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

Seeing the man retching all the time, Lin Yi frowned slightly.

The results of gastroscopy showed that it was nothing more than chronic superficial gastritis with erosion.

As the saying goes, ten people have nine stomachs, which means that nine out of ten people have chronic superficial gastritis.

As long as a gastroscopy is done, chronic superficial gastritis will generally be prompted.

Slightly heavier like this man, chronic superficial gastritis with erosion.

However, even if this chronic superficial gastritis is accompanied by erosion, it is not like a man who is constantly retching and nauseating.

Chronic superficial gastritis is accompanied by erosion, usually there will be abdominal pain and bloating after meals, and in some cases, nausea and retching, but definitely not like men.

Furthermore, after this man had a gastroscopy in another hospital, he also gave him omeprazole, Livzon Dele and other stomach-protecting drugs.

But according to the man, it didn't work at all.

After taking the medicine, I became nauseous and retched even more, which is outrageous.

There are many diseases that cause nausea and vomiting, not just stomach problems.

Besides, this man just has chronic superficial gastritis with erosion, which is not enough to cause continuous retching.

Sometimes malignant hypertension leads to a sharp increase in blood pressure, causing increased intracranial pressure, and nausea and retching.

So Lin Yi measured his blood pressure, but his blood pressure was within the normal range, which ruled out the cause of malignant hypertension.

Lin Yi looked at the man's face, he was already pale due to the violent vomiting.

And this man just had a gastroscopy and a blood routine check in another hospital simply because of nausea and vomiting, and did not do other checks.

Because of the poor treatment effect, he came to the central hospital.

"Doctor, what disease do you think I am? The last hospital said that I had chronic gastritis and erosion, and prescribed medicine for my stomach, but I took it.

In the future, there will be no effect, but it will get worse. Please ask the doctor to check me up. "

Lin Yi nodded, and started to open the checklist on the computer.

He gave the man a full abdominal CT and liver and kidney function tests.

He was basically sure what was wrong with this man.

After the test results come out, I can explain it to the man in detail.

I just don't know if he can accept it, the disease he got may not be as simple as chronic gastritis.

But this patient frowned when he saw that Lin Yi had prescribed so many checklists.

Some dissatisfied said: "Doctor, I just have chronic gastritis, at most it is a bit erosive. How dare you prescribe so many checklists for me? Why don't you prescribe some good stomach medicine for me.

I'm just nauseous and retching now, nothing else.You should give me less checklists and more good medicines. "

This patient was identified, he himself was nausea and vomiting caused by chronic gastritis.

He didn't think about whether it was for other reasons, but in the end he came to see Lin Yi for medical treatment, and thought that there were too many examinations.

To be honest, Lin Yi has already realized what kind of disease he is.

But if he said it directly without any inspection as a basis, the man would probably not believe it.

It would be even more irresponsible to just prescribe some medicine to treat his stomach according to what he said.

On the contrary, it is tantamount to harming the patient.

Today, when the relationship between doctors and patients is relatively contradictory, if Lin Yi did fewer tests, there would not be enough evidence to prove the man's illness.

Once he is diagnosed, Lin Yi may not be able to tell what kind of disease he is.

So no matter what kind of patient or disease, there must be enough tests to diagnose the condition.

This is responsible to the doctor, but also to the patient.

In today's hospital, this is essential.

If a patient comes to a hospital and only says what symptoms he has without any tests, he asks for a prescription.

Then the doctor who received the consultation would definitely not do what he said.

If the examination is not clear and the condition is not clarified, it is impossible for the doctor to prescribe medicine blindly.

The doctor listened to the patient's words, did not insist on doing the examination, but only prescribed medicine, and the patient had an accident.

The family members will not be grateful to the doctor, but come to the doctor in arrogance to take responsibility.

So now Lin Yijin seems to have divine eyes, but he will never disobey the rules and procedures, and prescribe medicine to this man casually without a checkup.

He couldn't do it, and neither could any other doctor.

Lin Yi held the checklist and patiently said to the middle-aged man: "Let me tell you, your condition is not just nausea and vomiting caused by chronic gastritis from the results of gastroscopy.

