Back in 2002 as a doctor

I didn't expect to have a thyroid gland.

"Professor Zhou, your...examination is really unconstrained." The doctor in the B-ultrasound room laughed.

Chapter 0920 hyperparathyroidism

"Hehe." Zhou Congwen ignored the faint ridicule of the doctor in the B-ultrasound room, and concentrated on doing the B-ultrasound.

The patient had an enlarged right parathyroid gland with numerous hypoechoic nodules.

"It's the problem here." Zhou Congwen said, "The diagnosis is relatively clear, it is a neurological symptom caused by hyperparathyroidism."

"What?" The doctor in the B-ultrasound room didn't understand.

The diagnosis of hyperparathyroidism was unfamiliar, but he knew what it meant.How can hyperparathyroidism lead to Alzheimer's disease?

"Liu Na, take the old man to do a blood test to see if the blood calcium is high." Zhou Congwen said, "If the blood calcium is obviously high, go to the thyroid breast department and be hospitalized. After the parathyroid glands are removed, the symptoms of Alzheimer's will be cured." ease."

"..." The doctor in the B-ultrasound room was stunned.

He had heard the term hyperparathyroidism before, but he didn't understand the specifics. He only knew that hyperparathyroidism seemed... well, it just seemed to cause gastrointestinal symptoms.

"Professor Zhou, just do a blood calcium test?" the equipment nurse asked.

"It's enough to check this one in outpatient clinic, and there are many other checks, so let's pay the hospitalization fee." Zhou Congwen said, "Normally, people can understand after the parathyroid gland is removed."

"!!!"

"However, it is still necessary as soon as possible. After all, the old man is too old to bear the toss."

"Okay!" The equipment nurse said quickly.

Although she didn't believe it, or half-believed it, Zhou Congwen gave an almost perfect ending. As a family member of the patient, she would rather believe that Zhou Congwen was unreliable than believe that her grandmother had an "incurable disease" like Alzheimer's.

"go quickly."

Zhou Congwen helped the old man get off the bed, and the doctors in the B-ultrasound room looked confused.

Seeing that Zhou Congwen was about to leave, the doctor in the B-ultrasound room quickly asked, "Professor Zhou, can you tell me?"

"Seldom come across similar patients?" Zhou Congwen asked back.

The doctor in the ultrasound room nodded.

"The typical symptoms of hyperparathyroidism are called 4S, including kidney stones, osteitis cystic fibrosis, gastrointestinal symptoms, and mental symptoms. Usually, gastrointestinal symptoms are the main ones, which are very common."

Seeing that the doctor on duty in the B-ultrasound room was still confused, Zhou Congwen continued to explain.

"Among them, damage to the central nervous system may cause symptoms such as memory loss, emotional instability, personality changes, depression, and lethargy. If there are no other typical symptoms, it may be misdiagnosed as a mental illness and delay treatment."

"So as long as you know this, when you meet a patient suspected of Alzheimer's disease, that is, senile dementia, it is necessary to have a thyroid B-ultrasound and a blood calcium test."

"Is this a differential diagnosis?" The doctor in the B-ultrasound room asked vaguely.

"Yes." Zhou Congwen said, "This is the differential diagnosis. Some Alzheimer's diseases are caused by hyperparathyroidism, but many people don't know it clinically."

The doctor in the ultrasound room was speechless.

Although he was still skeptical, he saw that what Zhou Congwen said was certain, and that the patient's parathyroid glands were indeed enlarged and had high-density nodules. These seemed to vaguely remind him that the young Professor Zhou was right.

It's just that the tone of his speech is too loud, which makes people feel unreal.

"Congwen, did you think of it because of Alzheimer's combined with gallbladder stones and kidney stones?" Shen Lang asked.

"It is rare to have stones in two organs while having mental symptoms." Zhou Congwen said, "Either it is a coincidence, or it is caused by the increase of blood calcium in the patient. In addition, Alzheimer's disease that appeared almost at the same time, A differential diagnosis must be made."

Shen Lang silently remembered what Zhou Congwen said.

