The system takes me for surgery

Liang Yi said: "There are three types of electrocardiograms for atrial fibrillation. The first is that the P wave disappears and the F wave appears, with a frequency of 350-600 beats/min. The second is that the ventricular rate is extremely irregular, usually 100-160 beats. / divided into the third category, the shape of the QRS wave is normal or widened. There are also three characteristics of auscultation, first, the heart rhythm is absolutely irregular; second, the strength of the first heart sound varies or the pulse rate is lower than the heart rate, and the third is this This missing pulse phenomenon is called pulse shortness or pulse shortness."

Such a complete answer with a textbook-like answer was somewhat beyond Miejue Shitai's expectations. She originally thought of this young man who was doing nothing.It is already very good to be able to get a question right.

She also smiled and said without hesitation: "The answer is very good. Ask a more difficult one. If anyone of you can answer it, I will give you both points. Do you agree?"

There is still such an operation, this kind of weird examiner, the two expressed their helplessness, but now that they have encountered it, there is nothing they can do. In the end, they both nodded in agreement.

At this time, the examination room was silent, and everyone had their ears pricked up, waiting for her to speak.

Miejue Shitai asked: "Why can primary spontaneous pneumothorax be treated conservatively?"

Shan Linfei frowned, and Liang Yi replied: "Conservative medical treatment of pneumothorax includes rest, keeping stool unobstructed, and using sedatives and cough suppressants as appropriate, which play an important role in the treatment of primary spontaneous pneumothorax. Especially in recent years, its status has become more prominent."

Miejue Shitai nodded and said, "Then what basis do you have?"

"Both the 2010 BTS Guidelines and the 2015 European ERS Expert Consensus on Primary Spontaneous Pneumothorax suggested that the treatment plan be determined based on the patient's symptoms rather than the degree of lung compression, and conservative treatment is sufficient for patients with mild symptoms or asymptomatic patients. Although 2001 The recommendation of the ACCP guidelines in 20 is not consistent with it, but it is consistent with the statement that "patients with less than [-]% lung compression can be treated conservatively." Liang Yi answered her question with the most authoritative official guidelines.

This is the most authoritative guide. Miejue Shi has read it too much. Although she knows what it is written in, she can't remember what the two guides have the same consensus in that year, and the two judges next to her are also stunned. .

The three of them thought that the young doctor was a bit of a fool, but they didn't expect that he was proficient in theory.

Unexpectedly, Miejue Shitai showed a smile. Her smile was very stiff, and it seemed that she usually had such a serious and dead face.

She continued to ask: "You are right. You remember it better than I do. Both versions have such a consensus. Then tell me, why can primary spontaneous pneumothorax be treated conservatively?"

Liang Yi said unhurriedly: "First of all, primary spontaneous pneumothorax mostly occurs in young people without underlying lung diseases, and life-threatening tension pneumothorax is very rare. After re-entering the pleural cavity, due to the pressure difference between the gas partial pressure in the thoracic cavity and the gas partial pressure in the pulmonary capillary, the gas in the pleural cavity will be slowly absorbed, and 24% of the gas volume can be absorbed every 1.25 hours. Therefore, if the patient has 20% of the gas enters the pleural space and it takes 16 days for the gas to be completely absorbed."

"Excellent!" Miejue Shitai couldn't help applauding.

This kind of dramatic personality was too much for everyone, Liang Yi and Shan Linfei also looked at each other suspiciously.

"Okay, the theory of both of you is very good, which department are you from?"

"Surgery." The two replied in unison.

surgical?These two surgeons have such strong internal and external theories, which is very beyond Miejue Shitai's expectation.

She smiled and said, "Since you met a surgeon, it would be unreasonable not to let you perform debridement and suture, how about you perform one?"

The two examiners didn't seem to be in a hurry to go back, and said, "One of you is on one side."

The two nodded. Anyway, they can do whatever they say.

The two stood on each side. Liang Yi and Shan Linfei were not nervous at all. To them, this was just the most basic thing for a surgeon.

Simply suturing is too boring for them. Once the instinct is formed, the two of them can repeat mechanical actions as soon as they get the crochet needle and suture thread.

A suggestion from Liang Yi said in a low voice: "See who uses more stitching methods. The speed is faster. How about comparing?"

"Bijibi, do you think I'm afraid of you?" Shan Linfei whispered.

Miejue Shitai is just like the referee in the boxing ring. Once he sees two boxers hugging each other, he will immediately break them apart and let them continue to attack each other.

She said: "You two, start quickly, don't mutter and dawdle over there."

The two started.

They also started with simple interrupted sutures.

This method is the most common method used by all surgeons, it is very simple, but there are still some points to pay attention to.

Needle insertion must be vertical, that is, the needle needs to be perpendicular to the incision plane of the wound surface. When it is difficult to insert the needle, the incision can be lifted lightly. The needle distance is 1cm and the edge distance is 0.5cm.

The three examiners nodded and said after reading it.

"These two young surgeons have very good basic surgical skills and their movements are very smooth."

"Yes, this is a bit like a doctor. The few candidates I met today are basically fooling around in the hospital."

Mrs. Miejue said: "So I will directly cross that kind of student. I would rather not fill up the quota this year, and don't let those people fill up the number and go from the lower level hospital to the higher level hospital to harm others."

Liang Yi changed the suturing method: "The second type of internal eight-character suture method."

This guy's hands and feet are quite fast, Shan Linfei frowned, speeded up the movements of his hands, and said, "The third type of horoscope stitching."

Suddenly, the two of them were here to take the exam, but it turned into a competition mode. The examiners who watched it became a little nervous, as if they were watching a race.

Liang Yi raised the corner of his mouth, quickly changed his gestures, and said, "The fourth type is simple continuous suture." Liang Yi said.

"Fifth overlock stitch." Shan Linfei followed closely behind.

The gestures of the two of them changed extremely quickly, just like the hot spirited guy waving his hands, which made people dazzled.

The examiners' eyes could hardly keep up with their movements.

Unexpectedly, this girl's speed is quite fast. If she doesn't work hard, she may be overtaken later.

Liang Yi also felt the pressure, and he also accelerated the speed of his hands, saying: "The sixth vertical inversion suture."