When doctors have a simulated operating room

The problem is that the patient is suffering from a serious illness.

But Chen Fang thought carefully and realized that there are many diseases that cause nausea, vomiting and diarrhea, and most of them are gastrointestinal diseases.

Could it be that the problem of the young man in front of him is not with the stomach, but with the intestines?

After thinking for a long time without any result, Chen Fang felt that he had really said the wrong thing just now.

This young man might really have an incurable terminal illness!

"Blood pressure 150/106mmhg, body temperature 37.4℃."

One minute later, the blood pressure and body temperature came out.

High blood pressure, body temperature is also a little low fever.

After hearing the result, Zhang Yi asked again:

"Did the dyspnea also start half a year ago?"

The young man nodded:

"Yes, I work during the day and occasionally deliver food at night.

It started about half a year ago. When I deliver food at night, I feel very tired and dizzy when I run from the gate to the community to deliver food to people. It's so uncomfortable.

I don't know why, and the feeling of nausea and vomiting has become more and more serious in the past six months.

In addition, the color of urine is very dark when urinating."

Exertional dyspnea plus dark urine?

"How dark is it? Dark yellow, brown, or blood red?"

"Between brown and blood red, in fact, the urine color has always been a bit dark before, and it was only yesterday that it was between brown and blood red..."

Hearing such a dark urine color, Chen Fang next to him also became nervous.

Dark urine is not a good thing.

"Lie there and I'll check you." Zhang Yi said as he started to put on gloves.

The girl quickly helped the boy to the bed in the clinic.

Zhang Yi lifted the patient's clothes on his chest, began to listen to the patient's heart with a stethoscope, and then palpated the chest and abdomen.

Although Zhang Yi already knew what the boy was like.

But the patient and other doctors didn't know, so Zhang Yi could only finish the examination and give the diagnosis as soon as possible.

In addition to the examination of the chest and abdomen, Zhang Yi also looked at the patient's face, pupils, cheeks, and limbs.

Then, Zhang Yi helped the patient up and said:

"I see that you have tenderness in your right lower abdomen, that is the kidney. Have you ever had pain in your right lower abdomen before?"

The boy nodded: "Yes, I had pain before, but I didn't pay much attention to it. I didn't hurt after enduring it."

Zhang Yi sighed and continued:

"If you have any problems, come to the hospital early. Early examination and early treatment, you know?"

It's delayed until now...

Oh!

It's a bit late!

"Also, I see you look a bit anemic. Have you felt weak in the past six months? Or have you had any other unexplained bleeding?"

The young man nodded vigorously:

"Yes, yes, yes! I don't know if it's anemia, but I feel dizzy and short of breath after jogging, and I have to sit or lie down to rest to feel better.

And last time I cut my toenails, I accidentally cut my flesh. It was a very small wound. It may not have hurt at all before, but last time it not only bled but also didn't heal for two days.

I...doctor...what's wrong with me? Do I have cancer?"

Chen Fang didn't dare to answer abruptly, but turned his eyes to Zhang Yi.

Zhang Yi was silent for a moment and then said:

"Let's put it this way. We can't give you a definite answer at the moment. You have to do a checkup first to be sure.

First of all, you are a little anemic, so you need to check your blood routine for red blood cells, platelets and some other infectious diseases.

In addition, I see that your whole face and limbs are a little swollen, it's edema, plus you have dark urine, my initial guess is that it's related to the kidneys.

So electrolytes, thyroid function, liver and kidney function and urine tests are also necessary.

And you have exertional dyspnea, so you also need to do a chest CT scan.

Then there is abdominal color Doppler ultrasound to see if there are any problems with the abdominal organs.

I won't prescribe other gastroscopy digestive tract examinations for you yet, wait until the results of these examinations come out and then see.

Don't worry, I don't prescribe any extra examinations, all the examinations I prescribe are mandatory items.

After these results come out, we will decide what to do next. If there is nothing serious, that would be the best."

