This doctor has a system

Chapter 68 68. Difficult patient 2
Gao Feng got up early in the morning and went to buy breakfast.

"Are you okay?" He asked, Li Xinyao was still unwilling to get up at 7:[-].

"My leg hurts badly." Li Xinyao frowned and didn't get a good rest all night.

"Then you can ask for leave today." Gao Feng sat next to her, "Forget about taking a day off, your body needs to be exercised."

"I hate it!" Li Xinyao gave him a blank look, "You go out, I'm getting dressed now."

"Our relationship, you hurt me a little by saying this." Gao Feng sat still.

Li Xinyao tried to hit him with a pillow, Gao Feng fled in despair.

Gao Feng got stuck and came to the department.After finishing the shift, Dong Qianqian looked at him and said, "Is there any happy event? I see you look happy."

"Haha, there is a little bit." Gao Feng replied: "I moved into the new house I bought yesterday. It's a happy housewarming."

"You bought a house right after you went to work!" Dong Qianqian became interested, "Where did you buy it? How flat is it?"

"It's in the provincial hospital, more than 160 square meters."

Dong Qianqian couldn't hold back anymore, "Good guy, rich second generation! My house has an area of ​​87 square meters, and the apartment is only 70 square meters. It's crowded to death."

"Change it to another one. What are you saving your money for?" Gao Feng persuaded her, "Sister Qianqian, you have to consume, or the country's GDP will be greatly affected."

"Let's put it down, if I have a second child one day, I'll change it." Dong Qianqian thinks it's better to save the money, why do you need so many houses, many people say that the house price will drop.

In a few years, Dong Qianqian will regret hitting the wall, and the house price will soar faster than she imagined.

After investigating the patient with pleural effusion caused by heart failure, Gao Feng routinely questioned the two Gui Peisheng.

"Heavenly gift, tell me a few diseases that can cause pleural effusion."

Zhang Tianci's expression suddenly relaxed, it's simple.

"Lung malignancy, tuberculous pleurisy, heart failure, pancreatitis, hypoalbuminemia from various causes."

Yes, Gao Feng gave him an approving look.

"Lia, tell me, if the pleural effusion is caused by tuberculous pleurisy, what is the adenosine dehydrogenase level?"

"Generally greater than 40U/L."

This question is a bit deep for these students who have just participated in the regular training, but Huang Liya has obviously put in effort.

The system sounded, and our protagonist Gao Feng gained another skill point.

"What disease do you think Cousin Fu Jie has?" After the house inspection, Dong Qianqian sat there looking at the test results, "I checked the information for a long time last night, but I still don't have a clue."

"The CT results of her chest came out, and the imaging department reported that there was no abnormality." Dong Qianqian felt a little headache looking at the CT film on the computer.

"Let me see." Gao Feng picked up the mouse.

Thanks to his advanced film reading skills, Gao Feng quickly discovered some problems, but they were all minor problems, such as a few inflammatory proliferation foci.

The radiologist probably thought the problem was too minor and didn't write it into the report.

"It's impossible for the patient to experience chest tightness!" Dong Qianqian looked around, "Could it be due to psychological reasons?"

"It's really hard to say, but it's unlikely. I think her mental state is fine." Gao Feng thought for a while and said.

He looked at the CT carefully again, but still found nothing of value.

"Godsend, go and get the patient's previous chest CT, and I'll compare it."

Zhang Tianci brought a large stack, "All the patient's films are here, and there are more than 10 chest CT scans."

"Bring me the one with the earliest time." Gao Feng turned on the switch of the reading light box, "Put them in order."

Zhang Tianci and Huang Liya quickly got busy, "Mr. Gao, the earliest one was 4 years ago." Zhang Tiancihui reported.

The patient hadn't developed the disease 4 years ago, which should be due to a previous physical examination or other reasons.

"At that time, the patient didn't feel uncomfortable, so why put it up? And it was written in the report that there was no abnormality." Huang Liya put it away, and brought up the other films.

Gao Feng and Dong Qianqian compared carefully for more than 20 minutes, and the result was very frustrating.

"Give the patient the film back." Dong Qianqian waved her hand, "No, let's use some steroid first."

"Let me take another look at the film from 4 years ago." Before Zhang Tianci left, Gao Feng's mind suddenly twitched for some reason, and he stopped him.

Zhang Tianci took out the film and inserted it on the light box, "This is the report at the time, saying that there is no abnormality."

Gao Feng took a closer look, the lungs were indeed clean, and there was nothing wrong with the trachea.

"Take it away." Gao Feng sighed, "It's really no problem."

"If it doesn't work, just use hormones for a few days!" Gao Feng also agreed with Dong Qianqian's suggestion, "But it probably won't work, the patient has used it before."

Gao Feng took the mouse to turn off the CT on the computer.

"Huh!" He stood up, "No, it doesn't seem right here."

"What's wrong?" Dong Qianqian came to her senses, "Tell me quickly!"

"What is the airway diameter of a normal person?" Gao Feng seemed to have an idea.

"Adults are generally 1.0-1.5cm." Dong Qianqian thought for a while.

"Adult males have a diameter of 1.2-1.5cm, and females have a diameter of 1.0-1.3cm." Gao Feng made it clear that this is the knowledge that comes with advanced film reading skills.

Dong Qianqian measured it with a measuring tool, "Then hers is also normal, 1.0cm".

"The key is that the film she made 4 years ago has a diameter of at least 1.3cm!" Gao Feng looked at Zhang Tianci, who looked confused.

This child is not as smart as Hu Jiaran, if Hu Jiaran would have already left the doctor's office.

"Go and make another trip and bring the film." Gao Feng said to him, "God-given, you have worked hard."

"Have a look?"

"Really!" Dong Qianqian took a ruler and measured, "It's between 1.3cm and 1.4cm. Fu Jie's cousin is very tall."

"This should be the reason why the patient always feels tight in the chest." Gao Feng analyzed: "For some reason, the diameter of the patient's airway was reduced by 0.3cm."

Don't dare to underestimate this 0.3cm, because of this 0.3cm, Fu Xinxin's husband and wife are scattered.

"What kind of disease could it be?" Dong Qianqian was also a little excited at the moment, "Wait a minute, I'll call and ask my senior brother, he's at the Guangzhou Respiratory Research Institute."

"Brother, we have a special patient here. Her airway diameter has shrunk by 1cm over the past few years."

"Bronchial endometrial tuberculosis?" Dong Qianqian raised her voice, "Okay, let's check for her!"

"My senior brother said it might be endobronchial tuberculosis."

"You helped Fu Xinxin clarify the diagnosis and gained 8 skill points." The system's voice sounded.

"System, where are my two skill points? Have you eaten them?"

"As you did not arrive at the final diagnosis alone, the task was not 100% complete."

"It's really picky!" Gao Feng was a little dissatisfied.

"The patient's symptoms do not have the typical symptoms of tuberculosis. How about a bronchoscopy and a biopsy?" Gao Feng suggested.

(End of this chapter)