This Doctor is Great

"Ah? Impossible..."

Chen Jinhong's body, which was a little sluggish, suddenly regained her spirits.

As a woman, I am very concerned about this 'stinky smell'.

But after smelling it, I still didn't smell it.

But Zhou Mo was sure that after smelling it carefully, it was definitely a 'fishy smell'.

Occasionally, the body emits odor, which is a signal of disease.

For example, the smell of rotten apples may be due to diabetes; the smell of urine may be caused by abnormalities of the urinary system and bladder; if the chest still emits a bad smell, it may be magnesium deficiency in the body; if both body odor and bad breath appear, it may be caused by liver metabolism problems; long-term bad breath Prolonged bad breath should be alert to gastroesophageal reflux, gastric ulcer, Helicobacter pylori invasion or gastric cancer, etc...

And the fishy smell, what is it?

Zhou Mo suspected that it was - liver odor!

Liver odor means too much blood ammonia in the body.

Then, it will be easy to produce - hepatic encephalopathy!

Zhou Mo still remembers that on the first day he entered the gastroenterology department, teacher Zhang Luojia took the three of them to round the room, and when the three of them were tested on the level of Zhou Mo, a question came up - hepatic encephalopathy! (Chapter 129)

(with photo)

"Wait... hepatic encephalopathy..."

"its not right!"

Zhou Mo thought of another question: when blood was drawn, there was blood ammonia, but it didn't increase at that time.

Zhou Mo took out the blood test report.

Indeed, blood ammonia levels did not increase much.

Moreover, blood ammonia to the point of liver odor often only appears in the late stage of liver cirrhosis, while the patient Chen Jinhong's liver cirrhosis is still in the compensation stage, which is not so serious.

"Did I smell it wrong?"

Zhou Mo was stunned.

At this moment, a very embarrassed voice came from the 77th bed next door (the curtain was drawn).

"I'm sorry, doctor, the fishy smell may have been passed down from our side. We went to the market to buy a pound of dried sea fish today..."

"what?"

"what?"

In the entire ward, the atmosphere suddenly became embarrassing.

Smell it wrong!

Zhou Mo is embarrassed!

Chen Jinhong's husband is also embarrassed!

"Cough cough... I'm sorry..." Zhou Mo sighed, it was a pity, he thought he had found a key clue.

"It's okay, it's okay..." Chen Jinhong breathed a sigh of relief. Good thing I don't smell bad.

With a pity, Zhou Mo came to bed 77 and rounded the room for the patient who had bought sea salted fish.

really,

A more intense fishy smell came in.

Zhou Mo hurriedly said, "It's better to wrap your fish quickly, the taste is too strong."

The family members of the 77-bed patient looked embarrassed and blushed: "I'm sorry, I'm sorry..."

Just as the family was about to pack up the fish...

"what……"

Zhou Mo's mind suddenly flashed!

"Although it is not 'hepatic encephalopathy', it seems to be 'hepatolenticular degeneration'."

Why did Zhou Mo think of this disease?

Because of hepatic encephalopathy and hepatolenticular degeneration, these two diseases have neurological symptoms: mental mood and movement accuracy will all have a certain impact.

"Hepatolenticular degeneration?"

Zhou Mo couldn't help looking at the patient's hand.

"Ok?"

"trembling?"

Zhou Mo saw the patient Chen Jinhong's hands shaking unconsciously.

This, in turn, happens to be one of the features of hepatolenticular degeneration (which also has this feature in hepatic encephalopathy).

Zhou Mo asked the patient Chen Jinhong: "Do you usually have this tremor in your hands?"

Chen Jinhong: "Ah? Hand shaking? No?"

Then the hand stopped shaking immediately.

Zhou Mo looked at her husband: "Have you paid attention?"

The husband thought hard for a while, and finally shook his head: "I'm sorry, I haven't paid attention..."

Zhou Mo nodded: "Okay... I'm probably guessing your wife's illness, what is it..."

Then the 'hepatolenticular degeneration' was introduced.

