I can see health

Chapter 13 Different Skills Tests

"There are still 2 minutes. Candidates are requested to pay attention to the test time and avoid overtime!"

"1 minutes left!"

"30 seconds left!"

"The first room, the exam is over!"

"..."

When Lu Chen came out of the first room, he was a little confused.

He still wasn't [-]% sure what the patient's diagnosis was.

He could only say the one he thought was the most likely diagnosis!
In this exam question, the two most important inspection reports are missing.

That is the result of coronary angiography or aortic CTA!
But if you just take out these two inspection reports, there is no need to take the exam.

"It's all about luck now..."

Lu Chen shook his head slightly. He just noticed that when he gave his answer, the female examiner beside him didn't show any expression.

He couldn't tell from the examiner's micro-expression whether he was right or not.

……

All four candidates stood at the door.

Outside the corridor, the middle-aged examiner shouted loudly: "All candidates will be postponed one by one and go to the next ward."

Lu Chen walked into the second ward.

In the second ward, lay a young girl.

The color on her head is also red!
"Start the consultation and physical examination!"

After Lu Chen heard the examiner's order, he immediately started to ask the doctor.

"The patient is female, 23 years old."

"Chief complaint: Headache for 3 days and admitted to the hospital."

"... Physical examination: blood pressure 220/130 mmHg..."

"The second patient's condition seems to be much simpler than the first one." Lu Chen thought.

For young female patients with elevated blood pressure, secondary hypertension should be considered first.

Hypertension can be divided into two types according to its etiology.

Essential hypertension has an unknown etiology and cannot be cured, requiring life-long medication.

Secondary hypertension, high blood pressure caused by other factors, is the only high blood pressure that can be cured.

After sorting out his thoughts, Lu Chen said in a deep voice: "The patient's current diagnosis: the cause of secondary hypertension is yet to be ruled out. It is recommended to improve the four items of hypertension, cortisol, catecholamines, and adrenal gland CT."

These inspection items that need to be improved are all inspections to determine the cause of secondary hypertension.

The examiner nodded, and also took out the relevant test sheets and inspection sheets.

Lu Chen carefully took the report and read it carefully.

"The four items of hypertension are normal."

"Cortisol normal."

"Catecholamines normal."

"The enhanced CT of the adrenal gland and renal blood vessels are all normal!"

"Heart ultrasound is normal!"

"..."

All tests and inspection reports are all normal!
"Is this essential hypertension?"

A question arose in Lu Chen's mind.

However, the patient is so young and has no family history of hypertension. Is it considered essential hypertension?

The exam time passed by every minute and every second.

The examiner continued to remind: "Candidates are asked to improve the diagnosis and treatment methods again."

Lu Chen couldn't make up his mind again.

On the face of it, persistent hypertension appears to have been ruled out.

But when Lu Chen looked at the patient on the bed, he still felt that something was wrong!

"The last 30 seconds to answer!"

"..."

When he walked out of the second ward, Lu Chen had already had deep doubts about himself.

Who came up with these questions?
It has completely deviated from the scope of undergraduate knowledge, and even if a doctor with rich clinical experience is asked to come, he may not be able to answer it correctly.

……

Exams are still going on.

Lu Chen walked into the third room.

The patient in this room is an old lady.

And the color on her head is also red!

From the physical examination, interrogation to the final diagnosis and treatment, Lu Chen did not dare to take anything lightly.

Fortunately, the case this time did not exceed Lu Chen's expectations.

The old lady is a typical patient with chronic heart failure. From diagnosis to treatment, Lu Chen thinks she answered perfectly.

"call……"

After walking out of the third room, Lu Chen breathed a sigh of relief.

This third case gave him a little confidence, now at least a sliver of certainty.

"Attention candidates, there is only one last ward left!"

Gently push open the door of the last ward.

Sitting in the ward was a young and middle-aged man who looked no different from a normal person.

His face was full of red light, and his spirit and posture were all normal.

Lu Chen focused and saw that the color on his head was green!
The color of the head of the patients in the first three wards is all red, only the color of the head of the last patient is green!
Green represents health.

Could it be that this young man is not sick?

