Great doctor starts with adding points
Chapter 7 Coping with ease (for collection, for follow-up reading)
"Brother Hao, there was no emergency room last night, right?" Wu Xie met Fang Hao at the entrance of the hospital, and still asked enthusiastically, looking very cheerful.
Fang Hao was slightly taken aback when he heard the words, and replied in a rather urgent tone: "Ah? There were no emergency patients yesterday."
After Fang Hao finished speaking, he looked at Wu Xie with his eyes, feeling quite guilty.
The two walked towards each other without stopping, and Fang Hao said again: "Xiao Xie, I'll go back first, I didn't sleep well yesterday because of insomnia."
"Brother Hao, you go to rest." Wu Xie paused, turned around and watched Fang Hao some distance away.
When they arrived in the department, Xu Rong and other nurses were gossiping. It seemed that the gossip was about 'Second Master Qin' and 'Second Uncle Qin'.
Wu Xie can't take care of these trivial matters.
Entering the office, the attending physicians He Ling and Liu Chengshan were all there, and except for Wu Xie and Fang Hao, the resident doctor Zhong Yusheng was busy in front of the computer with two medical assistants.
Seeing Wu Xie coming in, He Ling and Liu Chengshan both greeted: "Xiao Wu is here."
"It's pretty early today."
It was still early, only seven forty.
It's just that at this moment, except for the director and Fang Hao who is on the evening shift, everyone else in the department is here, so it's not too early.
Wu Xie responded casually, and soon the director Lu Junyin also came to the department and to the door of the office.
He deliberately glanced at Wu Xie, and then ordered: "Check the next room."
Zhong Yusheng and the two medical assistants got up immediately. Wu Xie, He Ling and the others were standing and filed out to wait for Lu Junyin at the door of the office.
Lu Junyin put on the white coat, but did not wear a badge: "Everyone just arrived today, and there was no operation. Let's slow down the process of rounds a little bit. We are also learning to do business learning in the department."
"Don't be afraid, our place is not as formal as a big hospital, we just check for omissions and make up for vacancies." Lu Junyin added.
Wu Xie frowned when he heard the words, and found out from the corner of his eye that the expressions of everyone hadn't changed at all, as if they had expected it.
My heart tightened secretly, Director Lu seems to be studying the business of the department, but he is actually trying to test me, right?
Although Wu Xie has a certain reserve of knowledge, Wu Xie is still a little confused by the encounters in the past few years, but he is not flustered.
When Lu Junyin glanced at the crowd, he still noticed the change in Wu Xie's expression, but he didn't comfort him: "Let's do the rounds."
If Wu Xie really didn't know what to ask, as he said, then no matter how much wine Wu Guonan had, it would be useless.
Bed 123 is in charge of Lu Junyin, and the medical assistant Guo Lixiang is in charge. Guo Lixiang has just graduated from a junior college for one year, and he is not even qualified to apply for the medical assistant qualification certificate. Now he can only be regarded as mixed in the department.
However, at the age of twenty-two, his face was still immature, and after entering the ward, he sold it with all his strength: "Director Lu, this patient has a fractured femoral neck, and the county hospital said that his physical condition is too poor to undergo surgery. "
"It has been ten days since he was transferred to our hospital, and he is in good condition now, and the traction is continuing."
The patient was a 70-year-old grandmother with an obese body and piles of fat on her stomach. Hearing someone coming, he hummed: "Director Lu, give me some good medicine so that I won't be in pain."
The family members who accompanied her cursed and said, "Where is the medicine that doesn't hurt when the bone is broken? You don't have to drink if you are told to avoid it. Now that something goes wrong, you come here again..."
"You are diabetic and still eat buns, steamed buns, braised chicken feet, and fatty meat every day. What can you not eat? What do you eat? Are you doing well now?"
The old man then continued to remain silent, just humming: "Then I'm in pain..."