Although he listened to it, it was still difficult for Shen Lang to understand for a while.

Xiao Kai stood aside silently, sighing in his heart.

The disease of hyperparathyroidism...maybe in the eyes of ordinary people, doctors are omnipotent incarnations, and all diseases and diagnoses should be clear to the chest.

But for a clinical veteran like Xiao Kai, he has long sneered at this view.

How difficult it is to train a great general practitioner. At least Xiao Kai thinks that he has good talent, but he will definitely not be able to become a Zhou Congwen-style general practitioner.

Speaking of hyperparathyroidism, Xiao Kai knew about the disease, but that was all he knew. As for the 4S symptoms, he didn’t know anything about it.He should have learned it back then, but after graduation, Xiao Kai returned all kinds of knowledge that had nothing to do with chest medicine to the teacher.

But Zhou Congwen was the exact opposite.

Talk eloquently, aggressively, with reasons.

Xiao Kai cherishes his opportunity to study in the Second Hospital of Medical University more and more.

The first time he came here to study, Xiao Kai's idea was a bit of a rogue. His main purpose was to make friends with Zhou Congwen, and maybe he might have a chance to make friends with Huang Lao.

After all, he was born in cardiothoracic surgery, and Huang Lao's position in the subconscious cannot be shaken.

Being able to meet Huang Lao, say a few words, and listen to Huang Lao's advice with his own ears, although these may be useless, at least they can be used for a lifetime.

Even...better than being a clinical vice president.

As time passed, Xiao Kai's attention was successfully shifted to Zhou Congwen.

Whether it's cardiothoracic surgery or diagnosis of other diseases, Zhou Congwen has a maturity and sophistication that doesn't match his age.

Senile dementia caused by hyperparathyroidism...

Xiao Kai silently remembered that this is part of clinical experience.

He didn't want to explore why Zhou Congwen had such a wealth of clinical experience, it was enough to benefit from it, but he wanted to know why?

Xiao Kai absolutely does not want to.

Curiosity killed the cat, and unnecessary curiosity at that.An old Jianghu like Xiao Kai knows that some things cannot be touched, absolutely must not be touched!

As long as there are benefits, I know so much, but the result is only two words - Yaoshou!

Even though he thought so, Xiao Kai still felt anxious in his heart occasionally.

"I'll go if it's okay." Zhou Congwen and the doctor in the B-ultrasound room finished explaining, smiled, turned and left.

"Liu Na!"

"Here, Professor Zhou."

"Send me a text message if you have any results." Zhou Congwen said.

"Okay!"

Zhou Congwen is also very proud.

After coming back for more than half a year, I finally got used to saying text messages instead of WeChat.

"Professor Zhou, how high do you estimate the probability is?" Xiao Kai asked.

"Almost [-] percent."

"Did the surgery work well?"

"Immediately."

Xiao Kai sighed, "To tell you the truth, Professor Zhou, I have encountered a similar situation, and now I think the patient should be delayed by me."

"Don't be depressed, remember in the future, talk to people more, and make fewer misdiagnoses." Zhou Congwen is more tolerant of this, because after all, it is impossible for everyone to be as bad as himself.

In particular, hyperparathyroidism is a disease that belongs to the treatment scope of endocrinology and thyroid breast. Blood calcium is not a must-check item for admission, and there is no way to see it.

"En." Xiao Kai nodded, and at the same time there was a buzzing sound from his pocket.

0921 - First Effect

"Hello." Xiao Kai answered the phone with a flat tone.

"Dean Xiao, a patient has complained."

"You handle it, I'm studying. Do you have to call me in the middle of the night for such a trivial matter? How do you do your work." Xiao Kai said lightly.

Usually, he talks to Zhou Congwen in the same way; he talks to Peng Yiming, Shen Lang, and Li Ran in the same way; when he picks up work calls, he talks in another way.

The faint official authority has already floated out in a paragraph, bringing infinite pressure to the person on the other side of the phone.

But even though Xiao Kai said that, he turned his head at the same time, smiled at Zhou Congwen, motioned for him to make a call, turned a corner and disappeared.

