This Doctor is Great

"When you have abdominal pain, how long does it last? Then how often does it occur?"

"It lasts for about a few hours each time... It's hard to say how long the interval is. Sometimes it appears during the day, and sometimes it appears at night..."

"Do you have diarrhea? Do you have nausea and vomiting?"

Patient Chen Qing shook his head: "No."

Zhou Mo's eyes lit up: "What about defecation? Is there any change? Or is the feces black or red?"

The patient Chen Qing shook his head: "No... I just don't want to eat."

Loss of appetite.

Abdominal pain for such a long time, if it is a bowel problem, nausea, vomiting, diarrhea, blood in the stool, changes in time and frequency... these should all be a little bit.

And this patient, no!

But will lose your appetite!

Peptic ulcer?

Gastrointestinal cancer?

Also, the pain in the upper right abdomen mentioned by the patient Chen Qing...

What's in the upper right abdomen?

Liver, gallbladder, pancreas and kidney exist, and there may be problems.

Another possibility is the lungs.

And heart problems.

A big experience gained after the cardiology rotation is that pain below the shoulders and above the lower abdomen should be checked by an electrocardiogram.

"Have you had an EKG?"

"No……"

The patient Chen Qing came from an outpatient clinic, not an emergency department. If it was an emergency department, the doctor would probably give an electrocardiogram empirically.

"I'll give you an electrocardiogram to review later."

Don't look at this is the inpatient department of gastroenterology, but the electrocardiograph is a must, and the equipment is not only available in the cardiology department.

Zhou Mo walked out of the ward and said to the nurse in charge, "Beauty Liang, go and get an electrocardiograph."

As a nurse, even though she's a woman, it's okay to be a man in the department.

Nurse Liang Meimei: "Okay, wait, I'm going through the admission procedures."

Zhou Mo returned to the ward.

Continue to consult.

In addition to the above organs, there may be infectious diseases.

"Have you had a cold and fever recently?"

"Have."

"How long? How many degrees?"

"The day before yesterday, I had a fever for 2 days. The highest was 39.8 degrees..."

Is it really an infectious disease?

Zhou Mo was curious.

Remember first.

Zhou Mo continued: "Are there any other symptoms?"

Chen Qing: "There is... that is..."

Speaking of this, the patient Chen Qing was a little embarrassed.

Zhou Mo said with relief: "Don't worry, I'm a doctor. You should take the initiative to tell the doctor if you have something... What's wrong?"

The patient Chen Qing twisted and said: "It's just that my hips and buttocks have some erythema, and it's a little itchy..."

Zhou Mo understood in seconds: "I'll ask the female nurse to come over and show you what it is... how about it?"

The patient Chen Qing nodded.

At this moment,

Nurse Liang Mei came over with an electrocardiograph.

connecting electrodes,

Measurement,

Soon, the electrocardiogram results came out:

ECG is fine!

Then the nurse drew the curtain and examined the rash for the patient, Chen Qing.

Normal rash, nothing special.

"In the outpatient clinic, did you have any examinations?"

"I did, and blood was drawn."

The patient pointed to her baby and pulled out several checklists.

Zhou Mo took it over and took a look. Urine routine, blood routine, liver function, kidney function, all of them...

Results: Everything was normal except for one eosinophilia!

"Hey, that's weird!"

Zhou Mo was surprised, it didn't look like the digestive tract had a problem.

Liver function is no problem, but the liver and gallbladder may not be.

"What's the problem?"

Zhou Mo is interested.

I love this weird case.

Zhou Mo said to the nurse next to him, "Beauty Liang, does our department have a bedside ultrasound?"

Nurse Liang Mei: "Yes."

Zhou Mo: "Where is it? Can you get it for me?"

Beauty Liang was shocked: "Can you use it?"

Under those shocked eyes, Zhou Mo modestly said, "I understand a little."

Liang Meimei was a little suspicious. After all, Zhou Mo is so young, can he know B-ultrasound? Heck!

But she still went to help Zhou Mo get the ultrasound machine.

Zhou Mo took advantage of this time to ask about his medical history, but there was no special medical history.

The patient was then examined.

Stomach, upper abdominal tenderness, soft.

The complexion is slightly yellow, but considering that the liver function is fine, it should not be jaundice, but unhealthy because of long-term loss of appetite.

At this moment,

The teacher Zhang Luojia walked in.

"What's the condition of the patient?"

"The patient's condition is like this..."

Zhou Mo recounted all the results of his consultation and physical examination.

Zhang Luojia: "What do you think?"

Zhou Mo: "I thought it was hepatitis, cholecystitis or something at first, but after so long with the disease, and then there is no problem with liver function, it may be a parasite..."

That's right,

Parasites!

This is Zhou Mo's consideration.

Zhou Mo added: "Of course...it may also be a tumor."

Teacher Zhang Luojia nodded when he heard the words: "It's possible... Then what will be the next inspection?"

Zhou Mo: "For parasites, do a stool test... For tumors, do MRI and blood for tumor markers."

Zhang Luojia nodded.

At this time, Zhou Mo continued to ask the patient Chen Qing: "Do you have the habit of eating raw food? For example, sashimi or something?"

Needless to say, sashimi is definitely the number one carrier of parasitic patients.

Patient Chen Qing shook his head: "No."

Zhou Mo: "You don't have to rush to answer me. You can think about it carefully. Did you eat anything raw in the half year before you got sick?"

The patient Chen Qing frowned and thought hard.

At this moment,

The B ultrasound was carried in by the nurse Liang Meimei.

Teacher Zhang Luojia immediately hugged her chest and looked at it with interest.

According to the information she learned through her cardiologist classmates, Zhou Mo's heart color Doppler ultrasound was very powerful. Echocardiography is relatively difficult. If you know your mind, you shouldn't have any problems with B-ultrasounds like the liver.

Zhou Mo skillfully turned on the ultrasound machine under the surprised eyes of the nurse Liang Meimei.

Power on, adjust parameters.

Real Liver!

If it is a parasite or tumor, the first place to suspect is the liver.

probe, couplant,

"I need to do a B-ultrasound for you, you lift up your clothes, right upper abdomen..."

"what?"

"Don't be shy, I'm a doctor."

The patient, Chen Qing, looked at Zhou Mo's scumbag face, and thought about it, forget it.

She lifted her clothes to reveal her fair and youthful skin.

Soon, she felt a greasy and cold touch, making her a little uncomfortable.

The first is the liver as a whole,

Zhou Mo kept cutting angles and measuring.

"Teacher, her liver seems to be bigger..."

"How many?"

"The length is about 27cm, the width is about 17cm, and the thickness is about 61cm...a little more than 1cm more than the normal range, and 2cm more wide..."

"That's an enlarged liver."

"yes."

Obviously, there is something wrong with the liver.

Nurse Liang Mei was shocked!

wow!

Dr. Zhou Mo will perform B-ultrasound!

Too arrogant, right?

At this time ~www.readwn.com~ Zhou Mo re-adjusted the parameters and cut out the details of the liver.

About 1 minute later, Zhou Mo found that the hepatic bile duct was dilated, and there were three places with relatively small hypoechoic nodules. Under normal circumstances, this display may be a 'tumor'!

"Is it a tumor?"

Zhou Mo continued to change angles and kept cutting...

Sudden!

"what!"

Zhou Mo found something special:

0.5cm round shadow!

shock!

"What is this?"

.