I think there are other reasons, so you have to do an examination to be sure, otherwise I can't prescribe medicine for you. "

"Furthermore, even if I prescribe you medicine to treat your stomach, you have taken it before, isn't it ineffective? If I really listen to you today and give you some medicine to treat your stomach, you go back It will still have no effect in the future.

On the contrary, it will delay your condition, so I advise you not to waste time here, and go for the examination as I said, and after the condition is clarified, we will make a detailed treatment plan. "

After Lin Yi's detailed explanation, although the man was still a little reluctant, he still took the checklist and went out for the checkup.

Patients like this, do not follow the doctor's orders, but follow their own wishes.

Lin Yi was in the emergency department, so he would meet seven or eight people a day.

Under normal circumstances, they will accept it if you explain it patiently.

Only a very small number of unreasonable and unreasonable people will make a big noise in the consulting room, but they are often dragged away by the security guards.

After he left, Lin Yi sat down in the consulting room for a few minutes, and then a man in his 30s hurried in from the door.

He clutched his stomach and bent over, looking in pain.

"Doctor, my stomach hurts, can you prescribe some laxatives for me to pull?"

Lin Yi frowned slightly when he heard the man's request.

The patient felt a little strange.

According to common sense, when ordinary patients come to see a doctor, they will definitely describe their illness and how it happened.

Then let the doctor check what kind of disease you have, and then treat it symptomatically!

But this man gave up the laxative when he came up!

Something is wrong with him!
Seeing that Lin Yi remained silent, the young man begged again: "Doctor, please give me some laxatives. I've only been constipated for a few days and haven't had a bowel movement. Give me some laxatives. I'll be fine once I have diarrhea."

What the man said made Lin Yi even more suspicious.

First of all, constipation is just that the stool cannot be resolved.

At most, it is abdominal distension, but no abdominal pain.

Moreover, laxatives can be bought in pharmacies outside.

So why did this man come to the hospital?

Lin Yi looked at the pain on the man's face, it didn't look like he was pretending, but he didn't talk about his condition, he just asked for a laxative.

This makes people have to doubt his motives.

Patients like this are asked to prescribe medicine when they come up, and they don't talk about their condition, and they don't let them check up.

It is impossible for Lin Yi to prescribe medicine for him.

Just like the young couple who held a child in their arms a while ago and let the antipyretics go, but they didn't let them see.

If Lin Yi hadn't been careful at the time, he might have been fooled by that young couple.

Fortunately, Lin Yi stuck to the principles, refused to let the children look after him, and resolutely refused to prescribe medicine, so he escaped the catastrophe.

But now that this man came to the consultation room, he didn't see a doctor and only gave up laxatives, which must be a little abnormal.

Lin Yi said: "You have to tell me about your detailed illness."

"When did your stomach hurt?"

"Is there any nausea and vomiting? Is there any previous medical history?"

"I have to check your situation thoroughly and make a clear diagnosis before I can give you medicine.

If I don't know what's wrong with you and just prescribe medicine for you, I'm irresponsible to you, and it's dereliction of duty for me. "

But the man still didn't give up, he clutched his stomach tightly with his right hand, sweat dripped from his face, and still begged Lin Yi.

"Doctor, I had a stomachache half an hour ago. I haven't had a bowel movement for a few days. It must be caused by constipation. Just give me some laxatives."

Lin Yi shook his head.

"I'm sorry, I can't fulfill your request. I can't prescribe medicine without a clear diagnosis. This is the principle of a doctor."

"If you just buy laxatives, there are a lot of laxatives in pharmacies outside, and you can buy them at will. There is no need to go to the hospital to register to buy laxatives."

"If you insist on letting me prescribe laxatives for you, and don't let me find out the cause of the disease, then please go to a pharmacy outside to buy them, and I can refund your registration fee."

The man saw that Lin Yi was unmoved at all, and his stomach hurt badly, so he had no choice but to undergo an examination.

Lin Yi asked the man to lie on the examination bed.

After a physical examination, it was found that his left lower abdomen had obvious tenderness, but no rebound pain.

Moreover, the abdominal distension is not obvious, and the tenderness in the left lower abdomen is relatively limited.

If it is tenderness in the lower right quadrant, acute appendicitis should be considered.

But this man had tenderness in the lower left abdomen, and no obvious flatulence.

