This Doctor is Great

Chapter 105: The real murderer appears!

"Fuck, what's going on? Why does the blood pressure go up and down?!"

Zhou Mo scolded while running wildly.

"Is it a fake drug?"

"That's not right. If you buy one kind of counterfeit medicine, you can pay for it. If you buy several kinds of counterfeit medicines, you will be too 'lucky'."

"what is the reason behind the scene?"

As Zhou Mo ran, he shouted to the nurse, "Bring fluids, anti-shock, and blood pressure boosters!"

When Zhou Mo flew to the 29th bed in the ward, he took a look at the ECG monitor for the first time.

68/39!

Worthy!

Really bungee jumping!

Quickly withdraw the syringe pump and stop the use of sodium nitroprusside antihypertensive drugs.

Soon, the nurse came in with a cart and brought the booster medicine.

injection!

Then the nurse quickly replenished the fluid, only replenishing a small amount of crystals.

Finally,

After 3 minutes, the patient's blood pressure finally stabilized.

Fortunately, there was no major problem. Otherwise, the patient would be in trouble if they came to rescue again.

"Take another electrocardiogram..." Zhou Mo ordered.

Soon, the electrocardiogram came out.

no problem.

Zhou Mo breathed a sigh of relief.

It doesn't seem to be a heart problem.

"By the way, did the troponin result come out?"

Zhou Mo picked up the ipad and checked the test. Hey, it came out. 3 minutes ago, the results of troponin were removed.

Creatinine protein: 0.09μg/L

normal range.

Therefore, myocardial infarction, etc. can be ruled out.

"Then what's the reason?"

"Excluding counterfeit drugs, what else can affect blood pressure?"

Zhou Mo fell into deep thought.

Stroke it again.

What does the human body rely on to regulate blood pressure?

- Neuromodulation!

- Fluid regulation!

Neuromodulation: There are 'baroreceptors' in the carotid sinus and aortic arch. High and low blood pressure will cause changes in the baroreceptors, which will then be transmitted to the brain center, and then feedback to command the blood vessels and the heart to make corresponding adjustments.

As for the regulation of body fluids: both 'norepinephrine' and 'adrenaline' secreted by the adrenal medulla can strengthen the contraction of the heart and peripheral arterioles, thereby increasing blood pressure and enhancing breathing.

After stroking,

"It seems...the reason has been found!"

Zhou Mo slapped his head!

"It should be it!"

"It turned out to be so simple, why didn't I think of it?"

"Sure enough, textbooks are awesome!"

Zhou Mo thought of the adrenal glands!

The reasoning is as follows:

The patient's adrenal glands have problems, resulting in the secretion of a large amount of norepinephrine and epinephrine, which then causes the blood pressure to rise.

As for the antihypertensive drugs the patient used, none of them worked.

Therefore, the effect of antihypertensive drugs is not obvious.

Maintained this hypertension level of 180-190 at the time of admission.

Then, Zhou Mo suggested that the patient be given sodium nitroprusside, the blood pressure was very obvious and it was maintained.

However, at this time, the patient's diseased adrenal glands started not to secrete norepinephrine and norepinephrine again, so the patient began to significantly lower blood pressure again.

Then, there was a situation where the blood pressure of the roller coaster and bungee jumping plunged.

Zhou Mo thought of this disease.

If the adrenal gland grows a tumor, the tumor may secrete a lot of hormones, including epinephrine, norepinephrine, etc. These hormones can stimulate the sympathetic nerves in the human body, such as high blood pressure, rapid heart rate, and diarrhea. Sweat, excitement, restlessness, etc.

It just corresponds to the patient's sudden high blood pressure, and the effect of antihypertensive drugs is not obvious.

"However, this is all reasoning..."

"It needs to be verified!"

Zhou Mo saw that the patient Chen Jianxin's condition had begun to stabilize.

Give the patient two additional emergency examinations.

First, urine, to detect the levels of related hormones and their metabolites

Second, CT to see if there is any change in the adrenal glands.

B-ultrasound is also possible, but Zhou Mo suspects that the patient has an 'adrenal tumor', so CT will be more accurate.

In addition to inspection, you can also empirically prescribe a drug:

—prescribe antihypertensive drugs corresponding to epinephrine,

The next time you boost the voltage, you can try it. If the blood pressure goes down smoothly, it means that the patient is indeed as Zhou Mo thought, the adrenal gland has a problem.

At this time, Chen Jianxin's parents rushed to the hospital.

"Where is my son?"

"My son's name is Chen Jianxin, girl, help me check it out..."

"Chen Jianxin, right, 29 beds."

"Okay, thank you..."

The two parents rushed to the 29-bed ward with anxiety. When they saw their son lying on the bed with a bunch of wires attached to him, they panicked.

"Son, what's wrong with you?"

"Son, don't scare me, mom is the only son like you, in case you have any problems..."

The patient Chen Jianxin didn't know the situation very well, but he just told his parents not to worry, and he didn't dare to say that he almost died from a cardiac arrest just now.

The parents were still worried and ran to the duty room to find a doctor.

Zhou Mo was writing the rescue records, checking the time with the nurse, and seeing the patient's parents coming, he could only put down his work. UU Reading www.uukanshu.com explained it patiently to them. He also didn't mention cardiac arrest, for fear that the two elderly people would have a heart attack on the spot.

After finally reassuring the two elderly people, Zhou Mo could continue to check the rescue process with the nurse.

…

until 15:00 in the afternoon,

The results of the urine test came out.

Zhou Mo breathed a long sigh of relief.

Sure enough!

There is a problem with the adrenal glands!

Urine test results:

Metanephrine, 2 times!

Norepinephrine, 1.1 times!

These two 'methoxy XX' are intermediates of epinephrine and norepinephrine.

The two large increases indicate that both adrenal glands and demethylation have been greatly improved.