This doctor has a system

Chapter 192 190. Terrible Misdiagnosis
Soon, Yi Zhonglun received a reply email from Fengxin Technology's human resources, and he packed his luggage in a hurry, only two suitcases, and nothing else.The boss was very dissatisfied with his resignation, which meant spending time trying to recruit newcomers.

Obviously if you work hard for a few more years, I can change to a Maserati, the boss muttered, why are young people getting smarter now?If things go on like this, what will happen to his Lili, Tingting, and Dandan?

It's so sad to think about it!

When checking out, the landlady was more talkative, not only didn't deduct his deposit, but also didn't count his rent for the past few days.

"Young man, come back if you have the chance."

"Okay." Yi Zhonglun replied, but he felt that he would never come to this city again.

There are too many new recruits this time, but the Human Resources Department of Fengxin Technology, which is in charge of this matter, is too busy. It will be a week after everything is done.

There are small groups in every place. When Yi Zhonglun first joined the company, he naturally integrated into the small group mainly composed of Z University graduates. Seeing everyone's fighting spirit, he felt that he should have come to the right place.

The company's humanistic environment and treatment are good, and the employees are so lively when they go to work, otherwise, going to work = going to the grave, they must be sluggish.

"Brother Liang, how much did you pay last month?" A new employee asked Wang Liang, and the others immediately pricked up their ears.

Wang Liang proudly raised his thumb and index finger.

"Only eight thousand? A little bit?"

"It's 13!" Wang Liang said loudly, "I'm still relatively small, and Lao Yue sent [-]." There was a burst of exclamation from around.

"The main reason is to issue a project completion award, which is usually not that high, which is more than 2 points." Someone explained.

As soon as his words came out, Yi Zhonglun and the others felt more at ease.

Gao Feng walked in at this moment. The purpose of Zhao Xingye's gathering everyone today was to meet his big boss.During the two days of recruitment, Li Xinyao felt a little uncomfortable. The nausea and vomiting caused by pregnancy were very serious. He was a little worried and stayed in the hospital with his wife for two days.

Originally, Li Zheng drove him here, but this point was too congested. In desperation, Gao Feng had to get out of the car and walk. He came to the large meeting room on the fourth floor from the freight elevator at the side door.

"Brother, this is the position of the leaders." Yi Zhonglun quickly gave him a hand, "It's time soon, so I dare not sit here."

"This is our big boss." Yue Penghui hurried over, "Boss, Manager Zhao and Mr. Hu are waiting for you on the first floor."

"I came in through the side door." Gao Feng was wondering if he didn't see any people, "Penghui, call them quickly." Yue Penghui didn't expect Gao Feng to remember his name, and he was a little excited.

"Where did you come in from? Where's my brother? Didn't he drive to pick you up?" Li Youliang was taken aback for a moment.

"He's blocking the front street, he's not as fast as I am." Gao Feng greeted everyone to sit down, and he was still in a hurry to go back.

Although the new employees already knew from others that the boss was a young man, most of them were still a little shocked and complicated when Gao Feng stood in front of them. Everyone seemed to be about the same age.
However, they are natural, they started a company, and they also made the first imitation of bevacizumab injection. The gap between them is simply desperate.

Gao Feng said a few simple words, to the effect that he welcomes the new colleagues, you work hard, the company will not treat you badly. Barbara
"Do it well! Then let Manager Zhao find you a partner."

After speaking, he left early, and Li Youliang quickly followed.

"Just two steps away, why are you following me?"

"It's fine for me to stay there, and I have another situation to report to you." Li Youliang mentioned the agreement signed with the hospital before. At that time, he said that some business experts or logistics managers were invited from the hospital every year to help their company. Conduct medical knowledge training and logistical business guidance.

Anyone with a discerning eye knows that this is just an excuse, except that Fengxin Technology made a payment to the hospital account once, and no one from the two sides has ever discussed this matter.

"It's 1 million a year. Manager Zhao asked if it will continue next year?"

"Go on." Gao Feng pondered for a moment, Vice President Guo is quite a good person, and the other party will make further progress this year, and he may have to rely on the other party for many things in the hospital.

Besides, it's only 300 million a year. It's nothing to let the hospital go whoring for nothing, he is just so generous.

When she got home, Li Xinyao had already fallen asleep. Although she was more than four months pregnant, the latter looked a lot thinner due to the recent morning sickness, so Gao Feng went to bed lightly.

In the afternoon of the next day, a patient with lung infection was sent to the emergency department. Dong Qianqian called him to have a look, saying that the patient's condition was a little special.

The patient Zheng Zhirong is a senior manager of a department of an investment company. He is just 40 years old this year. His originally happy life has undergone tremendous changes half a year ago.After questioning, everyone learned that Zheng Zhirong's experience was quite tortuous.

