This Doctor is Great

Aside from a positive ELISA test result...

A stool test also came back.

The feces of the patient collected at 1:00 noon were sent for testing. The sediment smear method was used to collect sediment. Among the three consecutive sediment smears, 11 large oval, light yellow, and egg caps were found at one end. Fluke eggs.

These eggs are undoubtedly in line with the characteristics of Fasciola hepatica eggs.

So far,

This patient, the dust has settled!

Diagnosed: hepatic fascioliasis!

Next, it was simple, Zhou Mo gave a doctor's order:

Oral bisquinone 20mg/(kg·d), divided into 2 doses, for 3 consecutive days, with an interval of 7 days, and then orally 10 mg/(kg·d) for 3 consecutive days...

(Biquinone, an anthelmintic drug for humans and animals, is specialized in the treatment of tapeworms and flukes. It is especially effective against schistosomiasis, Chinese liver fluke, and Schizophrenia. It is one of the most basic and important drugs for public health in the world. one.)

(The pagoda sugar I ate as a child, the ingredient is piperazine phosphate. (Exposure age series))

"Are you sure, I am a parasite?"

Chen Qing was in a complicated mood.

Zhou Mo: "At the moment, it's a parasite. If you don't feel safe, you can do an MRI to see if it's a tumor, and the price is not expensive..."

Chen Qing shook his head suddenly: "Forget it, don't do it, I trust the doctor..."

Zhou Mo: "By the way, you can be discharged from the hospital tomorrow."

Chen Qing was shocked: "Ah? He was discharged from the hospital so soon?"

Zhou Mo said as a matter of course: "Since the cause has been found, and it's not a big problem, then of course you will be discharged from the hospital. Do you want to live in the hospital?"

Because the patient Chen Qing is chronic, not acute, the treatment does not need to be so violent, nor does he need to be hospitalized, and he can be discharged tomorrow morning.

Chen Qing shook his head: "Let's leave the hospital."

Zhou Mo: "I will start giving you medicine this evening, to deworm the worms, and then when you are discharged from the hospital, the medicine will be brought back to you. The nurse will explain to you how to take the medicine at that time. You can just follow the doctor's order... After you finish the medicine, you will come back for a review..."

The review method is still to review the stool. As long as no eggs are found and the symptoms disappear, it means that the patient has recovered.

The patient Chen Qing nodded: "Okay, thank you doctor."

...

Rounds, rounds, rounds...

Then go back to the duty room to modify the course of illness, doctor's orders, etc...

The workload of 5 patients (1 upper gastrointestinal bleeding, 1 acute gastritis, 2 cirrhosis and liver ascites) is still not small, but for Zhou Mo's talent, the speed is still very fast. After all, for these patients, Zhou Mo had deliberately brushed up the relevant disease documents yesterday, so he saved the time to check the information today.

As for the patient with upper gastrointestinal bleeding, because of the poor hemostasis effect, he was forced to be sent to endoscopy to stop the bleeding today, and he can be discharged tomorrow.

As for the two patients with acute gastritis and liver cirrhosis with liver ascites, they will need to stay for another two or three days.

18:00…

Zhou Mo was busy with all the patients.

Huang Yiming: "Brother Mo, are you done?"

Zhou Mo nodded: "My patients are all from yesterday, and nothing needs special treatment, so it's faster."

The surrounding 13 medical students immediately brushed over.

Shock!

So fast? !

At their own pace, they only started to get the information of the 5 patients. It was a headache to check the literature and guide the guide!

Zhou Mo sat next to Huang Yiming and turned on the computer: "How many have you written? I'll help you review..."

Huang Yiming flew up happily: "Brother Mo, no, Dad, you are too good..."

Zhou Mo: "What's the patient's number?"

Huang Yiming was about to answer,

At this time,

A resident brother, Wang Zhen, walked quickly to the duty room and said to Zhou Mo:

"Junior Brother Zhou Mo, do me a favor. I just accepted a patient, and I'm a little uncertain. Can you do a B-ultrasound for me? Please have a late-night snack!"

"Okay, no problem." Zhou Mo nodded.

"Haha, thank you..." The inpatient senior brother Wang Zhen happily pulled Zhou Mo and went to the 12th hospital bed.

Huang Yiming: "…………"

fuck!

...

12 beds,

This is a 37-year-old middle-aged woman.

Abdominal pain for 1 day, came from the outpatient clinic.

The specific symptoms are abdominal pain without obvious incentive, mainly in the right lower quadrant, persistent abdominal pain with paroxysmal aggravation, abdominal distension, nausea, no vomiting, and no diarrhea.

Outpatient examinations are:

——Blood routine: normal hemoglobin, increased white blood cells, and inflammation.

- X-ray of chest and abdomen, no obvious abnormal X-ray signs were found.

peritonitis?

appendicitis?

The resident doctor Wang Zhen introduced Bing Qing: "The main complaint of the patient is that he didn't eat anything unclean, he ate it all at home, and he also ate with her mother-in-law and son. There was no problem..."

"In addition, if the McBurby's point is positive, it may be appendicitis..."

"In addition, I think about another point, peritonitis, because when I performed a physical examination on the patient, I felt there was fluid, although it was not obvious, but it was suspected..."

"As for gastroenteritis, it's not like, because in one day, if there is gastroenteritis, there should be diarrhea and vomiting, but the patient does not."

After a series of analysis,

Zhou Mo nodded in agreement.

Senior Brother Wang Zhen: "So, I want to invite you to come and help with an ultrasound..."

Zhou Mo: "Okay."

The B-ultrasound has been brought over by the nurse in charge of the bed.

Zhou Mo turned on the machine, set the parameters, and then began to probe the patient's abdomen.

This investigation,

The problem was found immediately!

Right abdominal bowel dilatation, effusion!

There is ascites!

Moreover, there is not only the accumulation of fluid, but also the accumulation of gas!

Whether it is fluid or gas, the amount is not a lot, so it is difficult to find it during a physical examination.

Then Zhou Mo took a look at his appendix.

There is nothing wrong with the appendix, the shape of the appendix does not change much. Generally appendicitis, inflammation, will become larger, edema, B-ultrasound is still relatively easy to see.

Appendicitis (picture)

So temporarily rule out appendicitis.

Zhou Mo told Senior Brother Wang Zhen his results: "If appendicitis is ruled out for the time being, we can consider another possibility - volvulus of the small intestine (the location of the cecum), or intestinal obstruction!"

volvulus (picture)

When Senior Brother Wang Zhen heard this, he nodded: "That should be a volvulus!"

Zhou Mo added: "Senior brother, in fact, this bowel torsion is still not very accurate. It can only be used as a reference. You can make an appointment for a CT to see if there is any abnormality..."

Senior Brother Wang Zhen thanked: "Okay, thank you. I'll treat you to dinner when I'm done!"

...

1 hour later,

Brother Wang Zhen arranged for the patient to undergo abdominal CT ~ www.readwn.com ~ abdominal CT results: abnormal position of the small intestine and blood accumulation.

CT teacher prompt: internal hernia? volvulus? The possibility of intestinal obstruction was ruled out.

At last,

The patient was sent to the anorectal department for surgery.

When Brother Wang Zhen went there, he said hello to Zhou Mo: "Zhou Mo, I'm sorry, the patient was diagnosed with volvulus, and there was blood accumulation and necrosis. I'm going to send the patient to the anorectal department for surgery. The supper can only be next time..."

Zhou Mo waved his hand, saying ok!

...

Final surgical results:

volvulus 240 degrees

+

Small intestine necrosis 60cm

.