Sleepless Doctor
Chapter 882: Soy sauce, who has drunk it?
"Mr. Wu..." Director Liang greeted in a low voice.
"Huh? How is the patient?" Wu Mian asked.
"Excuse me, I will toss you for a run. Next time I will pay attention, and I can't ask you directly if there is a problem..." Director Liang began to apologize.
"Director Liang, do you think it's just central pontine myelinolysis?" Wu Mian asked with a smile, her lips raising a beautiful arc.
Chu Zhixi was lucky, and happened to encounter a car that was going to leave. She waited for the person to come out and fell into it.
Director Liang didn't know whether Mr. Wu laughed at himself or was really happy because Professor Chu found a parking space.
"Don't think about it, go and watch the film before talking." Wu Mian said, "The situation is probably not as simple as you said."
"Huh? Any other questions?"
"I think the entire medical history you described is open to question."
"What's the problem?" Director Liang was surprised.
In his opinion, the matter is clear, all the patients' conditions have been diagnosed, and there should be no omissions.
"I'll talk about it after reading it." Wu Mian beckoned, and Chu Zhixi ran over happily, with her double ponytails floating, like a little girl going out on a date after class in the university town.
Youth, it feels so good, Director Liang is a little distracted.
All the way upstairs, Director Liang was pondering what Mr. Wu Mianwu had said.
Problem with medical history collection? How did he know? Director Liang quickly went through the patient's medical history twice, and still didn't find anything he hadn't noticed.
Whether it was because of a mental illness or being bewitched by a video on a public account, the patient drank soy sauce to "detox" and caused a cardiac arrest, he asked himself.
But after she came to the second hospital, she started emergency care and was rescued from the ghost gate. She went to ICU to observe that the situation had improved overnight. Fortunately, the rescue was timely, and the condition did not develop further.
Today, because of the rapid rate of correcting hypernatremia, a rare complication of central pontine myelinolysis has occurred.
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To be honest, Director Liang felt that the treatment was a little problematic, but... it was the first time that everyone encountered such a thing as drinking soy sauce.
At that time, everyone's thoughts were on the patient's cardiac arrest, and other problems were trivial.
Correction is slow, what should I do in case of cardiac arrest again?
What is Miss Wu thinking? Director Liang was puzzled, and Wu Mian walked into the doctor's office.
The little doctor under his hand prepared the film and inserted it into the reader.
"Director Liang, help find a white dress for the girl to wear." Wu Mian said softly.
Chu Zhixi changed her clothes and went for a physical examination. Director Liang hesitated and stayed with Wu Mian to watch the film.
Wu Mian's right hand was placed on the table in front of the reader, and the white jade-like fingers tapped on the table lightly, and the sound was very slight.
He looked at them one by one, and did not quickly express Director Liang's doubts.
After 10 minutes, Chu Zhixi came back.
"Brother, patient..." Chu Zhixi reported the physical examination quickly and seriously, as long as he focused on a few points-motor speech disorder, dysphagia, and sudden flaccid paralysis of the limbs.
"Do a serum anti-Tg2 antibody test." Wu Mian said.
"..." Director Liang was taken aback. This examination was to clarify an extremely rare gastroenterology disease-celiac disease.
Is the patient celiac disease?
Mental disorders, long-term eating of bread, weight loss, and malnutrition are indeed symptoms or triggers of celiac disease.
But... Celiac disease cannot be diagnosed with this alone.
Seeing Director Liang's eyes in a daze and obviously entering a state of contemplation, Wu Mian smiled and said, "Director Liang."
"Huh?" Director Liang was taken aback.
"Are you wondering why I judged the patient to have celiac disease?"
Director Liang nodded.
"Sit down, you and other doctors have overlooked a very important point in the entire medical history."
Director Liang sat down full of doubts, and Wu Mian began to look through the medical records.
She can always see the height of her eyebrows when she was hospitalized, and she quickly closed the door of the doctor's office. Then he quickly stood not far behind Director Liang and listened carefully, for fear of missing a word.
"Soy sauce, anyone in this room has drunk it?"
"..." Everyone looked at each other, no one thought that what Teacher Wu said in the first sentence was such a nonsense.
"It is described in the medical record that the patient drank 500ml of soy sauce within 1 minute. I don't know if you have similar experience, most likely not. I won't ask everyone, just talk about the data."
"There has been a condiment statistics. 393mg of sodium is equivalent to 1g of salt. Each brand of soy sauce contains 1268mg of sodium per 15ml, straw mushroom soy sauce contains 1215mg of sodium, and dark soy sauce contains 1144mg of sodium... Soy sauce is the least, containing 690mg of sodium."
The data on the sodium content of 15 kinds of soy sauce was gently spoken from Wu Mian's mouth, and everyone in the room was dumbfounded.
Is this something a doctor should know?
I am afraid that the big cows in the catering industry may not be able to know these data.
Although Mr. Wu said clearly, the number conversion in it was too complicated. Someone had already picked up a pen and started to calculate.
"Don't count." Wu Mian smiled slightly and said, "If you drink high-salt liquid into your stomach, normal people will definitely have a stress response, such as stomach cramps. This is a self-protection mechanism of the human body, except for patients. Besides, most people are like this."
The office is quiet. Is this Mr. Wu solving the case? A point so small that no one else can pay attention to it, he even found the problem.
But the stomach is not sensitive to irritation... By the way, Teacher Wu just talked about the diagnosis of celiac disease.
Celiac disease is a systemic immune disease mediated by gliadin and gluten in genetically susceptible individuals, that is, an allergic reaction caused by the human body not adapting to gluten.
Inflammation of the intestine~www.wuxiaspot.com~ Intestinal epithelial cells are damaged, the intestinal mucosa shrinks, and nutrient absorption will be blocked. Over time, complications of anemia and osteoporosis will also occur.
Atrophy of the gastrointestinal mucosa does not mean that it is not sensitive to irritating food.
Thinking of this, the causal connection between the front and the back is connected, and the willows suddenly become clear.
It turned out to be like this. Director Liang's eyes lit up, "Mr. Wu, I will explain to the patient's family and have a gastrointestinal endoscopy."
"Okay." Wu Mian said, "If the serum anti-Tg2 antibody test is positive and the diagnosis of celiac disease is diagnosed, then symptomatic treatment will be given to the patient's paranoid mental disorder."
"Thank you, Mr. Wu, thank you." Director Liang is also a smart person, and after hearing Wu Mian say a little detail that he hadn't noticed, he has long wanted to understand everything.
The patient’s medical history is like a mountain and flowing water. From beginning to end, all the weird points and the points that I suspected of family violence in the patient’s family have a reasonable explanation.
Director Liang couldn't bear the excitement in his heart, and stood up and prepared to examine the patient.
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