This Doctor is Great

"Did the ultrasound find anything?" Huang Yiming stretched his neck beside him.

He can't read the B-ultrasound.

Every time he watched Zhou Mo operate a B-ultrasound, he felt that he was a waste.

"Cholecystolithiasis was found." Zhou Mo said.

"Ah? Gallstones?"

The patient Liu Mo and his wife were shocked.

They just came to check for heart disease, why did they suddenly find gallstones?

They were a little hard to accept for a while.

"No, I don't feel anything at all." Liu Mo said in disbelief.

Zhou Mo: "Then do you get nauseated and nauseated after eating greasy food?"

Liu Mo thought for a while, and finally nodded: "It is true... I didn't pay attention to it before, I always thought it was a bad appetite."

Zhou Mo: "Cholecystolithiasis may cause nausea and vomiting."

Now Liu Mo is giving up!

beside,

Huang Yiming was thinking.

"Cholecystolithiasis? Is it the gall bladder syndrome?"

More than 3 hours from noon today, there was Zhou Mo's suggestion of percussion pain in the liver area, so Huang Yiming went to check the literature on the connection between the liver and gallbladder and the heart.

Then, he came across the literature on biliary heart syndrome.

If he hadn't checked, I'm afraid he wouldn't be able to think of the gallbladder syndrome all at once.

Liu Mo and his wife were on the side, they heard it clearly and asked nervously.

"Dr. Zhou, what is gallbladder syndrome?"

Zhou Mo looked at Huang Yiming: "You checked the literature, right?"

Huang Yiming patted his chest: "I checked."

Zhou Mo: "Can you memorize the guide?"

Huang Yiming: "Hehe... Brother Mexico, you still want to trick me, there is no guide for the gall-heart syndrome..."

Zhou Mo laughed: "I didn't expect you to see it through... Could you explain to them what the gall-heart syndrome is..."

Huang Yiming raised his head.

After all, he is a doctoral master of SYS, and his memory is still very strong. He can basically tell the contents of the documents he has read recently.

The patient Liu Mo and his wife looked at Huang Yiming.

Huang Yiming said: "Biliary-heart syndrome roughly means a disease of the biliary system that causes symptoms of the heart."

"At present, because doctors don't know enough about this disease, there are no guidelines or norms for the diagnosis and treatment of gallbladder syndrome at home and abroad."

"As for the reason, at present, most scholars believe that the heart is innervated by the T2-T8 spinal nerves, while the gallbladder is innervated by the T4-T9 spinal nerves, and the two intersect at the T4-T5 spinal nerves."

"When biliary tract disease occurs, it may cross influence at the T4-T5 spinal nerves in terms of neurofeedback, thereby causing heart spasm and contraction, reducing coronary blood flow, leading to myocardial hypoxia, thereby inducing angina pectoris and myocardial infarction. "

"Of course, there is another saying: it has nothing to do with the nerves, but after the biliary system has problems, it will cause toxin absorption, water and electrolyte disorders, which will lead to myocardial metabolism and electrical activity disorders, coronary spasm, and cause angina pectoris and arrhythmia."

Patient Liu Mo, wife, (reader): "…………"

Confused.

Confused about the fruit on the tree, under the tree, you and me...

Liu Mo coughed: "The doctor is really good... Then what should I do about my illness?"

Zhou Mo: "First of all, for the time being, further examinations are needed, such as a B-ultrasound or CT scan to see if there is really a gallstone. I suspect that the gallstone is the real culprit."

Because Zhou Mo's B-ultrasound results cannot be used as evidence, the patient needs to go to other departments to find a professional teacher for B-ultrasound or CT. .

Liu Mo didn't know the seriousness of gallstones yet, so he focused on the gallbladder syndrome: "If I really have gallstones, how can I treat my disease?"

