Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 133 Case review, new commission! (Please subscribe!)
"Brother Yi, this is so good, how come there are bacteria in the gallbladder?"

Sitting in the consulting room, Chen Qiang couldn't help asking questions.

Because he also followed this patient all the way down. He followed the diagnostic thinking and finally figured it out. He thought that a case had been successfully solved, but he didn't expect that there was a problem with the inexplicable gallbladder!
Not only him, but the water friends in the live broadcast room were also puzzled, and launched barrages one after another:

"The host said that the gallbladder was caused by fasting water, but why are there bacteria in the gallbladder?"

"Yes, does this patient have other problems?"

"Maybe his gallbladder was abnormal, and the two diseases happened to coincide."

"If this is the case, this patient is quite unlucky... There are so many problems in the body at the same time."

After taking a sip of water, Lin Yi explained:
"Generally speaking, the gallbladder of normal people has no bacteria. But under pathological conditions, especially patients with pancreatitis and digestive tract dysfunction."

"At this time, the bacteria in the intestinal tract may flow back into the gallbladder through the common bile duct, causing cholecystitis."

"oh, I see."

After hearing this, Chen Qiang nodded in understanding.

"We can give him targeted treatment immediately, and it's not a big problem."

Afterwards, Lin Yi said to Wu Jiang.

"Okay, I'll arrange it now!"

Wu Jiang agreed, and hurried out of the consulting room.

Afterwards, Lin Yi looked at the live broadcast camera and said:

"Brothers, now we have thoroughly analyzed the cause of this patient."

"I don't know if there are any medical students or medical-related workers in our live broadcast room. I can review this case for everyone to learn from."

After Lin Yi finished speaking, the live broadcast room quickly sent a bullet screen to give a response:
"I am, I am, I just started my freshman year! Watch the host's live study!"

"I'm a doctor in the hospital, tell me, the anchor!"

"I'm not a medical worker, but I want to hear it!"

"Yes, me too, but most of the anchor's live broadcasts are still understandable!"

"Come on, anchor, this is a classic case, my notebook is ready!"

Lin Yi saw that the barrage was very enthusiastic, so he said:
"Okay, since this is the case, then I will say that even if you are not a medical worker, you can use this patient's experience as a warning and pay attention to protecting your body."

"First of all, the patient himself is overweight. Due to previous overeating, heavy drinking, and hyperlipidemia (hypertriglyceridemia)."

"In this case, coupled with that party, he overeat on the spot, which directly induced acute pancreatitis."

"Then came to our hospital, during the treatment of acute pancreatitis, because the family members of the patient did not accept my suggestion immediately, blood purification treatment was performed."

"The patient developed complications again in the ward. First, the lungs were involved, and he developed acute respiratory distress syndrome, so that he was admitted to the ICU and put on a ventilator."

"After the situation improved, acute cholecystitis reappeared due to the patient's hyperlipidemia and cholestasis caused by long-term fasting and water deprivation, and it was non-calculous cholecystitis."

"In the end we performed a gallbladder puncture and aspiration of the patient's gallbladder, along with intensive antibiotic therapy."

"After this treatment, he must be fine!"

"Through the case of this patient, I want to remind everyone that you must actively exercise and maintain a good figure."

"No matter how excited you are when you are out with your brothers and friends, don't overeat!"

"Also, if there are water friends who have hypertriglyceridemia found in the physical examination, pay attention, you must be more vigilant!"

"You must keep your mouth shut and move your legs, otherwise it will be too late to regret after you get into big trouble!"

After Lin Yi finished speaking, there was a wave of echoes from the water friends in the live broadcast room:
"Okay, anchor, I understand!"

"In the future, when you go out to parties, you have to pay attention to your diet! Drink less alcohol!"

"The more I watch the anchor's live broadcast now, the more cautious I am!"

"Damn! It's good for you to be cautious, I'm paranoid every day now! I always wonder if I have this disease or that disease!"

"I feel like I have a mental problem!"

"Hahaha! Me too, I thought I was the only one like this!"

"I saw a case live broadcast by the anchor, and I thought I had this disease."

"Fuck! Then you are more serious, brother!"

…………

After several days of treatment, the patient's body temperature gradually dropped, and the bile drawn from the body became less viscous.

