When doctors have a simulated operating room

The next morning, the doctor in the Department of Stomatology sent a message to Zhang Yi as soon as he arrived at the department. "Doctor Zhang, you are amazing! The result of the bone marrow puncture of the female patient came out. She did not have leukemia at all. The reason for the low coagulation function was bromadiolone!" "That's good. It's much easier to treat with bromadiolone. You should notify her first and stabilize the patient's mood." "Okay, does she need to transfer to another department? Bromadiolone was used to be treated in the emergency department." Zhang Yi thought about it and replied, "Okay, take her to the emergency department." Half an hour later, the doctor in the Department of Stomatology brought the female patient to the emergency department. At this time, the doctor in the emergency department was handing over her shift. The staff on duty arranged for her to be hospitalized and arranged her in a ward on the second floor.

The female patient was in a very good mood all the way.

She didn't look like she was here to be hospitalized. She looked like she was here for vacation.

She was already very grateful to know that she didn't have leukemia.

Then the doctor said that she would be transferred to the emergency department for treatment!

Haha!

Wouldn't it be possible to see Zhang Yi every day if she was transferred to the emergency department?

Hiss~

I used to think that being sick was an unlucky thing, but now... just bromadiolone, what a deal~!

After the rounds, Zhang Yi prescribed vitamin K1 for the female patient.

Bromadiolone poisoning is also divided into acute and subacute categories.

In the acute stage, symptoms such as dizziness, nausea, and subcutaneous bleeding will appear, and you need to go to the hospital for gastric lavage, vomiting, or hemodialysis.

Subacute is in a state similar to the incubation period. There may be no symptoms in the first few days, and symptoms will not appear until 7-10 days or even longer.

The main reason why bromadiolone can reduce coagulation function is that it can inhibit vitamin K1 epoxide reductase in the human body, affect the synthesis of coagulation factors II, VII, IX and X, lead to coagulation dysfunction, prolonged coagulation time, and cause serious and continuous damage to the body's capillaries, resulting in increased permeability of blood vessel walls and aggravated bleeding.

Therefore, the key drug to solve bromadiolone poisoning is to supplement vitamin K1.

Then vitamin C is supplemented to reduce capillary permeability and promote hemostasis.

Considering that the dose of bromadiolone in her body is not large, there is no need for hemodialysis.

The hemoglobin is just at 112g/L. Although this value is at the critical point of anemia, it is not considered anemia, so there is no need for blood transfusion for the time being.

Her current main treatment plan is infusion.

At present, the cause of the bleeding of this female patient has been found.

But the cause has not been found.

Did she relapse after the poisoning four years ago, or was she poisoned for the second time two years ago?

Logically speaking, this disease is a minor one, and treatment plus infusion, or at least hemodialysis, will definitely cure it.

Why has this person been bleeding for two years?

This is equivalent to chronic poisoning.

Zhang Yi did suspect that she was poisoned for a long time with a small dose, but she didn't know it.

But... it seems that it cannot be ruled out that she was not completely cured four years ago?

Anyway, after thinking about it, there must be a problem.

The answer must be in the patient, or in some neglected examination.

In the office, Zhang Yi began to look through the patient's medical records.

He planned to start with other examination results to see if there were any suspicious points.

Mao Xiaoyuan also hurried over when he saw this.

Although he knew that he could not become Zhang Yi's apprentice, he understood the principle that the closer you are to the water, the better.

Being close, you can learn something from Zhang Yi~!

"Zhang Yi, what are you looking at? Which patient can make you frown all morning?"

Zhang Yi looked up at him: "Is it so obvious?"

"Of course! When you were doing the ward rounds, you looked like you were always thinking about something. Even a fool could see it. Besides, you don't have a girlfriend, so the only thing you care about is the patient. Hehe, am I right?"

Mao Xiaoyuan said as she showed a look of 'Look~ I know you so well~'.

Zhang Yi rolled his eyes at him mercilessly: "It's good that you know, don't bother me, I'll check it again."

Mao Xiaoyuan leaned forward and looked at the name on the first page of the case record.

"Fang Wenhui? Oh~ Is it the patient who was just transferred here with rat poison poisoning? Hasn't the cause of her bleeding been found? Why are you still looking at her? Can't she just be given vitamin K?"

Mao Xiaoyuan didn't understand. A patient with bromadiolone poisoning was not a difficult and complicated disease. Why was she so attentive?

If she was beautiful, she could

It can be explained.

The problem is that the woman is big and strong... she shouldn't make Zhang Yi like this, right?

Could it be that Zhang Yi likes this kind of woman with a fat waist and a big butt?

Zhang Yi raised his head again and rolled his eyes at him, and gave him a "get lost" word.

"Great~"

Mao Xiaoyuan really got lost.

The surroundings became quiet, and Zhang Yi began to immerse himself in the case.

First, the blood routine test, indeed only thrombocytopenia.

Then the liver and kidney function, this woman has a mild fatty liver, the rest is not a big problem.

Hmm? ?

Wait.

The liver function has been checked, what about cholesterol?

The patient is obese, so will the cholesterol be high? ?

Once it is confirmed that the cholesterol is also high, then maybe the cause can be found!

Zhang Yi looked through it carefully, and there was no cholesterol test in the case.

He had to quickly prescribe a cholesterol blood test for the patient.

You have to get up early in the morning on an empty stomach to check cholesterol, so the results will be known tomorrow morning.

After getting some clues, Zhang Yi got up and went to the ward to check on the patient.

When Zhang Yi came in, the woman was still lying on the bed and chatting excitedly with her friend.

But the next second, she sat up immediately!

"Hey, Doctor Zhang! Doctor Zhang, are you here to see me? I'm in good condition now~No problem~"

Zhang Yi looked at her and her friend before asking:

"Have you checked your cholesterol before? Is it high?"

"Ah? Cholesterol? I don't know about that?"

"Then were you at the same weight when you were poisoned four years ago?"

The female patient was a little confused. Why did she ask about my weight when she was seeing a doctor? ?

Don’t you know that the most unquestionable thing about women is age and weight…

Seeing her embarrassed look, Zhang Yi quickly explained: “Don’t think too much. Asking about weight is entirely because it may involve cholesterol, and cholesterol is directly related to bromadiolone poisoning in your body.”

“Ah? So that’s the case… In fact, four years ago, I was even fatter than I am now. I weighed almost 170 pounds. In the past few years, I realized that I seemed to be a little too fat, so I started to lose weight. Now I weigh 147 pounds, and I’m still working hard to lose weight.”

170 pounds? ?

A height of 160 actually weighs 170 pounds? ?

Good guy!

Then her cholesterol must be very high!

Now Zhang Yi’s guess in his heart can be confirmed.