Moreover, the symptoms of abdominal pain were obviously severe. During the examination, the sweat on the man's face had permeated a layer.

It was obvious that he was in great pain.

But at this time, Lin Yi's passive ability was not activated.

He could only consider several possibilities such as acute gastroenteritis, urinary stones, and intestinal spasms based on the man's symptoms.

But further inspection is needed to be sure.

It doesn't matter whether Lin Yi's passive ability is activated automatically, or whether he can directly see what disease the man has.

But the necessary inspection is absolutely indispensable.

Because of the current medical environment, it is not allowed to prescribe drugs to patients without any examination.

Nothing is okay, once an accident happens, you prescribe medicine to the patient without any evidence of examination, then the doctor will be held legally responsible.

Lin Yi prescribed an abdominal CT for the man, as well as abdominal color Doppler ultrasound and related blood routine examinations, and asked the man to go to the emergency room for a CT scan.

There is a CT in the emergency department, which is specially opened for emergency patients. It can be checked at any time, and the results can be issued at any time without queuing.

If it is the experts and professors in the outpatient clinic upstairs, they will prescribe the test results.

For example, CT and MRI, etc., all inspections need to be carried out on the basement floor.

Under normal circumstances, these large-scale inspections will not produce results on the same day, and they will have to wait until the next day at the earliest.

Because of the particularity of the emergency department, the hospital has specially installed a CT in the emergency department to serve emergency patients.

And some patients who often come to the hospital know this convenient condition. , They will not go if they can not go upstairs to find those experts and professors.

I came to the emergency department for examination, just to get the results quickly.

As long as this man has a CT scan, Lin Yi will soon see the CT results on the computer, which is also convenient for diagnosis and treatment of patients.

And the man knew that if he didn't get checked, Lin Yi would never see a doctor for him, or maybe he knew his condition in his heart and needed to be checked.

So he was not resisting, so he took the medical card and went to the CT room for examination.

Not long after the man with abdominal pain left, another 25-year-old young man entered the consultation room.

This man is not tall, probably less than 1.7 meters.

With sunken eye sockets and thin cheeks, he looks very thin and sickly.

He walked into the consulting room and said directly to Lin Yi: "Doctor, I have cancer, and I can't stand the pain. Please prescribe me a pethidine to relieve the pain."

Hey!Today is weird!

Two patients in a row, without mentioning their condition, just let the medicine go.

And this young man was even more outrageous, and he gave way to poison and anesthetic when he came up.

Demerol is a restricted drug!

It is a powerful pain reliever, but it is also a controlled narcotic drug.

With Lin Yi's current title of resident physician, he can't prescribe this kind of medicine at all.

Because the hospital will not give junior doctors the right to authorize narcotics.

And this young man in his 20s asked himself to be prescribed Demerol when he came up, and he also said that he had cancer.

But he didn't have the relevant certificate of cancer in his hand, which made Lin Yi even more suspicious.

Because some patients with advanced cancer do need to take analgesics to relieve pain.

But they usually have medical records and an anesthesia card issued in the hospital.

Those powerful analgesics can only be prescribed when you come to the hospital with your medical records and anesthesia card.

But the man in front of him didn't have anything in his hand, and he was about to take Dulantin when he came up.

The patient in front of him is very likely to be an addict!
It's worth it!

To prescribe restricted drugs in broad daylight, this person is very courageous!
This Du Lengding, not to mention that he is not qualified, even if he is qualified, Lin Yi will never prescribe it for him.

However, Lin Yi didn't want to provoke this kind of people.

After all, once these people become addicted, they can do anything.

After thinking about it, Lin Yi said, "I'm sorry, but I'm not qualified enough to prescribe the medicine you mentioned."

When the man heard that Lin Yi could not prescribe the medicine, he was a little anxious.

"Where can I prescribe this medicine?"

"If you want to prescribe this medicine, you must have the medical records and diagnosis certificate from the hospital, and then go to those old experts to prescribe it."

Lin Yi didn't hide from the man, he told the truth.

It is true that his qualifications cannot prescribe this medicine, and there is no need to hide it.

What if he guessed wrong?
This man is not a drug addict, but a real patient. Isn't that hurting him?