N-A-A Chapter 541
Chapter 541
"Have you been staying up a lot lately? Or did you eat something special? For example, medicine, medicine, wine, and so on..."
"Dr. Lin, you are really powerful, recently our company has a big project to tackle tough problems, I have been working overtime for more than a month, and I have less than 6 hours of rest every day..."
"It should be that you are too tired and produce all kinds of harmful substances throughout the day, causing the kidneys to run for a long time... Probably nephritis..."
Put the nail function first, and do the relevant examination of the kidney first.
"You go for 3 examinations: "blood routine", "urine routine" and "kidney function"... B-ultrasound should be inconvenient now, and it will have to wait until tomorrow..."
Lin Feng opened the bill.
"Thank you Dr. Lin..."
The patient Wang Zirui took the checklist and went to draw blood and urinate.
......
An hour later,
The patient Wang Zirui returned with the test results.
Blood routine: abnormal increase in white blood cells more than 1 times...
Kidney function: uric acid increased significantly, blood creatinine increased slightly, blood uric acid doubled...
Urinalysis: ...
See here,
It has been clearly found that it is "nephritis"...
However, because B ultrasound did not do it, it is not known whether there are other problems other than nephritis and kidney function damage.
But what is known is enough for Lin Feng to conclude that the edema of the patient's face is due to nephritis and kidney function damage.
Lin Feng told his judgment to the patient Wang Zirui.
"The current consideration is nephritis, kidney damage ... The reason may be staying up late..."
"I'll prescribe some kidney-protecting medicine, you take it first... Further examination can wait for the day B ultrasound, I will issue a bill to you, during the day you go to the B ultrasound department to do it, if there is a problem with the B ultrasound, come to me again for follow-up..."
"Of course, it's okay not to do B-ultrasound, after taking medicine for 3 days, if the condition improves, don't use it, if there is a problem, find me for follow-up... Also, try to rest as much as possible and don't stay up late..."
Lin Feng instructed a bunch of them.
"Thank you Dr. Lin..."
The patient Wang Rui thanked him again and again.
......
After Lin Feng diagnosed this patient, he glanced outside the ward.
Well
No patients!
Cool!
There are no patients on the night shift, it's easy...
And then......
"Shh~~~~~"
Nurse Xiao Chen rushed in.
"Dr. Lin, there was an emergency call just now, 10 minutes to... A heart patient is being delivered. "
Lin Feng: "..........................."
This night shift is poisonous!
God of the night shift, spare your life!!
Lin Feng, who was weak, could only gather the people and wait at the door of the emergency department.
......
After 9 minutes,
Beep beep ~ ~ ~
The sound of an ambulance rushed in.
"Here it comes!!"
Lin Feng and the others, move in unison!
Brake——————
The car stopped,
As soon as the rear door of the car opens,
The patient pushes out.
Lin Feng glanced at it.
The patient, male, about 50 years old...
Current condition: oxygen state, coma, rapid breathing...
A woman rushed out from the inside, grabbed Lin Feng's hand, and cried and shouted:
"Doctor Lin, save my dad..."
"Calm down first, don't be in a hurry, you will affect us to save people..."
change
Then it was quickly pushed to the rescue room.
On the way, the doctor accompanying the ambulance introduced the condition.
"The patient, 58 years old, has a history of hypertension... 10 minutes ago, suddenly fainted, shortness of breath, blood oxygen fell all the way to 94, and the oxygen intake stabilized..."
Barabbas, introduce a bunch ...
While running, Lin Feng grabbed the patient's old man's foot.
・Edema of the lower extremities!!
Press on the edema of the lower limbs, and depressions appear one by one.
Lin Feng was stunned.
Touch your arm again...
Edema of the upper extremities!
Looking at the patient's face, the face is a little swollen, and I don't know if it is edema.
But
A little
The patient's neck has symptoms of "jugular venous distention"!
Comprehensive: "hypertension" + "upper and lower limb edema" + "jugular venous distention"...
......
As said earlier:
If the face is edematous, but the hands and feet are not edematous, priority is given to "nephrogenic edema", the root cause is in the kidneys!
But!
If you have edema of both lower limbs at the same time, or suffer from chronic diseases such as hypertension, diabetes, and coronary heart disease, then you must consider the possibility of "cardiogenic edema".
That is, edema due to heart failure.
Cardiogenic edema is characterized by the first appearance of the body sagging, for people without mobility disorders, the earliest edema may be in the ankle joint, obvious after activity, relieved at rest.
For people who are unable to move and stay in bed for a lot of time, edema of the lower back may be more pronounced. This edema is generally symmetrical and depressed (more difficult to rebound).
And "cardiogenic edema" has another feature:
Jugular vein distention!!
(Specific: Look at the side neck area, there are thick veins exposed.) ）
(PS: The artery is inside and is generally not visible.) On the superficial are veins. ）
"Cardiogenic edema": mainly a manifestation of right heart failure. The manifestations of left heart failure are mainly chest tightness, wheezing, and coughing up pink foamy sputum.
As for the formation of edema: first manifested by a decrease in urine output, heavy limbs, weight gain, and then gradually the appearance of edema of the lower extremities and generalis. Edema begins in the sagging part of the body and gradually develops into generalized edema.
Obviously...
The old man of the patient in front of him:
The condition is obvious: high blood pressure - leading to strong pressure in blood vessels for a long time - the heart has to work hard to pump blood - prolonged load - heart failure - right heart failure - systemic edema.
Other words
The cause of the old man in front of him is: heart failure!!
From edema + hypertension, two conditions, heart failure is clearly deduced!
No need for ECG, no ultrasound, no CT ...
In just 20 seconds,
The cause was found!
This is the advantage of Lin Feng with rich medical knowledge!
。