This doctor has a system

Chapter 48 48. Hyponatremia

At around seven o'clock in the evening, Gao Feng brought a shrimp porridge and five cups of milk tea to the first ward of the Department of Neurology.

There have always been a lot of neurology patients, and some patients who have no symptoms will regularly receive some drugs to improve circulation, and the beds in the corridor are full.

At the nurse station, one nurse is sitting there writing ECG monitoring records, and the other nurse is doing regular treatment.Gao Feng handed the little nurse 2 cups of milk tea.

"I didn't order this." The little nurse stood up.

"Li Xinyao invited you to drink." Gao Feng smiled at her.

Li Xinyao was sitting in the office doing PPT, and a female student in regular training was writing medical records.

"Ms. Li, when will I stop writing the medical records? It hurts my head." The female guide Pearson complained.

"It's a beautiful idea! If you don't become a doctor in your next life, you don't have to write it." Li Xinyao replied.

Gao Feng walked up to her and sat down, "Why don't you make a phone call?" Li Xinyao was very happy, "I also bought milk tea, what should I do if I get fat?"

"It looks better when you're fat."

"Huh", Gui Peisheng pouted at the side.

Gao Feng immediately handed her a cup of milk tea, watch me gag you!
At this time, several directors of the emergency department were eating together.

After drinking for three rounds, everyone talked about the construction of departments.

"Director, do you think we should also recruit some people? Last time the hospital recruited, we didn't give us a plan. Now that the observation ward is established, there is too little staff." Director Qi complained to Director Dong Zhida.

"Yeah, it's not safe to rely on Gui Peisheng to stand there most of the time." Director Hou also echoed.

Others also spoke up.

"It's not easy." Dong Zhida was worried, "I guess we have to wait until the end of the year to recruit."

"You can choose a few from the regular training students. I think there are master students who come to the regular training." Director Hou suggested.

"Yes, those double first-class graduates probably don't like our emergency department." Director Qi said truthfully: "I think the academic qualifications can be relaxed."

"Our department now has a guy named Gao Feng, who I think is very good."

"Yes, the basic skills are indeed very solid!" Director Hou agreed.

"Okay, you can ask him." Director Dong made a final decision, "Come, let's have another drink."

At 8 o'clock in the morning, Ma Liang got out of the car with Gao Feng.

The patient is a 66-year-old elderly man. He has poor appetite these days, and he begins to experience nausea, vomiting, fatigue, and disorientation in the morning.

Orientation refers to a person's ability to recognize time, place, person, and one's own state. The loss of or erroneous understanding of the environment or one's own situation is called orientation disorder.

Disorientation is more common in symptomatic psychosis and brain organic psychosis accompanied by disturbance of consciousness.

"Has this happened before?" Ma Liang asked the family.

The patient's wife looked sad, "Your uncle had this situation more than a month ago. He was treated in a hospital and said it was hyponatremia."

"After a few days of treatment, I was discharged from the hospital. Who knew I would fall ill again today!" After speaking, the patient's wife handed over a stack of documents, which were photocopied medical records.

Ma Liang flipped through it, and handed it to Gao Feng, "Last time, the blood sodium was indeed very low, and it seems that there is no reason for it."

When he arrived at the emergency department, the patient's oxygen saturation, blood pressure, and heart rate were all within the normal range.

Ma Liang prescribed blood gas analysis and head CT to the patient.

The results of the blood gas analysis came out soon, and the blood sodium was 114mmol/L, which was far lower than the normal value.Head CT showed no abnormalities.

"It should be a series of symptoms caused by low sodium." Ma Liang said to Gao Feng and the three people: "First let the patient go to the emergency room to replenish the sodium, and then do other examinations."

"Please help the patient find out the real reason for the low sodium. You can get 3 skill points for completing the task." The system's voice sounded.

Gao Feng stood up immediately, and seemed to have to take a closer look at the patient. "Auntie, let me look at the medical records from last time. Is the film still there?"

"Here, there is a video recorded on my phone." The patient's wife pulled the phone away, "I kept it on purpose."

Gao Feng picked it up and looked at it carefully. The previous examination was quite comprehensive, including head MRI, chest CT, and full abdomen CT.

Gao Feng was stunned when he slid to the chest CT.

"Ms. Ma, there was something wrong with the patient's chest CT just now, but the previous hospital didn't report it." Gao Feng closed the door of the consulting room, "It should be lung cancer."

"What?" Ma Liang stood up, "I saw no obvious abnormalities in the chest CT report last time."

"Small cell lung cancer should lead to paraneoplastic syndrome - syndrome of inappropriate secretion of antidiuretic hormone, which is easily manifested as dilutional hyponatremia." Gao Feng flipped through the internal medicine book in the system.

"The mission is complete, you have obtained 3 skill points." The system's voice sounded.

"What should I do? I'll take the patient for another chest CT?" Hu Jiaran asked.

"Okay!" Ma Liang issued a checklist immediately.

Soon after CT imaging came out, Ma Liang called the diagnostic room of the imaging department, "Considering lung cancer? Suggest bronchoscopy? Okay, I see, thank you!"

"We have to talk to the patient's family and transfer the patient to the respiratory department." Ma Liang thought for a while, "If the patient doesn't mention what happened before, let's not talk about it."

"This is a missed diagnosis." Hao Mengpei was a little unhappy, "Isn't this delaying his treatment!"

"It's quite obvious on the CT. It's a bit unreasonable to miss the report. But the last time I looked at the ribs, there was already metastasis, and the ending may not have any effect." Gao Feng looked at Ma Liang.

"Oh!" Ma Liang sighed. "Wish this patient the best of luck."

"Old lady, is your child here?" Ma Liang didn't want the old lady to know the real situation of the patient.

The patient's wife seemed to realize what was going on, "We only have one daughter, and she's in Australia. Tell me first, she won't be back soon."

Ma Liang organized his speech, "The old man has a problem with his lungs. It may be lung cancer, but he needs to go to the respiratory department for further examination and diagnosis."

"Of course, this is only the current preliminary diagnosis. Maybe it's not. We have to wait for the results of the next inspection."

The patient's wife burst into tears, "Okay, I see, thank you doctor."

Gao Feng called Li Huizhen directly, and Hu Jiaran accompanied the patient's wife to push the patient over.

"The old lady is quite strong. The patient just recovered a little bit. When I asked her if it was serious, the old lady smiled and said it was fine." Hu Jiaran came back and said.

"It's so pitiful." Hao Mengpei felt very uncomfortable.

"Ma Liang, are you back from the clinic?" Director Hou opened the door and walked in. "Gao Feng, there is a good thing." Director Hou smiled.

"Do you want to stay in our department? Director Dong said yesterday that he would absorb you."

Gao Feng was stunned for a moment, "Director, I'm staying in the respiratory department of our hospital."

"What?" Director Hou looked disappointed. "What does the respiratory department do? It's dirty and tiring. How challenging our emergency department is!"

Gao Feng smiled, "Before I transferred to the Department of Respiratory Medicine, Director Zhao thought I was okay, so he asked me to submit my resume, and I have been admitted."

"Okay." Director Hou left sullenly. He finally took a fancy to a talent, but who knew he had already made an appointment.

"Brother Feng, cow!" Hu Jiaran looked proud.

"Brother, let me help you if you become rich in the future." Dr. Ma Liang laughed.

"It's amazing." Hao Mengpei thought to himself.

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(End of this chapter)