This doctor has a system

Chapter 3 3. COPD, the journey home of smokers
The day in the Department of Respiratory Medicine passed quickly. Gao Feng got acquainted with the hospital's HIS system in the afternoon and found it to be very smooth, much smoother than the broken system when he was studying in graduate school.

I asked a teacher in the next group and learned that the system costs tens of millions, and it costs a lot of maintenance fees every year.Sure enough, expensive things are easy to use.

We divided the patients, four Guipei students, 31 patients, and it happened that one person managed 8 of them.Qi Nannan selects the patients first. She just graduated from a junior college this year, and her foundation is relatively poor. She wants to take care of the patients first.

Gao Feng didn't care, and Cheng Song didn't have any objections either.On the contrary, Hu Jiaran had some objections, and he discussed with Qi Nannan in a harmonious voice: "Nannan, you can also assign me two lighter patients, my level is as rubbish as yours."

Qi Nannan couldn't help but rolled his eyes.

After the division of labor was clear, everyone started to seize the computer to write medical records. The internal medicine department of a large hospital has high requirements for medical records.At 05:30 in the afternoon, Li Huizhen appeared in the ward again and took everyone to check the patient again.

get off work!

Back in the dormitory, Wang Xuanxuan was lying on the bed weakly reading a book, and when he saw Gao Feng came back, he complained to him: "Respiratory medicine is so perverted, the ward rounds have been asking us all the time today, everyone is like a tortoise, being brought into the group The director scolded me for a long time. How are you doing?"

"It's all the same. It's normal for everyone to stumble and be scolded when they first arrived," Gao Feng comforted.

Hearing what he said, Wang Xuanxuan became much more interested. Sure enough, what was said in that sentence: Brother, I know that you are not doing well, so I am relieved
After a while, Li Wenbin and Wang Leifeng also came back. The two of them were assigned to the cardiopulmonary function department, responsible for taking electrocardiograms for patients, and they were still in the same group.

After all, Li Wenbin has been working for so many years. To him, taking an electrocardiogram is like a tiger eating bean sprouts-a piece of cake.The teacher who taught him was not as old as Li Wenbin, and he was very polite to him. After chatting for a while, the two became brothers, and even made an appointment to drink together the day after tomorrow.

Gao Feng is also going to take a look at the task assigned by Li Huizhen: lung adenocarcinoma.

Lung adenocarcinoma is a type of lung cancer and is the most common type of lung cancer.Unlike squamous cell lung cancer, lung adenocarcinoma is more likely to occur in women and non-smokers.

The incidence rate is lower than squamous cell carcinoma and undifferentiated carcinoma, the age of onset is younger, and women are relatively more common.Most adenocarcinomas originate from the smaller bronchi and are peripheral lung cancers.

In the early stage, there are generally no obvious clinical symptoms, and it is often found during chest X-ray examination.It presents as a round or oval mass, which generally grows slowly, but sometimes hematogenous metastasis occurs in the early stage.Lymphatic metastasis occurs later.

Thinking of that 14-year-old girl, Gao Feng felt a little uncomfortable.I don't know when humans will be able to conquer cancer.

Gao Feng got up early the next day, but there was nothing he could do. There were too many people living in the dormitory, and he couldn't eat food even 10 minutes late when he woke up.Today, I met Director Li who led the group, a smiling old man, and asked Gao Feng kindly where his family was.

Director Li also graduated from Xinxiang Medical College, so he can be regarded as Gao Feng's predecessor.Before the rounds started, Director Li received a call.After hanging up the phone, Director Li said to Li Huizhen: "Old Jia probably suffered from COPD again. I'll ask him to come and find you later."

The process of ward rounds is very cumbersome. Every time a patient arrives, he first needs to check the patient's examination and test results, and then conduct cardiopulmonary auscultation or other physical examinations, and then ask the patient whether the symptoms have improved or aggravated. Three meals a day and the situation of urination and defecation.

If you meet a few patients and family members who want to confide, it's over, and you may not be able to issue medical orders until you get off work at noon.

At this time, the sweet-looking nurse lady will come over aggressively and criticize you mentally.Since Gui Peisheng is at the bottom of the hospital food chain, he usually can only suffer silently or complain behind his back.

Today's ward rounds went smoothly, and after a while, the Lao Jia that Director Li was talking about came to the ward.He is a 76-year-old man with white hair and beard.

The son pushed him in a wheelchair with a small oxygen cylinder on it.When Mr. Jia saw Director Li and Li Huizhen, he raised his hand and wanted to stand up, but his son hurriedly asked him to sit down.

"Gao Feng, come and pick up this patient!" Li Huizhen said.

Gao Feng and the patient's son helped the old man to the bed, and the nurse gave him oxygen.After Gao Feng inquired, he learned that Mr. Jia is an old patient in the respiratory department.

Smoking was more aggressive when I was young, and I was diagnosed with chronic obstructive pulmonary disease more than 20 years ago.Since then, I have been admitted to the hospital 1 or 2 times a year because of chest tightness and wheezing.

This time, it was also because he caught a cold a few days ago and felt severe chest tightness. He took oral medicine at home, but the effect was poor, so his son rushed him to the hospital.Li Huizhen auscultated Mr. Jia's lungs, asked a few more questions, and then ordered a doctor's order.Gao Feng and Qi Nannan stayed behind to ask about medical history and write cases.

At this moment, the voice of the system sounded: Please make a preliminary diagnosis of this patient.

This is a sub-question!Gao Feng immediately gave the answer: acute exacerbation of chronic obstructive pulmonary disease.

"wrong answer."

What? !Impossible, absolutely impossible.

"The answer is not comprehensive."

Gao Feng thought about it carefully. The patient has been suffering from chronic obstructive pulmonary disease for more than 20 years, and now he has distended jugular veins, which may be combined with chronic pulmonary heart disease.

"The answer is not comprehensive. It is recommended to have a detailed physical examination." The system's voice rang again.

"Grandpa, don't speak for now, I'll listen to you later." Gao Feng took out his stethoscope.

After a careful cardiopulmonary auscultation, Gao Feng discovered the problem. Mr. Jia's right lung breath sounds could hardly be heard. Could it be that he had a pneumothorax?
"Congratulations to Dr. Gao for answering correctly, reward the cardiopulmonary auscultation skill book level."

Gao Feng was a little ashamed, he was too embarrassed to ask for this skill book.

Back at the doctor's office, Li Huizhen had already issued a doctor's order. Gao Feng stepped forward to check, but there was no chest CT or chest X-ray examination.Medications are some antibiotics and asthma drugs, as well as nebulized inhaled glucocorticoids and B2 receptor agonists, which are standard equipment for patients with COPD.

"Mr. Li, does Mr. Jia have a pneumothorax? Shall we take him for a CT scan?"

Li Huizhen froze for a moment, "Why do you say that, does he have chest pain?"

Gao Feng said truthfully: "He didn't say anything, but I just auscultated and found that the breath sounds in the right lung disappeared."

Li Huizhen reached out to get the stethoscope on the table, but Gao Feng quickly handed her the stethoscope hanging around his neck.

This is a brand-new stethoscope. It has a smoky appearance and is very textured. It is different from the usual colorful, tattered and coquettish stethoscopes that even lack an earplug. Li Huizhen noticed the brand name Littmann on it.

In less than 3 minutes, Li Huizhen came back and performed a chest CT scan. Gao Feng hurriedly inflated the oxygen bag and asked the nurse to seal the tube.

Mr. Jia's son was a little nervous, and Gao Feng asked him to borrow a wheelchair from the nurse's station, so that his nervousness would be relieved a little when he was busy.

(End of this chapter)