Zhou Congwen guessed that something serious had happened, otherwise he would not have contacted a vice president who was out of town.

The vice president who is in charge of the medical affairs department and the medical affairs department is the busiest person in the hospital, a position that even dogs don't want to do.

Of course, this dog refers to those who can become the deputy dean, and even have a wild look at the chief dean.

Zhou Congwen had worked with Han in the Medical Department of the Second Hospital of Medical University for less than a month in his last life. He heard complaints and noises from patients every day, and his blood pressure soared to over 200.

If there is one job that is harder than receiving emergency calls, it is the dispute handling of the medical department.

Zhou Congwen was not in a hurry, and quietly waited for Xiao Kai to come back.

After a full 5 minutes, Xiao Kai walked back with a strange expression, frowning tightly.

"Could it be the wrong organ?" Zhou Congwen asked.

Xiao Kai was concentrating on the matter, and was taken aback by Zhou Congwen's sudden words.

If you are a doctor and have done clinical work, your heart rate will be directly above 180 when you hear this.

"No." Xiao Kai regained his composure and sighed, "It's actually a small matter, but it seems to have a big problem. I have to go back and come back in one or two days. What do you think of Professor Zhou?"

"Oh? What's the problem?"

Even with Zhou Congwen's sophistication, he couldn't be sure what happened to Xiao Kai.

"Oh, forget it."

Xiao Kai briefly described what happened.

The pediatric emergency department received a 1-day-old patient at 62 am today.

At that time, the pediatrician was explaining the condition to the family members of the patient who was under observation, because he was picked up from the bed in the middle of the night, and he was not wearing white clothes.

Seeing the family members of the patients coming in with their children in their arms, the family members who were watching gave way first to the pediatric emergency doctor.

After the consultation, the patient's family members were unhappy in various ways, and even thought that there were too many physical examinations, so they kept trying to prescribe medicine.

After explaining a few words, the patient's family left with the newborn and went to the next hospital.

This afternoon, the patient's family complained to the doctor who received the treatment, and then the doctor resolutely submitted his resignation.

Things are actually very simple, and there are not many twists and turns and ghost tricks.

Zhou Congwen heard a little heavy.

"Dean Xiao, is there no one in your pediatric department?" Zhou Congwen asked.

"Yes." Xiao Kai didn't hide anything, "Now there are three shifts in the ward, and there are three shifts in the emergency department."

A shift of 3 days means that the nerves and bodies of front-line personnel have been stretched to the tightest, and they may collapse anytime, anywhere.

Zhou Congwen has a deep experience in Jianghai No. [-] Hospital.

People in cardiothoracic surgery are afraid of coming to the emergency department, but Zhou Congwen is even more afraid of pediatrics, especially neonates.

Patients are unable to communicate, so they can only do a physical examination and look for clues. The probability of misdiagnosis is far higher than that of other departments.

Moreover, family planning, a family with a child, is extremely expensive.

Sometimes when I bring a child to see a doctor, the family is neat and tidy, and all the next six wallets follow, with a worried look on their faces.

As for the number of nurses who were beaten because of needles and crying of children.

From 2002 to 2003, the Emergency Department and the Pediatric Department began to show signs of insufficient staff. As for the various things that had to be reduced in the quality of staff in order to fill up the number of people and support the department, Zhou Congwen didn't even want to think about it.

I didn't expect the situation in Baishui City to be so bad.

No wonder he had to call Xiao Kai, the vice president in charge of the clinic.

"Professor Zhou, what are you talking about?" Xiao Kai complained, but he had nothing to do.

"What are you going to do when you go back?"

"Persuasion, if it doesn't work, let their deputy director come down to be on duty. It's really not certain how long people in their 40s can last." Xiao Kai said.

"What did the doctor say?"

"He said that the patient's family fed the child apple juice, and he thought it was caused by eating too early and the apple juice was relatively cold." Xiao Kai said, "Before I asked a few words, the family got angry and left with the child in their arms. "