"Then...how much will it cost to do these examinations?" The patient looked at Zhang Yi embarrassedly.

Zhang Yi looked up at him and the girl next to him and said:

"Maybe 700 or 800, at most 900."

"Okay, then... I'll go check it out first."

After saying that, the patient was helped out of the clinic by the girl.

Chen Fangli

Ma asked:

"How is it, Zhang Yi, what disease do you suspect?

Hyperthyroidism or kidney problems?

At first I thought it was a minor illness, but the more I asked, the more I felt it was not simple."

Zhang Yi said with a serious face:

"I observed that his skin was dry, slightly edematous, his face was anemic, and his blood coagulation was also a bit problematic. In addition to digestive symptoms, he also had chest tightness and respiratory symptoms.

There was also a strong taste in his mouth when he spoke.

And the most important point is that his urine is dark, and the color is between tea and hematuria.

This is a bit dangerous. In short, I feel that it is a disease that can cause comprehensive symptoms throughout the body."

Chen Fang was slightly stunned: "What disease can cause a chain reaction throughout the body?"

Chen Fang muttered and thought.

"Edema, dark urine, anemic face, digestive tract symptoms, and high blood pressure..."

Suddenly, Zhang Yi slowly spoke:

"I suspect he had nephritis in the early stage, but it was delayed for a long time, resulting in renal failure."

"Ah?! Renal failure? Such a young guy? No way! I saw that he was only 24 years old on his ID card."

Chen Fang was surprised and could hardly believe it.

Such a young guy has renal failure? ?

"Yes, not only renal failure, but also early symptoms of uremia."

After hearing this, Chen Fang thought more and more that it was possible.

The urine he said was darker than tea color was close to hematuria!

There is also edema. Edema will appear in the early symptoms of renal failure and uremia.

There is also hypertension, anemia, and even bone disease.

These are all renal failure, that is, the systemic reaction caused by kidney strike!

"Oh my, after hearing what you said, I also think it's renal failure!"

While the two were thinking, the patient with gastric ulcer came in with a checklist:

"Doctor, my results are out. This is the gastroscopy result, and this is the blow test."

Zhang Yi took the checklist and looked at it.

The two pictures of the stomach on the gastroscopy list showed two small sunken ulcers in the wrinkled stomach bend.

Carbon 13 breath test, 30-minute DOB value> 23.0.

Carbon 13 is positive as long as it exceeds 4.0.

So this person is a gastritis infected by Helicobacter pylori, and then slowly developed into gastric ulcer.

Helicobacter pylori is not incurable. Combined with antibiotics, the symptoms will be relieved a lot after taking it for half a month.

Also take drugs to inhibit gastric acid.

Helicobacter pylori will accelerate gastric acid secretion, which will cause ulcers.

Adhere to taking medicine and take good care of the stomach, and the ulcer can still be cured.

Zhang Yi wrote a check-up form and reminded the patient:

"Go back and take the medicine on time. After a course of treatment, wait a month before coming back for a check-up. In addition, this disease is contagious. If you have it, your family members are likely to have it too. Remember to bring your family members to get checked. Remember to use public chopsticks when you go back to eat."

The patient nodded and left the clinic with the form.

Until noon when he was about to go to lunch, the young man with kidney failure had not returned.

This made Zhang Yi a little worried.

From Zhang Yi's perspective, this man did have kidney failure.

It was still chronic kidney failure, and the degree of atrophy of the right kidney was even more serious than that of the left kidney.

I don't know how this young man could endure it in the early stage? !

He actually waited until he had severe hematuria before coming to the hospital for treatment.

Alas!

The more I thought about Zhang Yi, the more I felt sorry for him.

This young man... is not easy to treat!

Suddenly, when Zhang Yi and Chen Fang walked downstairs of the inspection building and were about to go to the cafeteria,

Suddenly there was a cry from the second floor:

"Hurry up, doctor! Help! Someone has fainted!"