bookpower Chapter 385
Chapter 385
Flash
A day passed.
Lin Feng went to work at 23 o'clock in the evening.
Ward rounds patient Chen Yu.
At this point, the results of the cardiogram came out.
24 Cardiogram: No obvious abnormalities!
This time
Lin Feng was finally a little disappointed.
He also thought that the cardiogram could show it...
But
If no problem is found in the 24-hour cardiogram, it does not mean that the patient's heart is really fine.
Because the patient's seizures are intermittent, not continuous, if it is really a heart problem caused by epilepsy, then the arrhythmia of the heart should also be intermittent, not continuous. In this case, it makes sense that the cardiogram is okay.
thing
Once again, an impasse!
There are no patients tonight, so Lin Feng is very free.
Reclining in his chair, contemplative.
Why?
The last patient who was misdiagnosed with epilepsy was eventually found to be hypoglycemia, and then the cause was found to be islet tumor.
What would be the cause of this patient, if not epilepsy?
At this time,
Intern Chen Qingru walked in carrying a packing box.
"Doctor Lin, your supper, the fried noodles you ordered..."
"Put this..."
Chen Qingru put the fried powder on the table, then took out a bottle of medicine from his pocket, took one, and drank water to take it.
"What kind of medicine are you taking?"
"Calcium tablets..."
"Why did you take calcium tablets?"
"There was a little cramping in my legs, and I felt calcium deficient..."
"Oh..."
Lin Feng is just bored, ask,
suddenly
Lin Feng's mind flashed!
Calcium!
Calcium!
Charley horse!
"Groove! Could it be it! "
"No, you can't get excited first, it may not be... Give the patient a test first! "
Lin Feng quickly instructed Chen Qingru:
"You go to the patient, take a blood draw, and then send it to the laboratory department to do an electrolyte test..."
"Oh, good..."
"Be quick!"
Lin Feng was very happy.
Chen Qingru looked puzzled, what did Dr. Lin find? So excited?
Electrolyte test?
What does it have to do with the patient?
Chen Qingru didn't understand it for a while.
With doubts, she quickly went to the patient to draw blood, and then quickly whipped it to the laboratory department.
Half an hour later,
The results are out!
Electrolyte test, there are many indicators,
Dense......
However, Lin Feng directly skipped the others and found two indicators at once:
"Calcium ion concentration", "calcium ion concentration"!
Electrolyte examination: calcium ion concentration is only 2.1mmol/L (9-11), calcium ion concentration is 3.12mmol/L (1.1-1.3).
The calcium ion concentration is low!
The concentration of calcium ions is high!
Lin Feng suddenly became excited.
Really!
Just like I thought!
It's not enough calcium ions!
Reason: Human skeletal muscle activity relies on a lot of electrolytes, calcium ions are one of the keys, calcium deficiency is prone to muscle spasm, manifested as convulsions.
At this point, it is not possible to explain the cause of the patient's loss of consciousness!
Here, we are going to talk about another "high blood phosphorus"!
Low calcium and high phosphorus!
What does this mean?
In textbooks, "low calcium and high phosphorus" is one of the manifestations of "hypoparathyroidism"!
Hypoparathyroidism can trigger seizures!!
Parathyroid gland: is a small gland next to the thyroid gland!
Parathyroid hormone is specifically responsible for the regulation of calcium ion concentration and phosphorus ion concentration, if the secretion of parathyroid hormone is insufficient, it will lead to a decrease in calcium particle concentration and an increase in phosphorus ion concentration.
When the calcium ion concentration is low to a certain extent, paresthesia of the hands and feet, convulsions, and even epilepsy will occur!
The concentration of phosphorus ions can lead to dehydration in patients.
Lin Feng waved his hand, very excited.
"Go, go see the patient!"
Lin Feng wants to confirm whether it is hypoparathyroidism!
This condition can cause patients to be constipated, dry skin, cataracts, cardiac insufficiency and so on...
Lin Feng came to the ward.
Observe the skin of patient Chen Yun.
"Sure enough, the skin is relatively dry!"
Proof +1!!
Front, ECG · QT wave interval singing, QT interval prolongation, may also be caused by low calcium. Calcium ions are also involved in the electrical activity of the heart muscle, and if calcium is deficient, the electrical activity will also be abnormal, resulting in a prolonged QT interval.
Proof +2!
"Doctor Lin..."
Chen Yun looked at Lin Feng's excited expression, Yixi, could it be that his illness had found the cause?
Lin Feng: "Do you often have constipation?" "
Chen Yu was surprised: "Doctor Lin, how do you know?" "
Lin Feng smiled.
Corroboration, +3!!
Obviously, the patient is 99% more likely to be: "hypoparathyroidism"!
"Xiao Ai, draw her blood and get a parathyroid hormone level!"
Lin Feng's voice was full of surprise.
At this time, Chen Yu had already seen that Dr. Lin might have found his cause.
"Dr. Lin, my illness..."
"Don't worry, wait half an hour and see the results..."
Lin Feng said with a relaxed expression.
Chen Yu and her boyfriend now had a smile creeping up their faces, and their hearts were full of expectation.
Half an hour later,
The results of the parathyroid hormone test, came out.
Result: Lower than normal value range!!
"Whew..."
Lin Feng showed the final smile!
That's right!
It is definitely "hypoparathyroidism"!
Because of it, it induces the convulsions of the patient Chen Yu!
Not - epilepsy!
"My final diagnosis is this..."
"In the future, you don't need to take medicine, just supplement calcium and vitamin D..."
Lin Feng told the patient Chen Yu in detail about his diagnosis process and results.
After Chen Yu listened,
Covering his face, he cried out in pain!!
"Woooo
She is so miserable!
It's been 2 years,
It has always been misdiagnosed as epilepsy and treated like a crazy woman!
No one can understand the sadness behind an epilepsy patient.
Fortunately, it all came to an end.
"Thank you, Dr. Lin!"
"Thank you Dr. Lin!!"
Chen Yu thanked again and again, thanks for more than a dozen words!
She was so grateful to Lin Feng,
And at this time,
A patient came to the emergency department, and Lin Feng left the ward and went to the consultation room.
At this time, Chen Yu's heart was full of gratitude, pain, happiness, and excitement.
She opened her Zhihu account and wrote an article under her column.
"Thank you Dr. Lam for giving me a new life!" - Gratitude of an epilepsy patient
One article, 6000 words,
Spilling,
wrote about his grief over the years, as well as the luck of being finally diagnosed by Lin Feng.
In the second half, Lin Feng was full of praise and gratitude.
As soon as the article was published,
Zhihu makes waves again ~~~~
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ps: The end of the three changes, the new computer, many symbols have changed, can not be typed, originally the chapter was used [], now it can only become ".