Zhou Mo: "At present, there is no conclusion about the cause of gallbladder syndrome, so there is no special way to cure it. The only way is to solve the gallbladder problem, and then the gallbladder syndrome can finally be cured."

Next,

Zhou Mo didn't say much.

Because we have to wait for B-ultrasound or CT, the conclusion is reached.

"B-ultrasound and CT can be used. B-ultrasound requires color ultrasound. The price is about 100, and CT is about 200. It is more accurate, and there are fewer people. It doesn't take that long to line up. You choose one, and I will make an appointment for you..."

Liu Mo's wife: "No, Dr. Zhou, didn't you have a B-ultrasound just now? Why do you still need a B-ultrasound and CT?"

Zhou Mo: "This... Because of my personal reasons, I can only read it for you, but I can't give you a report, and of course I won't charge you. If you want to diagnose, you need a formal report, so you go to the following The radiology department does CT or B-ultrasound.”

The wife looked bewildered.

don't know.

"Choose B-ultrasound or CT?" Zhou Mo asked.

"CT right... Thank you, doctor."

"CT... Let's take a look (pick up the ipd and start flipping it), I'll be free at 11 am tomorrow, I'll make an appointment for you... By the way, don't eat greasy and spicy food, pay attention to your diet..."

"Okay, okay."

……

Next, Zhou Mo went to the other beds for rounds.

……

17:00

After Zhou Mo checked the room, he returned to the duty room.

Huang Yiming approached excitedly.

"Mexico, I think a patient with 36 beds can write a paper called "Clinical Diagnosis and Treatment Thinking of Gallbladder Syndrome"..."

This kind of rare patient can still form a good paper by summarizing the essence of the predecessors.

As a medical student, there are not too many papers.

Zhou Mo nodded: "Yes."

Huang Yiming: "Then I'll write it, and then add your name, Mo Ge, and you will come first."

Zhou Mo thought for a while, then nodded: "Okay, then I'll help you fix it..."

Huang Yiming clapped the table excitedly: "Just do it!!"

Then he excitedly ran to look through the data.

bell bell~~~~

At this moment,

Zhou Mo's cell phone rang.

Senior Brother Chen Bing: "Zhou Mo..."

Zhou Mo: "Senior brother~www.readwn.com~ You and your teacher went to Shenzhen?"

Senior Brother Chen Bing: "I arrived at the hotel and checked in. Now I have time to call you and ask about the three patients I gave you..."

Zhou Mo said with a smile: "Beds 34 and 35 are fine, but Liu Mo, a patient with chest tightness and shortness of breath in bed 36, seems to have found the cause."

"What? Did you find the reason?"

Senior Brother Chen Bing said in surprise, "Tell me, what's the reason?"

Zhou Mo: "My current diagnosis is biliary-heart syndrome...because the patient has tenderness in the upper abdomen, percussion pain in the liver area, and positive Murphy's sign, which is suspected to be cholecystitis, and then I performed a gallbladder ultrasound on the patient. Gallstones were found, but the patient never felt pain, so he didn't find out he had gallstones."

"The patient has symptoms of coronary heart disease + symptoms of biliary system disease, but has no history of coronary heart disease... This is the first clue."

"The clinical examination showed epigastric tenderness, no rebound tenderness, positive Murphy's sign, and no abnormality in cardiac auscultation... This is the second clue."

"And the electrocardiogram and echocardiogram didn't find any problems... This is the third clue."

"In short, this series of features point to the gallbladder syndrome."

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ps: Regarding the next department, consider gastroenterology for the time being.

Gastroenterology involves the esophagus, stomach, small intestine, large intestine, liver, gallbladder and pancreas.

It is very complicated, and the derivation and evidence-based disease are very interesting.

Then it is also more related to daily life. There is a lot of common sense. When writing it, book friends may have a sense of substitution.

Of course, the opinions of book friends will be respected:

The opinions of book friends are:

1: Gastroenterology (in this chapter)

2: Other departments (in this chapter)

.