bookpower Chapter 496
Chapter 496
"By the way, how long have you had high blood pressure?"
"It's been 2 years..."
For the patient Zhou Cheng, 38 years old and with high blood pressure, Lin Feng still has doubts.
Although he is 'old', he has been with high blood pressure for 2 years.
"By the way, what kind of medicine do you usually take for high blood pressure?"
"It seems to be called hydrochlorothiazide..."
Lin Feng nodded.
Losartan is an angiotensin II receptor antagonist (AIIA) class of antihypertensive drugs.
"Did you take your medicine on time?"
"Yes, take your medicine on time."
Lin Feng nodded: "Then go and check." "
The patient Zhou Cheng thanked him, and then took the checklist to go for examination.
......
About an hour later,
Lin Feng is giving a follow-up visit to the pregnant woman with excessive amniotic fluid, originally 34 weeks, now 36 weeks, amniotic fluid has been successfully reduced after Lin Feng's guidance.
"Dr. Lin, about my first child's heart failure, pulmonary edema (after heart failure, blood will return to the lungs, causing pulmonary edema, often complicated), amniotic fluid embolism, the second child... I'm a little worried. "
Lin Feng: "I studied your first discharge case, I feel that it is not amniotic fluid embolism, the doctor just deduces the symptoms of heart failure and pulmonary edema to amniotic fluid embolism, in fact, they don't know what the disease is... Rest assured, I have checked a lot of relevant studies at home and abroad, and no paper has mentioned that the amniotic fluid embolism of the first child will cause the amniotic fluid embolism of the second child... Don't worry, when you give birth, I will go in person, and I will find a few masters to watch you by the side..."
High-risk pregnant women are immediately happy.
"Thank you Dr. Lin!!"
Thank you from the bottom of my heart!
Leave the consultation room happily with your medical records.
Then
The patient Zhou Cheng knocked on the door and walked in.
All the inspection reports in hand.
Lin Feng: "??? "
Lin Feng frowned and looked at Zhou Cheng.
At this time, Zhou Cheng was not in the same state as an hour ago, and an hour ago, Zhou Cheng was just walking in vain.
And now, in addition to Zhou Cheng's vain steps, he actually had cold sweat and a runny nose...
"Doctor Lin..."
Zhou Cheng yawned, then sniffed.
The results of the examination were handed to Lin Feng.
Lin Feng frowned: "Why do you have a runny nose and still sweat?" "
Zhou Cheng was a little impatient: "I don't know, Doctor Lin, hurry up... Help me see if there is liver cancer..."
It seems a little anxious.
Lin Feng was silent and looked at the results of the examination first.
· Ultrasound: The liver, gallbladder, pancreas, and spleen are normal, and the kidneys and ureters do not see water and stones, etc...
"You don't have liver cancer, don't worry..."
Blood routine: No problem. White blood cell count, red blood cell count, platelets are normal, liver and kidney function: all normal, transaminases are not high, creatinine is not high.
Electrolyte: Potassium: 2.6mmol/L (3.5-5.5mmol/L)
"Huh..."
Lin Feng saw the last blood potassium and finally found the seed.
Hypokalemia.
It is also moderately hypokalemia: (2.5-3.0).
"No wonder you have no strength, it's that your blood potassium is low..."
Severe hypokalemia, hyperkalemia can cause heart problems, and even cardiac arrest is completely possible.
"What is hypokalemia?"
"It's that there are too few potassium ions in the blood..."
"How can I do this?"
"It's easy, just supplement potassium, I'll prescribe you potassium water (potassium chloride solution), you drink it, and you can make it up soon."
Patient Zhou Cheng breathed a sigh of relief.
"How are you eating these days?"
"I don't have a good appetite, I don't eat much..."
"What about fruits and vegetables?"
Fruits and vegetables are the main force of potassium ion intake...
"No appetite..."
"No wonder it causes hypokalemia..."
"But..." Lin Feng's words made patient Zhou Cheng nervous again.
"Although it is found that you are hypokalemia, it is difficult to say whether it is a bad appetite that causes hypokalemia, or a bad appetite because of hypokalemia, who is the cause, only by finding the root cause can you solve your disease..."
Let's sort it out first:
Causes of low potassium:
Too little intake
Excessive discharge (sweat, urine, stool...) ）
"Have you been sweating a lot in recent days?"
"Not much, it's all in the company, air conditioning ..."
"Pee, poop..."
"Urinate too much... Normal stool... But I've always peed a lot..."
Lin Feng nodded.
More urine is right, and more urine may lead to excessive loss of potassium ions, resulting in low blood potassium.
Wait a minute......
Lin Feng slapped his thigh.
"I almost forgot that the antihypertensive drug hydrochlorothiazide itself contains diuretic ingredients!"
Many antihypertensive drugs have diuretics.
Because diuretics have a certain antihypertensive effect, and the effect will be more significant, for obese or elderly hypertensive patients, the effect will be more obvious.
So
Circled back.
High blood pressure - > antihypertensive drugs (diuresis) - > urine - low > potassium - poor >appetite - > general weakness...
Lin Feng said his inference.
"You change to a blood pressure medication, I'll prescribe the medicine later, you can just take this medicine in the future..."
"After taking medicine, come back in four days for re-examination, if you still have weakness in the past few days, you don't have to wait for four days, you can come tomorrow and the day after tomorrow..."
"Thank you Dr. Lin..."
The patient Zhou Cheng wiped his nose while thanking.
Ahem~~~
A few more coughs.
"You have a cold?"
"I don't know, during this time, it's intermittent, but taking cold medicine is useless..."
"What medicine did you take?"
"It's aspirin (cold medicine), and "compound licorice tablets" (cough medicine)..."
“！！！"
Lin Feng was shocked!
Compound licorice tablets?