitro intake: Girl Chen Ruizhu has been eating glucocorticoids, resulting in too much.
In vivo production: Chen Ruizhu has problems with the adrenal glands, resulting in excessive secretion.
Lin Feng looked at Chen Ruizhu's mother:
"Did the child take hormone drugs for a long time before?"
"No..."
"Are you sure? Does your child have asthma, lupus, COPD, nephritis (these drugs are commonly used)? "
"None either."
Chen Ruizhu's mother said with certainty.
Lin Feng nodded,
The possibility of extracorporeal ingestion is basically excluded.
Then the only thing left is that there is something wrong in the body.
In the body, what causes glucocorticoids to be secreted in large quantities?
Adrenal tumors
• Cerebral pituitary gland. (It secretes "adrenocorticotropic hormone," meaning that this thing promotes the secretion of XX hormone.) ）
Next
It is to do a test and completely confirm the diagnosis:
· CT adrenal + CT cranial pituitary gland.
Blood tests, urine tests: glucocorticoid levels.
"I have good news for you..."
Lin Feng said with a smile.
The mother was overjoyed: "What good news?" Could it be that my daughter she... Saved? "
The girl Chen Ruizhu also looked up at Lin Feng, her face full of expectation.
Lin Feng: "After my diagnosis just now, I probably think that your daughter is not schizophrenic, but caused by hormonal changes..."
Then explain in detail: buffalo back, full moon face, Scud ... And so on characteristics.
"What?"
"Doctor Lin, what you said is not lying to us, are you?"
The mother and daughter shouted in surprise on the spot.
Joy from heaven!
Both almost fainted with excitement.
The mother wiped her tears, and her daughter's 'schizophrenia' in the past six months has tormented her miserably.
And Chen Ruizhu couldn't help but shed tears of excitement and grievance.
Lin Feng: "Don't get excited yet, I'm also guessing, and I need to do further checks..."
Explained the adrenal glands, pituitary gland, blood drawing and urine...
"Doctor Lin, you order as soon as possible, we can do any examination, don't be afraid to spend money!"
The mother said excitedly.
This is a help!
Money counts as a fart!
Lin Feng: "Well... CT results can be obtained in half an hour to an hour... The blood draw needs to wait until 8 o'clock tomorrow morning, because at that time, the urine test, it will have to wait 24 hours, that is, the results will be released tomorrow and the day after tomorrow..."
The mother nodded repeatedly: "I can afford to wait, I can afford to wait... Thank you Dr Lim! "
Take Lin Feng's slip, leave the consultation room, and go for the examination.
Before leaving, to the forest wind
Bowed again and again to thank you.
Thanks a lot!
......
But!
Things suddenly surprised Lin Feng!
After the CT results come out,
The pituitary gland, unchanged...
Adrenal glands, no change...
Lin Feng: "???? "
Lin Feng informed the mother and daughter of the CT results.
Mother and daughter are disappointed...
The loneliness in his eyes is very obvious.
The girl Chen Ruizhu just had light eyes, and this moment was once again flooded by darkness.
Lin Feng blamed himself a little.
suddenly
"That's not right!"
Lin Feng thought of a problem, adrenocorticotropic hormone, not necessarily secreted by the pituitary gland!
It may also be a tumor in another site!
Medically, this phenomenon is called
"Ectopic ACTH syndrome"!
This means non-pituitary and adrenal Cushing syndrome. More common in APUD tumors, such as small cell bronchopulmonary cancer, islet cancer, medullary thyroid cancer, lung adenocarcinoma, liver cancer...
Lin Feng: "Or... Let's do another chest CT..."
Lin Feng explained.
As a result, the mother and daughter seemed to have caught a life-saving straw.
"Do it! Do! "
Soon, push to do CT!
In less than an hour, the chest CT results came in.
There is a 3 cm large nodule in the left lobe of the liver.
Generally, greater than 2cm, the probability of basic liver cancer is greatly increased.
Now,
The probability of Cushing's syndrome suddenly increased again.
The mood of the mother and daughter is like a roller coaster, seven up and eight down.
Lin Feng also gave the patient Chen Ruizhu another examination:
"Alpha-fetoprotein"!
。