Lin Yi arranged for another culture, and there were no bacteria, which meant that the infection had been brought under control!

【Ding!Congratulations to the host!Complete advanced medical diagnosis tasks and get rewards:
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】

Cow batch!

………………

"Oh... this morning was really fulfilling!"

On this day, Lin Yi had been seeing surgical patients all day long, and he walked into the consultation room after lunch, and stretched vigorously.

"It's been a few days, and no patients with intractable diseases have come to the door."

Wu Jiang sat in front of the desk and said with a sigh.

"What's wrong? Is your hand itchy?"

Yin Liang couldn't help but asked with a smile.

"Yes! Needless to say!"

Wu Jiang moved his wrist and said directly,

"Now I can't meet patients with intractable diseases, and I feel uncomfortable all over!"

"Look at you here, even if there is such a patient, it's not diagnosed by Brother Yi. Those who don't know think it's all diagnosed by you!"

Yin Liang couldn't help but retort.

Wu Jiang glanced at him and said:

"What's wrong? Then I also participated, can't I?"

"Okay, okay, it's mainly because of your help, okay! If you don't watch by the side, the patient's appointment will not be able to get better!"

Yin Liang nodded and said again and again.

Watching the two of them fighting each other, Wang Qiaoya couldn't help covering her mouth and laughing.

Wu Jiang looked at Wang Qiaoya, pointed at Yin Liang and said to her:

"Qiaoya, don't listen to his nonsense, don't think that he has been in the hospital longer than me, but his medical skills are not as good as mine!"

"Hey, hey, I'm not as good as you? Don't put money on yourself in front of your new colleagues!"

Yin Liang looked at him with disdain, and said to him,

"Low-key, do you understand! You see, Brother Yi is so young and so powerful, and he is not as brazen as you!"

"Are you Brother Yi? You sound like yourself!"

"whispering sound!"

While everyone was watching the two quarreling, the office door was pushed open from the outside.

The two of them stopped involuntarily.

Everyone looked towards the door.

A doctor in a white coat came in and looked around.

"Zhang Cheng, why are you here?"

After seeing the doctor clearly, Wu Jiang couldn't help asking in doubt.

"Huh? Brother Jiang, are you also in this independent clinic now?"

The doctor named Zhang Cheng couldn't help being a little surprised when he saw Lin Yi.

"Of course."

Wu Jiang nodded.

"Who is this…………"

Lin Yi looked at Zhang Cheng and asked in doubt.

Wu Jiang hurriedly introduced:

"Oh, Brother Yi, he's from the immunology department."

"Immunology Department..."

Lin Yi nodded slightly, expressing his understanding.

But then I became curious again, why did the doctor from the immunology department suddenly come to my office?
"This is Dr. Lin Yilin, right?"

Afterwards, Zhang Cheng looked at Lin Yi, with a flash of surprise in his eyes, and asked Wu Jiang.

"That's right, this is Brother Yi, the boss of our consulting room."

Wu Jiang nodded affirmatively.

"Doctor Lin, it's like this. Our immunology department encountered a patient with a complicated situation. Our director Xu asked me to come over and ask if you have time. Go over and have a look."

Zhang Cheng looked at Lin Yi and said.

Since the director of the orthopedics department asked Lin Yi for help in diagnosing patients last time, the director of the orthopedics department told his friend Director Xu of the immunology department about it.

So when Director Xu encountered trouble, he first thought of Lin Yi.

"Oh? Is there a patient with a complicated condition? Really, Cao Cao will be here soon!"

Without waiting for Lin Yi to say anything, Wu Jiang immediately stood up excitedly, looking around the crowd.

Lin Yi frowned slightly and asked:
"What's the condition of this patient?"

Zhang Cheng frowned first, and then wondered:
"This patient... I can't explain his situation clearly. If you are free, come with me to Director Xu's office now."

"Okay, then I'll go and have a look."

After finishing speaking, Lin Yi stood up directly.

"Brother Yi, I'm going too!"

Wu Jiang immediately took the initiative to ask Ying to speak.

Lin Yi looked at him and said:

"I'll go there first and see what's going on. You guys are waiting here."

"OK then."

Seeing what Lin Yi said, Wu Jiang had no choice but to give up.

Afterwards, Lin Yi and Zhang Cheng walked to Director Xu's office of Immunology Department.