The matter started half a year ago. One morning Zheng Zhirong suddenly told his wife Ye Yuexiu that someone was following him. When the wife heard that her husband was being followed, she was angry and scared. Being followed in broad daylight is definitely not a good thing. What if someone wants to harm her husband?
Did you lose all your investors' money?

But what Zheng Zhirong said next made his wife Ye Yuexiu even more confused and dubious.

"Do you know how I knew someone was following me? Because I have super powers, I heard someone whisper to me through thousands of miles of voice transmission, saying that someone was spying on me over the corner."

Zheng Zhirong's words made Ye Yuexiu worry and afraid, superpower?Thousands of miles of sound transmission?What is this all about?Is this still the husband he is familiar with?
The next day, Zheng Zhirong didn't say such words again, which made Ye Yuexiu heave a sigh of relief.I thought this incident was over, but at this time other colleagues in the company quietly contacted her and told her that her husband's behavior in the company these days was very strange and unpredictable, such as losing his temper for no reason and talking to the wall , and myself giggling and panicking alone.

The idiot also knew that there must be something wrong, so Ye Yuexiu hurriedly put down her work and rushed to Zheng Zhirong's work unit, and took him to a nearby tertiary hospital to see what was wrong.

The doctor who received the treatment briefly asked about the situation and learned that the patient had delusional hallucinations, and soon referred them to the psychiatric outpatient clinic.The psychiatrist immediately said that Zheng Zhirong had auditory hallucinations and visual hallucinations, and after careful analysis and head CT, he was diagnosed with schizophrenia.

This was a bolt from the blue for the couple. How could the good-natured man suddenly have a schizophrenia? The two were puzzled. Although they were very helpless in their hearts, they had to accept this reality.

"It may have something to do with genetics, and the usual work pressure is also affected." The psychiatrist told them.

At present, the cause of schizophrenia is unknown. In order to rule out organic brain lesions, such as brain tumors, etc., the doctor also suggested to continue to do a head MRI examination, and the result was normal.There is no such thing as a head tumor, so it seems that Zheng Zhirong's schizophrenia is primary, and the so-called primary means that the etiology is unknown.

"Let's take anti-psychotic drugs first and observe the effect." The psychiatrist suggested.

After taking the medicine, the effect is still good. Zheng Zhirong's strange behaviors are much less, and he no longer says that he has superpowers, and he will no longer talk to the wall, let alone that someone is following him.But after taking the medicine, his energy was also a lot weaker, he was drowsy all day long, and he felt sluggish all day long. Not to mention work, even ordinary home life was difficult for him.

This situation lasted for nearly half a year, Ye Yuexiu was worried about her husband, she went to several specialized psychiatric hospitals, but all the doctors thought Zheng Zhirong was schizophrenic.

"Just take the medicine according to this, don't go back and forth." A doctor told Ye Yuexiu bluntly.

Five days ago, Zheng Zhirong accidentally caught a cold at night, and then developed high fever and cough symptoms. After taking medication at a community hospital near his home, his condition not only did not ease, but it even worsened.Ye Yuexiu felt that this was not possible, so she simply brought her husband to the emergency department of the provincial hospital.

Doctors in the emergency department performed a chest CT scan for Zheng Zhirong and found a large area of ​​infection in the right lower lung. After communication, he was sent to the respiratory department.Dong Qianqian gave him the antibiotic piperacillin-tazobactam injection, but about 1 hour after the infusion, the patient began talking nonsense and even had a tendency to self-mutilate.

This startled Dong Qianqian, she had never seen such a battle before, so she hurriedly called Gao Feng over.

Gao Feng's first impression of this patient was that his hair was disheveled, his expression was indifferent, and his eyes were dull, which was in line with the mental state of a schizophrenic patient. At such a young age, he felt compassion in his heart.

"Terrible misdiagnosis: Zheng Zhirong's experience can be described as miserable, and the terrible misdiagnosis almost ruined his life. Please help him make a clear diagnosis as soon as possible. You can get 20 skill points for completing the task, and 50 skill points will be deducted if you fail." The system immediately Task posted.

Gao Feng was taken aback, misdiagnosed?What does it mean?He had just seen the patient's chest CT, and the right lower lung was indeed infected. How could it be a misdiagnosis?Is the diagnosis of schizophrenia wrong?
"It will get better, the situation just now is really scary! Several people can't hold him down." Dong Qianqian was terrified, "No way, talk to the family members and transfer him to a mental hospital. We rarely deal with such patients here."

"Let me take a look first." Gao Feng stepped forward to conduct a careful physical examination on Zheng Zhirong. The patient was overweight, and his heart rate was going to be very fast, 120 beats per minute. A little moist rales could be heard in the lower right lung. Systematic examination revealed no abnormalities.

The patient's blood pressure was also relatively high. The nurse just measured 190/100mmHg. Dong Qianqian was very worried that he would have cerebral hemorrhage.

"Is the patient's blood pressure always this high?" Gao Feng asked.