"The patient has diabetes and high blood lipids. Diabetes has caused changes in the retina and hearing. The edema of both lower limbs is severe and the weight is too fat. Therefore, the risk of surgery is considered too high." Guo Lixiang continued to report the medical history.
After Guo Lixiang finished speaking, Lu Junyin asked in the direction of Wu Xie: "Xiao Wu, how do you treat a femoral neck fracture?"
Wu Xie was a little nervous when he heard the question, but quickly calmed down: "The fracture of the femoral neck is generally over sixty-five years old, and a total hip or half hip replacement is the choice."
This point is a must for practicing physicians and undergraduate final exams.
"Under sixty-five years old, internal fixation with hollow nails is the choice."
"If you can't do surgery, you can only use conservative treatment." Wu Xie felt that his answer was not good enough, but it was enough.
In the town hospital, there is no such patient at all.
Wu Xie's answer was quite satisfactory, not to mention amazing, but at least it was not as ignorant as rumored.
"When treating diabetes, what are the types of medication?" Lu Junyin continued to randomly pick a question.
This question actually has nothing to do with surgery. This is a knowledge point of endocrinology, but it can be used in surgery.
"Sulfonylureas stimulate insulin secretion." Wu Xie knew this knowledge point, and he was familiar with it, because it was something he had just read in physiology.
"Thiazolidinediones increase insulin sensitivity."
"Biguanides Lower Postprandial Blood Glucose."
"Alpha-glucosidase inhibitors, reduce sugar absorption."
"New drugs, insulin, etc." Wu Xie answered the general category while hooking his fingers.
Surgeons do not need to have a deep understanding of the details of hypoglycemic drugs, as long as they have a little understanding.
Although the content of Wu Xie's answer is simple, it is also comprehensive enough. There are some content that Lu Junyin may not be able to clarify.
The surgery in the town hospital never engages in theory, but only in operation.
Lu Junyin continued to smile: "The patient with high blood sugar, under what circumstances can surgery be performed?"
"7.8 on an empty stomach and below 10 after a meal. Stop taking the drug on the day of surgery." This is also a very basic question, which is the basic skills of surgery, which belongs to the content of the pre-operative preparation.
Wu Xie answered fluently.
After Lu Junyin heard the words, he didn't ask any more questions. He looked at He Ling and Liu Chengshan, and they didn't have any additional comments.
So Lu Junyin looked at Zhong Yusheng and asked, "Does Yusheng know the answers to these questions?"
Zhong Yusheng immediately became nervous, with an awkward smile on his face: "Director, I know a little bit, but it's been a long time since I graduated, and I've forgotten many things. I'm not as comprehensive as Xiao Wu."
Zhong Yusheng graduated from a bachelor's degree and was directed to work in the town hospital. He has graduated for five years, lost half of his basic skills training in three years, and probably lost a quarter of his work in two years.
The contents that Lu Junyin asked were also out of reach in the town hospital, so they would naturally be forgotten slowly.
Lu Junyin said to Zhong Yusheng: "I still need to read some books and make up for it when I go back."
Guo Lixiang hurriedly talked about the medical history of the 2-bed patient, but Lu Junyin directly asked He Ling, the attending doctor, to answer the questions about the 2-bed patient.
Some questions related to surgery, He Ling answered freely, more detailed than Wu Xie, but questions unrelated to surgery, such as how many types of antihypertensive drugs are there?
He Ling gave an incomplete answer: "Pril, sartan, Bell, and thiazide."
"I don't know about the rest, Director Lu."
These are common and prescribed drugs in clinical practice. He Ling's answer was not meticulous and professional, and he directly used the name of the drug instead of the effect.
"Does Xiao Wu know?" Lu Junyin moved the question to Wu Xie.
"Beta blockers antagonize sympathetic nerves." This is also the content of physiology that I just memorized, and Wu Xie is very familiar with it.
Everyone frowned when they heard the words, and the mystery in their hearts was laid out again.
What did such a Wu Xie do to be sent away by the county hospital?
"..."
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