"Dong dong!"

"Please come in!"

Zhang Cheng pushed the door into the office and said to the inside:
"Director Xu, Dr. Lin is here."

Lin Yi walked in, and saw that the office was very large, and there was a round table by the window on the left, with three people sitting there.

In the middle is an older doctor, sitting upright on a chair with a serious expression.

He is Xu Jie, director of the Department of Immunology.

Xu Jie looked at Lin Yi, nodded to him and said hello:

"Doctor Lin, hello, please sit down."

"Okay, Director Xu."

Lin Yi responded politely, and then sat down.

"Doctor Lin, Xiao Zhang should have told you why we invited you here. There is a patient whose condition is more complicated. We would like to invite you to come for consultation."

"I know that although you are very young and have not been in the hospital for a long time, you have extremely high levels of knowledge about these diseases and diagnosis ideas."

Afterwards, Xu Jie looked at Lin Yi and said with a slight smile on his face,

"These two are experts in immunology and oncology."

After speaking, he pointed to the two doctors next to him.

After Lin Yi greeted them, Xu Jie went straight to the point and said to Lin Yi:
"Doctor Lin, time is running out, let's get down to business."

"Let me tell you about this patient first."

"Okay, Director Xu."

Lin Yi nodded, cheered up, and waited for his narration.

"This patient is Sun Haiyang, 21 years old, a rich second generation."

"A few days ago, when he was driving a sports car with his little girlfriend, he suffered a sudden internal bleeding and caused a traffic accident. The sports car crashed into a bridge pier!"

"After the patient was sent to our hospital by the emergency center, his symptoms were low-grade fever and internal bleeding."

"We conducted a preliminary examination on him and found that his red blood cells were lysed, his indirect bilirubin was high, and his serum haptoglobin was low..."

Red blood cell lysis and indirect bilirubin are high. If these two situations occur, it means either liver damage, blood disease or autoimmune disease.

Hearing this, Lin Yi couldn't help thinking in his mind.

Immediately afterwards, Xu Jie continued:
"Through investigation, we found that the patient had repeatedly traveled to and from the hospital due to internal bleeding in the month before the accident."

"After our further examination of him, drug use, meningitis, infection, bacterial endocarditis and other conditions were ruled out."

"And we speculated about several disease possibilities."

"One is hemolytic anemia (a blood disorder in which red blood cells are destroyed at a rate far beyond the ability to compensate)."

"And there's lupus."

"And lymphoma."

Immediately afterwards, Xu Jie said to Lin Yi in one breath.

After hearing this, Lin Yi nodded slightly to express his affirmation.

Lupus erythematosus is a typical autoimmune disease.

"Doctor Lin, what do you think?"

After finishing speaking, Director Xu raised his head and stared at Lin Yi expectantly, waiting for some good insights to come from Lin Yi.

Lin Yi pondered for a moment, then asked:

"Does this patient have genetic hemolytic anemia?"

"No."

After listening to Lin Yi's question, Director Xu directly shook his head and denied it.

After hearing his answer, Lin Yi immediately said:
"In that case, he is not hemolytic anemia."

"As a 21-year-old young man, without genetics, the possibility of suffering from hemolytic anemia is almost non-existent!"

Hemolytic anemia generally occurs in young children and the elderly, and the root cause is autoimmunity.

In the absence of other diseases as incentives, hemolytic anemia will not occur at all.

"Ah."

After Lin Yi finished speaking, Director Xu nodded directly,

"Indeed, the chances of having hemolytic anemia are slim to none."

"But there is a slight possibility, I still list it."

"Of course, our main suspects are lupus erythematosus and lymphoid tumors."

"By the way, there's also... His mother died of stomach cancer."

After Director Xu finished speaking, he suddenly remembered and said to Lin Yi.

Lin Yi nodded slightly.

In this case, it is really possible that it is lymphoma.

Both diseases are possible!
Immediately afterwards, Xu Jie continued:
"Later, we checked the patient for these two items, and the test results showed that the antinuclear antibody of lupus erythematosus was negative, and no lymphoma was found."

"This…………"

Lin Yi couldn't help being taken aback, he didn't expect that they had already checked for these two diseases, and the result turned out to be negative for both of them!

(End of this chapter)