This Doctor is Great

In addition to hypokalemia,

There are also blood ketone bodies, more than 5mmol/l, which is obviously acidosis.

(Although it is not diabetes, but because of low blood sugar for too long, the body begins to break down fat, producing ketone bodies, resulting in ketoacidosis. Reducing sugar intake is also one of the ways to lose weight, but beware of ketoacidosis )

(Hypokalemia, which also affects metabolic balance, can lead to ketoacidosis.)

Obviously, this uncle is "hypokalemia + ketoacidosis".

At this moment,

Uncle asked, "Doctor, I've been feeling a little sore all over my body recently. Is it related to this disease?"

Li Dongmei thought for a while and nodded: "There is indeed a little possibility..."

Because acidosis easily induces osteolysis and inhibits renal tubular reabsorption of calcium.

Finally, it causes osteoporosis...

However, this should take the long term.

The elderly feel osteoporosis, which may be due to the fact that the human body has a little osteoporosis, which has nothing to do with the low potassium + ketoacidosis that has only been two or three days.

"Wait, I'll give you some medicine, calcium supplement, and potassium ion supplement..."

For the problem of ketoacidosis, Uncle has already eaten something, added sugar, and solved the low blood sugar. Then it will be relieved slowly.

What about hypokalemia?

Li Dongmei: "I'll order you some "potassium chloride" later, just drink it with a drink. "

The classic "potassium chloride"!

Cheap and easy to use!

but,

When Li Dongmei gave the doctor's order like this,

Teacher Zhang Luojia: "…………"

Zhou Mo: "…………"

At this time, it is absolutely impossible to open potassium chloride.

Zhou Mo: "Wait..."

Zhang Luojia saw that Zhou Mo was blocking her, so she didn't speak, but sat and watched Zhou Mo's performance.

Zhou Mo whispered to Li Dongmei: "I think it would be better to open "Potassium Citrate". "

Li Dongmei: "???"

Suddenly at a loss.

Suddenly nervous.

Did I prescribe the wrong medicine?

Li Dongmei hurriedly looked at Zhou Mo for help.

Zhou Mo smiled and said to Uncle: "Uncle, I'm sorry, potassium chloride is very unpleasant to drink, and the effect is average, or I will replace it with another medicine for you, potassium citrate. , how is it? You have been procrastinating for a long time now, and I think potassium citrate is more suitable."

Zhang Luojia watched with a smile.

She was very satisfied with Zhou Mokai's "Potassium Citrate".

Uncle's intuition is that there is something wrong in it, he looked at Zhou Mo, his eyes fluctuated: "I know you, you have been on TV... Then let's do it according to you."

Zhou Mo hurriedly said, "Thank you, Uncle."

Quickly opened "potassium citrate", and then told how to use it.

Uncle left with the prescription and went to the pharmacy to get the medicine.

Li Dongmei couldn't help but ask Zhou Mo curiously, "Why can't I use potassium chloride?"

This question made her curious!

After all, potassium chloride is cheaper, the commonly used potassium supplement 'hard vegetable'.

Zhou Mo shook his head: "Have you seen this uncle's urine routine just now?"

Li Dongmei shook her head.

Zhou Mo opened the urine routine in the system and pointed to the pH in it.

"This uncle's pH value is 7.5 (alkaline), which belongs to alkaline urine (normal people are generally between 5.0 and 6.5, which is acidic)."

"But Ashu is clearly suffering from acidosis."

"why is that?"

"This is called "paradoxical alkaline urine"! "

Paradoxical alkaline urine?

Li Dongmei thought about it, and finally remembered what it was.

Li Dongmei frowned: "No, isn't "paradoxical alkaline urine" only in hyperkalemia? "

Zhou Mo shook his head: "This is not certain, hypokalemia is also possible..."

One of the criteria for judging ketoacidosis is the concentration of bicarbonate, mild bicarbonate

The patient is ketoacidosis, so the body lacks enough "bicarbonate".

The hydrogen ion decreases, so the potassium ion has to replace it with the sodium ion exchange, resulting in an increase in potassium excretion from the kidneys, and the pH value of the urine naturally rises after the acid is reduced, so the urine is alkaline, which is called "abnormal alkali". Sexual urine".

This is a little different from normal acidic urine.

It is also a place that will stumbling many doctors.

Zhou Mo explained it again, and then: "Why do you prescribe the drug "potassium citrate"? Because the uncle himself lacks bicarbonate, if the patient is supplemented with "potassium chloride", the chloride ions will increase, the concentration of bicarbonate will further decrease (combined), and the acidosis will be aggravated! "

At this time, intracellular potassium will be transported to the outside of the cell, and then excreted through the kidneys, aggravating the loss of potassium. "

"Supplementing potassium chloride at this time will actually make potassium ions - the more the supplement, the lower!"

"The best way is to supplement "potassium citrate"! "

That's why medicine is complicated, and sometimes the same thing, the opposite conclusion. Maybe what Zhou Mo said above may not be correct, and it may be the other way around.

"So it is."

Li Dongmei frowned, feeling a headache.

It seems that I have to go back and study a lot.

But he couldn't help looking at Zhou Mo in amazement. He felt that Zhou Mo really knew everything, and nothing could trouble him.

Zhou Mo: "Okay, let's go to the next patient..."

Li Dongmei: "Oh oh oh~~~"

Panic pressing the number machine.

Teacher Zhang Luojia continued behind, thinking about things leisurely, her thesis experiment...

With students like Zhou Mo around, sometimes it's pretty cool.

...

Not long after,

A strange patient came to the consultation room.

Still having abdominal pain.

(abdominal pain: emmm my chances of appearing are too high?)

The patient is a young woman.

He walked in clutching his stomach.

The main complaint is a heart-piercing pain in the stomach, which has been painful since yesterday, intermittently.

"Have you had diarrhea?"

"Nausea? Vomiting?"

"Have you eaten anything unclean?"

A lot of questions were asked, followed by a physical examination.

At last,

The female patient burst out: "Doctor, I bought a roundworm egg a month ago in order to lose weight and ate it. I don't know if it has something to do with it."

Zhou Mo: "!!!"

Li Dongmei: "!!!"

clang~~~

The book in Teacher Zhang Luojia's hand fell directly to the ground.

Zhang Luojia: "!!!!!!"

What the hell!

Awesome, this guy! !

I have seen so many patients, and this patient is the most awesome.

Others wish there were no parasites in their stomachs, but this beautiful girl in front of her was so good, she even took the initiative to eat parasites!

Stunned dog!

Eyes pop out!

Chin fell to the ground!

Or a woman who loses weight is awesome~www.readwn.com~ The last woman who lost weight took beauty medicine and ate her intestines into snake skin.

This woman is even more powerful and eats roundworms!

Shut up!

is a big guy! !

"Don't you know it's dangerous?"

"What if a bug rips through your stomach?"

Li Dongmei said angrily.

.