While introducing, Zhou Mo began to pay attention to the patient Chen Jinhong's hand again, and then saw that 'it' was secretly shaking.

Now,

The probability of 'hepatolenticular degeneration' is greatly increased!

With liver cirrhosis, it's even more like it!

"'Hepatolenticular degeneration' is an autosomal recessive hereditary disease. Due to a certain gene mutation, the bile copper excretion disorder is caused, and excessive copper deposits in the liver, brain and other tissues and causes the disease..."

In layman's terms, in the process of metabolism, due to the problem of gene expression, copper ions are ignored, resulting in the inability to metabolize copper.

At this time, Zhou Mo's confidence increased greatly as the patient's hands trembled.

"To confirm whether it is the disease, it is very simple, do a few tests..."

"One is "K-F ring (corneal pigment ring, one is urine copper, and the other is liver copper test (previously the gold standard)..."

There are five commonly used methods for diagnosing this disease, but they all have certain errors. Do it together, if they are all positive, it is definitely no problem.

Among them, urine copper is the fastest and easiest!

Secondly, the K-F ring, when there is too much copper, will be deposited in a large amount near the cornea, and then the "K-F ring", a green-brown ring, can be found by the slit lamp microscope!

Finally, the liver copper test was the gold standard in the past, and the most accurate one later became a genetic test.

back to the duty room,

Zhou Mo reported his condition to Teacher Zhang Luojia.

"Hepatolenticular degeneration?"

"Yes... I suspect that the patient's amenorrhea also occurs because of it."

"Specific?"

"Perhaps too much copper is deposited in the pituitary gland, which leads to endocrine disorders..." Zhou Mo analyzed.

"It makes sense. I don't know the reason for this. I haven't seen the relevant literature. If the patient is cured, and later follow-up finds that the Yue Jing has been restored, this can definitely be written into a paper..." Zhang Luojia pointed.

Zhou Mo smiled and said, "My thoughts are the same as the teacher!"

The title of the paper has been thought out - "A Case of Hepatolenticular Degeneration with Amenorrhea as the First Symptom"!

...

the next day,

morning,

Teacher Zhang Luojia immediately helped Zhou Mo to contact the ophthalmology department and sent the patient over for a slit lamp microscope.

Soon, the results are out!

Sure!

"K-F Ring"!

At this time, urine copper test and liver copper test are also in progress.

...

day three, afternoon

Urine copper test and liver copper test have basically come out.

Formal diagnosis: 'hepatolenticular degeneration'!

In other words, the patient's liver cirrhosis should not be a home remedy or other reasons, but liver cirrhosis caused by 'hepatolenticular degeneration'.

Find the cause, then you can treat the symptoms and reverse liver cirrhosis!

When Zhou Mo told the couple about the result of 'hepatolenticular degeneration', the husband and wife were overjoyed.

did not expect!

When I came to the Department of Gastroenterology, I just wanted to be a rehabilitation therapy for liver cirrhosis, but I did not expect to find out the cause. Especially after Zhou Mo also said that it may also be the culprit of amenorrhea, it is even more surprising!

Unexpected joy! !

"Thank you doctor!"

"Thank you doctor!"

The husband took Zhou Mo's hand and was incoherent with excitement! !

Zhou Mo reassured: "Don't get excited yet... I'm just guessing~www.readwn.com~ The real reason will be determined after your wife's excess copper is cured and whether it can be recovered!"

The husband was happy: "Dr. Zhou is so powerful, he must have made the right point!"

Zhou Mo couldn't help laughing and said, "I also hope that you can have your son early, haha~~"

Next,

is treatment.

Program: block copper absorption (zinc gluconate) + copper excretion (D-penicillamine) + liver protection.

As for the future diet, but also try to reduce the intake of copper.

...

Sunday,

The couple was discharged from the hospital, and they still need liver protection treatment after discharge to reverse liver cirrhosis.

In addition, after calling back to her hometown, she found that the elder of the patient Chen Jinhong did indeed have an elder with cirrhosis, but she did not know it.

.