The Surgeon's Studio
2348 Low-magnesium syndrome due to high magnesium ions
"Definitely not. Do you know what chatting is?" Su Yun looked at Zheng Ren in disdain.
"Boss Zheng, what kind of illness do you think it is?" Professor Liang quickly asked.
"I can't make a judgment based on the symptoms you mentioned." Zheng Ren said,"bring the old lady here later for me to take a look and do a simple physical examination."
"Yes." Professor Liang nodded.
Chinese medicine talked about looking, listening, asking, and touching, while Western medicine talked about looking, touching, knocking, and listening. These were the most basic things.
Su Yun flipped through the test results again. Seeing that professor Liang had done a comprehensive check on her mother, she had nothing to say.
Other than a small problem with her electrocardiography, everything else was normal, including her electroencephalogram and throbbing waves. She couldn't diagnose any mental illness, let alone epilepsy.
Professor Liang left the examination report behind, greeted the old man, and hurried to pick him up. "Boss, you really don't have any guesses?" Su Yun asked after he left.
"The only abnormality is the electrocardiogram." Zheng Ren took out the electrocardiogram, looked at it again, and said,"The extended PR and QT intervals, the wider the QS waves, the lower the ST-segment, and the wider the T waves. What would you think of these changes?"
"It's not just that. We can also see the voltage reduction in the P and QR waves in some of the oscillations. Looking at the waves, I'm sure it's hypometalline. It's as accurate as a Panda eating bamboo. " Su Yun picked up the ion test report."But look, the magnesium blood is normal."
"Pandas are carnivores ..." Lin Yuan said softly.
"I don't know?" "How are you going to explain this?" Su Yun glared at her.
The latter part of his sentence was already directed at Zheng Ren.
"The magnesium in her blood serum is normal, but we still can't determine that she doesn't lack magnesium ions. Because the blood plasma magnesium is greatly affected by changes in pH, protein, and other factors, a simple ion test can't explain anything. " Zheng Ren said.
Su Yun shrugged her shoulders."Your explanation is a little stiff."
"Let's take a look at the patient first. Some of the symptoms will also appear in some cases of low-potassium syndrome."
"Can you die if you don't talk nonsense?" Su Yun said,"in the diagnosis of low-potassium syndrome, the key is to identify the U-wave. The general rule is that as the condition of hygromalosis gradually worsens, the T wave will gradually decrease, the U wave will increase, and the number of leads where the U wave will appear will increase. The U wave will be equivalent to or higher than the T wave in the same lead, and it will appear like a camel. The T and U fusion will not be able to be distinguished, and the ST segment will move down. "
Zheng Ren did not want to argue with Su Yun. He had too little information on hand. The argument in front of them belonged to the kind of situation where no one could convince the other.
Soon, professor Liang brought his mother over. Zheng Ren looked at the medium red system panel, and the diagnosis was clear about the patient's low magnesium syndrome.
"Aunty, are you feeling uncomfortable?" Zheng Ren smiled and started to ask about her medical history.
Although there was a diagnosis from big pig's trotter, Zheng Ren still asked from the beginning, no matter how big or small, so detailed that Lin Yuan felt it was a little long-winded.
The patient's positive medical history was only intermittent foot spasms, and nothing else.
After Zheng Ren finished asking, he said to professor Liang,""Liang Zi, take Auntie to do a magnesium load test."
"Boss Zheng, you're thinking of hypomelexosis?" professor Liang asked after a moment of surprise.
"Yes, spasms in the wrists and feet, changes in the electrocardiograms, and slight tremors in your mother's eyes during her speech. During the physical examination, there was a slight excitement in the reflexes, and nerve and muscle tremors. Although the blood plasma test showed that it was normal, we can't rule out this illness. "
"Alright," he said. Dr. Liang took his grandmother for a checkup.
"Boss, it looks like it now." After the physical examination, Su Yun did not object. He pondered and asked,"but how did you get it?"
Zheng Ren was also thinking about this problem.
Lin Yuan couldn't keep up with boss Zheng's and Su Yun's thinking rhythm. In her opinion, it was already amazing enough that a clear diagnosis of meteoric low-magnesium syndrome was provided by just a slightly abnormal electrocardiogram, a physical examination, and a medical history.
As for how it came to be ... It was better for him to figure out how to diagnose it first.
"First, the patient might have lost too much of his digestive tract." Su Yun held her phone and chatted with someone while she said,"because magnesium is absorbed in the small intestine and part of the colon, severe diarrhea, fatty diarrhea, malabsorption, intestinal fistles, and major fistlectomies can all lead to low magnesium syndrome."
"Yes, I just asked. He hasn't had any surgery. Normal people shouldn't have problems with absorbing magnesium ions, so we can rule out this. " Zheng Ren sat on the chair and squinted his eyes. He was also thinking about professor Liang's mother's condition.
"Second, we lost too many kidneys. Chronic pyelonphretitis, renal tubular acidity, acute kidney failure in the urinary tract, or long-term use of loop lauretics, thiudes, and permeable servant would cause the loss of magnesium in the kidney and lead to low magnesium syndrome. "
"I just asked, No." Zheng Ren replied,"don't consider that it's a kidney problem."
"I've already considered the possibility of losing it. Next is the possibility of insufficient replenishment and intake." Su Yun said,"I think this is the most important point."
"But I asked just now, and professor Liang didn't find any problems with the food at home. A while ago, I read a report that vegetarians are prone to low magnesium blood. The old lady ate meat, so she probably wouldn 't. "
"What about drinking water?"
"Usually, there won't be any problems." Zheng Ren shook his head."Trace elements are the minerals that make up 0.01% of the body weight in a region. They are mainly iron, zinc, copper, manganese, selenium, iodine, Fuluo, cobalt, and magnesium. These elements can not be synthesized by the human body and can only be obtained from food. "
"The human body can only absorb organic trace elements, but can't absorb non-organic trace elements. Most of the trace elements in water are non-organic, and the content is very small."
"It has nothing to do with drinking water. Humans generally obtain trace elements from plants and animals."
"Boss, have you read this book? United States 's' healthy water 'written by Dr. Fox, Dr. Martin from the US. " Su Yun changed the topic again.
Zheng Ren shook his head.
"The book said that the standard for health water is to have a certain degree of hardness. The ideal value is about 170 mg/L, and it has a certain amount of soluble total solid ..."
"Let's not talk about that. How did you get hypometsis? This is a rare illness. " Zheng Ren brought the topic back and continued asking.
"You must have a medical history that you didn't ask clearly. Boss, your clinical skills are very poor. Wang Lin, I'm sending you to ask. You must get to the bottom of this. " Su Yun laughed.
Lin Yuan tactfully didn't move or say anything.
The medical history that boss Zheng had asked about was complete, and he didn't know what to add.
And ask for a medical history? The memory of the last patient with an incomplete oval shaped hole and a migraine was still vivid in his mind. Lin Yuan was not willing to experience it again.
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