"No, his blood pressure is very unstable, sometimes high and sometimes low." Ye Yuexiu replied, "So I didn't let him take antihypertensive drugs."

"It should be related to the patient's mental state. He was very restless just now, so his blood pressure went up." Dong Qianqian speculated.

"That's right!" Ye Yuexiu said, "It was like this once before, and the blood pressure was even higher that time, almost 210."

Gao Feng didn't have a clue for the time being, so he asked Dong Qianqian to take a blood test on the patient first, "Check the hormone level for him too." Zheng Zhirong was a bit fat, with a thick waist and a round face, which looked like a full moon face.

Full moon face is a medical term. Some patients' faces become round, like a round moon, which is called full moon face. Full moon face is common in some patients who have used glucocorticoids for a long time.

Glucocorticoids are very critical hormones that are essential for the normal functioning of the human body.But if it is excessive, such as asthma, lupus nephritis, chronic obstructive pulmonary disease and other diseases, when long-term use of a large amount of hormones is required, it will cause problems with the protein-fat ratio of the patient's whole body, and people will become very fat and feel a little bit thick-backed. It is a buffalo back, and the face will become round, which is a full moon face.

"Yani, tell me what is the most common disease for full moon face?"

"Cushing's Syndrome." Wang Yani replied without thinking. This is not a problem for her. Whether it is a practicing doctor or a postgraduate entrance examination, this question is the key point, and the students memorize it badly.

Cushing's syndrome, also known as hypercortisol syndrome, is a clinical syndrome caused by excessive secretion of collagen hormones by the adrenal glands. Hypertension, hypokalemia, osteoporosis and secondary diabetes.It is a clinical syndrome that can occur at any age, mostly between 2045 and [-] years old, more adults than children, and more women than men.

"Call me when the results come out." After Gao Feng finished speaking, he went to the bronchoscopy room. When he sent out the report in the afternoon, he needed to review it again to ensure that every report was correct.

Dong Qianqian called him at around 4:2.8 p.m. and said that the patient's blood potassium was very low, only 3.5mmo/L (the normal value was 5.5-[-]).

Full moon face, hypokalemia, high blood pressure, is it really Cushing's syndrome?Gao Feng was taken aback, and he suddenly had a bold idea in his mind, could the patient's schizophrenia symptoms be caused by Cushing's syndrome?
Assuming that there is an excessive amount of glucocorticoids in the body, these hormones can completely cause mental symptoms in the brain. Some people show depression, some people are manic, and some people can show schizophrenia.

"There is such a report. In 09, a patient in the UK was treated as schizophrenia. After 5 years, he was diagnosed with Cushing's syndrome by chance. The patient suffered a lot and was hospitalized in a mental hospital. He was imprisoned for 2 years." Dong Qianqian retrieved such a case using a computer.

"Let's wait for the hormone level to come out tomorrow. It's not yet possible to judge." Gao Feng pondered for a while, "Don't tell the patient and family members, lest our guess is wrong."

Hu Jiaran took everyone to rent some apartments near Z University. Due to the speed of construction at the airport, their preparatory work for this project still had to be completed in the laboratory of Z University.

Seeing that the company provided both food and housing, Yi Zhonglun felt heavy in his heart. Unlike other stupid people, he always believed that there is no free lunch in the world.The company is willing to provide such good conditions, it must want to get more from them.

How long is this going to be without rest? 3 months?half a year?He couldn't really be exhausted in the laboratory, he suddenly shivered on a hot day.

"Mr. Hu, start working quickly! I can't wait to work overtime!" Wang Liang said.

"Yes! Hurry up and do it!" Someone echoed.

Is this the corporate culture of the company?It's too scary, Yi Zhonglun is panicking now.

Zheng Zhirong's hormone level test came out the next afternoon. Dong Qianqian immediately called Gao Feng after seeing it. Seeing the result dozens of times higher than the normal value, Gao Feng was overjoyed that Cushing's syndrome was gone!

The next step is to find the cause of the patient's onset. The main cause of Cushing's syndrome is the dysregulation of the hypothalamus-pituitary-adrenal axis, and the adrenal cortex secretes excessive glucocorticoids, leading to a series of manifestations.

Gao Feng first thought of ACTH-dependent Cushing's syndrome, which refers to the long-term stimulation of excessive ACTH or CRH secretion, excessive ACTH stimulation, diffuse hyperplasia of bilateral adrenal cortex, and excessive secretion of glucocorticoids, which causes various systemic disorders in the body. related performance.Excessive ACTH or CRH mostly comes from hypothalamus-pituitary or certain tumor tissues other than pituitary.

Dong Qianqian ordered Zheng Zhirong's head + pituitary MRI plain scan + enhanced and adrenal gland plain scan + enhanced CT examination. His wife Ye Yuexiu ran to make an appointment with the checklist.

"I hope there will be gains." Gao Feng has great expectations for this.

　I'm not in shape today, I have something to do at home.

　　
　
(End of this chapter)