In addition, Lu Chen was a little surprised that this patient was also connected to ECG monitoring.

This made Lu Chen dare not relax at all.

This skills test has already given him too many "surprises".

Start the consultation and physical examination.

"Male patient, 30 years old."

"Chief complaint: intermittent heart palpitations for 1 year, reoccurrence for half an hour."

"Every time the symptoms of palpitations occur suddenly and then stop suddenly. The cardiopulmonary and abdominal examinations are all negative!"

This time the examiner was not in a hurry to ask Lu Chen to make a diagnosis, but took out an electrocardiogram from the patient's attack.

"Interpret this electrocardiogram to diagnose and treat patients."

Lu Chen picked up the electrocardiogram and began to study it carefully.

"Rhythm is regular, heart rate is fast, about 160 beats per minute."

"No P wave, normal QRS wave. Retrograde P wave can be seen."

Lu Chen quickly browsed through the entire ECG.

This is a typical ECG of a paroxysmal supraventricular tachycardia attack!
Paroxysmal supraventricular tachycardia, a type of cardiac arrhythmia.

It can be seen in normal people and patients with organic heart disease, and can be completely cured by radiofrequency ablation!

This is also one of the few diseases that can be cured in cardiovascular medicine.

Lu Chen also had doubts.

Why does the system judge that the color of the "paroxysmal supraventricular tachycardia" patient is green?

When paroxysmal tachycardia occurs, the heart rate rises to around 160 beats per minute.

Normal heart rate is 60-100 beats/min!
When the heart rate reaches 160 beats per minute, it can lead to heart failure, myocardial infarction, and even sudden death!

So even if the color of this young man is not red, it should at least be yellow!
Anyway, it will definitely not be green!
Just as Lu Chen was thinking, the ECG monitor next to the bed suddenly sounded an alarm!

"woo woo woo woo……"

The siren was a bit harsh, and Lu Chen immediately looked at it intently.

Heart rate actually reached 164 beats!
The waveform on the monitor looks the same as the electrocardiogram in my hand.

This is a paroxysmal supraventricular tachycardia!
But what made him a little strange was that the examiner on the side didn't move at all, and he wasn't nervous at all.

And the color of the patient's head is still green!
A gleam flashed in Lu Chen's eyes, and he had his own judgment in his heart.

This patient is a fake patient!
Absolutely impossible to be a real patient!
The waveform of supraventricular tachycardia monitored by ECG is likely to be recorded before!
"Doctor, I'm a little flustered..."

The young man suddenly covered his chest and frowned.

Your acting is too fake, Lu Chen is a little speechless.

A person with a heart rate of 160 beats per minute does not have such a relaxed expression!
However, what should cooperate with your performance, you still have to cooperate.

"Are the symptoms the same as the previous episodes?" Lu Chen asked quickly.

"Yeah, it's the same." The young man nodded, "Then what should we do?"

Lu Chen smiled and said, "Don't worry, this is a paroxysmal supraventricular tachycardia."

"Next, you do these moves with me."

"Okay, doctor."

The first choice for supraventricular tachycardia is not drug treatment, but to stop the onset of supraventricular tachycardia by stimulating the vagus nerve!

"Hold your breath and exhale forcefully."

"Irritation of the pharynx causes nausea."

"Massage the carotid sinus, first try the right side for 10 seconds, if it doesn't work, try the left side for 10 seconds, do not pressurize both sides at the same time."

"Press the eyeballs, first right and then left, each time no more than 10 seconds."

"..."

After this series of methods of stimulating the vagus nerve, the heart rate on the ECG monitor began to drop slowly!
From 160 to 140, then to 110, and finally stabilized at 90!

If he didn't know that this is a fake patient, maybe Lu Chen would still be a little complacent.

By stimulating the vagus nerve to stop the onset of supraventricular tachycardia, the success rate is not very high.

During the internship, Lu Chen only saw one case.

"Thank you doctor, I don't panic anymore." The young man looked "excited".

Lu Chen smiled slightly.

The system did not increase the appreciation value, nor did the completion rate increase!

Your thanks are too fake!

　Whenever the update is late, don't doubt it, I am a night shift.

　　
　
(End of this chapter)