bookpower Chapter 401
Chapter 401
What is systemic lupus erythematosus?
It is an autoimmune disease.
In layman's terms, there is a problem with the immune system in the patient's body, and the immune system will attack its own organs or tissues, resulting in multi-system damage.
As for why it causes problems with the immune system?
Sorry, the medical community has not yet figured out how it works, maybe it's genes, maybe it's the environment.
So, it can't be prevented.
Lin Feng told the patient everything he knew.
"Doctor Lin, can I cure this?"
The patient Zhang Wu looked nervous.
Lin Feng: "It is very difficult to cure, but it can be reasonably treated to achieve the purpose of long-term remission, and bring the disease for a lifetime." "
"One more point..."
Lin Feng solemnly said:
"You have anemia, but now you can't find the place of bleeding, it cannot be ruled out that it is alveolar hemorrhage (blood from the lung microvessels enters the alveoli, a syndrome), if it is really alveolar hemorrhage, the general prognosis is very poor, and there may be suffocation due to heavy bleeding, the onset is extremely rapid, and it is too late to be sent to the hospital for rescue (there is also a sentence that dare not be said: the mortality rate is as high as 50%)..."
Patient Zhang Wu: "...................................."
It already feels like life is dark!
Lin Feng: "I'll give you a B-ultrasound and do a more detailed examination." "
The patient Zhang Wu took the slip and quickly went to check.
"Don't be alveolar hemorrhage!"
He prayed.
......
An hour later,
Patient Zhang Wu looked at the return with the checklist with a dejected face.
· Ultrasound results: Consider alveolar hemorrhagic syndrome!
Lin Feng: "..........................."
Diagnosis is a good thing, the cause has been found, and the right medicine can be prescribed. The bad news is that alveolar hemorrhage is a serious condition.
"Doctor Lin, what now?"
The patient Zhang Wu had a determination to 'die' at this time.
Lin Feng: "You are more serious, you may need to use strong medicine: "hormone shock therapy": use a large dose of hormones to suppress the inflammation and disordered immune situation in the body as soon as possible and reduce organ damage. "
The so-called "XX shock" means to use a 'large dose'!
And in large doses, there will be powerful side effects.
Among them, large doses of hormones will bring:
Diabetes: Hormones can cause disorders of glucose metabolism
High blood pressure, glucocorticoids have the effect of sodium water retention, which will make people obese, which in turn will increase blood pressure.
Osteoporosis...
Gastrointestinal ulcers, bleeding...
Decreased immunity... (The goal is to reduce the immune system in the patient's body to attack the human body itself)
This time, the patient Zhang Wu, his wife and parents all came.
Therefore, such a major decision is just discussed and solved together.
Lin Feng explained the side effects of "hormone shock".
"Dr. Lin, this side effect is so big, do you have to use it (hormone shock)? Is there no other way? "
Lin Feng: "At present, the patient's condition is still relatively serious... My advice is hormonal shock, but you can hang up a rheumatology and immunology department and see the opinion of the doctor over there. "
The patient's family discussed for 30 minutes...
At last
People are gone!
That's right, Lin Feng never saw the family again.
Lin Feng: "..........................."
Obviously, he must have gone to see the rheumatology and immunology department, and he did not 'say goodbye' to Lin Feng because of his weakness.
Lin Feng sighed.
In fact, there was still a sentence just now: don't look at the patient Zhang Wu now seems to be not sick, just low-grade fever, cough, maybe in a few days when the condition worsens, he will go to the ICU.
......
......
Next patient,
A young man, supported by his girlfriend, walked into the consultation room.
Walking, limping, the pain is so painful that the face is contorted.
"Doctor Lin..."
An authentic Cantonese.
Seeing that it was Lin Feng, his expression was full of surprise.
Lin Feng: "Sit... What's wrong? "
Young man Wang Qing: "It's like this, this time I came to the imperial capital with a group of friends, seven or eight people, to travel, climb the Great Wall, and then last night I don't know why, suddenly my knees hurt sharply... It still hurts. "
Lin Feng: "How old is it?" "
Wang Qing: "24 years old..."
Lin Feng nodded.
Knee pain, there are several possibilities:
Knee joint damage and inflammation (patients climbing the Great Wall, knee joint may be damaged and inflamed)
Lumbar spine (waist and knee joints seem to be incompatible, but in fact they are closely connected, and there are sciatic nerves and femoral nerves in the lumbar spine that are distributed to the lower limbs, passing through the knees on the way. ）
Gout
Rheumatism
Osteoporosis (the knee is the most important joint for the body to withstand gravity, calcium loss will cause osteoporosis, degeneration or wear and tear obviously, local pain will often ... ）
Lin Feng now needs to rule out the cause.
"Have you tried low back pain?"
"No..."
"Did you have a disease like a herniated disc in the waist before?"
"No..."
Lin Feng nodded.
Nerve conduction pain due to the lumbar spine is temporarily excluded.
"Yesterday, go climbing the Great Wall, right? How long did it climb? "
"About seven or eight beacon towers, right?"
Lin Feng: "??? "
Lin Feng had never been to the Great Wall, so he didn't know how far seven or eight beacons were.
Wang Qing: "I can't tell how far seven or eight beacons are, but it's hard to climb, climbing for about 4 hours, very few people can climb so high and far..."
When he spoke, Wang Qing looked proud.
Lin Feng nodded.
Conclusion 1: Exercise a lot, climbing mountains, there should be damage to the knee.
Lin Feng continued to ask: "What did you eat yesterday afternoon?" "
Gout has a lot to do with food.
Gout, there is a name "rich disease".
Gout, generally "high purine" + "excretion" ...
Both, no matter which one goes wrong, has the potential to cause gout.
"High-purine" foods: Seafood, grilled duck intestines and other foods, shrimp, shellfish and other seafood and animal offal all contain high "purine", excessive eating, can lead to high levels of "uric acid" (uric acid is the end product of purine metabolism in the body), increasing the risk of gout.
In addition, hot pot soup, thick broth, etc. are all high-purine foods, and excessive intake can also lead to increased uric acid levels.
Therefore, Guangdong Province likes to drink soup, and the probability of gout is higher than that of other regions (excluding coastal seafood areas).
In addition, alcoholic beverages can also increase the risk of gout, such as beer contains guanylate, which can be metabolized to produce purines in the body, and the alcohol in beer can also produce "lactic acid" after metabolism by the body, which can inhibit the excretion of "uric acid", thereby increasing the risk of gout.
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